Contract Health Care Summary

From: Arthur G. Steinberg, Chief Trustee – Health & Welfare Fund
Date: July 28, 2017
Subject: PFT 2017 Contract Health Care Summary

With Open Enrollment (August 1 – August 31, 2017) on the immediate horizon, the Health & Welfare Fund, addresses frequently asked post contract ratification questions.

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 remains top-level at minimum costs to members.