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THE TORCH: June 2006

THE BOTTOM LINE

     Hugh M. Spoljaric, President

              Kingston Teachers’ Federation 

                         Opportunity is an Option   

      It’s graduation time. Nursery Schools, fifth and eighth graders, high school seniors, and college students are all celebrating. Successful candidates are moving on; some to a known destination and others to unknown areas. Over the years, we know the demographics of our community have changed. This year, I noticed one particular item that provides a snapshot of the times in which we live.

     On the wall outside of the guidance office at Kingston High School, there is a map that illustrates where students are going after graduation. My reflections are an observation. I’m trying to figure out what it means.

     In past years, there has been a map of the United States designated various colleges that are the destinations of the graduating seniors. In the past, there was a smaller list, to the side, of those students who were going directly to the work force and to the military.

     This year, there is a map of New York State, with a smaller addendum under it of mostly the eastern half of the country.  To the side is a listing of those going into the work force. This year, it is a larger than normal list of 48 students. There are 168 students going to Ulster County Community College. 42 others are going on to other community colleges, six to the military, 30 to SUNY schools, and 14 to continuing education. Then, there is a smattering of two handfuls that are going out of state. Now, that’s a total of less than half the class of potential graduates who have secured their positions for the fall. In past years, the declarations were more far-reaching and determined. So, what are we to draw from this single footprint?

     I’ve spoken with some parents who have stated that college is too expensive for the limited returns that are received. Specifically, they point to the ‘boomerang generation’ that, after college is over, return home because they cannot secure any position that enables them to support themselves. There are parents who have little faith in an educational system that did not advance them in life. Some say that they are looking for specific training, a marketable skill, for their children, rather than a generic liberal studies education, that will ensure employment. It’s all a big change from recent past years.

     Fewer students are challenging themselves at four year institutions. More are opting out of any advanced training or education. As a teacher, it makes me feel like they have been tolerating me, waiting for high school to end, as opposed to using secondary studies as a springboard to greater things. This year seniors are really nice kids; polite, kind, giving, and sincere. I am puzzled by their lack of incentive to pursue greater things in life, yet I somewhat understand the situation. We have two generations where they see no usefulness of further education. The system has failed them. Perhaps, it’s another reason why even high school is undervalued. Young people graduate with no marketable skill that distinguishes them from everyone else. One size benefits all, but benefits none.

     A hundred years ago, education in America expanded beyond primary grades and into secondary school. Are we, like an expanding nova, now in      prior to thethe early stages of a contracting of the system wherein secondary public education will become a choice?  All that may be needed is an unrelated catastrophe to allow government to make wholesale changes to our current lifestyles.

     In New Orleans, the government has taken the opportunity to change the way life has been. To date, only 4 of nearly 200 public schools have reopened. Most of the private, parochial, and charter schools have reopened. It’s a message that if the opportunity to change the public school system comes about, life will change for everyone. Don’t ever bet that it couldn’t happen here.

     And, that’s the Bottom Line.

                              APPLE GALA—SOLDOUT!

     The 13th annual Apple Gala, a celebration of retirement, graduations, and extraordinary contributions, is sold out. The event at the Wiltwyck Golf Club on June 21 will honor 33 retiring teachers (already mentioned in the Torch) and 5 ESP members. The ESP members are Lila Davidson, Betty Eaton, Elaine Martin, Margaret Stoddard, and Margie Whitaker.

     The Community Service Award for 2006 will be presented to John and Paul Benkert of Allways Moving for their support of education in Kingston.

     A parent from each building will be honored and KTF scholarships will be presented to 50 graduating seniors. National Health Administrators will present a $1000 scholarship to one of the seniors for their performance in mind, body, and spirit throughout their high school career.

                                     BUDGET REVOTE

    Thanks to everyone who voted on May 16. Board of Education trustees Chris Farrell and David Fletcher were reelected along with newcomer James Shaughnessy. Unfortunately, even with the efforts of Debi Wilcox and the KTF Phone Bank of 1500 calls, the budget went down to defeat. The Hudson Valley was one of the few areas of the state where budgets failed en masse. 6 of 11 in Ulster and 9 of 13 in Dutchess failed.

    On June 20 is the revote. Kingston has trimmed the budget to an increase of 4.2%, just .2% above the contingency level of 4%. Your vote and support of the budget is needed on June 20.

CORRECTIONS:

     *The April Torch incorrectly reported the student eligibility age for health insurance coverage. The correct age is 25.

     * The May Torch incorrectly reported the maximum contribution of days to the Moore Days Sick Bank for retiring teachers hired before 1997. The maximum contribution is 50 days. All retiring teachers are asked to donate days in excess of 205 to the bank by contacting Glenn Gallagher at GW.

                                                                                                          

KINGSTON TRUST FUND HEALTH PLAN

                       Notice of Material Modifications and Amendments

     The Trustees of the Kingston Trust Fund have a fiduciary responsibility to respond proactively, as the medical industry changes, to any impacts on the plan that need to be addressed. Many other plans fail to address changes and continue to raise premiums. Compared to all other plans in the United States, the Trust plan provides a superior benefit package and at no cost to the members. Additional benefits, like stroke screening, are provided at nominal cost.

     Some concerns are beyond local control. Presently, for example, medical ID’s and prescription ID’s, in the industry, do not follow the same criteria and use two separate ID’s (an encrypted medical and a Social Security prescription). The medical card is encrypted to prevent identity theft. Adding another card with your Social Security number (for prescriptions) could prove costly to the member and to the Trust. In the future, to enhance security, a picture ID card would further enhance security.

     Therefore, the following changes have been adopted and agreed to by the Trustees and shall be made effective as July 1, 2006. Please keep a copy of this Amendment and Notice of Material Modification with your plan booklet.

1.       The Rx Out of Pocket (OOP) limit has been increased to $1,500 from $1,000.  This is the first increase in the Rx OOP limit since the plan’s inception.   This limit is significantly less than the OOP limit under Medicare.  The Rx coverage under the NHAI plan continues to Creditable Coverage for purposes of the Medicare part D Program.

2.       The Rx copays have been increased to $10 for generic and $20 for brand for a 30-day refill at your local pharmacy.  For mail order, the generic copay is $15 and the brand copay is $30 for a 90-day refill.  Further, if diabetic supplies and drugs are filled at the retail level, the normal retail copay will apply. 

3.       The Emergency Room copay is now $75 for acute emergency treatment.  The ER copay for non-acute treatment is now $125 and the balance of the expenses shall be paid at 80% subject to the out of pocket limit.   The ER Copay is waived if an individual is admitted within 24 hours.

An emergency or life threatening condition is defined as any accident or illness that requires immediate treatment to relieve the sudden onset of severe pain, fever, swelling, serious bleeding, severe discomfort and to the extent that treatment cannot be delayed until the following day during normal business hours where treatment can be rendered by your own physician or at an Urgent Care Center.

4.       The Physician Office Visit Copay (POV) is increased to $15 from $10 and the Specialist Office Visit Copay (SPOV) is increased to $25 from $20 as of July 1, 2006.  The Chiropractic Copay remains at $20.

5.       Durable Medical Equipment (DME) shall now be paid at 90% with 10% coinsurance in Network or 80% Out of Network with 20% coinsurance up to the Out of Pocket (OOP) limit.  Repairs to DME will be paid at 80% with no deductible.

6.       The monthly COBRA premium as of July 1, 2006 shall be $404 for single medical Coverage and $1,001 for family medical coverage.  The Dental COBRA premium is $23.57 for single and $73 for family.  COBRA Premium will be updated each July l.   This is the first increase in COBRA premiums since 3/1/2004.  The COBRA costs are significantly less than the actual district funding cost. 

7.       The copays for BASIC lab and x-ray will remain at $15.  However, the copays for complex imaging shall be as follows.  Most plans today will not cover the following tests at all.  Most of the tests that fall under item c below are considered “experimental” by major insurers and are not covered at all.  Some of the new tests that are now available may only be offered by one entity, which keeps the costs of such tests quite high.  NHAI plans continue to take a leading stance on preventive and progressive treatment and these modest copays make such treatment available for coverage under the Kingston Trust Fund Plan.

a.       The copay for Complex Imaging and Diagnostic Testing (MRI’s, Cat Scans, Complex CT Scans, Cardio Electro grams and Complex Diagnostic Tests costing $750 or more) shall be $100.

b.       The copay for Ultra Fast Heart Scan, Heart/Chest Scan, or Liver Scan is now $50.

c.       The copay for Chest CT Angiography, Genomic Health Oncotype Diagnostic for Breast Cancer or other State-of-the Art Complex Imaging or Lab Tests with a cost in excess of $2,500 is now $200.

8.       The Precertification requirement for MRI’s and Cat Scans is being reinstated and will now be required along with other diagnostic lab or x-ray test that costs $1,000 or more.

9.       Case Management is monitored on behalf of the Plan by NHAI.  One important element of the Case Management benefits that are unique to NHAI is that NHAI plans have always provided for certain “extended treatment” beyond the basic benefits provided by the plan.  Extended benefits are not available under generally provided by traditional health care plans.  NHAI plans have always provided for extended benefits for therapy, home health care, skilled nursing, etc. under case management when additional benefits were medically necessary.  While extended benefits continue to be available under NHAI’s case management program, there have been some changes.  First, the normal copays and/or coinsurance as specified in the plan now apply to extended treatment and the copays or coinsurance on the extended treatment will not be credited toward your out of pocket (OOP) limit nor subject to the plan OOP limit.  Example:  If physical therapy treatment is required beyond the normal 50 visits, additional treatment approved under case management would be available, subject to the same copay.

Extended benefits for home health care or skilled nursing benefits will be paid at 50% and limited to 50 additional visits or days.  Long term care, custodial care, and nursing home care are not covered benefits under any group health plan.  It is recommended that members consider purchasing Long Term Care to cover this potential need.

Listed on the Trust web site is a detailed explanation of Coordination of Benefits for the plan. Go to the KTF site at www.NYSUT.org and click on Kingston Trust Fund.

     Updated ID Cards will be issued soon. Also, there will be a new Hotline available for providers and members to call for a pre-recorded message that will provide the current copays, deductible and out of pocket limits for your plan.  This will eliminate the necessity to mail out new ID cards whenever there is a change in the basic benefits.  Should you have a specific question about your benefits, contact the Compliance Office at 1-888-679-2400, Ext. 5.

                       DENTAL Modifications and Amendments

     As of July 1, 2006, spouses or domestic partners who are eligible for dental coverage through the Kingston Trust Fund and who are both active and/or retired employees of the Kingston Schools, may designate only one family dental plan for coverage under the Fund.

     The annual dental claim expenditure shall be capped at $2000 per person.        

    Schedule of Benefits: Class 1, #8, add: “except in the case of periodontal prophylaxis where members are eligible for two additional maintenances.”

          IMPORTANT REMINDER FOR FOREIGN TRAVEL

With the summer travel season upon us, members are reminded that if they intend to travel outside the U.S., Mexico or Canada, travel insurance is highly recommended.  Benefits outside the U.S., Mexico and Canada are limited to emergency treatment, which will be paid at 80% after a $250 copay.  Any non-emergency treatment would be subject to prior approval and pre-certification as well as the NPPO deductible as a copay for each incident, as all such treatment is out of network.

     If members or their dependents plan to travel to war zones, you should also be aware that benefits may be denied due to injuries incurred as a result of an act of war, such as a suicide bomber in such countries as Israel, Iraq or other high risk countries.

 

Foreign Travel (Outside the U.S., Mexico or Canada)

N/A

Paid at 80% after $250 copay (waived if admitted within 24 hours)

Only emergency treatment is covered while traveling, up to a maximum of six (6) weeks outside the U.S. in any one country.  Vacation travel insurance is recommended for extended coverage.  No benefit will be provided after six (6) weeks in any one country or three (3) months of consecutive travel.  Foreign treatment is also subject to NPPO deductible.

 

Treatment Outside the U.S., Canada, or Mexico:  Treatment is not covered, except for emergency treatment, while traveling “temporarily” for a period not exceeding six (6) weeks in anyone country or three (3) months in total.  Any service provided outside the U.S., Canada, or Mexico will be subject to the normal NPPO Plan deductible as copay for each incident.  The deductible/copay will not be credited to your NPPO deductible or out-of-pocket limit under the Plan.  After the deductible/copay is met, the member will be responsible for the basic NPPO coinsurance up to the NPPO Out-of-Pocket limit for emergency service or for any other non-emergency service as pre-approved by the Plan.   

     Non-emergency treatment of chronic illness requiring hospitalization outside the United States will not be covered unless the treatment is pre-authorized within 24 hours of admission (72 hours if hospitalized over the weekend).  No approved services for medical services rendered outside the U.S. are covered. 

Emergency Treatment in Canada or Mexico will be subject to the same Emergency Room copay as treatment within the U.S. 

     Retirees living permanently outside the U.S. are covered, according to the NPPO Schedule of Benefits, as long as proof of residency is provided and non-residence status is approved by the Plan, in advance.  The approval will be at the sole discretion of the Plan, based on all relevant facts and circumstances, including the country in which the retiree resides.  Coverage in countries considered “high risk” areas will not be approved, subject to the sole discretion of the Plan.  Students on exchange-type programs are not covered.  Parents are advised to secure special travel and medical insurance through their travel or insurance agent, through their school for extended travel, or if they or a dependent intends to live abroad for an extended period.    

War/Service in Armed Forces:  Expenses that result from loss or damage directly or indirectly, due to any act of war (whether war is declared or not), including resistance to armed aggression, will not be covered unless otherwise required by law.

                                                    125 Plan

     Teachers are reminded that June is a deadline month for securing a 125 plan for the next school year. If you are aware of defined expenses for the coming school year, contact Kimberly Huppert at Ryan Insurance to sign up for a 125 plan. It provides for tax free reimbursement of specific expenditures.

                                       ESP CONTRACT!

     After two years without a contract, there is a tentative settlement of a new collective bargaining agreement between the district and the KESP. Members will vote on ratification during the third week in June and are hopeful of a ratified agreement before school breaks for the summer.

                                      CERTIFICATION

     Professionally licensed teachers and teaching assistants are reminded that it is their responsibility to maintain their certifications. The May Torch alerted members to the state’s position on certification. Members who are in the process of obtaining permanent certification can go to www.nysut.org and click on ‘Teacher Certification’ on the menu. There are links to state ed sites and teachers can check the status of their submissions by going to the TEACH site.

                                   RELAY FOR LIFE

     KTF Grievance Chair Suzanne Jordan has announced that the elay For Life Drive for the American Cancer Society netted $3100 from Kingston teachers. Many of the donations were for luminaria at $10 each in honor or in memory of a person who has been stricken by cancer. George Washington School was the largest, and Kingston High School the smallest, in per capita donations. Members are thanked for their support and are reminded of other KTF support drives throughout the year, including the Pantry Drive, Blood Drive, Mental Health, Juvenile Diabetes, Habitat for Humanity, and the Kids’ Classic. As always, extraordinary circumstances like 9-11 and Katrina, seems to touch us each year.

                             LITCHKA GONE…AGAIN

     The North Salem School district in Northern Westchester has announced that Peter Litchka will leave as district superintendent on August 7. The reason given was that he is retiring and will take an instructional position at Loyola of Maryland college. He had served two years of a three year contract at North Salem.

     The budget at North Salem went down to defeat on May 16 and it was faulted for raising taxes as much as 16% in a year when the district experienced no population growth.