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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Amid Health Reimbursements Debacle, Teachers Union And Health Insurer Point Fingers

Julie Ste. Marie, courtesy

Twenty-one thousand Vermonters, many employed by Vermont school districts, have had problems with the health reimbursements they are supposed to receive from their employers.

Julie Ste. Marie teaches preschool at Jay/Westfield Joint Elementary School in Jay, Vermont. Since January, the district has automatically put a portion of her paycheck as well as an employer contribution into spending and reimbursement accounts managed by the financial planning company, Future Planning Associates.

Ste. Marie says she and her medical providers have not been able to access that money.

Initially, Ste. Marie says, it took a while for her account debit card to arrive: "I was told to, you know, download my receipts and send them in. And I  jumped through all the hoops and heard nothing and heard nothing."

Five months later, Ste. Marie still hasn't received the $500 reimbursement.

Later, Ste. Marie went to a chiropractor, also covered by her reimbursement plan. 

"They're still calling me and asking me for payment," she says.

Back in January, Ste. Marie and roughly 21,000 Vermont school employees and family members were enrolled in health reimbursement arrangemenet (HRA) and other accounts with the Williston company Future Planning Associates.

Many such enrollees have not received their reimbursements. Others have received payments that don't make sense, and some providers complain they aren't getting paid.

Early last week, Future Planning Associates terminated its agreements with Vermont school districts.

Now, all 21,000 members are in a 20-day reimbursement blackout while their new company gets up to speed.

Everyone agrees it's debacle — but few are willing to take the blame.

"It actually irks me that there are some people that are trying their best to point the finger away from themselves and at somebody else," says Bristol Rep. David Sharpe, chair of the House Committee on Education.

"I actually think there's a little bit of blame for everybody," he says.

A Change In Procedure

The nonprofit risk-pool Vermont Education Health Initiative (VEHI) has long offered comprehensive health insurance to Vermont school employees. All school districts and some private schools have elected to join.

In order to comply with Affordable Care Act rules around grandfathered status, the pool kept employees' costs steady, while school districts' premiums increased.

In 2015, VEHI decided to switch to new, high-deductible plans starting January 2018. School districts would then shop around for health reimbursement accounts, to help share the cost of the high deductibles.

Finger Pointing

Darren Allen, with the Vermont teachers union, blames VEHI for the bungled health reimbursement situation.

"Vermont-NEA three years ago warned VEHI that an abrupt shift of all plans to close and open on the same day would lead to chaos. And sadly, that's what has happened," Allen says.

"I'm mystified by that perspective," says VEHI President Laura Soares. 

According to Soares, the Vermont-NEA collaborated on the changes. Plus, she says, the rollout of the new health plans went just fine.

It's not VEHI which provides the reimbursement accounts, but rather a third party. These were contracted by individual districts which negotiated with local union representatives.

"I did express concern about their capacity," Soares says, as Future Planning Associates had initially told Soares the company was too small to take on all that business.

"So I recommended that people feel confident in their due diligence review process that something had changed in Future Planning to make them able to take it on," she says.

How We Got Here — And What's Next

Before January, when Future Planning Associates took on the 21,000 accounts, the 44-year-old Williston company had managed just dozens of HRAs.

One reason the school districts chose Future Planning Associates was the company's willingness to customize benefits by district; other benefit administrators had said customization would be too burdensome to administer.

But in an email, the company's attorney writes it terminated the HRA accounts to focus its business on retirement planning.

The Vermont Superintendents Association declined to comment.

Meanwhile, Sharpe says the debacle is about something else that's been in Vermont news a lot lately: collective bargaining.

Sharpe says the Legislature should have gotten involved earlier in the debate over whether and how to move teachers' benefits to a single statewide bargaining agreement — the same issue which caused a standoff in the Vermont Legislature a year ago.

"Then we might have moved forward in a way that was more thoughtful," Sharpe says. "And we wouldn't have gotten ourselves into, you know, allowing a gazillion different kinds of high-deductible accounts."

While school employees wait for their new reimbursement administrator to get up to speed, VEHI is reimbursing eligible school employees for prescriptions.

As for medical services, Soares says "anything people pay out of pocket that they are entitled to be reimbursed for, they will eventually be reimbursed for."

Editor's note: Julie Ste. Marie is related to a VPR employee.

Correction: Since publishing, VPR has corrected the type of health accounts Ste. Marie contributed to. 

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