Update about health insurance changes
Posted Oct 18, 2024
Thank you to everyone who has reached out with your concerns and questions about the new health insurance provider being rolled out by PeaceHealth across their campuses. We wanted to give you an update on what the union is working on and try to answer any questions you have about what your rights are as a union member at St. Joseph when it comes to health insurance. The union was notified about the new provider the same day all the caregivers were alerted, and since that day we have been working hard to get a better understanding of what this will mean for our members.
Can PeaceHealth just change insurance providers?
Yes, they are allowed to change providers for health insurance any time before the open enrollment period, but in the contract the new healthcare benefits must be "substantially equivalent" to the ones previously offered by UMR (Article 14.1.2). We have received a response to our information request and are looking over the details provided to us so we can see whether the hospital has met that burden. They, of course, assure us that they have, but we would prefer to verify this claim. As you well know, health insurance is incredibly complex so it will take us some time to verify what they have said. If we find the benefits are not equivalent, we can issue a demand to bargain over the changes.
Will Moda cover FCN?
We are still not sure at this time. We have heard reports from nurses who have been told no by FCN, and others that have been told yes. We have asked PeaceHealth directly to confirm or deny whether services from FCN will be covered.
What should members do now?
We strongly advise everyone to carefully examine the plans being offered to see what is the best fit for them and for their family, and participate in open enrollment as you normally would. If you see anything the concerns you, we strongly encourage you to reach out to the contact people for the open enrollment process to discuss your concerns. PeaceHealth needs to know if the changes they are proposing will alienate and potentially harm their staff! PeaceHealth uses self insurance so they have far more control over what is covered and how much it costs than they may appear to. UMR and Moda act as a Third Party Administrator for the health insurance plan, meaning they cover the paperwork and negotiate with providers, but ultimately the decisions of what is offered and who is covered is up to PeaceHealth. As a religious entity, PeaceHealth falls under the purview of the Catholic Church is is thus entitled to exceptions from regulations that other types of facilities have to navigate.
What is the union going to do about it?
We are researching the plans being offered and comparing them to the previous plans to ensure that they offer substantially equivalent benefits, but that process will take a while because there is a lot of data to digest. We will keep everyone updated with our findings as we comb through the documents we've been provided. After the start of the new year, if members are finding that they are receiving benefits below those that were offered previously under UMR, we will have the right to take action, so please keep your union rep and officers updated and gather as much documentation to support your concern as possible. We are also entering into contract negotiations in January so please fill out your negotiation survey if you haven't already to ensure your voice is heard!
We hear your concerns. Please reach out to your local unit officers as well as your nurse rep, Grace Chesterman (gchesterman@wsna.org), with any questions.