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FRESNO UNIFIED RETIREES ASSOCIATION
Notice from the Department of Managed Health Care
The California Department of Managed Health Care (DMHC) is responsible for regulating health care service plans and specialized plans such as vision service plans. If you have a grievance against your vision service plan, you should first telephone your vision service plan at 800.877.7195 and use your vision service plan’s grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your vision service plan or a grievance that has remained unresolved for more than thirty (30) days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for an IMR, the IMR process will provide an impartial review of medical decisions made by a vision service plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature, and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number (1-888-466-2219) and a TDD line (1877-688-9891) for the hearing and speech impaired. The department’s Internet Web site http://www.Healthhelp.ca.qov has complaint forms, IMR application forms and instructions online.
P.O. Box 1717
Clovis, CA 93613
There is going to be a set of ratification meetings from July 11 to July 19 for the FTA board to answer questions about the tentative FTA/FUSD agreement. It would be a good idea for FURA membership to have a presence there to express our challenge to this tentative agreement. At least some of the FTA membership could see what impact it will have on retirees and eventually some of them as they approach retirement. It could change votes. Press coverage is a possibility.
July 11 — CTA office (In the same parking lot as the Barstow branch of EECU) at 4pm
July 13 — Roosevelt HS (probably the library) at 10am
July 19 — Fresno HS library at 4pm
Key issues to address
- Document RETIREE HEALTH BENEFITS we signed at retirement states “No monthly premiums required after age 57 ½ for medical only.” There is no reference to the Plan Document.
- Many retirees made their decision to retire based on this medical insurance guarantee.
- The proposed differentiation between post and pre-65 retirees is nothing less than age discrimination. Retirees are already required, by the Plan under which we retired, to apply and join Medicare parts A and B at 65.
- Neither FTA nor FUSD contacted all affected retirees for input into this agreement.
- FTA is not a contracted bargaining unit for retirees. We do not pay dues. We cannot vote. As they do not have the power to increase our retirement allotment, they also do not have the power to bargain away a legally binding promise. FURA has retained counsel to address this issue.
- Retirees are not represented on the proposed Joint Health Management Board as proposed in the tentative agreement (pick a copy of the tentative agreement at the FTA office).
- Retirees are on a fixed income. Their lifestyle is based on some degree of constancy in monthly income and outgo. The proposed agreement indicates that if the Health Fund initial allocation is under-funded (employees and retirees have more health costs than budgeted) our monthly premiums, co-pays and/or deductibles will increase to pay for this shortfall. This increase could be catastrophic for some retirees.
- Retirees should not be a pawn in an attempt to show that these changes in our benefit package will make the district more solvent. It will also make each retiree less solvent.