happenings
Support the Fillowich Family
Please consider helping out the family of Shawn Filiowich to defray his medical expenses. Sadly Shawn lost his battle with cancer on 1/4/25. Shawn had dedicated his 28-year career to protecting and serving the City of Saint Paul and now his family needs our help.
Thanks in advance for your generosity! Please use the button below to help out if you can.
Social Security Fairness Bill Signed
Social Security Fainess Act Information
From the SSA Website
The Social Security Fairness Act, HR 82, concerning the Windfall Elimination Provision and Government Pension Offset, was signed into law on January 5, 2025. Upon implementation, the Social Security Fairness Act eliminates the reduction of Social Security benefits while entitled to public pensions from work not covered by Social Security. The Social Security Administration is evaluating how to implement the Act. We will provide more information as soon as available.
At this time, you do not need to take any action except to verify that we (SSA) have your current mailing address and direct deposit information if it has recently changed. Most people can do this online with their personal my Social Security account without calling or visiting Social Security. Visit www.ssa.gov/myaccount to sign in or create your account.
Federation Requests City Position on Unused Retiree Health Insurance Benefits
Federation Requests City Position on Unused Retiree Health Insurance Benefits
Some time ago, we notified the Federation that Regular Retirees were not allowed access to unused health insurance benefits to pay Medicare Part B premiums. The first Federation attorney had a strange response and rejected our position (see newsletter accounts here).
Federation President Mark Ross disagreed with the attorney's opinion and decided to pursue the issue directly with City Labor Relations. In August of this year, President Ross requested a documented interpretation why the City is choosing to withhold our use of excess Federation benefits for a City-provided health insurance premium.
The City replied to the Federation soon after.
We at the SPPRA find the City response incomplete and inaccurate. The Part B premium is not separate nor is it a part of a third-party insurance program. The Part B premium is a seamless requirement of the only private health insurance plan offered to Regular Retirees under contract.
SPPRA & Veteran Firefighters request LMCHI information on Medicare coverage
SPPRA & Veteran Firefighters request LMCHI information on Medicare coverage
Federation Requests City Position on Unused Retiree Health Insurance Benefits
Hopefully, those of you on and approaching Medicare have been following the insurance coverage news here and in the media.
We and the St. Paul Veteran Firefighters Association (retired firefighters) discovered our City Medicare insurance contract expired at the end of this year. When we investigated, we found there had been no mention of it at the St. Paul Labor Management Committee on Health Insurance (LMCHI).
Management routinely discusses and negotiates with Labor all health insurance provided by contract or CBA. Or so we foolishly thought. The LMCHI is composed of representatives of all bargaining units in the City (unions) and City Benefits team members.
We requested our representatives from the Federation (Police) and Local 21 (Fire) place a letter on the August 12 meeting of the LMCHI agenda asking what is in store for 2025 City Medicare users. Go here if you'd like to read about what we found out.
Support Grundy's Battle Against Cancer
SPPRA & Veteran Firefighters request LMCHI information on Medicare coverage
Support Grundy's Battle Against Cancer
Early in July, Don Grundhauser was diagnosed with colorectal cancer with metastasis to his lungs, liver, and lymph nodes.
So, we need to show up big for Donny
Thank you in advance for your generosity and support for Donny and his family. Please use the button below to help out.
MONTHLY RETIREE DINNER - Thursday, February 6th - 4P
Join us at Mancini's
Social hour starts at 4:00 pm with dinner orders taken around 5:00-5:15 pm. Cost is $35 which includes choice of entree, two drinks, dessert and tip. Please notify Dan Collins by noon on Tuesday the 4th of February if you plan on attending. Arrive by 4pm for the best seating options.
US Senate Releases scathing medicare advantage Report
US Senator Richard Blumenthal, Committee Chair, Speaks Out
"...Blumenthal joined state (Connecticut) disability advocates in criticizing the deceptive and misleading advertising of in-state insurance providers, particularly UnitedHealthcare, which made false or misleading claims in promotion of Medicare Advantage. Blumenthal said that the blame for Medicare Advantage’s inadequacy falls at the feet of private insurance providers. “Quite simply, the insurance companies are profiteering,” said Blumenthal. “They are taking advantage of excuses to deny or delay coverage, and the victims of those practices are patients and their families..."
"...Furthermore, Connecticut State Senator Saud Anwar said that, in 2022 alone, 3.4 million prior authorizations for care had been denied by Medicare Advantage. That number represented 7.4% of all service and care requests made by Medicare Advantage policyholders. Anwar noted that 83% of appeals were successful, ascertaining that this statistic showed how many of those denials were wrong. “This is the cause of a significant burden in the healthcare system, to have people fight on the phones in this archaic manner, to wait and listen to music for hours, to be able to get their medications” said Anwar..."
Read news articles about the report here and here. The full Senate Subcommittee report is here.
Us HHS OIG is skeptical with UHC at-home visit billing
Medicare Advantage plans received billions from Medicare for home visits
"...An estimated $7.5 billion in risk-adjusted payments was pocketed by MA insurers (Medicare Advantage Plan insurers) when diagnoses were only found on chart reviews but no other service records. At-home visits and chart reviews make up $4.2 billion of the total payments from the government to MA insurers in fiscal year 2023, yet at-home visits make up just 13% of all chart reviews..."
"...There were no follow-up visits, procedures or tests provided to 1.7 million enrollees, leading the feds to believe the diagnoses were incorrect or members were not adequately treated. Private insurers received greater payments from at-home reviews than other types of chart reviews. MA companies generated $1,869 on average in payments from at-home visits, versus just $365 from facility-based chart reviews..."
"...Of the $7.5 billion in risk-adjusted payments, 20 companies received 80% (or $6 billion) of the funds yet only treat half of MA enrollees. These companies received a share of payments that exceeded their percentage of enrollees by more than 25%, the report explained. UnitedHealth Group earned $3.73 billion in payments, by far the most of any other health plan..."
Read news article about the report here.
