Insurance During A Strike

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HEALTH INSURANCE  DURING A STRIKE

 

One of the biggest concerns around going on strike will always be “what happens to health care insurance during the strike?”

 

Let’s assume the worst possible scenario :
The District decides to shut off access to health insurance on day 1 of a strike.

 What happens if I go to a medical appointment?

    In most cases patients are billed and have a certain amount of time to pay.  If asked about insurance you can give your insurance card and state that you are on strike. If it’s not an essential medical appointment you should wait until the strike is over.

 

What happens if I try to pick up a prescription at a pharmacy?

    The worst case is that the pharmacy sees that you have no insurance in place and won’t give you a prescription unless you pay the whole cost up front.  For some prescriptions this could be thousands of dollars.  If possible, once a 10 day strike notice is sent then any members should refill prescriptions that can be refilled.  

 

What happens if I am scheduled for a surgery or have some sort of emergency?

    Get it done.  Often when you have major procedures the provider will have you sign off  stating that if the procedure is not paid by insurance that you will be liable for those costs. Don’t be surprised by this, in the end the procedure will be paid.

 

What will happen with medical bills incurred during a strike?

    There are two possibilities:

  1. The Strike is settled: We will not agree to end a strike unless all medical bills incurred during a strike are covered.

  2. The Strike lasts longer than 60 days: This seems unlikely, but we are using the worst case scenario.  In this case if any substantial medical bills are incurred before the 60 day mark, then members should elect to pay for District benefits through COBRA (the Consolidated Omnibus Budget Reconciliation Act).  This is a right of any employee who was earning benefits and lost coverage.  Once a member elects to buy the coverage through COBRA then the member has an ADDITIONAL 45 days to pay the premium.  The coverage is retroactive to the beginning of the lost coverage, so all bills will be paid.  

Under this scenario if the member has medical bills that cost less than the COBRA premium then the member may choose to pay for the coverage out of pocket.

 

What happens to members who are seriously ill and on a leave of absence?

    Members in this category should still be covered under District insurance  They are not on strike.  They need to take care of themselves and not be concerned with any disruption in coverage.

 

What happens to members who are pregnant?

    Babies will be born and prenatal appointments will happen.  If the member is not on a leave of absence then the same advice above applies.  No one is going to keep your baby from leaving the hospital if you don’t pay the bill.  You will have time to elect COBRA if that is what is required.  It is more likely that the strike will be settled and all bills will be covered under our health plan.

 

Letter from one of our members about getting insurance from the Marketplace

I get that most of you have had employer benefits for a long time and have no idea what other healthcare options are available. When I was working part-time for parental job-sharing I couldn’t pay for district healthcare.  Because the district doesn’t offer the same rates to part-time employees I was eligible for Marketplace.  

Marketplace is a place you purchase health care.  No, you don’t need to run out and get it on Dec 2nd.  With my health issues, I am still choosing to “go without” for a while and see how long this goes on.  If I need to, I will hop on and purchase some.  It is nowhere near as expensive as COBRA.  Is the coverage different? Yes. But you can choose what coverage you want.  You can pay more to have more covered or you can pay less. 
 
When I purchased it, I chose to pay less. Did I have medical bills? Yes. However for both my daughter and I, and they were less than 3k in over two years' time, and I could use my HSA  to pay it.  That includes ER trips and a CT scan. 
 
I get it. Change is scary. But not having your district coverage for just a little while is truly far less scary than it’s being made out to be because it’s an unknown. You have 60 days to sign up because the loss of coverage is a qualifying event.  Please stop panicking over “what if I get COVID?”  If you think you’re sick, hop on the computer and purchase coverage or COBRA if you prefer.  
 
For those of you who like me, deal with chronic and serious health issues, I get it. Trust me.  I am in no way making light of the fact that this makes you feel very scared.  That was the point.  If you would like to reach out, please do.  Spend this time enjoying your family and not worrying about the “what if”. What if we all stick together and everything is okay? That could work too.

 

IMPORTANT HEALTH INSURANCE UPDATE - COBRA AND COVID-19

The impact of the COVID-19 pandemic on employees throughout the nation has resulted in changes in the COBRA election time frame.  

Last May, the Department of Labor and the IRS extended the deadlines on employees for electing health insurance under COBRA which is defined as an “Outbreak Period” due to this national emergency. This extension period began on March 1, 2020 and is set to end January 21, 2021, so with the 60 day election period, our members can wait until May, 2021 to elect COBRA.

If members elect COBRA any time during this period, they would be responsible for premiums retroactive to the date they lost coverage.     

Two items to keep in mind:

  • Members can keep track and add up their claims before deciding if it’s cost effective to elect COBRA..

  • Our present Union position is that we will not agree to a settlement unless all insurance claims that occurred during the strike are covered.