 |
 |
to fill out a simple form to connect to Classified Postings in your area.
|
|
|
|
|
Mayers v. Orange Unified School District6/30/2003
I.
Between 1977 and 1994 the Orange Unified School District provided "classified" retirees with the exact same health benefits that it provided its active employees. During this period the health benefits provided active employees were such that they had no out-of-pocket cost to be enrolled in a given medical plan, though some plans required deductibles and co-payments. Employees could choose from two HMO's and one PPO (an indemnity plan), but if they chose the PPO, they were subject to a deductible and co-payment. That was a fairly expensive proposition for the school district. (See generally Ventura County Retired Employees' Assn. v. County of Ventura (1991) 228 Cal.App.3d 1594, 1598 ["The spiraling cost of health care in America is simply unconscionable. The present high cost of medical insurance has unfortunately become a fact of life . . . ."].) And so, in 1992, Orange Unified ended eligibility for post-retirement health benefits for new hires.
In 1994, Orange Unified stopped paying 100 percent of the cost to enroll in all health plans offered on behalf of active employees. The "actives" now had to pay something out of pocket if they wanted to enroll in the more expensive PPO plan. By contrast, the retirees remained free from the obligation to pay anything out of pocket for the cost of enrollment in any health plan offered by the district.
That difference in treatment was phased out in 1999, when retirees were required to pay $95 a month to enroll in the PPO. (The coverage provided by the PPO was also reduced from 90 percent of all costs to 80 percent.) The district still completely paid for the cost of enrolling in an HMO. Additionally, retirees over 65 were required to sign up for Medicare parts A and B, and, depending on the plan, some might also be required to enroll in a Medicare Risk Program (i.e., a Medicare HMO).
A group of retirees led by Evelyn Becky Mayers, the former president of the classified employees' union from 1978 through 1994, suing as a class, then filed this action for declaratory and injunctive relief. The class, which consists of about 325 individuals, sought to require the district to provide the option of a PPO covering at least 90 percent of health care costs with no more than a $150 deductible at no cost to the retiree.
The case went to a full bench trial in January 2000. The result was a permanent injunction forbidding the district from:
-- "treating" classified retirees "different from active employees regarding the selection of and participation in the medical/health care programs" offered by the district;
-- requiring classified retirees over 65 who chose the PPO to pay the "additional cost of that coverage over the cost of the District-sponsored Medicare Risk HMO if that same requirement is not upon active employees" (emphasis added);
-- requiring classified retirees to enroll in Medicare A or B, pay for Medicare A or B, or assign Medicare benefits as a "condition precedent" for health care benefits "since that same requirement is not imposed upon active employees" (emphasis added).
The injunction followed from the trial court's core perception: There was a contract between the district and the class of retirees, providing that the retirees would be treated the same for purposes of health care benefit plans as the district's active employees. Hence, as the emphasized words in the portions of the injunction quoted above show, the district could not require retirees to pay anything out of pocket for a PPO plan "if" it wasn't also required of active employees, and the district could not require retirees to be involved in Medicare, "since" it did not
Page 1 2 3 4 5 6 California Classifieds
Classified Postings
|
| |
to fill out a simple form to connect to Classified Postings in your area.
|
|