Retired Illinois Teachers To Have $1,000 Maximum Out-Of-Pocket for Health Care

That’s not the whole picture, but it is the part of the United Health Care plan that stuck out the most.
There is a $47.56 a month premium in addition to whatever retired educators are payoing for Medicare.
Prescription drugs are priced separately with co-pays starting at $10 for generics.  (But available cheaper at some drug stores.)
All of this information and more was presented to a standing-room-only crowd at the Crystal Lake Country Club on Wednesday.
The program was presented to the McHenry County Retired Teachers Association by the Executive Director of the Illinois Retired Teachers Association.
News to me is that the Federal government has figured out that private enterprise can handle calculation and payment of medical benefits better the government.
There was laughter in the audience when that was said.
United Health Care has be retained by the Feds to administer Medicare for its clients.
That seems to have penetrated Centegra to some extent, but, according to one retired teacher who spoke to a couple of Centegra employees, the lack of a specific United Health Care contract was leading to responses that Centegra would not accept United.
United will pay the same amount that Medicare will pay, so, if a medical provider is “a willing provider,” that is, willing to accept Medicare payments, there should be little problem once the word gets disseminated to those answering the phones and Centegra’s physicians’ group members.
Another retired teacher relayed that a Good Shepherd Hospital employee looked at the play, said that Advocate would accept it, concluding, “You’ve got a wonderful plan there.”
So, it doesn’t matter if a provider is in the United Health Care network or not.
“If the provider accepts Medicare and are a willing provider, they will get paid the Medicare rate,” the presenter said.
United is the only choice for those who winter elsewhere.  It is a nationwide network.

Comments

Retired Illinois Teachers To Have $1,000 Maximum Out-Of-Pocket for Health Care — 24 Comments

  1. Not many people have a better healthcare plan specially at the price that teachers plan for the plan, than retired teachers and it’s subsidized by taxpayers.

    Remember hardly any retired teachers even worked 35 years to be eligible for full retirement.

    Teachers get retirement after as little as 20 years with ERO.

    And administrators too.

    Although teachers have to pay extra to retire under ERO, school districts pay twice the rate that teachers pay.

    And that means taxpayers, because school district payments come from taxpayers at the expensive of say educating kids.

    And after the teachers retire early, taxpayers pay for the replacement teachers.

    It’s completely dysfunctional and the costs are largely hidden from the public.

    When is the last time you saw the cost to taxpayers of school district ERO payments?

    Probably never.

    When is the last time you saw the cost to taxpayers for teacher/administrator retiree healthcare insurance.

    Probably never.

  2. Oh by the way thank your legislators for voting to renew ERO this year.

    It would have expired otherwise.

    But their priority is renewing ERO so all those teachers will vote for them and contribute to their campaigns and campaign for them.

    And TRS pension reform?

    Well, that just got kicked down the road again.

  3. And because of early retiree healthcare, ERO, and TRS, no one really knows what teachers and administrators really earned.

    They earn taxpayer subsidies all over the place.

    Typically government benefits are 20% better than private benefits.

    Teacher and administrator benefits are much better than typical government benefits.

    So maybe a guess is teachers earn 20 – 40% more than their posted salaries.

    It’s really shocking.

    Go do the research yourself.

    It will take you a month of Sundays and you will get the runaround.

    It’s like looking for a needle in the haystack.

    They don’t want you to know.

    Because if you knew, you would be angry.

  4. To be honest, teachers and administrators themselves probably don’t know.

    THe unions certainly are not going to tell them how much their benefits costs.

    And the unions, specifically the lobbyists, are responsible for getting all the legislation passed to hike these juicy benefits over the last 40 years.

    The legislators probably don’t know.

    Probably no one knows.

    COGFA analysis never goes back far enough.

    So who does that leave that really knows.

    No one.

    All this legislation just gets passed and hey the taxpayer will come up with the dough somehow between
    property taxes, income taxes, fees, and whatever else they can dream up.

  5. And how about those Crystal Lake and Cary High School teaches who have voted to strike if necessary and have declared an impasse.

    THey have not had a single salary freeze since the financial crisis began or going back to at least 1999.

    Not one.

    ARRA subsidies just allowed them to keep sailing along with salary increases.

    Collective bargaining allowed them to sail along with salary increases.

    And now the Board wants to reign in costs so now what do you see from teachers and their unions – threat to strike.

    Why do teachers think they should not have to sacrifice.

    Why are they so special.

    Go back and look at CHSD 155 teacher and administrator salary history since 1999.

    Salaries have easily doubled across the board for anyone working that long.

  6. Now what will you hear from the IEA, teachers, and administrators after reading the above.

    Oh, another attack on hard working teachers.

    OK.

    Tell us the truth IEA.

    Tell us the truth teachers.

    Tell us the truth administrators.

    Tell us the truth legislators.

    Tell us the truth Governors.

    Tell us the truth Democrats and Republicans.

    Tell us the truth COFGA.

    List out every single benefit increase to TRS and retiree healthcare form 1971 – current.

    List each Public Act for teach benefit increase.

    List each House Bill or Senate Bill associated with each Public Act.

    How about the roll calls for each house bill and senate bill for each benefit increase so you can determine how your legislators voted.

    List in common language what each benefit increase meant.

    Explain in common language what each benefit increase meant.

    Now tell me who has been under attack.

    Not teachers.

    You, the taxpayer.

    You have been under attack and you didn’t even know it.

    A 40 year siege.

    There’s been a war going on for 40 years and no one even knew it.

    No one even reported it.

    The Unknown War.

  7. Actually, a few people did catch on.

    Jack Roeser and Bill Zettler.

    Zettler wrote a 300 page book about the mess.

    Zettler called it a Scam.

    I used the think that was harsh.

    But when you really analyze what happened, and is still happening, it is a scam.

    As incredible as that may seem.

    At it’s core it’s about greed.

    All the special interests were served at the expense of the taxpayer and students.

    Now if it was all on the up and up, honest to goodness do gooder legislation, if really the kids came first, the entire system would have been explained in simple language to the taxpayer.

    But you have to realize that unions are not about kids first.

    Unions are about teachers first.

    That’s the definition of a union.

    Looking out for it’s members, whom are teachers.

    Now many things things that benefit teachers also benefit kids.

    But not everything.

    If teacher unions put kids first, they would be an association, not a union.

    If the union put the kids first, it would be a kid union.

    If this was not a scam, you could easily obtain information about how all of this works.

    But that is not the case.

    That’s what makes it a scam.

    A legal scam.

    Within in the system you have some awesome people who were not part of passing this legislation.
    And that unwittingly is part of the problem.
    Those awesome people did nothing to explain how all these benefit increases have piled up and their true costs.
    The taxpayer did nothing to unravel the mess.
    So here we sit.
    When pension reform is passed it’s not going to be reform.
    It will be a pothole patch.
    And we will have pothole patch after pothole patch for decades.
    Well we could easily write another 300 page book about the mess.
    Back to the main point of the article.
    Teacher retiree healthcare.
    Teachers receive taxpayer subsidized early retiree healthcare.
    How many people realize that.
    How many people subsidizing teacher and administrator early retiree healthcare, themselves receive taxpayer subsidized healthcare with equivalent benefits?
    Maybe 1%?

  8. Now an interesting thing happened in 2011.

    Legislation was passed to to pothole patch the teacher and administrator state pension system, known as TRS.

    One of many pothole patches to come.

    The new TRS pension plan is known as TRS Tier II pensions.

    Anyone who was not employed as a teacher or administrator a single day prior to 2011, and that includes did not substitute teach a single day prior to 2011, is in Tier II.

    The Tier II teachers are paying into the TRS pension plan.

    But they will not receive Tier I benefits.

    They will receive much lesser Tier II benefits.

    How would you like to be a Tier II teacher funding Tier I teachers.

    And the longer we wait for true reform, the more Tier II teachers will be hurt at the expense of Tier I teachers and administrators.

    So there is one of the endless nuances of TRS teacher and administrator pensions.

    All those teachers and administrators who began their career prior to Jan 1, 2011, Tier 1.

    That is a whole lot of teachers and administrators.

    And as benefits have increased over the years and salaries increased, the snowball has gotten bigger and
    bigger.
    Once you roll a snowball down a hill and it gets so big, it’s really hard to stop.
    That’s the mess we are in now.
    The Tier I snowball is REALLY big.
    And it keeps getting BIGGER.

  9. Here is some more technical information on teacher and administrator retiree healthcare in Illinois.

    The name of the program is Teachers Retirement Insurance Program (TRIP).

    It is administered not by the TRS pension fund, but by the Illinois Department of Central Management Services (CMS).

    There are many parts of TRIP, but two main categories exist.

    Retirees not yet eligible for Medicare (primarily early retirees).

    Those eligible for Medicare.

    The above article is about those eligible for Medicare.

    The Average Joe who retires prior to being eligible for Medicare is on his own for healthcare coverage.

    However, teachers who retire prior to being eligible for Medicare receive the TRIP taxpayer subsidized healthcare, which means they get a deal not available to other taxpayers.

    Let’s look at what the TRS website has to say about the latter group.

    “State-Mandated Changes for TRIP Members in Medicare

    On or before Dec. 13, 2013, most TRIP members covered by Medicare will be required by the Department of Central Management Services to enroll in a state-sponsored Medicare Advantage health insurance plan. CMS began mailing the Medicare Advantage enrollment kit with the enrollment form on Nov. 7. The administering insurance companies for Medicare Advantage will mail information about each of the plans separately.

    Click here for:
    * Enrollment Video
    * TRAIL Decision Guide
    * image of enrollment kit’s envelope
    * FAQs
    * information from CMS on this change
    * seminar dates and locations
    * the letter from CMS dated Oct. 21”

    Now if one reviews the TRS and CMS websites regarding the information provided to teachers, one will be hard pressed to find information regarding benefit increases.

    Why is that?

    Because the legislators, Governors, and Lobbyists caused the benefit increases with their benefit hiking legislation and lobbying, and because they have so much power, no one wants to point the finger at them.

    Instead everyone blames the State of Illinois for not making the hiked payment to the TRS pension fund.

    And where does the State of Illinois get the money for the hiked payment to the TRS pension fund?

    From the taxpayer.

    The teachers get their information about the cause of the TRS pension funding shortfall primarily from their union and the state.

    The statewide teacher unions (IEA and IFT) and the state are not telling the teachers the whole story.
    However, there are some pretty smart teachers and administrators out there.

    Surely they know the whole story.

    But they are not telling the press and the taxpayer the whole story, or at best they are minimizing the story.

    The age old axiom applies.

    You have to believe when the stakes are high enough, many people will lie.

    How true that is.

  10. Here is the link to the TRS website.

    Depending on when you click on the website link, the above mentioned information quoted form the TRS website may or may not still be present.

    As of right now it’s on the home page.

    http://trs.illinois.gov

  11. Well here it is, more specific information about the Medicare program available to teachers but not available to taxpayers funding the program.

    Name: Total Retiree Advantage Illinois

    Included: Medicare Advantage plans with prescription drug coverage (MA-PD plans).

    Availability: Available through the Teachers’ Retirement Insurance Program (TRIP).

    Introducing Total Retiree Advantage Illinois

    The State is offering a new retiree healthcare program called Total Retiree
    Advantage Illinois (TRAIL), which takes effect February 1, 2014.

    This program provides comprehensive and valuable medical and prescription drug coverage for eligible retirees and their eligible dependents.

    Depending on where you live, you’ll have up to three Medicare
    Advantage plans with prescription drug coverage (MA-PD plans)
    to choose from:

    A Preferred Provider Organization (PPO):
    • This is a PPO plan administered by UnitedHealthcare (UHC)
    • It is available to members nationwide.

    HMOs:
    • These are HMOs administered by Coventry Advantra and Humana
    • They are available to residents of certain Illinois counties.

    Open Enrollment Period: November 12 – December 13, 2013

    2014 Coverage Period: February 1 – December 31, 2014

    Rate Schedule effective February 1, 2014

    TRIP Medicare Advantage Plan MONTLY Rates
    Coventry Advantra HMO Humana HMOs United Healthcare PPO
    Member Rate $035.36 $055.34 $047.56
    Dependent Rate $106.08 $166.02 $142.67

    Benefits website at http://www.benefitschoice.il.gov

    Sincerely, CMS Group Insurance Division

    What are your monthly payments to your Medicare plan?

  12. Here’s the above information reformatted.

    TRIP Medicare Advantage Plan MONTHLY Rates.

    Coventry Advantra HMO Monthly Member Rate: $035.36

    Coventry Advantr HMO Monthly Dependent Rate: $106.08

    Humana HMO Monthly Member Rate: $055.34

    Humana HMO Monthly Dependent Rate: $166.02

    United Healthcare PPO Monthly Member Rate: $047.56

    United Healthcare PPO Monthly Dependent Rate: $142.67.

    What are other Illinois residents monthly rates for Medicare?

  13. Now let’s tie this back to Crystal Lake – Cary High School District 155.

    Roughly, in general, teachers after having worked 35 years or so are retiring with $100,000 salaries or so and $65,000 pensions or so.

    All taxpayer funded.

    But we won’t settle for theoretical or averages.

    We’ll come up with some real world examples.

    Remember, funded in whole or in part by your property taxes and State and Federal income taxes.

  14. OK here’s a real world example of a retired Crystal Lake High School teacher.

    The information came from FamilyTaxpayers.org and OpenTheBooks.com who receives the data from TRS.

    Use this data as a rough guideline.

    There could be errors in the reporting or interpretation of the data.

    The data can be confirmed via FOIA from TRS.

    Carol J Alfus was earning $61,414 in 1999 with a Masters degree and 13 years experience.

    She retired in 2011 earning $128,565 after 25 years experience as a Learning Behavior Specialist I.

    Her pension began in 2011 with 27.33 years of service.

    You will notice her years of service is different than her years worked.

    This is typical and furthermore it’s typical to exchange unused sick days for years of service credit to
    retire with more years of service than actual years worked.

    Her annual pension was or is $72,454.92 annually.

    Which is $6,037.91 monthly.

    She might have been the best teacher in the world, or the worst, for the most part they all advance the same on the salary schedule.

    Do you ever hear these kind of numbers from TRS?

    Ever?
    No.
    But here it is the cold hard facts.
    We can find other examples.
    This is not uncommon.
    The salary figures do not represent the subsidy from the State of Illinois for the TRS pension.

  15. Here’s another real world salary example in CHSD 155.

    Michael Bailey in 1999 was earning $89,656 after 26 years worked.

    He retired in 2003 earning $97,949 after 30 years worked as a Vocal Music teacher.

    His pension began in 2003 with after 34.07 years of service.

    Notice the years of service is more than the years worked.

    Teacher and administrator pensions use years of service rather than years worked.

    Good luck convincing Social Security to use years of service instead of years worked.

    Since only a maximum of 2 years of unused sick days can be exchanged for 2 years of service credit,

    Michael obtained years of service credit in ways other than or in addition to exchanging unused sick days for years of service credit.

    The pension on Better Government Association website is listed as $106,073.88.

    Michael may have been the best music teacher in the world.

    With a pension of $106,073.88 after working 30 years he had better have been one of the best music teachers in the world.

    When is the last time you heard an Illinois Education Association radio advertisement on WBBM 780 stating teachers are earning more after 10 years of retirement than their final retirement salary?

    When is the last time you heard an IEA ad stating a teacher is earning a $106,000 pension after having worked 30 years and being retired 10 years.

    The list goes on and on.

    We can find many more examples.

    Yet that’s not good enough for Crystal Lake teachers.

    They have authorized a strike if they don’t get what they want in negotiating with the school board.

    $100,000 pensions aren’t good enough.

    They want more.

    Heaven forbid if the evil school board wants some concessions in a tough economy and house values that have dropped.

    Who cares if a taxpayer might have to take a loss on the sale of their home.

    Taxes must go up to pay for teachers salaries and benefits.

    What a joke.

  16. Alright here we go again.

    More $100,000 pensions in Crystal Lake High School District.

    Because gee whiz the only way to get a quality teacher is to pay them a $100,000 pension.

    And heaven forbid if you question a teachers pay and benefits, that means you are attacking them.

    You can only give them whatever they want because they are hard working and deserve it.

    You can only appreciate them if you give them what they want.

    Baker Jeanne earned $87,712 in 1999 with 30 years teaching.

    She retired in 2002 earning $98,790 with 33 years worked.

    She retired in 2002 with 34 years of service credit.

    Pension on Better Government Association website is $103,381.

    Notice pension is more than final salary.

  17. Another $100,000 pension in Crystal Lake High School District 155.

    hristine Balsano earned $121,935 with 31 years experience and a Masters Degree.

    In 2004 Christine earned $127,910 with 32 years experience as a Librarian/Media Specialist.

    It’s very common for public school librarians to also be media specialists.

    She retired in 2004 with 34 years of service.

    Note years worked is less than years of service.

    Could this be one reason why pensions are underfunded?

    Pension listed on Better Government Association website is $108,245.64.

    Not good enough for Crystal Lake High School teachers.

    They still authorized a strike, hanging that threat over the school board.

    Do you remember hearing over the years how virtually every year there is a school funding crisis in Illinois?

    That the State does not contribute enough to education?

    Well our legislators and Governors have had no problem passing increases to pension and healthcare benefits those very same years you have heard of a state funding crisis.

    There’s many more examples where this came from.

    But don’t take my word for it.

    Do your own research.

    And don’t believe all those evil websites such as FamilyTaxpayers, Better Government Association, and Open the Books.

    And for the definitive answer FOIA the exact data from TRS.

    There might be a errors in interpreting or reporting the above data.

    Seriously.

    Just use the figures as a ballpark.

    But if you read enough examples you get the picture.

    You might detect a bit of irritation in these words.

    You know what’s really irritating?

    The IEA, IFT, legislators, Governors, school boards, teachers, administrators, and media not telling the
    public the real story.

  18. This pension while not nearly as generous as the previous examples is still a very very good pension.

    Renee H Bartholomew earned $73,343 with a Masters in 1999 after 23 years experience.

    She earned $98,234 with a Masters in 2007 after 31 years experience.

    She retired in 2007 with 32.69 years of service credits.

    Better Government Association lists the pension as $68,981.16.

    Since pension is typically 75% of the average of the last 4 years pay, that seems more likely to be about the starting pension.

    She was an English teacher.

    The databases are not clear the time period of the listed pensions.

    Which is why caution should be used in interpreting the data.

    Just use these figures as a ballpark unless you confirm them with TRS or some other definitively reliable source.

    For all we know this person may no longer even be alive.

    Which would obviously be sad.

  19. Another CHSD 155 Pension.

    Lorraine S Baxter earned $106,738 in 2003 with 33 years worked and a Masters Degree per Family Taxpayers.

    She retired in 2003 with 34 years of service per Better Government Association.

    Better Government Association lists the pension as $90,285.72.

  20. Another CHSD 155 Pension.

    James E Beck earned $104,327 in 1999 with 34 years worked per Family Taxpayers.

    He retired in 1999 with 35 years of service.

    The pension in Better Government Association is listed as $100,964.40.

  21. Does it seem to you that taxpayer subsidized healthcare, unavailable to the taxpayers subsidizing the healthcare, is a good investment of tax dollars for retired teachers and administrators earning $100,000 + pensions?

    Of course not.

    For many reasons.

    State pensions are underfunded.

    The State has a huge backlog of unpaid bills to state vendors.

    Kids struggling in reading and math need extra help.

    The list goes on.

    You might wonder if the use of specific names and numbers in the comments is really necessary, instead of just generic names and average numbers.

    Well the union lists the phone numbers and addresses of CHSD 155 school board members on the union website.

    What is the purpose in teacher contract negotiations of knowing where an unpaid elected school board member lives.

    So you can drive by their house to intimidate them or picket their house?

    Do you see any phone numbers and home addresses here?

    Remember that a teacher work year is listed in their collective bargaining agreement, typically 36 weeks which is 180 days, less than 8 hours a day.

    Subtract from that the 10 – 15 sick days a year listed in the collective bargaining agreement, which either the teacher uses or can exchange at retirement for cash or years of service credit.

    No such thing as use it or lose it for teacher sick days.

    The work year of administrators is listed in their contract.

    A principal work year is typically pretty closely aligned with a teacher work year.

    Superintendents and some Assistant Superintendents contracts might stipulate year round work, with a generous allowance of vacation and sick days.

    Often or typically no such thing as use it or lose it for administrator vacation and sick days, usually they can be rolled over and exchanged for years of service credits or cashed out at retirement.

    Teachers receive extra pay for duties over and above standard teaching.

    For example coaching a sport or leading a club.

    That pay is called stipend pay.

    So if stipend pay is involved, the teacher works longer hours.

    So when you see high paid gym or Drivers Ed teachers, they are sometimes coaching one or multiple sports.

    The degree of difficulty of the job varies greatly.

    The same classroom could be easy for one teacher to handle yet difficult for another teacher to handle.

    A Kindergarten teacher for example may be sailing along fine and all the sudden one year have three very unruly kids in the classroom and it turns into an extremely difficult job for even the best teacher.

    Just as with any job there are all sorts of nuances that only one doing the job fully understands.

    So when teachers say they have a difficult job, well just about everybody has a difficult job in their own way.

    Roofers, waitresses, taxi cab drivers, bell hops, pilots, healthcare professionals, etc. just about everyone has a difficult job.

    Teachers are no better and no worse than any other profession.

    All things to consider when analyzing teacher and administrator salaries and benefits.

    The one thing that really stands out in public education and a few other public sector careers.

    No competition for the tax dollars being spent.

    Despite budgets being posted, annual financial reports, salaries posted, and other transparency, not a
    good understanding how the money is being spent.

    It’s a 500 piece jigsaw puzzle that needs to be pieced together.

    There’s a lot of teacher and administrators fed up with the dysfunctional system.

    But because the pay and benefits is so good in suburban Chicago, most of them just put up with it until
    they retire.

  22. TRIP Medicare Advantage.

    A Medicare plan for the advantage of retired teachers subsidized by taxpayers, for which taxpayers not part of the teacher special interest group are not eligible.

    Advantage goes to teachers.

    Disadvantage goes to taxpayers whom are not teachers.

    Taxpayer money is being spent so teachers with $100,000 pensions have more affordable healthcare than many other Medicare eligible retirees whom have much less generous retirements.

    Is that a good use of taxpayer dollars?

    Subsidizing Medicare for teachers with $100,000 pensions?

    Have we gone mad?

  23. The TRIP Medicare Advantage Program is also known as Total Retiree Advantage Illinois (TRAIL).

    TRIP and TRAIL are for the teacher special interest group.

    Funding provided by Illinois taxpayers.

    Not in the special interest group?

    Too bad, you have to pay for it anyways.

    Too bad, you have to fund the teacher Medicare plan which is better than most Medicare plans.

    Teachers with $100,000 + pensions are eligible for the teacher Medicare plan too.

    There is no income eligibility ceiling.

    Another good use of Illinois taxpayer dollars.

    What about the taxpayers struggling to pay for their more expensive Medicare with worse coverage.

    Oh well.

    Too bad, too sad.

    They are in the losers bracket.

    Because this is not about using state taxpayer dollars for those in financial need.

    This is about taking care of special interest groups that provide campaign contributions, votes, and
    electioneering assistance.

    And, to get good teachers the State must allow retired teachers with $100,000 + pensions to be eligible for special taxpayer subsidized teacher Medicare.

    All in the name of educating kids.

    Don’t you dare criticize the special teacher Medicare plan.

    Because that would be attacking teachers you mean person.

  24. COGFA report dated September 2013 stated TRIP and it’s community college cousin CIP (College Insurance Program) prevented themselves from becoming insolvent by holding claims until the following year.

    The Illinois taxpayer subsidies for TRIP and CIP are also detailed.

    It’s a 25 page report.

    http://cgfa.ilga.gov/Upload/Sept2013TRIP-CIPprograms.pdf

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