Dental Plan Update for Kaleida Employees
Kaleida recently changed dental insurance companies. We were assured that the new company, Guardian, would be offering the same previously negotiated plan available to employees, formerly serviced by Nova. Members soon found they were charged more by their dentists than they had been under the previous plan. Members began to call the Union office to alert us to this issue.
The Union researched our plan and asked why members were being charged more. We found that documents about dental coverage had indeed been modified after we were told they would not be. Several differences in coverage were noted. A very common new cost was fillings. Guardian now only covered the “silver” or amalgam fillings at 100%. Members were now paying additional fees for “white” or composite fillings.
There are two problems here. First, many dentists don’t use silver fillings anymore, leaving members with no choice but to pay the difference in cost for white fillings. Second, the larger issue is that we were told there would be no change in coverage.
The plan members were paying for had been part of contract negotiations. This was a unilateral change and violated our collective bargaining agreement. The Union filed a class action grievance. Because we pursued this issue, and only because THE UNION filed the grievance, Kaleida has agreed to correct this error. They instructed Guardian to make the necessary changes such as covering white fillings as originally agreed upon.
Guardian was charged with reprocessing claims. All reprocessing of claims should have occurred by August 31, 2015. If you have not heard anything from your dentist/provider, you may call your dental office to confirm your eligibility for a refund. There are two scenarios – IN and OUT of network:
* 81% of the claims that were being reprocessed are from Guardian PPO network providers and the additional claim payments will be sent directly to the providers per the contractual arrangements with each provider. The providers will refund the plan participants.
*19% of the claims were being reprocessed to out of network providers and these payments will be sent to the employee or provider based on claim assignment status when the initial claim was submitted. This is an arrangement elected by the employee when they entered into treatment with the provider.
While we are very pleased to help our members by bringing Guardian into compliance, this situation never should have occurred. This problem affected over 1100 members and their families. Fortunately as Union members we have recourse through the grievance procedure to resolve such issues. As always, if you have any questions, please call the office. CWA :639-1168 SEIU:982-0540
St. Joe's Update: Working Under an Expired Contract
The bargaining committee has decided to let the St. Joe’s RN contract expire. We have made this decision due to the number of issues still on the bargaining table, and due to the fact that the Employer did not come to the table prepared to address the issues related to staffing, including employee retention, floating, and shift rotation.
The employer seems focused on trying to reach an agreement quickly, rather than taking the time to address the issues currently faced by St. Joe’s employees and improving conditions for RNs at the Hospital.
In addition, the employer has come to the table with many concessions, and so many unreasonable proposals.
What does this mean?
The main impact is that the arbitration provision no longer applies. We can still arbitrate cases over the following items:
- Grievances filed while the contract was still in effect
- Grievances over events that occurred prior to expiration
- Grievances over rights that accrued under an expired agreement
For grievances over new matters, the employer has a duty to discuss the matter and supply information.
Does this mean we will go on strike?
We now have the ability to go on strike, after providing a ten day notice (legally required for health care facilities). The bargaining committee is committed to bargaining in good faith with the Employer to reach an agreement. We want to address the issues that were raised by members in the bargaining surveys.
A strike is a last resort, and we will only consider that option once we have had the opportunity to fully bargain with the hospital.
What about other provisions of the contract?
Labor law is clear that the employer must maintain the “status quo” including written agreements and consistent past practices. If there is a change in benefits or practice, we have the ability to file charges at the National Labor Relations Board.