"Unions seek court OK in health insurance case." February 04, 2009. NYSUT: A Union of Professionals. www.nysut.org
NYSUT - A Union of Professionals
  
 

Unions seek court OK in health insurance case

With $350 million at stake, what's next for affected NYSUT members?

 

As New York Teacher went to press, thousands of NYSUT members were awaiting a federal judge's signoff on a $350 million settlement between United Healthcare and subscribers to its popular Empire Plan who were improperly reimbursed for using out-of-network providers.

A Feb. 3 hearing was scheduled in U.S. District Court in New York City, three weeks after a settlement was announced in a class-action lawsuit that joined NYSUT with three other New York-based unions accusing United Healthcare of overcharging union subscribers: the Civil Service Employees Association, the Organization of New York State Management/ Confidential Employees and the New York State Police Investigators Association.

An estimated 100,000 NYSUT members in 160 school districts and United University Professions, the NYSUT affiliate at the State University of New York, are subscribers to the Empire Plan, according to NYSUT Executive Vice President Alan Lubin.

The court's preliminary approval would clear the way for dissemination of a notice of settlement, including individual mailings and advertisements, to the affected union members and other subscribers.

Given the size of the class, it will take several months for that step, according to the attorney for the unions, Brian Hufford of Pomerantz Haudek Block Grossman & Gross LLP, the New York City law firm handling the case.

A followup hearing to evaluate claims and allocate money would likely be scheduled in the fall, he said.

The notices will advise subscribers what they will need to file in order to make a claim against the settlement fund for medical services dating back to 1994. Hufford said claims administrators will have access to claims dating back to 2002.

The lawsuit charged that United Healthcare's wholly owned subsidiary, Ingenix, Inc., had skewed data to lower reimbursement rates for out-of-network services provided under the Empire Plan, leaving subscribers with considerably higher deductibles than expected.

State Attorney General Andrew Cuomo has ordered a $50 million overhaul of the databases as part of the settlement. Cuomo's office reports the data had understated the true market rates of medical care by up to 28 percent. A new, independent system, to be run by a university, will determine prevailing costs of medical care in specific regions.

Hufford said NYSUT and the other unions played a key role in the litigation "by sending a strong message — both to the court and to United Healthcare — that they were not going to sit idly by and watch their members be injured through these improper health care practices."

— Liza Frenette