SOUTH PLAINFIELD, NJ – A standing room only crowd of teachers and staff gathered at the South Plainfield Board of Education’s Sept. 11 meeting, joining together to show their opposition to a proposed change to the district’s current health care benefits plan.
Currently, the South Plainfield Board of Education (SPBOE) is considering the addition of a Difference Card along with a revision to the Horizon Blue Cross/Blue Shield plan to help reduce both employee Chapter 78 contributions and district premiums and, in return, ease the burden of reduced state aid over the coming years.
“Three of the responsibilities we have as a school district are giving our children a quality education, meeting commitments to our employees and being proper fiduciaries for the taxpayers money,” SPBOE President Doug Chapman told TAPinto South Plainfield. “Governor Murphy has informed us that we will be getting our state aid reduced by almost $1 million over the next few years. Knowing this is coming we have to look for ways to minimize the negative impact this is going to have on our ability to meet those three responsibilities.”
Representatives and members of the South Plainfield Education Association (SPEA), however, feel the changes would not be beneficial and are a violation of the ‘equal to or better than’ clause in their contract. Diana Joffe, a high school teacher and the current president of SPEA, 'formally' told the board that the teachers union ‘holds the Difference Card as a mandatory negotiary issue’ and that ‘any imposition of this program will be met with any and all challenges through the courts and collective actions available…’
The proposed change to the plan comes at the recommendation of medical broker Stuart Migdon who, during the July renewal process, was asked to look for ways to save the district ‘as much money as possible’ while still maintaining ‘the integrity of the benefits offered to the employees and their dependents.’ Migdon, who serves as managing director of the Business and Government Agency, recommended the Difference Card.
During a presentation made at the meeting, Chris Calderone, northeast sales director for the Difference Card, said the proposed change to the plan would lower insurance premiums for employees and the district ‘this year and into the future’ while continuing to provide existing benefits and making up for any changes in copays and deductibles so that members’ out-of-pocket costs remain the same.
Under the proposed revised plan, said Calderone, copays would increase but a swipe of the credit card-type Difference Card at a doctor’s office or medical facility would drop out-of-pocket fees down to the current rate; according to the chart presented by Calderone, $20 in-network primary care copays along with $35 specialist copays and $35 urgent care copays would remain at $10 and the $100 emergency room copay would still be $50.
Manual reimbursements could be filed if someone should forget to swipe the card during a visit and flexible spending could still be used to offset remaining co-pays. The $0 co-pay on preventive visits would also remain the same.
With the Difference Card, insured employees of the South Plainfield School District would continue to have a $0 deductible and $0 out-of-pocket coinsurance cost for in-network services; the out-of-network deductible, however, would increase from $300 to $800 but, said Calderone, the card would pick up the $500 difference. Out-of-network co-insurance would also change from 80-20 to 60-40 with the card paying back the difference and the insured paying the same 20-percent to $700 as before.
“Nothing would change with the networks; the same things would be covered that were covered last year. The Difference Card is picking up any changes in copays, deductibles, and co-insurance,” said Calderone.
Under the proposed change, however, reimbursement claims for those who forgot to bring or swipe the card as well as for those who accrue out-of-network expenses would have to be manually submitted. Several employees of the teacher’s union stated that this additional process would create more work and be inconvenient for those with children at college and forgetful spouses as well as someone who just had a baby or who is undergoing extensive medical treatments.
“I feel we are going to be doing more paperwork…this really seems like more complication for our families,” said one SPEA member.
“If someone has a catastrophic illness…and they are worried about getting well, I don't honestly think they are going to be submitting all these different bills to the Difference Card,” said another.
“I already have to enough paperwork as it is just being a teacher, justifying the grades that I give, making sure all my bases are covered,” said another teacher, stating that with the district ‘rationing paper like it is the Great Depression’ teachers won’t be able to print out forms.
“We’re teachers; we have a lot to do to make our students fabulous. I don't believe it is our job to hunt down our money…and have to worry about submitting [paperwork]. What we have now works,” said one SPEA member seated in the front row.
“I understand that now a very time-intensive process of managing these claims [is being] shifted from someone I trusted to do it for me, Horizon, to me. I have to spend my time doing it; I have to make sure I am taking care of the details for something that I was paying for before [because] it is now being shifted back to me in the name of cost savings,” said David Landry, a special education teacher at the high school, noting that with the proposed change ‘cash flow’ for some of the transactions would also shift to him.
“In the past, I was able to sign off on benefits at the bottom of the claim form, have my provider paid directly once the claim was processed and now, based on what I heard, that option isn’t available to me. Now, the bill comes to me, I have to submit the claim, I have to collect the money, I have to pay the money back out,” Landry said. “This is new. This is different. This is not the plan that we’ve had, “‘same or better.’”
According to materials presented during the meeting, implementation of the revised plan and Difference Card would save both the district and the employee money each year. Currently, the South Plainfield School District pays $8.3 million a year for health insurance; implementation of the Difference Card and a revision to the current Horizon plan would decrease that number by 8-percent to $7.6 million.
Chapman stated the district would pay the Difference Card $5 per participant per month for a total of approximately $24,000 a year and would see a little over $683,000 in savings with approximately $546,000 going back to the district and close to $137,000 in combined savings to those insured.\
“We are in situation right now where we are trying to do some effective financial planning. The state has already told us our aid is going to be reduced by almost $1 million over the next four years,” Chapman said, noting that a reduction in state aid combined with salary and medical insurance premium increases could put the district in a difficult financial situation down the road. “We want to make sure we have proper financial planning to be able to keep everything fiscally smooth moving forward,” he said.
Although she understands the need to be financially prepared, Joffe, an employee of the district for 43 years, told the BOE that doing so should not come ‘on the backs of the teachers.’
“We are the ones who have to sacrifice and we are tired of it. We haven’t received great raises. We haven’t received any great language in the contract. We have stood up. We have helped. We have worked very hard. You have praised us and told us how great we are,” said Joffe. “This is not the thanks we expect. Our health and our well-being is worth more than a million dollars…”
“Everything isn’t about financial savings. We are saving bupkis – pennies – for the stress about having to worry about this,” said a teacher. “The money that we get each year in a raise gets eaten by Chapter 78 so what’s 8-percent if you pay $900 a month? Leave it alone. If it is not broken, don't fix it.”
Currently, just two dozen of the state’s more than 600 school district have implemented the Difference Card, leading SPBOE members Pio Pennisi, a retired superintendent, and John Farinella, a high school principal in Rahway, to question why so few are utilizing it.
“Everything sounds real good…[but] with these districts representing just three-percent of the districts throughout the state I am curious as to why this isn’t being pushed through the other 635 districts…They are going to be losing money, too,” said Pennisi. “It looks really good but I am trying to figure out what is wrong with it.”
“There are over 600 school districts in the State of New Jersey; the Difference Card is used in very few of them at this point in time,” added Farinella. “If something is that good it is quickly jumped on by the education community if it is working.”
According to Migdon, the Difference Card is currently more popular in the private sector and Chapman agreed, telling TAPinto, “This technique of administering the medical benefits is widely used in the private sector and is just now starting to be adopted in the public sector.”
Pennisi also questioned why his requests for the names of the 24 districts that currently have the program in place have been denied and told Calderone that the company should be forthcoming if they are looking for South Plainfield to come on board.
“If I am told I cannot have them when I should be able to get them I start wondering why. I can only inject my own thoughts on that …” said Pennisi, adding, “If you think I am going to look around for them, I am not. You’re trying to sell us the card and I want that information.”
Calderone said the company provided the district with three references and has not released information on its other clients due to a nondisclosure agreement with the brokers. At Chapman’s request, however, Calderone said he would reach out to the brokers and provide the district with additional client lists.
During the course of the nearly two-hour meeting, numerous SPEA members asked questions and voiced concerns. One stated she is ‘very happy’ and ‘not just satisfied’ with the current plan and another questioned how, in an era of social media, the 20-year old Difference Card company only has 84 ‘likes’ on Facebook. Additionally, an employee raised concerns about unfavorable reviews posted online by current and/or former Difference Card clients.
“I think you’re intelligent enough to go and look up Difference Card reviews’ and read them. They are not very flattering,” she said.
Sandy Doyon, the union’s vice president, stated that district employees were told the Difference Card was a ‘done deal’ by a company representative and several teachers in attendance echoed that they, too, had been told the change was indeed occurring and needed to be in effect for Oct.1.
Landy stated that ‘confusing info [is] being circulated’ and told the SPBOE that, in the past three months, there have been ‘three very different benefits sheets that describe this single plan, what’s covered, what’s not covered, how much is covered, what gets paid for, [and] what doesn't get paid for.’
“…I hear people say that I am going to be whole and what I was paying for before I am going to be paying for again, but when I look at some of the documents and the fine details I don't see that in every case,” he said. “Maybe I am confused and some reconciliation needs to happen before we go forward.”
Additionally, SPBOE member Debbie Boyle questioned why the agenda for that evening’s meeting was changed last minute with items – including a vote on the Difference Card as well as a bills list item for a $29,000 payment to the company and the establishment of a bank account in the company’s name – removed earlier that day.
Board Secretary Alex Benanti said he prepared the agenda ‘for every option and possibility’ and those items were removed because the board didn't ‘have a quorum.’ “Everything we’ve done can be voided and removed and the bank account can be cancelled with no issue,” he said.
Of the nine-member board, only the five non-conflicted members - Chapman, Farinella and Pennisi along with Sharon Miller and Stephanie Wolak – can vote on the Difference Card. Neither Miller nor Wolak were present at the Sept. 11 meeting. Members Boyle, Keith Both, Tom Cassio, and Jim Giannakis are conflicted and cannot vote for or against the proposed plan changes because they have family members who work for the district.
“Change is never easy and we haven’t voted to implement this technique yet,” Chapman told TAPinto. “Additional information was requested and we’ll review it once we get it and make a final decision at that point in time.”
“My research, supported by the NJJEA and presidents of other local associations, reveals that there are numerous issues, as you have heard, with this Difference Card…It is [my] responsibility as an association leader to find out all the information [I] can but it is also the board’s responsibility to not only discover the pros, but the cons and I think that the board is going to do that now and I do not think you did that before,” said Joffe.
“This program is a direct threat to our health benefits along with its administration. If you want to introduce this at the beginning of a bargaining table we are ready and willing to meet and discuss this in bargaining. If you prefer to impose this upon us then we will, as I have already said, use any and all means at our disposal…” she added.
The South Plainfield Education Association’s current three-year contract runs through June 2020 with negotiations between the teacher’s union and the district for a new one scheduled to begin the end of this year.
“At the last board of education meeting, you discussed ways to show our members your appreciation for us. Let’s begin with this,” said Joffe.
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