Cigna Grievance

Email from Kye to Membership, December 12, 2014
——————
Dear Concerned Members,
W/respect to the ‘extreme’ Cigna cost increases being imposed on Pratt faculty, please read the attached grievance statement as filed on 12/10/14.
The UFCT Local 1460 is determined to pursue arbitration if the Administration’s response to the attached formal grievance statement is less than satisfactory.
Warm Regards,
-Kye

 

MEMORANDUM

TO:                   Peter Barna, Provost

FROM:             Kye Carbone, President UFCT Local 1460

DATE:               December 10, 2014

RE:                    Step III Grievance:

Cigna Plan Changes & Extreme Cost Increases

=====================================================================

One hundred twenty-nine full-time and sixty-five adjunct w/CCE UFCT Local 1460 faculty bargaining unit members are currently enrolled in one of four Cigna plans: Plan A/single, Plan A/family, Plan B/single, or Plan B/family.

Likewise, many of our bargaining unit members are rightfully concerned about what are — from any objective stand-point – extreme cost-increases to these Cigna Plans.

CONTEXT

  • The employer, i.e. the Pratt Institute Administration, through its Human Resources, shops for, and negotiates with various health-care providers, plan-designs for its eligible employees;
  • Pratt’s contract with Cigna recently came-up for renewal. (For the record: over the last decade Pratt has been in contract with Cigna, prior to that Oxford and before that Aetna…);
  • Cigna is demanding — apparently as a condition for contract renewal with Pratt — that should the current A & B plan designs go forward without amendment or change, there will be an across-the-broad increase of 43.8% for each and every employee currently enrolled in Plans A or B;
  • Cigna contends they “lost money” this past year due to the fact that twelve (12) individual claims each exceeded $100,000 in cost, when their ‘probability-rate’ (or cost-loss ratio) for the year was just one (1) claim potentially exceeding $100,000 in cost;
  • The UFCT Local 1460 does not negotiate directly with any health-care provider. We only negotiate w/the Pratt Administration: (1) who should be ‘benefits eligible’ and (2) the respective contribution or percentage rate(s) for its bargaining unit members;
  • At present a FT faculty member contributes 15% of the cost of their health-care plan, while an Adjunct w/CCE contributes 25%. These contribution rates remain the same and are not being increased.

The UFCT met w/HR on November 6th. Break-downs, information, data, and documentation ‘justifying’ the aforementioned Cigna increases were forwarded to the Union, which we have since forwarded to the Local’s State Affiliate: NYSUT for its review.

PLAN PROPOSALS

  • Plan B (the higher of the two options) will continue without loss of benefits but w/a 43.8% increase;
  • The current Plan A will be supplanted or replaced by a new ‘equivalent’ (in coverage) plan, although it disallows any out-of-network care. Moreover, this plan will now be a “High Deductible” alternative, i.e. wherein $1,300 for an individual, and $2,600 for a family plan, must be met before coverage is 100%. The Administration is proposing that they will contribute 100% of these deductibles to respective HSAs or ‘health savings account(s)’. The cost increase for this Plan A alternative will be 8.9% higher for 2015 than the current Plan A for 2014.

Grievance Statement

This Union clearly objects to what we and our members regard as exorbitant, irrational, extreme, and unjustifiable 43.8% increases in the costs of our bargained for health benefits. Cigna’s justification for such extreme increases, as was explained to us at our November 6th meeting, was Cigna’s inexplicable use of a low probability-cost-loss-ratio of one (1) ‘probable’ claim for the year exceeding $100,000, when there were in fact twelve (12) such claims.

It would appear then from the UFCT’s perspective, that in deliberately low-balling the ‘probable’ cost(s) of delivering health-care to Pratt faculty, Cigna is passing-off their diminished profit-margin to the unsuspecting bargaining unit member; who to the tune of a 43.8% increases in cost, will effectively subsidize Cigna’s so-called “loss”. This form of accounting is from the Union’s perspective, dubious at best, and possibly a calculated maneuver on Cigna’s part to appear as benevolent in ‘coming-in-low’ (two years ago) only to gouge their Pratt customers at a later date once we have become comfortable w/our plan-coverage, doctors, and/or health-care providers.

As such, the Union is rightfully concerned about what will be in the end, significant cost-increases to its members, and reserves all rights in contesting through the proper forum: Arbitration: (1) whether Cigna is permitted by law to fleece its customers or the ‘insured’ in using low-probability rates designed to maximize profit, and (2) whether the new high-deductible alternative plan replacing the current Plan A — disallowing any out-of-network care — is in fact “substantially comparable” in accordance w/the 2011-2015 CBA, Article XXVII: Health Benefits, section: 27.2.

To be clear, this Union will not and has not made any demands of the Pratt Administration to: (1) ‘cease and desist’ in withdrawing these plan proposals, or (2) postpone or discontinue its scheduled open-enrollment period… as the Union is convinced that were we to make any such demand(s), the fall-out would most assuredly guarantee that each and every member currently on either of the Plan A or B options, would be gifted by Cigna a draconian 43.8% increase to their respective health-care contribution(s) for the new 2015 year.

The Union believes this is exactly what Cigna wants. We will not be party to such antics.

As such, the Union will not take the bait nor be cuckolded by Cigna in appearing to be standing in the way of members having a choice between their current plan designs, and now, a new high-deductible plan alternative.

Remedy

A formal hearing in which a full-review of all related information & data; cost analyses, and break-downs are presented to the Union, explaining how Cigna was able to impose such extreme increases to the insured.

Questions:

  • Did Pratt ‘shop-around’ for another health-care provider other than Cigna?
  • If so, why did Pratt then choose to renew its contract w/Cigna?
  • Has Cigna acted in good faith?
  • Are Cigna business practices par-for-the-course? Do they meet a reasonable standard with respect to profit, and do such practices comport w/recognized norms within the health-care industry?

Cigna Cost-Increases and Open Enrollment

Email from Kye to Membership, November 24, 2014

Dear Members,

(There are four parts to this email, from bottom-up: (1) HR’s open-enrollment announcement, (2) UFCT VP: Emily Beall’s response to delegates, (3) my latest letter to HR Director Tom Greene, and (4) what follows, my email to members which hopefully goes some distance in explaining the matter of Cigna’s drastic cost-increases…)

Many of you are rightfully concerned about what are from any objective stand-point, exorbitant cost-increases to the current Cigna health-care Plans A & B available to many of our bargaining unit members. One hundred twenty-nine full-time and sixty-five adjunct w/CCE faculty are currently enrolled in one of the Cigna plans: Plan A single, Plan A family, Plan B single, or Plan B family.

To be clear, if you are FT or CCE, and on the Self-Insured PPO (closed for any new enrollment since 1998), or an Adjunct (without CCE), and on the Emblem HIP Plan, these Cigna increases do not effect you.

CONTEXT

  • The employer, i.e. the Pratt Institute Administration, through its Human Resources, shops for, and negotiates with health-care providers plan-designs for its eligible employees;
  • Pratt has a contract with Cigna which recently came-up for renewal (Over the last decade Pratt has been in contract with Cigna, prior to that Oxford, and before that, Aetna…);
  • Cigna is demanding — as a condition for contract renewal with Pratt — that should the current A & B plan designs go forward without amendment, there will be an across-the-broad increase of 43.8% for each and every employee enrolled in Plans A or B;
  • Cigna contends they “lost money” this year due to the fact that twelve (12) individual claims each exceeded $100,000 in health-care expense, when their ‘probability-rate’ for the year was just one (1) claim exceeding $100,000;
  • The UFCT Local 1460 (the union for faculty employees at Pratt) does not negotiate directly with any health-care provider. We only negotiate w/the Pratt Administration: (1) who should be ‘benefits eligible’ and (2) the contribution percentage rates for its bargaining unit members;
  • At present (and since faculty started making contributions to their health-care in 1998), FT faculty contribute 15% to the costs of their health-care plan, while Adjunct w/CCE contribute 25%;
  • These contribution rates remain the same and are not being increased!

The UFCT met w/HR on November 6th. All relevant break-downs, information, data, and documentation ‘justifying’ these increases was forwarded to the Union, which has since been forwarded to NYSUT for review.

PROPOSALS

  • Plan B (the higher of the two options) will continue without loss of benefits but w/a 43.8% increase;
  • Plan A is being supplanted or replaced by a new ‘equivalent’ (in coverage) plan, although it disallows any out-of-network care. This plan will now feature a ‘high deductible’ of $1,300 for an individual, and $2,600 for a family which must be met before coverage is 100%. The Administration will contribute 100% of these deductibles to a ‘health savings account’ (HSA). The cost increase for this Plan A alternative will be 8.9% higher for 2015 than the current Plan A for 2014;

GOING FORWARD

The open-enrollment period is now.

The UFCT Local 1460 will be seeking arbitration on this matter. We have secured the services of NYSUT health-care analyst and specialist: Sue Klug, who also has served as expert-witness in similar arbitration(s).

The focus of such an arbitration would be on whether it is/was (1) appropriate for Cigna to use an exceedingly low-probability rate in their cost-loss analysis, and (2) whether the new high-deductible alternative plan to Plan A which disallows any out-of-network care, is in the end “substantially comparable” (see: CBA, Article XXVII: Health Benefits, section: 27.2). Odds are we would not prevail in an arbitration. Yet, we have nothing to lose in trying.

However, for the immediate future, which is now, understand that the Union will not demand that Pratt either withdraw these plan proposals or discontinue open-enrollment (see: letter to Greene below), as this would guarantee a 43.8% increase for everyone without exception; our only hope then, that some retroactive reimbursement might come months from now, should we even prevail in an arbitration which as I stated, is doubtful…

This situation is a series of bad options.

We believe we are taking the best (or least worst?) course of action in going forward. Likewise, we can always try and negotiate something new in our forthcoming negotiations, maybe language that addresses cost increases: “no annual percentage increase for any plan institute-wide shall exceed market-rate-increases” (which fall in the 8-10% range…)

You’ll note my soap-box-screed at the end of my letter to Director Greene. This situation is not unique to us. Many of our faculty brethren at both public and private institutions are countenancing the same; our LIU brothers and sisters just down the block included.

In Solidarity,

Kye

—————————
UFCT President Kye Carbone’s most recent letter to HR Director Tom Greene

Dear Tom,

With respect to any necessity in meeting again regarding Cigna plan changes, their increased costs, and the scheduling of open-enrollment, I have spoken w/Judy Sandler who as you know, has been in correspondence with Neil Abramson. Judy informs me that as based on their exchanges, the Pratt Administration awaits a formal response from the Union on what we plan to do going forward.

Our response:

The Union clearly objects to what we and our members regard as exorbitant and unjustifiable 43.8% increases in the costs of our bargained for health benefits. Cigna’s justification for such extreme increases, as was explained to us at our November 6th meeting, was Cigna’s inexplicable use of a low probability-rate of one (1) ‘probable’ claim for the year exceeding $100,000, when there were in fact twelve (12) such claims.

It would appear that in low-balling the ‘probable’ costs of delivering health-care to Pratt faculty, Cigna is effectively passing-off their diminished profit-margin to our bargaining unit members to make up the difference at the cost of 43.8%. This form of accounting is from the Union’s perspective, dubious at best, and possibly a calculated maneuver on Cigna’s part to appear as reasonable in ‘coming-in-low’ only to gouge their Pratt customers at a later date once we have become comfortable w/our plans, coverage, doctors, and health-care providers.

As such, the Union is rightfully concerned about what will be in the end, increased costs to its members, and reserves all rights in contesting through the proper forum: Arbitration: (1) whether Cigna is permitted by law to fleece its customers in using low-probability rates designed to maximize profits, by passing on exorbitant increases in health-care delivery to the ‘insured’, and (2) whether the new high-deductible alternative plan replacing the current Plan A, disallowing any out-of-network care, is in fact “substantially comparable” as enumerated in our Collective Bargaining Agreement w/the Pratt Administration (see: Article XXVII: Health Benefits, section: 27.2).

However, to be clear, the Union will not at this juncture, make any such demands that: (1) Pratt withdraw these plan proposals, or (2) postpone or discontinue the scheduled open-enrollment period ending Friday, December 12th.

The Union is convinced that were we to make such demands, the fall-out would most assuredly guarantee that each and every member currently on either of the Plan A or B options would be gifted by Cigna, a draconian 43.8% increase to their respective health-care contribution(s) for the new 2015 year. I believe this is exactly what Cigna wants. The Union will not take this bait nor be cuckolded by Cigna in appearing to be standing in the way of members having a choice between their current plan design, and now, a new high-deductible plan alternative.

The Union acknowledges the work you, your consultants, and your HR staff have endeavored in negotiating a plan alternative w/Cigna, albeit w/what appears — on its face — to be onerous high deductible(s). Further, we appreciate your ceding to our demand that should said plan have to go forward, only a 100% administrative contribution to these deductibles could possibly take some of the sting out of what is still a bitter-pill to swallow for the average faculty member. Point being, faculty do have a choice, while the plan options are less-than-ideal from our perspective.

Lastly, as long as I have a soap-box, I will state unequivocally as many times as is necessary that what we all are having to countenance with ‘for profit’ health-care ‘providers’ is a national disgrace.

If you feel it necessary to meet, we will of course oblige.

Regards,

Kye

——

UFCT VP Emily Beall’s letter to delegates

Delegates,

In response to the discussion about the 43% increase in premiums for the Cigna plans:

This is a union issue.  The Grievance Team notified Pratt Administration yesterday that they would be filing a Step IV grievance for Arbitration on this matter.

Firstly, for context:  the union negotiates the percentage of premiums a faculty member pays for the health plan available to them.  Our contract specifies that:  Full Time contribute 15%, CCE contribute 25%, and Adjuncts contribute 50%.  Full  Time and CCE are on the Cigna plans; Adjuncts are on the HIP plan.

We have little room to negotiate the specifics of a given plan; this is because the Administration must negotiate with the various health care providers (e.g. Cigna, Emblem) to in effect buy coverage (keep in mind these are for-profit entities, in effect syndicates who cannot countenance not making a ‘healthy’ profit).

However, the percentages of premiums faculty cover (15%/25%/50%) aren’t what’s at issue here.  What’s at issue is that Cigna raised their premiums 43% from last year to this, and thus the Administration is asking faculty to pay 43% more for their coverage from what they did last year (whether they’re contributing at 15% or 25%). 

So:  our contract also specifies that Pratt has the right to change plans or coverage so long as (1) they make that same change for administrators, too, and (2) the new plan provides “substantially comparable” benefits to the current plan (Article 27.2)

The Grievance Team notified administration yesterday that they would be filing a grievance in response to this change in plans available to FT and CCE, as what is being offered to those faculty for 2015 does not provide “substantially comparable” benefits.  That a FT or CCE member enrolled should suddenly have to pay 43% more toward their health coverage, or loose out-of-network coverage and still pay 8.9% more, is not only NOT “substantially comparable” to what was provided before, it is egregious and unacceptable–too bitter a pill to swallow.

Union Leadership stands for our members on this, and the Grievance Team will be pursuing this grievance vigorously and as quickly as possible.  We have engaged NYSUT’s Health Care specialist to aid us in our grievance; it is my understanding other effected Unions on campus are similarly grieving this change.

This situation has developed rapidly; the Union will update membership at large by week’s end.  We will keep Delegates and Membership posted as the Grievance Team goes forward.  Meantime, thanks for reading, and I’m glad to answer any further questions Delegates have on this matter.

In solidarity,
Emily

——

Open Enrollment Announcement

From: Thomas Greene <tgreene@pratt.edu>
Date: Tue, Nov 18, 2014 at 10:15 AM
Subject: Open Enrollment – Pratt Cigna Medical Plan
To: tgreene@pratt.edu

This is to inform you that Open Enrollment for Pratt employee benefits will begin immediately and continue from November 17 through Friday, December 12, 2014.  Open Enrollment is the time when eligible employees can enroll in and/or make changes in their employee benefits, including medical, dental, retirement, commuter benefits and flex spending accounts.  It’s also an opportunity for employees to gain more information about benefits and ask the Benefits staff any questions.

Open Enrollment was delayed this year while we considered significant changes to the Cigna medical plan.  As a result of a very high increase in the premiums paid to Cigna effective in 2015, Pratt will be modifying the plan options offered to employees to choose from:

  • The High Plan offered by Cigna will remain as an option.  As the Cigna premiums will be increasing by 43.8%, employee contributions (through payroll deductions) will increase by the same amount.
  • The Low Plan will be replaced by a High Deductible Health Plan (HDHP) with a Health Savings Account (H.S.A.).  This plan differs from the existing Low Plan in that members are limited to the Cigna network  for medical care and a deductible must first be met by the member ($1,300 individual/$2,600 family) after which all medical care is covered 100%.  However Pratt will fund 100% of the deductible for members enrolled in this Plan for 2015.

Information sessions about the new HDHP w/H.S.A. plan are scheduled for the following dates and times:

Monday,  November 24, 2014,  Pratt Manhattan, Room 213,  3-4:30p

Thursday,  December 4, 2014,  Engineering Room 307,  12:30-1:30p & 2:30p-3:30p

Monday,  December 8, 2014,  Alumni Reading Room,  12:30-2p

All employees enrolled in a Cigna medical plan are strongly encouraged to review the options carefully to ensure they are enrolled in the appropriate plan option for their medical needs.  An employee currently enrolled in the Low Plan will be automatically enrolled in the HDHP with H.S.A. unless s/he actively selects a different option during Open Enrollment.  Likewise an employee currently enrolled in the High Plan will remain in the High Plan unless s/he selects otherwise.

More information on the options and employee contributions is available on the HR section of my.pratt.  In the meantime, you are able to make changes to all other benefit plan changes.

Tom Greene

Certified Election Results

Dear Members,

We would like to announce the results of today’s final election count:
Overall Participation was 51.94% (186 out of 387).

143 Members voted for candidate Kye Carbone.
43 Members voted for candidate Jenny Lee.

Yours in Solidarity,

The 2014 Election Committee

Luis Alonso
Linda Lauro-Lazin
Mark O’Grady

The final and official Certification of Results and Audit Report on Activity and Integrity provided by to us by our election agent, Votenet Solutions, is provided here:

UFCT1460 Certified Results

VOTING INSTRUCTIONS for the 2014 Re-Run Election for Union President of Local 1460 UFCT

Dear Members,

The election is on as of 12pm, Dec. 3, 2014.

Below is a copy of the voting instructions contained on the official ballot which you received directly from VoteNet on Dec. 3, 2014.

Please read your individual email and it’s voting instructions, with particular attention to the Username and Activation Code procedures, so that your individual vote may be properly executed and counted.

If you have NOT received a direct email from VoteNet containing your own personalized access codes and instructions for a valid voting experience please contact the Election Committee at election2014local1460@gmail.com.

Please remember to exercise your right to vote!

 

VOTING INSTRUCTIONS:

The system will ask you to enter your Username and Activation Code, (which will be sent to you); they will then ask you to create and confirm an 8-digit Password.  Lastly it will ask you to login using your Username and Password.  This three-step process keeps your vote secret and safe.  No one has access to your password.

Note: the online ballot can be accessed from any smartphone or device that has full browser capabilities.

All of your choices are held in a secure database and are completely secret.  No one has access to the choices you made.  Both systems will give you a confirmation number.  This number is proof to you that your vote has been successfully transmitted to Votenet’s secure database.

Online Ballot: https://eballotuv.votenet.com/ufct1460/

Username: ……………………
Activation Code: ……………..

LETTER ACCEPTING CANDIDACY OF JENNY LEE AND KYE CARBONE FOR UNION PRESIDENT AND EXPLAINING ELECTION PROCEDURES TO CANDIDATES 

For the Fall 2014 Re-Run Election for Union President of Local 1460 UFCT

IN THE INTEREST OF TRANSPARENCY AND FAIRNESS, THE LETTER ACCEPTING CANDIDATE’S ELIGIBILITY AND OUTLINING THE ELECTION PROCEDURES, SENT TO THE CANDIDATES BY THE ELECTION COMMITTEE, ON NOV. 9TH, 2014, IS BEING PROVIDED BELOW FOR ALL MEMBERS TO SEE:

Union Letter to Kye and Jenny

The Elections Committee

Questions about voting?
Please send an email to the election committee at: election2014local1460@gmail.com

2014 Re-run Election for Union President of Local UFCT 1460

Dear Union Members,

The Union Elections Committee  of Pratt Institute announces the 2014 Re-run Election for President of the Union Local UFCT 1460.

This election will start on:

December 3rd at 12 p.m. Eastern and conclude on:

December 12th at 5 p.m. Eastern.

Candidates: Jenny Lee and Kye Carbone.

This election is being rerun due to a technical violation of the LMRDA that the union was made aware of after the December 2013 election.

The candidates have been asked to provide statements which will are posted on the Union website.

Method of polling will be by electronic balloting administered by Votenet.

You will receive an email and paper mailing from VoteNet instructing you how to cast your vote securely and privately.

If you are not able to vote for any reason, please contact the election committee below.

Please note that we the Elections Committee, will be sending out additional reminders and notification by email up to the time of the election but please be aware of this upcoming important election.

SPECIFIC VOTING INSTRUCTIONS WILL BE PROVIDED BY VOTENET. We will post them on the website before December 3rd and as soon as they are available.

Thank you for your attention,

The Elections Committee

Questions about voting?
Please send an email to the election committee at: election2014local1460@gmail.com

2014 Re-Run Election for President – Candidate Statements

Hello Members,

We are happy to announce the beginning of the Fall 2014 Re-Run Election for Union President of Local 1460 UFCT.

This election will be starting December 3rd and concluding on December 12th, 2014.  Specific times and instructions will be following shortly.

The candidates are Kye Carbone and Jenny Lee. Their election statements are provided below:

Candidate’s Statements:

Kye Carbone:

Kye Carbone for UFCT Local 1460 President:  A Decade of Positive Faculty Accomplishment

I am honored to again be nominated for President of UFCT Local 1460.

Since 2003, I have faithfully served the office of Union President.  I believe I have demonstrated the necessary strength, forthrightness, integrity, honesty, drive, focus, and transparency of means warranting leading our Union going forward.

Accordingly, I respectfully ask for your enthusiastic and affirmative vote.

Moreover, a vote for me is a vote of confidence for the Local’s elected officers: Emily Beall (VP), Holly Wilson (Secretary), and Dennis Masback (Treasurer). As a team, we are dedicated to strengthening faculty’s roles in academic life at Pratt Institute.  As a Union, it is our individual acts that coalesce to form collective gains.

Three pillars constitute effective union governance:  I. Contract enforcement, II. Grievance adjustment and III. Collective bargaining. I have a deep and demonstrable understanding of each.  I led the negotiating team for our last three Contracts, which encompass twelve-years of verifiable gains in salary, benefits, rights and protections:

  • annual percentage increases of 3+% a year;
  • FT salary and PT rate increases, granting 10-15% at promotion;
  • expanded health benefits for PT Faculty;
  • expanded medical leave for PT Faculty, full medical leave for FT and CCE;
  • increased sabbatical leaves for tenured Faculty;
  • equity “adjustments” for FT Faculty;
  • strengthened Academic Freedom to protect faculty’s right to input on curriculum

I continue to pledge my dedication and commitment to the challenges that invariably lie ahead and promise never to lose sight of the confidence and trust you have bestowed upon me.

In Solidarity,

Kye

Jenny Lee:       Statement not provided by candidate.

 

The Elections Committee

election2014local1460@gmail.com