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Home » Clarion » 2013 » August 2013 » ‘Audit’ of Dependent Coverage

‘Audit’ of Dependent Coverage

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The City of New York, which administers the health insurance program that covers full-time CUNY faculty, staff and retirees, has begun an “audit” of dependents on City health insurance. The announced purpose of the audit is to determine whether dependents covered under the City health insurance plan are in fact eligible for coverage. If you have a spouse, child or other dependent covered under the City health plan, you should have received correspondence from the City about the audit. This article describes what the City is doing, and how municipal unions have responded to date.

Focus on Dependents

The audit is not on behalf of or approved by PSC or any other municipal union; it is a NYC initiative. The City says its goal is to determine whether dependents receiving health coverage are legitimately entitled to be covered, and it has hired a for-profit consulting company, Aon Hewitt, to conduct the audit.

As described below, the specific procedures used for the audit are being challenged in court by a coalition of NYC worker unions, including the PSC. But do not ignore the audit. The City has said it will cut off coverage for any dependents for whom no response is received by September 20 –so it is very important to pay attention to any letters you receive, and keep yourself informed.

On June 3, the City’s Office of Labor Relations (OLR) sent a letter to all current employees and retirees who have a spouse, child, or other dependent covered under their City health insurance plan. The letter asks those who receive it to prepare to submit documentation of the eligibility of their dependent(s). (If you do not have dependents covered on your health plan, you should not have been sent the letter. Retirees over 80 years old should not have been sent the letter, either. (Adjuncts with family coverage through the PSC-CUNY Welfare Fund should also not have been sent the letter, since their coverage is not through the City’s plan.)

The NYC OLR sent a second letter in June to those with covered dependents, specifying the documents to submit for each dependent. The second letter stated that the eligibility of dependents needs to be verified by September 20, 2013, to avoid their being removed from coverage. Recipients were given instructions about how to submit copies of the required documents by mail, by fax or by scanning and e-mailing them. (Anyone responding to the audit must never send in your original documents. They will not be returned.) The City’s letters directed employees and retirees to a website for instructions on how to comply with the audit, and a phone number for questions.

Legal Challenge

The Municipal Labor Committee (MLC), a coalition of NYC’s public-worker unions that includes the PSC, filed a legal challenge to the way NYC is conducting the audit. “We’re not against the survey, we want some rules,” MLC Chair Harry Nespoli told the Daily News. The lawsuit says that the City’s unilateral implementation of the audit, without negotiating the procedures with the MLC, is illegal under NYC collective bargaining law. The City unions are primarily seeking to assure 1) that employees are held harmless for any prior discrepancies; 2) that personal security and privacy are protected; and 3) that efficient, timely appeals procedures are in place.

A lower court judge granted the unions a restraining order in July. “This stops the City from proceeding…until the court can consider if a longer injunction is also appropriate,” said an MLC statement on July 18. The City has appealed the restraining order, and the final outcome is not yet known.

The PSC will keep members informed of further developments. But if the audit proceeds as planned by New York City, the consequences of ignoring the letter or failing to produce the necessary documents would be serious. Dependents for whom the required information is not supplied risk losing their health coverage.

Making Copies

So it’s important to pay attention to any letters you receive about the City’s plans for the audit. Members should prepare to submit all requested documentation in the event that successful terms are negotiated or the restraining order is lifted. CUNY employees who receive a letter should therefore compile and make copies of the necessary documents now. It will be important to have copies available because, again, you must not send original documents – they will not be returned to you.

The union will continue to monitor the conduct of the audit aggressively and to work with other unions for guarantees of fair procedure, PSC leaders said. “While the need for accurate health insurance coverage information is obvious, the rights of members must also be protected,” said PSC President Barbara Bowen. The union, she said, will keep bargaining unit members informed.


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