From: Arthur G. Steinberg, Chief Trustee – Health & Welfare Fund
Subject: PFT 2017 Contract Health Care Summary
Summary: The new PFT Contract successfully resisted the District’s attempts to drastically slash benefits.
The level and scope of coverage for members remains the same. The new Contract undoes most of the School District’s coverage changes and demands.
The School District demanded that members give up their Plan coverage. The District demanded that members pay 13% of the ever increasing Plan premium costs. The District demanded huge service co-pays. (District demanded members pay 10 percent for many services and procedures.Example: District demanded members pay roughly $900 out of pocket for an MRI.) The School District won none of these demands.
With the new Contract, members will pay only 1.25% (1.5% 2019) of their salaries towards health care, saving members thousands of dollars in District-demanded premium payments.
Health Plan – Same Plan (With minor modifications) – Members and families keep top-level care with increase in medical Co-pays limited to $5 for physician visits.
| School District Health Plan Co-Pay Demand | Ratified Contract Health Plan Benefit Costs |
|---|---|
| In-Network Deductible | NO Deductible |
| 10 percent of cost for hospital stay (Including maternity, facility fee[s], physician charges, etc.) | $0 Out-of-pocket |
| 10 percent of cost for out-patient X-Ray Radiology (Example: MRI: estimated out-of-pocket cost - $900.00 | $0 Out-of-pocket Keystone $30 Personal Choice |
| 10 percent of cost for Chemotherapy, Radiation, Dialysis, etc. | $0 Out-of-pocket |
| Urgent Care visit - $100 | Same cost as Specialist visit: $30 Keystone - $35 Personal Choice |
| 10 percent of cost for Self-injected Drugs | $0 Out-of-pocket |
| 10 percent of cost for Durable Medical Equipment | $0 Out-of-pocket Keystone $30 Personal Choice |
| 10 percent of cost for Inpatient Mental Health Care/ Substance Abuse Detox/etc. | $0 Out-of-pocket |
| Supplemental Benefits (Prescription,* Dental and Vision) cancelled | Benefits remain intact with Health & Welfare Fund control |
Conclusion: Health Care and Supplemental Benefits coverage remain superior with minimal cost to members.