John Curry's answer to Damon's query, 'What are you talking about?'

From John Curry, September 27, 2006

Subject: Curry to Asbury #3

In reference to the recent letter to Damon Asbury that I sent on 9/25/06 and his five word reply that he sent back to me -- "What are you talking about?" (this letter is listed at the very end of this email): I will inform not only Damon (as if he didn't know what I was talking about) and the rest of the people reading this letter of what I was talking about. Damon, what I am talking about are the following "official" board minutes from the August 17, 2006 STRS Board meeting at which you were present. I will highlight, in boldface and larger text, what I was "talking about." I can't believe Damon had forgotten this discourse on enrollment restrictions requested by the board. It is apparent that this research was requested by the STRS Board - very apparent. Will we see these suggestions go from lip service to a funeral service for tens of thousands of STRS retirees and their spouses? ...and yes, Damon, this HAS opened up a whole new can of worms. John Curry

P.S. Thanks, Damon, for sending me a copy of the official board minutes!

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"Mr. Billirakis recognized Greg Nickell, director of Health Care Services, for a presentation on enrollment restrictions requested by the board. At this time, Ms. Ramser said that Mr. Lazares had been called away on personal business and would not return for the remainder of the day.

Mr. Nickell then reviewed the four ways benefit recipients with 15 years or more of service credit may join the STRS Ohio Health Care Program or enroll in an STRS Ohio-sponsored health care plan:

1. At retirement

2. During any open enrollment;

3. At any time, if they had creditable coverage before enrolling and enroll within 31 days of losing coverage; or

4. After a six-month waiting period if they did not have creditable coverage.

Mr. Nickell reported that based on a request from the Retirement Board on enrollment restrictions, additional legal research at the federal and state level has been completed. On the federal level, the HIPAA provision found in the Public Health Service Act (PHSA) applies to STRS Ohio. Staff also explored if the STRS Ohio health care plan may take advantage of the small plan exception to HIPAA portability requirements because it has "less than two participants who are current employees." With the assistance from outside legal counsel, Tucker Ellis & West LLP, staff received a favorable informal response from Centers for Medicaid and Medicare (CMS), which indicated it agreed that STRS has a reasonable basis to conclude that it is not subject to the HIPAA portability requirements under the small plan exception. Based on this response, STRS Ohio would not have to offer an annual open enrollment and therefore can significantly limit special enrollment provisions (SEP) opportunities.

Ms. Ramser asked if a rehired retiree would be considered a "current employee" and Mr. Nickell said "no" because a rehired retiree still receives a pension benefit. Mr. Billirakis asked about an STRS Ohio retiree who chooses STRS Ohio's health care at retirement but the spouse does not enroll at that time. Mr. Nickell affirmed that as long as the STRS Ohio retiree was enrolled in the STRS Ohio plan, a spouse could enroll at a later date. He went on to explain that if the STRS Ohio retiree and spouse had both decided to go elsewhere for health care coverage and subsequently lost it, then neither of them would be allowed to enroll in the STRS Ohio health care plan under the restrictions currently being explored.

On the state level, Tucker Ellis & West LLP determined there are no Ohio laws other than court-ordered guardianship and Board Rules that must be considered in connection with restricting enrollment opportunities. Tucker Ellis & West LLP recommended focusing attention on clear revisions to the Board Rules if the Retirement Board pursues limiting enrollment Mr. Nickell also reported if STRS Ohio considers making enrollment provisions more generous than the minimum HIPAA requirements, additional consideration should be given to the impact on specific enrollee segments.

Due to several important issues, staff recommended delaying any change in enrollment opportunities until 2009. By waiting until 2009, adequate analysis may be conducted and advanced notification could be given to the membership. Dr. Leone questioned if the Retirement Board passes this motion and something happens in the next 12 months, could the Board change its mind. Mr. Billirakis and Mr. Nickell responded "yes" to this question. Mr. Billirakis also explained there was no motion to take formal action.

Dr. Leone also questioned why outside legal counsel was needed to conduct this research rather than having the Attorney General provide it. Bill Neville, general counsel, responded the Attorney General had determined outside counsel was necessary because of the specialized nature of the health care topic and the major implications of such research. Currently, Mr. Neville indicated STRS Ohio does not have this specialized expertise in house.

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From: Damon Asbury

To: John Curry

Sent: Monday, September 25, 2006 7:12 PM

Subject: RE: Curry to Asbury

What are you talking about?

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From: John Curry

Sent: Monday, September 25, 2006

To: Asbury, Damon

Cc: John Lazares; Leone, Dennis

Subject: Curry to Asbury

Damon,

So now, some at STRS are considering the possibility of not letting retirees who (due to $700 a month hc insurance premiums left the system to go back to work to afford "affordable" hc insurance) left STRS healthcare programs NOT COME BACK IN??? What next?

To those at STRS (Not Dennis Leone or John Lazares) who would ever coalesce with this gutless concept I say to you, " Your predecessors on the Board and in management were playing golf, racking up bar bills, eating at expensive restaurants, watching Broadway musicals, and globetrotting (all on our dime) while they should have been minding the store and now you are giving lip service this concept while we were and are still subsidizing your child care center and furnishing your associates with an excellent (and inexpensive) healthcare package far superior to retirees (with free dental coverage included), and paying for Associate's private attorney fees? You have no conscience." Of course, most of those who will aid in this decision, if it is ever made, will retire with OPERS benefits and healthcare insurance, won't they? Will today's lip service be tomorrow's reality?

Damon, this has opened up a whole new can of worms.

John