Summer 2007
Together with our employers and the Union, we’re addressing the needs of the healthcare workforce – which helps us meet our shared goal of providing quality patient care. IN THIS ISSUE . . .
1199SEIU Family of Funds 330 West 42nd Street New York, NY 10036-6977
First Class U.S. Postage PAID New York, NY Permit No. 3700
LETTER FROM THE EXECUTIVE DIRECTORS No one understands the pressures of rising healthcare costs like those of you at the center of the industry. As many of you may know, the Union and its Greater New York employers recently agreed to re-open the current contract to address the funding shortfalls in the Benefit Fund. You’ll read about the challenges that the Benefit Fund faces in providing highquality, low-cost health coverage in this issue of 1199SEIU Greater New York Employer News, as well as how the Fund is responding to the industry’s concerns about controlling rising healthcare costs with a new series of cost-savings programs. These new initiatives, which begin October 1, will build on the Fund’s earlier cost-containment successes and at the same time ensure the continued quality of care that your employees receive. This edition also includes news about other ways that our Funds are strengthening the workforce and the nursing home industry. We continue to respond to the industry’s needs through services like the Training and
New Cross-Funds Website Improves Service to You . . . . . . . . . . 2
Employment Funds’ program to upgrade home care workers to fill shortage
Bridging the Funding Gap. . . . . . . . . 3
reimbursement program that offers working parents flexible support to
In the Face of Rising Healthcare Costs, New Cost Savings Initiatives Will Save Dollars . . . . . . . . . . . . . . . 4
positions in contributing facilities, and the Child Care Fund’s voucher balance work and family responsibilities. Together with our employers and the Union, we’re addressing the needs
New Program Initiatives Ensure Quality Care While Keeping Expenses Low . . . . . . . . . . . . . . . . . 5
of the healthcare workforce – which helps us meet our shared goal of
Training and Employment Funds Upgrade Home Care Workers to Fill Critical Positions . . . . . . . . . . 6
Sincerely,
Voucher Program’s Flexible, Affordable Childcare Options Benefit Workers, Families and Employers . . . . . . . . . . . 7
providing quality patient care.
Mitra Behroozi Executive Director Benefit and Pension Funds
Deborah King Executive Director Training and Employment Funds
Vivian Fox Executive Director Child Care Funds
N E W C R O S S - F U N D S W E B S I T E I M P R O V E S S E R V I C E TO YO U
www.1199SEIUFunds.org Provides One-Stop Shopping for Employers, Members and Providers This July, the 1199SEIU Family of Funds is launching a new cross-funds website for members, employers and providers to access information about the full range of benefits that your contributions pay for through the Benefit and Pension, Training and Employment and Child Care Funds.
Similar to the Member Handbook that the Funds created last year, the new site will make it easier for members to understand and use their benefits. By simply entering their facility name into the Member Benefits Finder, your employees will be pointed directly toward the specific benefits that they are eligible for.
Balancing a job and family responsibilities is a challenge for any working parent. For nursing home workers who often work irregular shifts, finding quality, dependable childcare can be particularly stressful – and that can translate to higher absence rates and even affect patient care.
Besides making it easier for your employees to find information about the benefits your contributions support, the site also includes a special section for employers. Employers can use this area to download reporting and enrollment forms, find important benefit news and contact Fund representatives with any questions. In the coming months, the site will also have enhanced functionality to allow you to submit forms, reports and other information directly online.
To address this need, the 1199SEIU Child Care Fund offers a voucher program that provides members with full or partial reimbursement for childcare expenses. The vouchers are based on a sliding scale that takes into account members’ income, as well as the number of children in a family and the type of childcare they are receiving. In the years that the voucher program has been offered, it has rapidly become the Fund’s most popular and most frequently requested childcare benefit.
Starting this July, log on to www.1199SEIUFunds.org for any questions about your employees’ health, pension, training and childcare benefits – all in one, easy on-line location. 2 EMPLOYER NEWS Summer 2007
Voucher Program’s Flexible, Affordable Childcare Options Benefit Workers, Families and Employers
The flexibility of the voucher program makes it a unique service tailored to 1199SEIU members. For instance, members can either choose licensed day care providers on their own, or receive vouchers to cover the cost of babysitting services by a relative, friend or neighbor. For the youngest children, newborn to five years old, parents can apply for a “Day Care” voucher that covers costs for full-time care. Members with school-aged children between six and 12 can choose an “After School” voucher, which can be used for part-time care either before or after the school day, depending on the parents’ needs and work schedule. For children and youth from three
to 17, a “Summer Day Camp” voucher is available that covers an eight-week period during the summer. There are also special vouchers for parents of children with documented special needs. Thanks to this flexible resource, working parents can feel confident that their children are getting the care they need, freeing workers to in turn provide quality care to their patients. Summer 2007 EMPLOYER NEWS 7
Training and Employment Funds Upgrade Home Care Workers to Fill Critical Positions in Participating Institutions
Bridging the Funding Gap Although the Benefit Fund’s sound, efficient management and cost-savings programs have kept cost increases below the national average, the Fund still purchases healthcare services in the same economic environment as commercial
In response to the industry’s staffing needs, the
To request a placement in your facility or for
Training and Employment Funds have created a
more information, contact Faith Wiggins,
specialized program focused on training and
Director of the Bill Michelson Home Care
upgrading home care workers to fill Certified
Education Fund, at (212) 494-0507.
plans. Even keeping a tight rein on costs, the Fund’s costs of providing health coverage have increased significantly. At the same time, employer contributions have not kept pace.
Nursing Assistant and Patient Care Associate positions in participating nursing homes and hospitals. With $300,000 in support from the Robin Hood Foundation, the Funds are currently working to place 100 home care workers. This summer, the Funds will evaluate the program to
Drawing from the home care workforce to meet the
make recommendations for expanding it further. Drawing from the home care workforce to meet the needs of nursing homes and hospitals makes sense. Many of the home care workers in the program are immigrants who were either nurses or medical technicians in their own countries,
needs of nursing homes and hospitals makes sense. Many of the home care
with experience and skills that will be an asset to the field. And since 90% of the participants already speak a variety of languages including Mandarin, Cantonese, French Creole, Russian, Polish and Spanish, these workers will be a valuable resource for providing thorough, quality care to
workers in the program are immigrants who were either
New York City’s diverse patient population.
nurses or medical technicians
To best meet the needs of employers, the Funds
in their own countries, with
are working one-on-one with the participants to ensure that each receives a comprehensive pre-training assessment and an orientation from the 1199SEIU Employment Center staff. And working with the institutions, each training program is customized to meet the specific employment
requirements
of
and clinical placements so that employers can 6 EMPLOYER NEWS Summer 2007
be an asset to the field.
Although the Benefit Fund’s sound, efficient management and cost-savings programs have kept cost increases below the national average, the Fund still purchases healthcare services in the same economic environment as commercial plans. Even keeping a tight rein on costs, the Fund’s costs of providing health coverage have increased significantly. At the same time, employer contributions have not kept pace. Keenly aware of this growing problem, the Union and the employer’s association have sought creative solutions over the past few years. In fact, in 2006, the Union succeeded in winning $52 million in funding from the New York State Legislature to support benefits for nursing home employees covered through the Greater New York Benefit Fund. The funding was supposed to cover the cost of benefits through the end of the current contract in April 2008.
interested
employers. Funds can set up on-site internships screen participants on the job.
experience and skills that will
At the time of this writing, the Union and Greater New York employers are in negotiations to find both short and long-term solution to fund benefits for members in the face of a growing deficit in the Greater New York Benefit Fund.
However, not only was the funding delayed for many months, but in the end the Fund only received half of the funding from the
state. This amount falls far short of the total needed to pay for benefits for nursing home employees at current levels. On average, the Fund pays $12 million each month for coverage for these workers, but receives only $10 million in employer contributions. Up to now, the Fund has managed to continue to provide quality benefits to nursing home members while awaiting the committed funds from the state. But during that time, the Fund has been accruing a significant deficit that will virtually equal the amount not received from the state, and cannot continue to carry this financial responsibility. As it stands now, the Benefit Fund's Actuaries are predicting that contribution rates will need to increase to 28% or more to sustain the benefit package over the next three years. In the meantime, given the existing funding gap and the need to contain costs in other Benefit Funds, the Trustee Cost-Containment Committee – comprised of representatives from the Greater New York Benefit Fund, National Benefit Fund and Home Care Benefit Fund – developed a series of new cost-savings programs. These programs were recently adopted in the National Benefit Fund, and the Greater New York Health Care Facilities Association and the Union have asked the Greater New York Benefit Fund to adopt these programs as well. Summer 2007 EMPLOYER NEWS 3
In the Face of Rising Healthcare Costs, New Cost Savings Initiatives Will Save Critical Dollars:
New Program Initiatives Ensure Quality Care While Keeping Expenses Low
Programs Begin October 1 The skyrocketing costs of healthcare are unrelenting – and no one knows that better than the industry’s employers. In fact, costs for employer-sponsored coverage have risen a startling 87% since 2000, and are projected to increase by another 53% between 2006 and 2010. Caught in the eye of this storm are many of the nation’s employers, who simply can’t afford the health coverage for employees that commercial, for-profit insurers offer. But 1199SEIU employers have the benefit of the Fund’s cost-efficient model, which provides the best value for your contributions. As a not-for-profit welfare fund with sound fiscal management, the Fund spends more than 93 cents of every contributed dollar directly on benefits. In contrast, the five biggest commercial insurers – UnitedHealth Group, Wellpoint, Aetna, Cigna and Humana – spend only an average of 73 cents of each dollar on health coverage, with the rest going toward marketing, advertising and profits. While healthcare premiums alone can cost $11,765 per year or more, the Fund provides a comprehensive benefit package to your employees for only $6,536 per member. Even if a similar package of benefits was available from a commercial insurer, it could cost up to $25,000. But even with these efficiencies, the Fund is grappling with rising healthcare costs – just like insurers and employers nationwide. Though the Funds’ costs have risen more slowly than the national average – 68% compared to 87% – they continue to escalate. 4 EMPLOYER NEWS Summer 2007
The Greater New York Benefit Fund’s costs have risen more slowly than
To hold the line on costs, the 1199SEIU Benefit Funds will build on the successful cost-containment initiatives. These new programs, developed with the Cost-Containment Committee of Trustees, will go into effect October 1. They include:
the national average – 68% compared to 87% National Average Costs
GNY Fund’s Costs
Revised Preferred Drug List and Generic Programs To hold down prescription drug costs, the Fund’s clinicians are working with Medco to further develop the Preferred Drug List, which will include more generic drug options and higher discounts on key preferred brands.
authorization on some additional services such as podiatric surgery. Prior authorization is also being considered for certain high-end imaging tests. This month, the Fund begins its education of members and providers on the programs through an extensive communications campaign.
Expanded Wellness Program
87% 68%
Percentage Increases from 2000 – 2006
Sources: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006; Bureau of Labor Statistics; LRA Consulting
The Fund will also expand its Wellness Program by contracting with Health Dialog, a comprehensive disease management program that will provide wellness support, including a 24-hour nurse hotline and oneon-one health coaching for members with chronic conditions. The health coaching is expected to help members keep their diseases under control, reducing significant acute medical costs that occur when conditions are left unmanaged.
Enhanced Prior Authorization The Fund is evaluating services that require prior authorization to ensure that members receive the most appropriate care from the most appropriate providers, and requiring prior Summer 2007 EMPLOYER NEWS 5
In the Face of Rising Healthcare Costs, New Cost Savings Initiatives Will Save Critical Dollars:
New Program Initiatives Ensure Quality Care While Keeping Expenses Low
Programs Begin October 1 The skyrocketing costs of healthcare are unrelenting – and no one knows that better than the industry’s employers. In fact, costs for employer-sponsored coverage have risen a startling 87% since 2000, and are projected to increase by another 53% between 2006 and 2010. Caught in the eye of this storm are many of the nation’s employers, who simply can’t afford the health coverage for employees that commercial, for-profit insurers offer. But 1199SEIU employers have the benefit of the Fund’s cost-efficient model, which provides the best value for your contributions. As a not-for-profit welfare fund with sound fiscal management, the Fund spends more than 93 cents of every contributed dollar directly on benefits. In contrast, the five biggest commercial insurers – UnitedHealth Group, Wellpoint, Aetna, Cigna and Humana – spend only an average of 73 cents of each dollar on health coverage, with the rest going toward marketing, advertising and profits. While healthcare premiums alone can cost $11,765 per year or more, the Fund provides a comprehensive benefit package to your employees for only $6,536 per member. Even if a similar package of benefits was available from a commercial insurer, it could cost up to $25,000. But even with these efficiencies, the Fund is grappling with rising healthcare costs – just like insurers and employers nationwide. Though the Funds’ costs have risen more slowly than the national average – 68% compared to 87% – they continue to escalate. 4 EMPLOYER NEWS Summer 2007
The Greater New York Benefit Fund’s costs have risen more slowly than
To hold the line on costs, the 1199SEIU Benefit Funds will build on the successful cost-containment initiatives. These new programs, developed with the Cost-Containment Committee of Trustees, will go into effect October 1. They include:
the national average – 68% compared to 87% National Average Costs
GNY Fund’s Costs
Revised Preferred Drug List and Generic Programs To hold down prescription drug costs, the Fund’s clinicians are working with Medco to further develop the Preferred Drug List, which will include more generic drug options and higher discounts on key preferred brands.
authorization on some additional services such as podiatric surgery. Prior authorization is also being considered for certain high-end imaging tests. This month, the Fund begins its education of members and providers on the programs through an extensive communications campaign.
Expanded Wellness Program
87% 68%
Percentage Increases from 2000 – 2006
Sources: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006; Bureau of Labor Statistics; LRA Consulting
The Fund will also expand its Wellness Program by contracting with Health Dialog, a comprehensive disease management program that will provide wellness support, including a 24-hour nurse hotline and oneon-one health coaching for members with chronic conditions. The health coaching is expected to help members keep their diseases under control, reducing significant acute medical costs that occur when conditions are left unmanaged.
Enhanced Prior Authorization The Fund is evaluating services that require prior authorization to ensure that members receive the most appropriate care from the most appropriate providers, and requiring prior Summer 2007 EMPLOYER NEWS 5
Training and Employment Funds Upgrade Home Care Workers to Fill Critical Positions in Participating Institutions
Bridging the Funding Gap Although the Benefit Fund’s sound, efficient management and cost-savings programs have kept cost increases below the national average, the Fund still purchases healthcare services in the same economic environment as commercial
In response to the industry’s staffing needs, the
To request a placement in your facility or for
Training and Employment Funds have created a
more information, contact Faith Wiggins,
specialized program focused on training and
Director of the Bill Michelson Home Care
upgrading home care workers to fill Certified
Education Fund, at (212) 494-0507.
plans. Even keeping a tight rein on costs, the Fund’s costs of providing health coverage have increased significantly. At the same time, employer contributions have not kept pace.
Nursing Assistant and Patient Care Associate positions in participating nursing homes and hospitals. With $300,000 in support from the Robin Hood Foundation, the Funds are currently working to place 100 home care workers. This summer, the Funds will evaluate the program to
Drawing from the home care workforce to meet the
make recommendations for expanding it further. Drawing from the home care workforce to meet the needs of nursing homes and hospitals makes sense. Many of the home care workers in the program are immigrants who were either nurses or medical technicians in their own countries,
needs of nursing homes and hospitals makes sense. Many of the home care
with experience and skills that will be an asset to the field. And since 90% of the participants already speak a variety of languages including Mandarin, Cantonese, French Creole, Russian, Polish and Spanish, these workers will be a valuable resource for providing thorough, quality care to
workers in the program are immigrants who were either
New York City’s diverse patient population.
nurses or medical technicians
To best meet the needs of employers, the Funds
in their own countries, with
are working one-on-one with the participants to ensure that each receives a comprehensive pre-training assessment and an orientation from the 1199SEIU Employment Center staff. And working with the institutions, each training program is customized to meet the specific employment
requirements
of
and clinical placements so that employers can 6 EMPLOYER NEWS Summer 2007
be an asset to the field.
Although the Benefit Fund’s sound, efficient management and cost-savings programs have kept cost increases below the national average, the Fund still purchases healthcare services in the same economic environment as commercial plans. Even keeping a tight rein on costs, the Fund’s costs of providing health coverage have increased significantly. At the same time, employer contributions have not kept pace. Keenly aware of this growing problem, the Union and the employer’s association have sought creative solutions over the past few years. In fact, in 2006, the Union succeeded in winning $52 million in funding from the New York State Legislature to support benefits for nursing home employees covered through the Greater New York Benefit Fund. The funding was supposed to cover the cost of benefits through the end of the current contract in April 2008.
interested
employers. Funds can set up on-site internships screen participants on the job.
experience and skills that will
At the time of this writing, the Union and Greater New York employers are in negotiations to find both short and long-term solution to fund benefits for members in the face of a growing deficit in the Greater New York Benefit Fund.
However, not only was the funding delayed for many months, but in the end the Fund only received half of the funding from the
state. This amount falls far short of the total needed to pay for benefits for nursing home employees at current levels. On average, the Fund pays $12 million each month for coverage for these workers, but receives only $10 million in employer contributions. Up to now, the Fund has managed to continue to provide quality benefits to nursing home members while awaiting the committed funds from the state. But during that time, the Fund has been accruing a significant deficit that will virtually equal the amount not received from the state, and cannot continue to carry this financial responsibility. As it stands now, the Benefit Fund's Actuaries are predicting that contribution rates will need to increase to 28% or more to sustain the benefit package over the next three years. In the meantime, given the existing funding gap and the need to contain costs in other Benefit Funds, the Trustee Cost-Containment Committee – comprised of representatives from the Greater New York Benefit Fund, National Benefit Fund and Home Care Benefit Fund – developed a series of new cost-savings programs. These programs were recently adopted in the National Benefit Fund, and the Greater New York Health Care Facilities Association and the Union have asked the Greater New York Benefit Fund to adopt these programs as well. Summer 2007 EMPLOYER NEWS 3
N E W C R O S S - F U N D S W E B S I T E I M P R O V E S S E R V I C E TO YO U
www.1199SEIUFunds.org Provides One-Stop Shopping for Employers, Members and Providers This July, the 1199SEIU Family of Funds is launching a new cross-funds website for members, employers and providers to access information about the full range of benefits that your contributions pay for through the Benefit and Pension, Training and Employment and Child Care Funds.
Similar to the Member Handbook that the Funds created last year, the new site will make it easier for members to understand and use their benefits. By simply entering their facility name into the Member Benefits Finder, your employees will be pointed directly toward the specific benefits that they are eligible for.
Balancing a job and family responsibilities is a challenge for any working parent. For nursing home workers who often work irregular shifts, finding quality, dependable childcare can be particularly stressful – and that can translate to higher absence rates and even affect patient care.
Besides making it easier for your employees to find information about the benefits your contributions support, the site also includes a special section for employers. Employers can use this area to download reporting and enrollment forms, find important benefit news and contact Fund representatives with any questions. In the coming months, the site will also have enhanced functionality to allow you to submit forms, reports and other information directly online.
To address this need, the 1199SEIU Child Care Fund offers a voucher program that provides members with full or partial reimbursement for childcare expenses. The vouchers are based on a sliding scale that takes into account members’ income, as well as the number of children in a family and the type of childcare they are receiving. In the years that the voucher program has been offered, it has rapidly become the Fund’s most popular and most frequently requested childcare benefit.
Starting this July, log on to www.1199SEIUFunds.org for any questions about your employees’ health, pension, training and childcare benefits – all in one, easy on-line location. 2 EMPLOYER NEWS Summer 2007
Voucher Program’s Flexible, Affordable Childcare Options Benefit Workers, Families and Employers
The flexibility of the voucher program makes it a unique service tailored to 1199SEIU members. For instance, members can either choose licensed day care providers on their own, or receive vouchers to cover the cost of babysitting services by a relative, friend or neighbor. For the youngest children, newborn to five years old, parents can apply for a “Day Care” voucher that covers costs for full-time care. Members with school-aged children between six and 12 can choose an “After School” voucher, which can be used for part-time care either before or after the school day, depending on the parents’ needs and work schedule. For children and youth from three
to 17, a “Summer Day Camp” voucher is available that covers an eight-week period during the summer. There are also special vouchers for parents of children with documented special needs. Thanks to this flexible resource, working parents can feel confident that their children are getting the care they need, freeing workers to in turn provide quality care to their patients. Summer 2007 EMPLOYER NEWS 7
Summer 2007
Together with our employers and the Union, we’re addressing the needs of the healthcare workforce – which helps us meet our shared goal of providing quality patient care. IN THIS ISSUE . . .
1199SEIU Family of Funds 330 West 42nd Street New York, NY 10036-6977
First Class U.S. Postage PAID New York, NY Permit No. 3700
LETTER FROM THE EXECUTIVE DIRECTORS No one understands the pressures of rising healthcare costs like those of you at the center of the industry. As many of you may know, the Union and its Greater New York employers recently agreed to re-open the current contract to address the funding shortfalls in the Benefit Fund. You’ll read about the challenges that the Benefit Fund faces in providing highquality, low-cost health coverage in this issue of 1199SEIU Greater New York Employer News, as well as how the Fund is responding to the industry’s concerns about controlling rising healthcare costs with a new series of cost-savings programs. These new initiatives, which begin October 1, will build on the Fund’s earlier cost-containment successes and at the same time ensure the continued quality of care that your employees receive. This edition also includes news about other ways that our Funds are strengthening the workforce and the nursing home industry. We continue to respond to the industry’s needs through services like the Training and
New Cross-Funds Website Improves Service to You . . . . . . . . . . 2
Employment Funds’ program to upgrade home care workers to fill shortage
Bridging the Funding Gap. . . . . . . . . 3
reimbursement program that offers working parents flexible support to
In the Face of Rising Healthcare Costs, New Cost Savings Initiatives Will Save Dollars . . . . . . . . . . . . . . . 4
positions in contributing facilities, and the Child Care Fund’s voucher balance work and family responsibilities. Together with our employers and the Union, we’re addressing the needs
New Program Initiatives Ensure Quality Care While Keeping Expenses Low . . . . . . . . . . . . . . . . . 5
of the healthcare workforce – which helps us meet our shared goal of
Training and Employment Funds Upgrade Home Care Workers to Fill Critical Positions . . . . . . . . . . 6
Sincerely,
Voucher Program’s Flexible, Affordable Childcare Options Benefit Workers, Families and Employers . . . . . . . . . . . 7
providing quality patient care.
Mitra Behroozi Executive Director Benefit and Pension Funds
Deborah King Executive Director Training and Employment Funds
Vivian Fox Executive Director Child Care Funds