[jja-announce] JJA/NWU health insurance complications

Jazzmandel@aol.com Jazzmandel@aol.com
Wed, 15 Jan 2003 09:34:55 EST

Hi, JJA colleagues. 

Below is a note I received from the National Writers Union that will be of 
interest to those of you who have health insurance through the JJA's 
connection with the NWU, or who have contemplated it. I wish the news was 
better; it isn't very promising. But you should know what's going on. 
Procuring reasonably priced health insurance is one of the most difficult and 
frustrating of all challenges attendant to being a freelancer in America. 

please let the JJA know, maybe by posting at the new Jazzhouse BBS, if you've 
found any solutions to this problem. 

thanks, Pres Howard

Dear Leaders of Groups Participating in the NWU Associate Benefits Program:

This afternoon, National Writers Union President Jonathan Tasini 
distributed an important update on the  UniCare health insurance plan 
offered through the NWU to all Associate Benefits Members currently 
participating in the plan.  Below please find a copy of that message, which 
addresses significant issues facing the plan.  Also please note that this 
message only pertains to the UniCare plan.  This does not apply to the 
Aetna plan, which is offered in New York State.

As always, please do not hesitate to contact me if I can be of any 
assistance to you or your organization.


Chris Zic
Executive Director


From: "National Writers Union" <nwu@nwu.org>
Subject: NWU's UniCare Health Coverage

TO: NWU Unicare Members
FROM: Jonathan Tasini
RE: NWU's UniCare Health Coverage

Last summer, there was good news on the health insurance
front: UniCare offered us a national plan, with coverage
available to all NWU members, except those in New York
State. Now, just a few months later, we regret to report
that things are not going as well as we'd hoped.

In December, UniCare contacted us to say it was dissatisfied
with the rate at which NWU members were using their
health benefits, asserting that they were paying out
in claims approximately twice the amount they were
collecting in premiums. They proposed some radical
changes in the plan. NWU insisted that UniCare provide
us with the data documenting claims experience before
we would begin renegotiating our contract.

Several weeks went by with no word from UniCare, and
then, just after Christmas, we received a letter notifying
us that UniCare would cancel our policy early - on
March 1, 2003 - on grounds that NWU had failed to meet
a contractual obligation to enroll 75% of "employees"
in the plan.

Against this backdrop, here's what has happened since

* First, there is no 75% enrollment requirement in
the NWU contract. This requirement was identified as
unsuitable by our attorney, Lowell
Peterson, at the time of the initial negotiations,
and the UniCare
contract was amended to eliminate this requirement
and to strike every reference to "employees", since
NWU has no employees. Thus, our position is that UniCare
cannot legally use this tactic to cancel us.

* Mr. Peterson sent an express letter to UniCare stating
this position and threatening legal action. Although
he had hoped that UniCare's cancellation notice was
a ploy to get us to the bargaining table, our arguments
were rejected by them.

* Currently, our attorney is drafting legal documents
to file for an injunction to prevent UniCare from cancelling
us on March 1. He believes we have a strong case, and
is hopeful that we will secure the injunction. He is
also hopeful that UniCare will, in fact, be willing
to negotiate further.

* UniCare provided the experience data to us last week.
We have provided these data to CSS, our health care
consultants, Segal & Company, and to representatives
of the UAW Social Security Department. They are analyzing
the data, so that we are prepared with the strongest
case possible - either to renegotiate with UniCare
or to secure insurance with a new carrier.

* CSS is already seeking proposals for new insurance
coverage, and both the Segal consultants and the UAW
experts are advising us as to how to proceed and how
to make our group as attractive as possible to
prospective carriers. It's worth noting that the Segal
consultants seem to believe that there are other carriers
out there who might be willing to undertake an NWU

* What do you need to do right now? Don't panic. There's
no need to call CSS because all the information we
have is contained in this memo and CSS is focused on
obtaining new coverage. Continue to pay your UniCare
premiums so that your coverage remain in force. We
will provide you with immediate updates on the progress
of our legal strategy, any negotiations with UniCare
and any progress we make in negotiating new insurance.

Thank you.

Jonathan Tasini