Guild works to fix News’ health plan: Union finds health insurance flaws now being corrected

The Guild have been working with The News to correct two important Univera Healthcare coverage problems discovered by our members and leadership after The News sent out its NewsFlex benefits package to Guild members.

These issues, which have now been fixed, would have otherwise led to higher out-of-pocket hospitalization costs for our members and hurt those who have dependent children who live away from home but depend on their parents for coverage.

As background, the Guild health plan in the new arrangement with Univera Healthcare for 2014 was to be “substantively equivalent” to the plan we had in the past with BlueCross BlueShield of Western New York. In one area of improvement, there would no longer would be a $500 deductible for hospital stays.

Here is a summary of the issues that have developed and their status:

  • The Guild benchmark plan in the NewsFlex packet lists a $500 hospital deductible even though the plan presented by management during this year’s negotiations required no deductible.

We alerted the company to the error, and the company has now informed the Guild by letter that there will now be no hospital deductible for members. The News also agreed to adjust credits for the Guild benchmark plan during next year’s negotiations to reflect the full cost of a health plan without a $500 hospital deductible.

  • Under our old Blue Cross Blue Shield of Western New York plan, Guild members could apply for a “guest membership” to cover the costs of dependent children who may live away from home. The new Univera plan made no provisions for this.

Under the Blue Cross plan, dependents could become “guests” of an affiliated Blue Cross plan elsewhere when they are away from home for a prolonged period. This was ideal for members with dependent children living in other areas, such as full-time college students and the children of divorced parents.

During open enrollment, it became apparent that the Univera Guild benchmark plan did not include this guest benefit. Without it, a guest member’s medical care would be treated by an insurer as “out-of-network,” and the employee’s share of costs would be much higher.

Because of the corporate structure of Univera and the type of health plan it offered, the fix for this problem is complicated. But The News has worked out a solution with Univera that it says will mirror the old guest membership benefit and allow away-from-home college students and others to access the Blues’ network of doctors and hospitals.

This solution can’t be put into place until March 1, but News management has promised to find a way to cover guest member medical expenses incurred in January and February. Guild members who expected to take advantage of a guest membership in 2014 should choose the Guild benchmark plan. The company said it will notify the Guild soon about how exactly it will cover expenses in the first two months of next year.

If you have questions in the meantime, please contact Tammy Turnbull at 856-2828.