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Employment & Labor Law for Public Safety Agencies


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Health Insurance & Benefits

     Because of a city’s dire financial situation, the state of Michigan placed it under the supervision of an emergency manager under the authority of a state statute. The emergency manager, with the approval of the state’s treasurer, issued a series of orders temporarily replacing city retiree health-care benefits with monthly stipend payments that retirees could use to buy individual health-care insurance. The retired employees filed a federal civil rights lawsuit claiming violations of the Contracts Clause of the U.S, Constitution, the Due Process Clause of the Fourteenth Amendment, and the Takings Clause. A federal appeals court rejected these claims, holding that an alleged Contracts Clause violation cannot be the basis for a federal civil rights lawsuit under 42 US.C. Sec. 1983. Further, as the other federal constitutional claims for deprivation of property derived from contract, the court found that a state contract lawsuit would be sufficient to protect any contractual property rights the retirees might have. As the claims failed on their merits, the appeals court found it unnecessary to rule on an asserted Eleventh Amendment immunity defense. Kaminski v. Coulter, #16-1768,  865 F.3d 339 (6th Cir. 2017).

     A retired police officer elected to pay for retiree health coverage through a group plan offered by the city which had employed him. It was administered by Blue Cross. When he turned 65, he was getting medical care for congestive heart failure and severe osteoarthritis of the spine. Blue Cross started denying his claims based on the failure to provide them with a "record of the Medicare payment." He had no Medicare coverage as he had never paid into Medicare and his employee group had not opted to obtain Medicare coverage. He never claimed to have Medicare coverage. The city did start to participate in Medicare, but that was after he retired. The State Employees' Insurance Board determined that his Blue Cross retiree health insurance was the secondary payer to Medicare, even though he had no Medicare. He sued the city, arguing that it had broken an agreement to provide him with lifetime health benefits upon retirement. The Alabama Supreme Court upheld summary judgment for the city. Even if the statements in the employee handbook created an employment agreement, nothing in the handbook could be interpreted as promising health benefits to retirees much less definite vested lifetime benefits. Boman v. City of Gadsden, #1150987, 2016 Ala. Lexis 102.
     Speech-generating devices assist individuals with severe communication impairments by "speaking" typed messages out loud. A federal employee and a group advocating for such individuals sued the federal Office of Personnel Management ("OPM") and its director challenging the agency's approval of health benefits plans for federal employees that exclude or limit insurance coverage of speech-generating devices. The trial court dismissed the lawsuit for lack of standing. A federal appeals court upheld this result. The plaintiff employee failed in the trial court to show that he suffered a traditional financial injury-in-fact caused by the defendant's action, and then attempted on appeal to raise an entirely different theory of injury and standing not presented in the trial court. The appeals court said that it would not address the procedural injury or standing argument since it was not raised before. Huron v. Cobert, #14-5042, 2016 U.S. App. Lexis 788 (D.C.).
     A city tried to terminate a retired employee's health plan coverage and require him to accept Medicare based on the adoption of an ordinance mandating that all retirees had to apply for Medicare when they reached the age of 65. The Louisiana Supreme Court ruled that the city could not do this as the plaintiff had a vested right under his contract with the city to continue to participate in the health plan and he retired before the effective date of the ordinance. His retirement benefits were a form of deferred compensation for the services he gave the city. Born v. City of Slidell, #2015-C-0136, 2015 La. Lexis 2184.
     A police officer responding to an emergency call fell after slipping on ice. He was found to be suffering from significant osteoarthritis in both hips, which was aggravated by the fall. After two hip replacement surgeries, he was awarded a line-of-duty disability pension. The employer sought a court ruling that it was not required to pay for his health insurance premiums under the Illinois Public Safety Employee Benefits Act, 820 ILCS 320/10. The Illinois Supreme Court rejected this argument, upholding rulings from the trial court and an intermediate appeals court. Once a line-of-duty disability pension is awarded, that establishes that an officer suffered a "catastrophic" injury obligating the employer to pay the officer' health insurance premiums. The employer was not entitled to a hearing to satisfy due process requirements, and was not denied due process, as it made the decision not to intervene in the officer's disability pension proceeding or to object to the award of the line-of-duty disability pension. Village of Vernon Hills v. Heelan, 2015 IL 118170, 2015 Ill. Lexis 774.
     A town had adopted the requirements of a state statute under which it had to contribute over 50% of the health insurance premiums of all retired town employees. Before employing the plaintiff, however, the town also adopted a policy under which it only contributed to retirees' group health insurance premiums if an employee retired after at least ten years of service with the town. As a result, the town found the plaintiff ineligible for a contribution to her health insurance premiums when she retired because she had worked for less than ten years. The highest court in Massachusetts found that the state statute governed both whether and in what amounts the town had to contribute to a retiree's health insurance premium, and that the policy requiring a minimum term of service was invalid since it contradicted the statute. Galenski v. Town of Erving, #SJC-11772, 471 Mass. 305, 2015 Mass. Lexis 170.
     Statutory standards for the state of Illinois' contributions to health insurance premiums for members of three of the state's employee retirement systems were constitutionally protected by a pension protection clause of the state Constitution. The Illinois Supreme Court rejected the argument that this protection only applied to retirement annuities while not applying to health insurance.
Kanerva v. Weems, #115811, 2014 IL 115811, 2014 Ill. Lexis 847.
    An Illinois correctional officer's wife suffered from mental health problems relating to opiate dependency. He submitted a Family and Medical Leave Act (FMLA) form seeking leave to take off work intermittently or to work less than a full schedule to care for her, based on recommendations from his wife's psychiatrist, who believe that the need for the leave would continue for an "unknown" period of time. The leave request was approved, and no further medical documentation was asked for, and the employer paid its share of his health insurance costs. After 130 days of absence were recorded, he was told that his FMLA leave had expired, but that he could take up to a year of unpaid leave under a state program, the Illinois Family Responsibility Leave program, but that the state would only contribute to his health insurance cost for six months. After he took 29 absences under that program, a request for two more days off was denied by a warden. He was later notified that the state mistakenly continued to pay for his health insurance beyond the time to which he was entitled, and started withholding 25% of his pay until he had refunded $8,291.83. He sued the state, claiming interference with FMLA rights. A jury returned a verdict in favor of the state. The trial judge, however, entered a judgment notwithstanding the jury's verdict finding that the plaintiff's FMLA leave should have lasted one additional month, and awarding him, therefore $1,222.10 for that one month's medical benefits cost, a ruling the appeals court upheld. Holder v. IL Dep't of Corrs., #12-1456, 2014 U.S. App. Lexis 8431 (7th Cir.).
     An emergency manager appointed by Michigan's governor because of a city's significant economic difficulties made modifications to the collective bargaining agreements of retired city workers and severance benefits, including pension benefits, for retirees not covered by the collective bargaining agreements. These modifications would, among other things, modify or eliminate some retiree health care benefits. Further proceedings were ordered to determine whether provisions of the bankruptcy code could bind the retirees without their consent and whether state sovereignty precluded the application of the federal bankruptcy law in this manner. Also to be considered on remand were whether the emergency manager's orders were legislative acts under the Contract Clause of the U.S. Constitution, and whether it was "necessary and reasonable" under the Contract Clause to reduce and/or eliminate the retiree health care benefits at issue, as well as whether the retirees stated a viable due process claim and whether the collective bargaining agreements created protected property rights. City of Pontiac Retired Emps. Ass'n v. Schimmel, #12-2087, 2014 U.S. App. Lexis 8392, 2014 Fed App. 0094P (6th Cor.).
     A California city put a cap on retired city workers' health benefits after it failed to reach an agreement with the employee union. An intermediate state court rejected a retiree's claim that the cap on her health benefits was unlawful. The retiree health benefits were an employment benefit not a benefit under the city's retirement system, and therefore restrictions in the city charter that required a majority vote by all members of the pension system before any reduction in retirement system benefits took place did not apply. Dailey v. City of San Diego, #D060049, 2013 Cal. App. Lexis 1082, ordered published 2014.
     A retired police officer and several retired firefighters challenged a city's decision to reduce the amount of retirement health benefits allegedly promised when they retired. Seeking to resolve the case on nonconstitutional grounds if possible, the appeals court ordered further proceedings to see whether any of the plaintiffs had a specific vested right to certain health benefits based on the terms of the contracts in effect when they retired. In doing so, the trial court should presume that there was vesting unless the contract proves that no such vesting was intended. Marconi v. The City of Joliet, #3-11-086, 2013 IL App (3d) 110865.2013 Ill. App. Lexis 271
     A county did not breach its contractual obligation to provide health insurance benefits to sheriff's office command officer retirees when the contract that provided for them required that payment be made from a specefic fund and made the benefits contingent on adequate funding. The benefits were cut when there were no longer adequate money in the funds to pay for the benefits. While a new fund with more adequate funding had been created, it was a product of a new separate contract, and could not be used to fulfill the obligations imposed by the former contract. James v. Clackamas County Court:, #S059680, 353 Ore. 431, 2013 Ore. Lexis 270.
     An association of retired county employees sued to try to prove that the county breached obligations to provided vested health insurance benefits in "perpetuity." The complaint in the lawsuit was properly dismissed for failing to state a claim. In light of a recent California Supreme Court decision, Retired Employees Ass'n of Orange County, Inc. v. County of Orange, 52 Cal. 4th 1171; 266 P.3d 287; 134 Cal. Rptr. 3d 779 (Cal. 2011) recognizing that, in certain cases a county could form a contract with implied terms, the plaintiffs should still be granted leave to amend their complaint. Sonoma Cnty. Ass'n of Retired Emp. v. Sonoma Cnty, #10-17873, 2013 U.S. App. Lexis 3856 (9th Cir.).
     A union representing police officers believed that a retiree health insurance subsidy provision in a collective bargaining agreement locked the subsidy in place as it existed at the time of the officer's retirement. The union sought arbitration of a dispute over the county's attempt to reduce the subsidy. The county argued that it need not arbitrate as the collective bargaining agreement had expired and that the subsidy was subject to change from year to year. An arbitrator agreed, but an intermediate appeals court vacated the award. Reversing, the highest court in Maryland ruled that an arbitration clause can survive the expiration of a collective bargaining agreement as to vested rights obtained during the contract's term, and that the issue of arbitrability had been one for the arbitrator to initially determined rather than the courts. Baltimore County Fraternal Order of Police Lodge v. Baltimore County Court, #3/12, 2012 Md. Lexis 750.
     County employees covered by group health insurance were offered a wellness program, featuring testing for various maladies, such as asthma, hypertension, diabetes, congestive heart failure, and kidney disease, using both biometric screening and an online health risk assessment questionnaire. When the risks of such diseases were indicated, employees were offered a disease management coaching program. Any employee who declined to participate in the wellness program was penalized by having $20 deducted from each paycheck. A class action lawsuit by former county employees argued that these requirements violated prohibitions in the Americans with Disabilities Act (ADA) on disability-related inquiries and non-voluntary medical examinations. Upholding summary judgment for the defendant county, a federal appeals court held that, as the wellness program was a "term" of the group health insurance program, it was exempted from these prohibitions by the ADA's "safe harbor" provisions for insurance plans. Seff v. Broward County, #11-12217, 2012 U.S. App. Lexis 17501 (11th Cir.).
     A city received shares of stock from the company that provides health insurance for its employees. The shares were issued when the insurer converted from mutual to stock status. The city sold the shares for $55 million, using the money for various city projects. City employees and retirees claimed that the shares of stock or money derived from them should have gone to them rather than the city. The city was the policyholder and the insurer was an Indiana company. Under Indiana law, the city was entitled to the shares and the proceeds of their sale. The court rejected the plaintiffs' argument that the city could not be the policyholder because a "municipality has no health of its own to insure." Mell v. Anthem, Inc., #10–3440, 2012 U.S. App. Lexis 15299, 2012 Fed. App. 0230P (6th Cir.).
     The U.S. Supreme Court has upheld the individual health insurance purchase mandate of the health care reform legislation popularly known as Obamacare. While rejecting the notion that such a mandate could be imposed under the Commerce clause, it ruled that it could be upheld under the power of Congress to impose a tax. The consequence of failing to purchase health insurance under the law is the imposition of a tax penalty collected by the IRS. A portion of the law expanding the Medicaid program, however, was unconstitutional in threatening states with the termination of their present Medicaid funding if they do not implement the planned expansion. National Federation of Independent Businesses v. Sebelius, #11-363, 2012 U.S. Lexis 4876.
     To be eligible for continuing health coverage benefits under the Illinois Public Safety Employee Benefits Act, 820 ILCS 320/10, a disabled employee must suffer an injury due to an unforeseen circumstance involving imminent danger to a person or property requiring an urgent response. A firefighter who suffered a "catastrophic" injury to his shoulder during a training exercise with a live fire when a hose got tangled on a piece of furniture was eligible for such benefits. He reasonably believed that he was responding to an emergency. A second firefighter who suffered a knee injury during a controlled exercise with no live fire that went on just as scheduled was not eligible. The injury occurred when a co-worker tried to free him from an obstacle, but there were no unforeseen developments and no imminent danger, and therefore no emergency. Both firefighters were awarded line-of-duty disability benefits, and only the continued payment of health benefits was at issue. Gaffney v. The Board of Trustees of the Orland Fire Protection District, #110012, 2012 Ill. Lexis 313, 2012 IL 110012.
      A federal court has ruled that the Defense of Marriage Act (DOMA) is an unconstitutional violation of the equal protection rights of a federal employee legally married to another person of the same sex. The statute bars the recognition of same sex marriages for purposes of granting federal benefits, and was used to prevent the employee from enrolling her wife in the health benefits program available to opposite sex spouses of employees of the federal judiciary. Golinski v. U.S. Office of Personnel Management, #10-00257, 2012 U.S. Dist. Lexis 22071 (N.D. Cal.).
     An intermediate California appeals court rejected the claim of retired firefighters or their surviving spouses that two cities were required to make additional payments a year earlier than they did towards the cost of their health insurance under an amendment to a state statute designed to eliminate some of the disparities between municipal contributions to the health care costs of current employees and the contribution to the cost of health care for retirees. The court found that it should defer to the interpretation of the disputed language in the statute by the health care plan administrator that the increased contributions had to be made beginning on January 1, 2008, rather than on January 1, 2007, as the plaintiffs claimed. Bernard v. City of Oakland, #A127853, 2012 Cal. App. Lexis 81 (Cal App.).
  An intermediate Illinois state appeals court upheld a trial court's ruling that a municipal employer's obligation under a state statute to pay the whole health insurance premium for an injured police officer and his family is not applicable until and unless it is determined that he is entitled to a line-of-duty disability retirement pension because he will never return to work after suffering permanent disability caused by a catastrophic injury. Nowak v. City of Country Club Hills, #111838, 2011 IL 111838, 2011 Ill. Lexis 1834.
     The California Supreme Court stated that a county and its employees can enter into a binding implied contract granting a vested right to health insurance benefits on retired county employees when there is no explicit statute or ordinance prohibiting such an arrangement. The court made its ruling in response to a certified question submitted to it by the U.S. Court of Appeals for the Ninth Circuit in a case in which an association of county employees challenged the validity of changes a county made to health benefits for retirees, which would have the effect of eliminating a subsidy for retirees' health insurance. Retired Employees Assn. v. Co. of Orange, #S184059,  2011 Cal. Lexis 12109, 52 Cal. 4th 1171.
      After a firefighter settled workers' compensation claims for various job-related injuries, he was awarded a line-of-duty disability pension. He then sued to have his continuing health insurance premiums paid under the Illinois Public Safety Employee Benefits Act, 820 ILCS 320/10, and Public Employee Disability Act, 5 ILCS 345/1(b). An intermediate appeals court found that the plaintiff was entitled to payment of the health insurance premiums under both statutes, based on agreed upon facts in the workers' compensation commission proceeding, which the Village was barred from relitigating. Richter v. Village of Oak Brook , #2-10-0114, 2011 IL App (2d) 100114, 2011 Ill. App. Lexis 1037 (2nd Dist.).
     The State of Arizona, in 2008, extended health insurance benefits to both same-sex and opposite-sex domestic partners of state employees. Later that same year, voters in the state approved an amendment to the state constitution that defined marriage as only including relationships between a man and a woman, and then in 2009, the governor signed into law legislation removing health insurance coverage for domestic partners. A federal appeals court ruled that doing so violates equal protection of the law. Saving funds in this manner depends "upon distinguishing between homosexual and heterosexual employees, similarly situated, and such a distinction cannot survive rational basis review." Diaz v. Brewer, #10-16797, 2011 U.S. App. Lexis 18467 (9th)
     When a city realized that police and firefighters who had previously retired on disability pensions were receiving full reimbursement of their medical benefits without legal entitlement, the payments were stopped. In a lawsuit brought by the retirees, a federal appeals court ruled that, except for two retirees who received explicit promises of continued full medical benefits, the retirees had no right to such payments. The city had no obligation to continue payments not authorized by law, and to do so would be a misuse of public funds. Cahoon v. Shelton, #10-2134, 647 F.3d 18 (1st Cir. 2011).
    A county "wellness" program which imposed a $20 per paycheck financial health insurance penalty on employees who declined to participate, refusing to undergo a health assessment, did not violate the Americans with Disabilities Act (ADA), as the program carried out principles of insurance and risk management. The assessment includes a health questionnaire and biometric screening, including a blood test to measure glucose and cholesterol levels.
     While the ADA requires that such programs be voluntary, the court in this case found that imposing a financial penalty on those who don't participate doesn't violate the statute, but is protected by the Act's "safe harbor" provision allowing the establishing, sponsoring, observing, or administering "of the terms of a bona fide benefit plan that are based on underwriting risks, classifying risks, or administering such risks that are based on or not inconsistent with State law." Seff v. Broward County, #10-61437-CIV 2011 U.S. Dist. Lexis 44807 (S.D. Fla.).
     Rhode Island court restores dental health benefits to retired police officers, because they had vested rights and were not represented by the union that represents employed officers. Beauchemin v. City of Woonsocket, #10-2066, 2010 R.I. Super. Lexis 104.
    An Oregon city's policy of denying health insurance coverage to its retirees does not violate their due process rights. The plaintiffs lacked a legally protected property interest to health benefits. Doyle v. City of Medford, #07-35753, 2010 U.S. App. Lexis 10722, 188 LRRM (BNA) 2799 (9th Cir.).
     U.S. Departments of Treasury, Labor, and Health and Human Services publish rules under H.R. 3590 (2010), the Affordable Care Act (P.L. 111-148), requiring plan sponsors to amend their healthcare plans to redefine the term "dependent," for purposes of eligibility of adult children under age 27. Interim Final Rules for Group Health Plans, 75 (92) Federal Register 27122-27140, 29 CFR Part 2590 (5/13/2010).
     New, national healthcare law provides that adults with pre-existing conditions will be eligible to join a temporary high-risk pool, which will be replaced by a health care exchange in 2014. Insurance companies will face restrictions on annual caps, which will be prohibited by 2014. Insurers can no longer drop policyholders when they get sick. A Senate amendment was signed in the same week. Many other provisions will not take effect until 2011 to 2017. Patient Protection and Affordable Care Act, Pub. L. No. 111-148 (2010).
    Current city employees lack standing to sue over a lack of health-care benefits for retirees. Bova v. City of Medford, #08-35091, 2009 U.S. App. Lexis 9606, 106 FEP Cases (BNA) 206 (9th Cir.).
     Ninth Circuit holds that retired employees who receive healthcare benefits, while no longer members of a valid bargaining unit, have standing to challenge an end of benefits as "plan participant" under ERISA, 29 U.S. Code §1132. Poore v. Simpson Paper Co., #05-36060, 2009 U.S. App. Lexis 11174 (9th Cir.).
    A Pennsylvania city could recover funds spent for an injured officer’s wages and medical expenses from any judgment the officer might collect from a third party. State law did not bar an employer’s right of subrogation. Cole v. City of Wilkes-Barre v. Shiels, #08-1412, 2009 U.S. App. Lexis 8777 (Unpub. 3rd Cir.).
     Section 6432 of the American Recovery and Reinvestment Act of 2009 provides premium assistance to persons eligible for a COBRA continuation of group health insurance coverage due to an involuntary termination of employment. The Act provides for a subsidy of 65 percent of the COBRA premium charged to an individual for a maximum period of nine months, which is offset by a reduction in employer payroll taxes.
     City employee recovers payment for the two hours of work time lost to take a mammogram. N.Y. Civil Service Law §159-b/c provides that employees are entitled to up to four hours leave annually to have a mammogram or prostate cancer screening. Moran v. City of Saratoga Springs, #45-1-2008-0150, 2008 N.Y. Misc. Lexis 4605 (Sup. Saratoga Co.).
     Arbitrator sustains the termination of a municipal employee that intentionally delayed providing notification of his divorce to management so that his ex-wife could continue to access his health insurance coverage; when confronted, the grievant was not honest or forthcoming. City of Eugene and AFSCME L-1724, 124 LA (BNA) 1724 (Henner, 2008).
     The Office of Personnel Management now authorizes insurance carriers participating in federal employees health benefits plans to reimburse physicians who screen their patients for substance use behavior (alcohol, illicit drugs, and prescription drug abuse) and to provide intervention programs. Office of Natl. Drug Control Policy News Release (4-7-2008).
     The mere fact that a county sheriff has chosen to participate in a group health plan managed by a city does not make the city the "employer" of county correctional officers. City of Boston and AFSCME C-93, #MUP-03-3880 (Mass. Emp. Rel. Bd. 2008).
     Eighth Circuit overturns a city's unilateral discontinuance of health insurance premium payments for retired public employees as required by a bargaining agreement; Art. I §10 of the U.S. Constitution prohibits the impairment of contracts. AFGE L-2957 v. City of Benton, Ark, #07-1589, 2008 U.S. App. Lexis 1416 (8th Cir.).
     Arbitrator finds that management violated the bargaining agreement by unilaterally adding a spousal surcharge or additional payment for health coverage. City of Painesville and IBEW L-673, 123 LA (BNA) 1563, FMCS Case #06/58893 (Cohen, 2007).
     Arbitrator holds that management violated the bargaining agreement by charging higher medical co-payments without improving the coverage. Hamilton Co. Sheriff's Dept. and FOP Ohio, FMCS Case #06/00964, 123 LA (BNA) 851 (Dissen, 2007).
     Massachusetts appellate court concludes that it was lawful for a town to fire an at-will animal-control officer after she requested enrollment in the town's health insurance plan. "Mere eligibility for the insurance does not in any way protect the employment status of a town employee." Parker v. Town of North Brookfield, #06-P-167, 68 Mass. App. Ct. 235, 861 N.E.2d 770, 25 IER Cases (BNA) 1283, 2007 Mass. App. Lexis 157.
     Arbitrator rejects a grievance that the county deducted too much for medical insurance; "for at least fifteen years prior to the instant grievance, the county has administered the opt-out provision in precisely the same fashion." Cuyahoga Co. and Ohio PBA, FMCS Case #050926/59407, 122 LA (BNA) 1808 (Ruben, 2006). [N/R]
     A police officer, who was injured in an automobile accident, was entitled to retain money paid to him under an underinsured motorist claim. Although the village paid his medical claims, it was not entitled to a lien on his insurance recovery. Musgrove v. Amer. Prot. Insur. Co., #12865/04, 2006 NY Slip Op 6566, 2006 N.Y. App. Div. Lexis 10877 (2006). {N/R}
     Appellate court holds that a city did not violate the Equal Protection Clause when it denied a retired firefighter's claim for health benefits. Sellars v. City of Gary, #05-3858, 453 F.3d 848, 2006 U.S. App. Lexis 16965- (7th Cir. 2006). {N/R}
     Employee's claim that the group health insurance policy provided by a public employer did not cover in vitro fertilization, does not establish a prima facie case of disability discrimination. Knight v. Hayward Sch. Dist., #A106449, 132 Cal.App.4th 121, 33 Cal.Rptr.3d 287, 2005 Cal. App. Lexis 1339 (1st Dist. 2005). {N/R}
     Seventh Circuit holds that the due process rights of retired officers were not violated when the county required retired sheriff's deputies to pay higher health care premiums than required by currently employed deputies. Germano v. Winnebago County, #04-3319, 2005 U.S. App. Lexis 6075 (7th Cir. 2005). {N/R}
     Arbitrator holds that management did not violate the bargaining agreement when it stopped paying for health insurance for a pregnant police officer who was on FMLA leave, and ineligible for group coverage. Vil. of Huntley, IL and Metrop. Alliance of Police C-207, 120 LA (BNA) 949, FMCS #040218/03758-A (Cox, 2004). {N/R}
     Arbitrator holds that management did not violate the bargaining agreement by requiring new enrollees in the health plan to document the status of persons they claim as dependents. Enrollment procedures are an administrative matter and the process does not confer a benefit on employees. Milwaukee Bd. of Sch. v. Teachers Educ. Assn., 120 LA (BNA) 279 (Winton 2004). {N/R}
    Arbitrator holds that management violated the bargaining agreement by unilaterally imposing deductibles on employee medical benefits. The terms "deductible" and "coinsurance" are not interchangeable. City of Middletown and IAFF L-336, 120 LA (BNA) 8, AAA Case #52-390-00845-03 (Braverman, 2004). {N/R}
     EEOC approves a final regulation that allows employers to reduce or end health benefits when a retiree becomes eligible for Medicare or under a comparable state retiree health plan, without violating the Age Discrimination in Employment Act. Age Discrimination in Employment Act: Retiree Health Benefits, 29 CFR Parts 1625 & 1627, RIN 3046-AA72, 72 (40) U.S. Law Week 2640 (2004). {N/R}
     Employers will be able to reduce or eliminate retired workers' health benefits after they qualify for Medicare, under a revised Rule of the Equal Employment Opportunity Commission. U.S. E.E.O.C. Notice of Proposed Rulemaking: Age Discrimination in Employment Act -- Retiree Health Benefits, 68 (134) Fed. Reg. 41542 (July 14, 2003). [2004 FP Jun]
     Arbitrator holds that a county did not violate the collective-bargaining agreement when it negotiated a new health plan. Some employees were disadvantaged by the changes, and others benefited. Clark County [Ohio] Sheriff and FOP, 118 LA (BNA) 1493, FMCS #02/04119 (Graham, 2003). {N/R}
     Arbitrator holds that a sheriff's dept. violated the bargaining contract when it unilaterally changed the health insurance plan, based on the recommendations of a cost containment board. Lucas County Sheriff's Office and Ohio PBA, 118 LA (BNA) 929, FMCS Case #03/06631 (Coyne, 2003). {N/R}
     Arbitrator rules that management violated the bargaining contract by changing the health insurance carrier, increasing firefighter co-pay costs. City of Glenpool, Okla. and IAFF L-2990, 118 LA (BNA) 761, FMCS Case #020827/15296-8 (Neas, 2003). {N/R}
     Supreme Court declines to review an en banc appellate decision that held, 9-to-3, that the government was not obligated to honor medical claims of veterans that had enlisted with a promise of lifetime medical benefits. Schism v. U.S., #99-1402, 316 F.3d 1259 (Fed. Cir., en banc 2002); cert. den. #02-1226, 2003 U.S. Lexis 4404, 71 Law Week 3750 (2003). {N/R}
     Federal appeals court splits 9-to-4 to deny VA hospital benefits to retired service personnel who enlisted between 1941 and 1956, even though they were told by military recruiters they would receive free lifetime health care if they stayed in the service 20 years. In 1995 the Pentagon ended those benefits for veterans over 65 because they are eligible for Medicare. The majority found that the recruiters had no authority to make those promises. Schism v. U.S., #99-1402, 2002 U.S. App. Lexis 23769 (en banc, Fed.Cir. 2002). {N/R}
     Arbitrator sustains a grievance that a new health plan, which allowed the employer's premium payments to remain constant, but caused employees' out-of-pocket expenses to skyrocket, was not an equivalent program. Coles County 911 Board and IL FOP Labor Council, FMCS Case #010502/10114-A, 117 LA (BNA) 462 (Petersen, 2002). {N/R}
     Arbitrator holds that a Township violated the bargaining agreement when it raised drug prescription costs from three dollars to $15 per prescription for generics and $30 for brand name drugs. Olmstead Twp. and Frat. Order of Police, 117 LA (BNA) 540, FMCS Case #00120/00854-6 (Van Pelt, 2002). [2002 FP Dec]
     Arbitrator holds that a city did not violate the CBA when it increased fees for ER visits and changed the payment system for prescription drugs. "Substantially similar benefits" should refer to changes that apply to a plan as a whole, and not to minor provisions. Elk Grove Village and Prof. Firefighters L-2340, 117 LA (BNA) 152 (Nathan, 2002). {N/R}
     Arbitrator rules that a city did not violate the bargaining agreement when it had to replace the dental coverage with a more expensive policy, which required a worker co-payment. The contract was silent on dental plan coverage. Oklahoma City and FOP L-123, FMCS #01/05071, 116 LA (BNA) 1502 (Moreland, 2002). [N/R]
     An employer complies with its duty under COBRA, 29 U.S. Code §1161-1169, by sending a letter to an individual's last known address by certified mail, even when the employer knows that the individual did not actually receive the letter. Degruise v. Sprint, #00-31320, 279 F.3d 333, 2002 U.S. App. Lexis 1116 (5th Cir. 2002). [N/R]
     Federal court in Seattle orders an employer to cover the cost of prescription contraceptives in its insurance plan. Erickson v. The Bartell Drug Co., #C00-1213L, 141 F.Supp.2d 1266, 85 FEP Cases (BNA) 1569, 2001 U.S. Dist. Lexis 7550 (W.D. Wash. 2001). [2001 FP 120]
     City, for valid financial reasons, could not unilaterally change the benefits paid on its health plan, where the bargaining agreement prohibited a reduction of benefits. Arbitrator holds that past practices were not controlling. Norman (City of) and FOP L-122, FMCS #00/15703-8, 115 LA (BNA) 827 (McReynolds, 2001). [2001 FP 83]
     Arbitrator finds that management violated the bargaining agreement when it adopted new health plan that increased the employee co-pay from $10 to $15. Muskegon (County of) and AFSCME C-25, L-570, AAA # 54-390-00712-00, 115 LA (BNA) 1239 (McDonald, 2001). {N/R}
     Wisconsin arbitrator holds that a town violated the bargaining contract, which provided that management could change insurance carriers provided that benefits remained equivalent. Oconomowoc (Town of) and Wis. Prof. Police Assn., Grievances #98-311 and 00-220, 115 LA (BNA) 169 (Petersen, 2000). [2001 FP 83-4]
     EEOC holds, in two cases, employers violated Title VII and the PDA by not providing prescription benefits to women for contraceptives. www.eeoc.gov/docs/decision-contraception.html [2001 FP 24-5]
     Federal workers now allowed 4 hours time off for some health screenings. White House Executive Dept. Memorandum, “Preventive Health Services at the Federal Workplace” (Jan. 4, 2001). [2001 FP 25]
     Health plan that excludes infertility treatments does not violate the ADA or PDA. Krauel v. Iowa Med. Ctr., 915 F.Supp. 102; 69 FEP Cases (BNA) 182 (D.Iowa 1995). [1996 FP 88]
     Federal appeals court holds that ERISA does not prevent an employer from reducing the maximum benefits for AIDS related illnesses from $1 million to $5,000. McGann v. H&H Music, 946 F.2d 401 (5th Cir. 1991); cert.den. 113 S.Ct. 482 (1992). {N/R}
     Township that agreed to pay retired employees’ medical insurance could not unilaterally terminate obligation. Newport Twp. v. Margalis, 532 A.2d 1263 (Pa. Cmwlth. 1987).
     Recipient of medical benefits was entitled to due process before termination; commission of a felony did not eliminate these rights. Knudson v. City of Ellensburg, 832 F.2d 1142 (9th Cir. 1987).
     COBRA's Public Health Amendments requires state and local governments to continue health insurance to former employees, their ex- spouses, and certain dependents under specified conditions. Consol. Omnibus Budget Reconcil. Act, P.L. 99-272 Sec. 10003 (April 7, 1986).
     City could not require married employees to be covered under same health policy if issuance of second policy increased benefits. Fraternal Order of Police v. City of Columbus, 24 Ohio App. 157, 493 N.E.2d 983 (Ohio App.).
     Domestic Partners: See topic by that name, with several cases relating to health insurance.

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