Monday, February 1, 2016

The NYC Teacher Healthcare Crisis: Part 1, 'Great Insurance!'

This is the first of three parts about the problem with health insurance that city employees are (all) about to face. This is some fairly wonky stuff but I'm convinced that, unless there is a shift in policy, we will all be paying -a lot- for our healthcare. 

Part 1 is about how great our great insurance is.
Part 2 about how the city has tried, and failed, to slow the increase in healthcare costs to its employees.
Part 3 is about what we, as employees lost (and will soon lose) for that failure.

Teachers in New York City enjoy some of the very best healthcare in the State of New York. Teachers here (and most other New York City employees) can choose from more than twenty (when you take the prescription riders into account) different options of health coverage (see here). Some of these choices require deductions to be made from our salary but these deductions are small when compared with teachers from other districts throughout the state.  And the deductions are just plan tiny when compared with any employee working in the private sector.

We have it good. We have it very very good.

Most (if not all) of the teachers who I know have chosen GHI for their healthcare insurance. One of our GHI options is a Comprehensive Benefits Plan or CBP. This plans allows us to see a doctor whenever we need with no deductible, no significant cap on the amount of coverage and a copay of only $15 per visit.

Stubbed toe? $15.
Cold? $15.
Flu? $15.
Cut yourself shaving and require stitches? $15.

If we'd like to see a specialist, need a test performed or go to the emergency room, the copay is only $20.

Broke you finger skiing? $20.
Broke your femur ice skating? $20.
Need an x-ray of that femur? $20.
Embarrassed that you fell while ice skating and broke your femur? Need to see a therapist or other mental health professional? $20

Because GHI is the largest health insurance provider in the city, doctors and other medical professionals line up to become a provider with the GHI network and, at the end of the day, settle for whatever GHI gives them. As a result, the patient (that's us) has access to some damn fine doctors who will serve whatever medical need we may have in the future.

 (here's hoping we never have one).

And the amount that is deducted from our check for this magnificent service? The amount that we must contribute? Our responsibility toward the premiums on this insurance? $0.


That's correct. Teachers in New York can pay absolutely nothing from their check and receive some of the very best healthcare there is. And, those of us who are vested can receive that same level insurance for the rest of our lives at no cost.

No one else has that.  No one.

I've been through teacher contracts from other districts on Long Island in the past and I have a good sense of how their healthcare stacks up to ours. Some district teachers pay nothing from their checks and receive a poor plan. Some pay something and receive an OK plan. Some districts even pay a significant amount each check for a terrible plan. Some pay for a plan similar to ours! But they pay for that plan. We don't. And many of them pay when they retire. We don't.

Say what you want about teacher pay in the city vs teacher pay in other districts. When you factor in healthcare and our TDA (which is for another discussion), the facts make themselves clear: No one has it better than NYC teachers. No one.

But someone has to pay for all that health insurance. And that someone is our employer, the City of New York.

Since 2010, since the Patient Protection and Affordable Care Act became the law of the land, the city has been required to note the amount they spend each year on all of our healthcare costs. (This includes GHI, as well hospitalization and, I'm sure, other coverage). For the past six years, this amount has been counted as deferred wages on our W2 form. This allows us, and Obama, to see how much the city has paid for our benefits.

Now this amount has outraged some people and media outlets capitalize on that outrage (see here for example or here ($) for another) but it is a fact that, if you select the top rate GHI-CBP as your health insurance, the city pays the cost of the premium and we pay nothing.

Nothing, that is, unless the cost of your plan goes up over $10,200 for individual coverage and $27,500 for family coverage. If that happens, if the amount increases over those prices (and if city actuaries count our aggregate insurance as one), then we pay a tax of 40% of that amount (here). This is the famous Cadillac Tax and it goes into effect for those plans in two years -2018.

Nothing, that is, unless the mayor exclusively decides that we must now coin up and contribute from our paychecks. The unions quietly gave him this power almost three years ago.

Nothing, that is, unless both of these things happen. And this, too, is entirely possible.

I'll end this first part by suggesting that we may be at the peak of healthcare benefits we receive as city employees. We may soon wind up be paying more (a lot more) for service that is not nearly as good.

Part 1: Great Insurance
Part 3: The Road Ahead