• Private Fee-for-Service Plans Have High Disenrollment Rates
• Social Security COLA for 2009 Is 5.8 Percent
• Deadline Near for 2009 Medicare Drug Decision
• Medicare Part D Costs for 2009
• AARP Endorsement Often Boosts Insurer Premiums
• Quote of Note: Failure of American Auto Rescue
• Web Site of the Week: https://unionshop.aflcio.org/For_Union_Kids_C23.cfm?Link_ID=7&

PRIVATE​ FEE-FOR-SERVICE PLANS HAVE HIGH DISENROLLMENT RATES
Medicare beneficiaries in private fee-for-service (PFFS) plans disenroll at higher rates than other Medicare managed-care plans and can be left with larger bills for medical care than other managed-care or traditional fee-for-service plans, according to a Government Accountability Office report released Dec. 15. In the report (requested by House Democrats), the GAO found that during a six-month period in 2007 beneficiaries disenrolled from PFFS plans at an average rate of 21 percent, compared with 9 percent for other Medicare managed-care plans. Beneficiaries who left PFFS plans were sicker compared with other PFFS enrollees and had healthcare expenses about 6 percent higher than those remaining in the plans, GAO reported. GAO said the higher disenrollment rates in PFFS plans could be an "indicator of beneficiary dissatisfaction with access or quality of care or could indicate that other plans with more attractive benefit packages are available." GAO said the Centers for Medicare & Medicaid Services has not complied with statutory requirements to mail Medicare beneficiaries disenrollment rates for managed-care plans in their areas. Enrollees in PFFS plans also can be left on the hook for the cost of a medical service if they or their providers do not seek prior authorization for treatment from Medicare, the report said. If authorization for the service is later denied, the beneficiary could have to pay the entire cost of the service or a higher cost-sharing amount than under other managed-care or fee-for-service plans. GAO said PFFS plans are paid up to 17 percent more than Medicare pays fee-for-service providers. About 2.3 million beneficiaries were enrolled in a PFFS plan as of June 2008. The GAO report also said that private Medicare Advantage (MA) plans spent less on healthcare services than they projected in 2006. As a result, private plans pocketed an extra $1.33 billion in profits-65 percent more than estimated in their 2006 bids. This is the second year in a row that MA organization profits exceeded their own projections. Many policy experts say that private insurers would hold down costs and improve care if they had to compete with a public plan.

SOCIAL​ SECURITY COLA FOR 2009 IS 5.8 PERCENT
Monthly Social Security and Supplemental Security Income benefits for more than 55 million Americans will increase 5.8 percent in 2009-the largest increase since 1982. These benefits increase automatically each year based on the rise in the Bureau of Labor Statistics' Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W), from the third quarter of the prior year to the corresponding period of the current year. The 5.8 percent cost-of-living adjustment (COLA) will begin in January 2009 for the more than 50 million Social Security beneficiaries. The average monthly Social Security retiree benefit will be $1,153 (individual) and $1,876 (couple) in 2009. In addition, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase from $102,000 to $106,800. Eleven million of the estimated 164 million workers who will pay Social Security taxes in 2009 will pay more as a result of the increase in the taxable maximum.

DEADLINE​ NEAR FOR 2009 MEDICARE DRUG DECISION
Time is running out for Medicare beneficiaries to review the dozens of private insurance plans offering Part D prescription drug coverage for 2009. The hard truth is those who plan on enrolling for the first time or changing plans had better do it this week if they expect coverage to begin Jan. 1. Although the 45-day open enrollment period runs through Dec. 31, consumer advocates and Medicare officials suggested early on in the process that seniors and the disabled have their enrollment completed as soon as possible to ensure uninterrupted coverage for prescription drugs. Switching plans near the end-of-year deadline could delay coverage as insurers deal with a barrage of changes. The bad news, as has been the case since Part D was implemented in 2006, is monthly premiums have increased an average of 24 percent. As many as 90 percent of beneficiaries in plans will see price increases, according to the National Senior Citizens Law Center. The good news is that if you satisfied with your current drug coverage, you don't have to do a thing. To compare plans, go to www.medicare.gov but be sure to check with your plan of choice before making a final decision because costs may have changed.

MEDICARE​ PART D COSTS FOR 2009
Part D plan costs change every year and each private plan has different costs, so check with plans in your area to find out what you will pay. With most plans, you pay a monthly premium and part of the cost of each prescription (copayments or coinsurance) until total drug costs paid by you and the plan equal $2,700 (for most plans) Then you may have to pay the full cost of your drugs during the coverage gap, or "doughnut hole"). If you spend $4,350 in 2009 in out-of-pocket drug costs, you will then pay no more than 5 percent for each prescription (plus the premium).

To learn more about the costs and coverage under Medicare Part D, log on to Medicare Interactive at www.medicareinteractive.org/teachers, which is brought to you by American Federation of Teachers and New York State United Teachers. Medicare Interactive Counselor is a resource provided by the Medicare Rights Center, the largest independent source of healthcare information and assistance in the United States for people with Medicare coverage.

AARP​ ENDORSEMENT OFTEN BOOSTS INSURER PREMIUMS
Insurance premiums for plans endorsed by AARP, which it claims in advertisements can save members money, often cost more than other plans, in part, because the insurers build into the cost of their plans hundreds of millions of dollars of royalties and fees paid to the advocacy group for its endorsement. Under AARP's insurance plans, the group collects premiums from its members and then pays the insurers. The insurers then return the royalties and fees given to AARP. In 2007, the royalties and fees totaled $497.6 million, or 43 percent of AARP's $1.17 billion in revenue, compared with 11 percent in 1999. In addition, AARP generates income by holding members' premium payments for up to one month and investing the money before it pays the insurers. Bloomberg/Globe reports that those investments brought in $40.4 million in revenue in 2007. AARP's marketing has been expanded to include 17 types of insurance. AARP's expansion of its supplemental insurance provider contract after lobbying on behalf of the Medicare Modernization Act, which became law in 2003, shows its conflicting roles. Marilyn Moon, former director of AARP's Public Policy Institute, said AARP's mission has been compromised by its reliance on the royalties and fees. "There's an inherent conflict of interest," she noted. "A lot of people there are trying to do good," she added, "but they're ending up becoming very dependent on sources of income." Last month, U.S. Sen. Charles Grassley (R-Iowa) sent letters to AARP CEO William Novelli and state insurance commissioners to inquire into whether the organization misrepresented what is covered in some of the health coverage plans it sold. Four days after the letter was sent, Novelli announced that AARP would review its marketing and suspend sales of those policies.

QUOTE​ OF NOTE: Failure of American Auto Rescue
"Last week, Senate Republicans picked a fight with the U.A.W. on union pay scales-despite the fact that it's the legacy benefits for retirees, not pay for current workers, that's really hurting Detroit, and despite the additional fact that, in any case, labor amounts to only about 10 percent of the cost of a car. But the Republicans were fighting Big Labor! They were standing firm against bailouts! Some of the same conservatives who (correctly, in my view) made the case for $700 billion for Wall Street pitched a fit over $14 billion in loans for the automakers."

William Kristol, conservative columnist
New York Times
Dec. 15, 2008

WEB​ SITE OF THE WEEK:
https://unionshop.aflcio.org/For_Union_Kids_C23.cfm?Link_ID=7&

Looking for last-minute gift ideas for your grandchildren this holiday season? The AFL-CIO's Union Shop Online has lots of great children's items. You can help teach a child about the importance of the labor movement with a Rosie the Riveter jigsaw puzzle or the Community of Workers Coloring Book displaying the diverse range of work and workers. Or check out the great selection of books for children of all ages. Other sites where you can find union- or American-made goods include: www.allamericanclothing.com, www.usmadetoys.com, www.deansbeans.com, www.equalexchange.com, www.powells.com, www.leathercoatsetc.com and www.nosweatapparel.com. Buying at the Union Shop Online and these sites is a great way to support America's workers and share your values with family and friends.

Happy Holidays and Best Wishes for 2009!

Contributors and sources: New York Times, Stockton Record, BNA Healthcare Daily Report, New York Teacher, Medicare Rights Center, National Senior Citizens Law Center, Social Security Administration, Alliance for Retired Americans Friday Alert, Kaiser Health Policy Report. Frank Stella, editor; Laura Baker, copy editor Paula Dutko, design.