School District backs down on health insurance
Facing a $7 million health fund deficit and skyrocketing insurance premiums, the Indian River County School District this fall dropped 300 employees from its program.
But last week, after Vero Beach 32963 reported that art teacher Lis Bech, who is undergoing chemotherapy for stage-four ovarian cancer, was cancelled without warning because she filled out an online form incorrectly, the School District decided to allow 100-plus employees dropped for form errors to re-enroll.
Bech had not completed the spouse survey at the beginning of the online application because her husband had never been covered on her policy, and she was in the midst of a divorce. That’s why her application was rejected.
Now it turns out hers was not an isolated case. Teachers union President Liz Cannon said the School District last week sent out 111 emails to employees who failed to fill out the spouse survey, telling them they were out of the program but could re-enroll by Nov. 10.
This came after the teachers union researched the Affordable Care Act and notified the district of two infractions in its treatment of people kicked out of the health insurance program.
First, the district violated ACA rules by dropping Bech and others for filling out the online form wrong. The only allowable reasons for canceling coverage are non-payment of premiums, fraud or deliberately giving false information, and even then 30-days’ notice is required.
Second, the district, which is self-insured, is required to put an internal and external appeals process in place, and notify those who have been dropped of their appeals options. The district did not inform Bech she had been dropped, nor that she could appeal that action. She learned she was no longer covered only when she went in for a chemotherapy treatment and was told her insurance had lapsed.
Shocked and scared, Bech called the district’s benefits department, but no one would take her call. She was allowed to email, however, and got a response. “They told me in an email that I was no longer on the district insurance, and it was my fault because I filled out the form incorrectly," Bech said.
“I felt like a beggar. I had to sign all these forms [at the doctor’s office] so they could apply for funds to pay for my treatment. I felt horrible about it. I’ve always paid my bills. I think it was very unfair to be treated so horribly by the district.
“I think they thought they would get away with it. It’s poor management of the health fund and the buck stops with [Assistant Superintendent William] Fritz. He’s supposed to know how to run the fund. That’s why he got the job,” Bech said.
Lis Bech has since filled out the spouse survey form and her health insurance has been reinstated, and the district is now allowing the 100-plus other employees dropped for form errors to re-enroll.
Fritz, however, told Cannon the union’s legal research had nothing to do with the re-enrollment decision.