A healthcare provider is suing the city for not providing Medicare Advantage benefits to 250,000 retired employees. The city plans to shift those employees to the Medicare Advantage program on Jan. 1. The healthcare provider’s case is now before the State Supreme Court in Manhattan. What are the basic arguments? Read on to find out. If you’re interested in joining the legal fray, read on. The case is complicated, but the basics are the same.
Unilateral contract theory
The law of contracts often relies on the Unilateral Contract Theory to defend employers from a Union Retiree Health Insurance lawsuit. As a result, employers have been compelled to make necessary changes to their policies to avoid liability. While insurers use statistical probabilities to limit their risk, extreme cases could force them to pay large sums of money. In addition, there are two types of contracts: unilateral and bilateral. While unilateral contracts are one-sided and involve only the offeror, bilateral contracts involve equal obligations from both parties.
A Unilateral Contract is a contract in which an individual or company makes a promise to pay a certain sum of money to another party. The law of contracts regards these types of contracts as enforceable, but they can also result in legal disputes when the offering party fails to pay the amount offered. Under such a theory, the breach of the contract depends on the agreement’s terms and the circumstances under which the offeror and offeree agreed.
Unilateral statement rule
The case involved the U.S. Court of Appeals for the Fourth Circuit’s decision that the employer and union had a joint intent to provide retiree health insurance benefits. This joint intent prevented the employer from unilaterally altering retiree health coverage benefits after the policy had expired. The ruling could have a significant impact on the future of employee benefits, including retiree health insurance. As a result, employers are encouraged to take care when negotiating employee benefit plans.
The UAW’s claims are unique in many respects. While the health insurance benefits of former union workers were vested in the union at the time of their retirement, the UAW sought a VEBA with benefits comparable to the benefits they received while employed. Specifically, the union sought a pension plan that would continue providing its retirees and their dependents with the same levels of medical coverage that they enjoyed during their active working years. The benefits sought by the union were calculated by taking into account the rate of inflation in medical costs, and the duration of the employees’ service.
Litton court’s “clear statement” rule
In recent ERISA retiree medical cases, the courts have consistently applied the “clear statement” rule. This rule helps determine whether a collective bargaining agreement vests retiree medical benefits. It requires a plaintiff to show the agreement was latently ambiguous as to the extent of the benefits. While it does not address the issue in Union Retiree Health Insurance cases, it is important to understand how the courts have applied this rule in the past.
The courts have repeatedly relied on the Third Circuit case, Crown v. Auburn Gear, Inc., for guidance. However, the “clear statement” rule in Union Retiree Health Insurance is far stronger than in this case, because the contract language used by the insurance company was more specific. This means that the parties were probably able to infer that the benefits would continue even after they retired.
TIAA’s Medicare Advantage program
On Jan. 1, the City of New York shifted the Medicare benefits of 250,000 retired government workers into the Medicare Advantage program. The healthcare provider is suing TIAA to prevent this move. The city’s mayor, Eric Adams, has said he will consider a similar move, but it may be a more favorable one. The lawsuit was filed in the State Supreme Court of New York.
In December, the Municipal Labor Committee gave the contract to Anthem despite its lack of experience running the program, which the union and other organizations claim is inadequate. However, the firm was selected by the Municipal Labor Committee because it was more familiar with the retirees’ needs. The case is currently before Judge Lyle Frank. If you want to read more, click here. This article was originally published in December 2014.
CUNY’s Medicare Advantage program
A group of retired city workers has filed a lawsuit against the City of New York over the City’s Medicare Advantage plan. The suit challenges the City’s plan, which is called “MA+.” The judge has yet to rule on the City’s plan’s ability to fix its defects. Despite this setback, the lawsuit is not over. The judge’s decision could have a major impact on the way retirees pay for their healthcare.
The Council of Municipal Retiree Organizations is mobilizing municipal retirees to take action. The organization has an online petition asking the City to maintain Medicare Part B for retirees. The petition has already garnered over 28,000 signatures. The PSC pushed for the postponement of the vote before the vote but was defeated. A group of retirees gathered at City Hall to protest this decision on September 24.
