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LIUNA Conference Brings PPACA Concerns to Surface

Demonstrating widespread concern about how best to implement the emerging requirements of the Patient Protection and Affordable Care Act (PPACA), more than 200 trustees and administrators from LIUNA’s health & welfare funds turned out for LIUNA’s Health Care Conference, March 24-27, in Washington, D.C.

PPACA, also known as Obamacare, is a vast reform of America’s insurance-driven health care system. Reaching into virtually every corner of the system, the law requires that all U.S. citizens have health insurance coverage and aims to make health care more accessible to every citizen and legal resident.

LIUNA’s health & welfare funds, along with other union-affiliated multiemployer plans, represent a relatively small sector of the health care marketplace. As a result, the impact of the provisions of the legislation on union-affiliated plans was hardly considered. And while many of the law’s rules and regulations are still in development, the ones that so far have been promulgated have paid scant attention to the operations of multiemployer funds.

Now, with enrollments for coverage under PPACA’s health care exchanges to begin in October and take effect in January, 2014, LIUNA’s funds are working to ensure that their plans are incompliance with all of the applicable PPACA provisions.

LIUNA convened the Conference to identify and address concerns and discuss implications of implementation requirements for existing funds. By bringing together the trustees, fund personnel and union leadership who ultimately must make decisions on behalf of LIUNA’s H&W funds, General President Terry O’Sullivan and General Secretary-Treasurer Armand E. Sabitoni provided a forum for these key decision-makers to express concerns, share insights and forge consensus on the ways to move forward in the months ahead.

O’Sullivan and Sabitoni addressed the general session, as did Phyllis Borzi, Assistant Secretary of Labor; James S. Ray, legal counsel to LIUNA; Randy DeFrehn, Executive Director of the National Coordinating Committee for Multiemployer Plans; Kathy Bakich, Senior Vice President, The Segal Company; Mila Kofman, Executive Director of D.C.’s Health Benefit Exchange Authority; and Bill Cavanaugh, President, ULLICO.

The core of the Conference, however, was three roundtable sessions. Rotating through each, participants discussed PPACA Health Plan Coverage Issues, Plan Design Mandates and Plan Design and Cost Containment Issues.

Future of Union-Provided Health Care

Underlying much of the Conference discussion was on-going concern about whether the advent of insurance exchanges will cause small union contractors to doubt the value of continuing their contributions to LIUNA H&W funds through collective bargaining agreements. While an initial assessment shows that those with less than 50 full time employees can opt to provide no insurance (or, equivalently, make no contribution to a multiemployer plan) without penalty under PPACA, a more nuanced assessment reveals many reasons why they are likely to continue to provide coverage. Given on-going confusion about the meaning of many PPACA regulations, the continuing regulatory gaps in some key areas and the lack of actual exchange operations to assess, the Conference consensus was that it is simply too early to know what impacts lie ahead. Therefore, funds will be proceeding on the assumption that LIUNA’s labor-management partnership in health care will continue with both sides taking a constructive approach to resolving coverage issues and options as they arise in actual practice.

Questions Answered

Realizing that there would be questions that would not be answered at the Conference, participants were encouraged to leave questions or requests for clarifications with the roundtable facilitators to be answered following the Conference. Those questions and answers have been posted on the Fund’s Health Care Reform Updates’ page. If there are any additional questions that come up as the implementation of PPACA provisions continues, please send them to Mary Jane MacArthur, Director, Health Promotion Division, at

[Steve Clark]

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