Adverse Decision in Health Care Arbitration
April 15, 2018
Adverse Decision In Health Care Arbitration. An arbitrator jointly selected by CAPS and CalHR has ruled that the state did not overcharge state scientists when it set the employer contribution amounts for 2017. CAPS alleged that the state underpaid its monthly share.
The state’s contribution to health plan premiums is based on a formula which calculates the weighted average for the four most utilized plans. The state’s contribution for state scientists is 80% of the average premium for employees and 80% of the dependent premium. The employee pays the difference, if any, depending on the plan the employee selects from among those offered by CalPERS.
However, in 2016, CalPERS announced that one of the two Blue Shield plans, which had the fourth-largest enrollment, would not be offered in 2017. Employees in those plans were transferred to another Blue Shield plan (which is also one of the top four). After an evidentiary hearing, the arbitrator on April 15 issued his ruling, concluding that the state’s calculation of its contributions was correct.
Appellate Decision RE Travel Reimbursements
February 6, 2018
The Third District Court of Appeals ruled against CAPS Tuesday on the question of whether Unit 10 employees were owed travel expense reimbursement rates equal to those given to SEIU in 2013 under CAPS’ MOU “me-too clause.” The Decision tracked closely with to the trial court’s decision from 2014. The Appellate Court agreed with the state that CAPS was unable to show the Legislature knowingly and definitively approved increases to Unit 10 travel reimbursement rates at the time it approved CAPS 2011-2013 MOU, which contained the “me-too clause,” or SEIU’s 2013-2015 MOU, which triggered it. We are analyzing the case and evaluating possible next steps.