Union intervention overturns surprise health insurance cost spike

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VALHALLA — In non-union workplaces, employees grappling with unexpected health care costs usually have no choice but to foot the bill.

Thanks to our union, when management blindsided Westchester Medical Center Unit members with higher out-of-pocket costs, we were able to get justice.

“Without a union, we wouldn’t have been able to fight this,” said Westchester Medical Center Unit President Susan Fontana. “We wouldn’t have had legal assistance like we did with CSEA. We would have had to fight individually and pay attorneys, case by case. We realized we were dealing with something that affects every single member, so having our union behind us made the difference.”

Benefit of a contract
With health insurance provisions spelled out in our union contract with the hospital, Fontana filed a class-action grievance when she realized management was violating a part of the contract stating that any CSEA member would pay no more than a 5 percent increase in costs following agreed upon changes to their health insurance plan design. The only exception was if members used Westchester Medical Center facilities for treatment.

That violation quickly hit our members in the wallet. Unit Treasurer Jim Mazzella was one of a number of members forced to dig into their pockets to pay unexpected out-of-pocket costs.

Mazzella went to a nearby hospital for outpatient knee surgery. Before the plan changes, he would have paid a $15 co-payment. Instead, he was told to shell out $272.87.

“I got calls constantly,” Fontana said. “When you see doctors or go to urgent care, they want the co-payment upfront, so this was costing people a lot of money. Imagine you have a couple of kids who are sick in the middle of winter and need to go to urgent care? That’s a serious expense.”

The case ultimately went to arbitration, at which CSEA regional attorney Nathaniel Charny argued that the unit’s contract language was clear and that CSEA members were being forced to pay far more than a 5 percent increase in costs.

The arbitrator ruled in our union’s favor, ordering hospital management to reimburse members for the costs incurred.

Sticking together
It was roughly a year from the time Fontana filed the grievance that the arbitrator’s decision arrived. Now, Fontana and her officers are working with CSEA staff and Charny to ensure members are reimbursed and the arbitrator’s decision is honored.

While members could have avoided the out-of-pocket costs by using Westchester Medical Center facilities and doctors, Fontana said members want the freedom to choose their health care providers.

“We should have a choice,” Fontana said. “There are some services that aren’t offered here, such as urgent care.

Some people want a little more privacy, and they feel more comfortable going somewhere other than their own workplace for medical care.”

Thanks to our union, members will retain that freedom.

— Jessica Ladlee

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About Author

Jessica Ladlee

Jessica Ladlee is the communications specialist for CSEA's Southern Region. A graduate of Boston University, Ladlee is an award-winning journalist who worked as a newspaper editor before joining the CSEA communications team in 2004. She is passionate about the opportunities unions provide for people to join the middle class, something her grandmother did as a Rockland County CSEA member over 50 years ago.

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