An intermediate Illinois state appeals court upheld a trial court's ruling that a municipal employer's obligation under a state statute to pay the whole health insurance premium for an injured police officer and his family is not applicable until and unless it is determined that he is entitled to a line-of-duty disability retirement pension because he will never return to work after suffering permanent disability caused by a catastrophic injury. Nowak v. City of Country Club Hills, #111838, 2011 IL 111838, 2011 Ill. Lexis 1834.
     The California Supreme Court stated that a county and its employees can enter into a binding implied contract granting a vested right to health insurance benefits on retired county employees when there is no explicit statute or ordinance prohibiting such an arrangement. The court made its ruling in response to a certified question submitted to it by the U.S. Court of Appeals for the Ninth Circuit in a case in which an association of county employees challenged the validity of changes a county made to health benefits for retirees, which would have the effect of eliminating a subsidy for retirees' health insurance. Retired Employees Assn. v. Co. of Orange, #S184059,  2011 Cal. Lexis 12109, 52 Cal. 4th 1171.
      After a firefighter settled workers' compensation claims for various job-related injuries, he was awarded a line-of-duty disability pension. He then sued to have his continuing health insurance premiums paid under the Illinois Public Safety Employee Benefits Act, 820 ILCS 320/10, and Public Employee Disability Act, 5 ILCS 345/1(b). An intermediate appeals court found that the plaintiff was entitled to payment of the health insurance premiums under both statutes, based on agreed upon facts in the workers' compensation commission proceeding, which the Village was barred from relitigating. Richter v. Village of Oak Brook , #2-10-0114, 2011 IL App (2d) 100114, 2011 Ill. App. Lexis 1037 (2nd Dist.).
     The State of Arizona, in 2008, extended health insurance benefits to both same-sex and opposite-sex domestic partners of state employees. Later that same year, voters in the state approved an amendment to the state constitution that defined marriage as only including relationships between a man and a woman, and then in 2009, the governor signed into law legislation removing health insurance coverage for domestic partners. A federal appeals court ruled that doing so violates equal protection of the law. Saving funds in this manner depends "upon distinguishing between homosexual and heterosexual employees, similarly situated, and such a distinction cannot survive rational basis review." Diaz v. Brewer, #10-16797, 2011 U.S. App. Lexis 18467 (9th)
     When a city realized that police and firefighters who had previously retired on disability pensions were receiving full reimbursement of their medical benefits without legal entitlement, the payments were stopped. In a lawsuit brought by the retirees, a federal appeals court ruled that, except for two retirees who received explicit promises of continued full medical benefits, the retirees had no right to such payments. The city had no obligation to continue payments not authorized by law, and to do so would be a misuse of public funds. Cahoon v. Shelton, #10-2134, 647 F.3d 18 (1st Cir. 2011).
    A county "wellness" program which imposed a $20 per paycheck financial health insurance penalty on employees who declined to participate, refusing to undergo a health assessment, did not violate the Americans with Disabilities Act (ADA), as the program carried out principles of insurance and risk management. The assessment includes a health questionnaire and biometric screening, including a blood test to measure glucose and cholesterol levels.
     While the ADA requires that such programs be voluntary, the court in this case found that imposing a financial penalty on those who don't participate doesn't violate the statute, but is protected by the Act's "safe harbor" provision allowing the establishing, sponsoring, observing, or administering "of the terms of a bona fide benefit plan that are based on underwriting risks, classifying risks, or administering such risks that are based on or not inconsistent with State law." Seff v. Broward County, #10-61437-CIV 2011 U.S. Dist. Lexis 44807 (S.D. Fla.).
     Rhode Island court restores dental health benefits to retired police officers, because they had vested rights and were not represented by the union that represents employed officers. Beauchemin v. City of Woonsocket, #10-2066, 2010 R.I. Super. Lexis 104.
    An Oregon city's policy of denying health insurance coverage to its retirees does not violate their due process rights. The plaintiffs lacked a legally protected property interest to health benefits. Doyle v. City of Medford, #07-35753, 2010 U.S. App. Lexis 10722, 188 LRRM (BNA) 2799 (9th Cir.).
     U.S. Departments of Treasury, Labor, and Health and Human Services publish rules under H.R. 3590 (2010), the Affordable Care Act (P.L. 111-148), requiring plan sponsors to amend their healthcare plans to redefine the term "dependent," for purposes of eligibility of adult children under age 27. Interim Final Rules for Group Health Plans, 75 (92) Federal Register 27122-27140, 29 CFR Part 2590 (5/13/2010).
     New, national healthcare law provides that adults with pre-existing conditions will be eligible to join a temporary high-risk pool, which will be replaced by a health care exchange in 2014. Insurance companies will face restrictions on annual caps, which will be prohibited by 2014. Insurers can no longer drop policyholders when they get sick. A Senate amendment was signed in the same week. Many other provisions will not take effect until 2011 to 2017. Patient Protection and Affordable Care Act, Pub. L. No. 111-148 (2010).
    Current city employees lack standing to sue over a lack of health-care benefits for retirees. Bova v. City of Medford, #08-35091, 2009 U.S. App. Lexis 9606, 106 FEP Cases (BNA) 206 (9th Cir.).
     Ninth Circuit holds that retired employees who receive healthcare benefits, while no longer members of a valid bargaining unit, have standing to challenge an end of benefits as "plan participant" under ERISA, 29 U.S. Code §1132. Poore v. Simpson Paper Co., #05-36060, 2009 U.S. App. Lexis 11174 (9th Cir.).
    A Pennsylvania city could recover funds spent for an injured officer’s wages and medical expenses from any judgment the officer might collect from a third party. State law did not bar an employer’s right of subrogation. Cole v. City of Wilkes-Barre v. Shiels, #08-1412, 2009 U.S. App. Lexis 8777 (Unpub. 3rd Cir.).
     Section 6432 of the American Recovery and Reinvestment Act of 2009 provides premium assistance to persons eligible for a COBRA continuation of group health insurance coverage due to an involuntary termination of employment. The Act provides for a subsidy of 65 percent of the COBRA premium charged to an individual for a maximum period of nine months, which is offset by a reduction in employer payroll taxes.
     City employee recovers payment for the two hours of work time lost to take a mammogram. N.Y. Civil Service Law §159-b/c provides that employees are entitled to up to four hours leave annually to have a mammogram or prostate cancer screening. Moran v. City of Saratoga Springs, #45-1-2008-0150, 2008 N.Y. Misc. Lexis 4605 (Sup. Saratoga Co.).
     Arbitrator sustains the termination of a municipal employee that intentionally delayed providing notification of his divorce to management so that his ex-wife could continue to access his health insurance coverage; when confronted, the grievant was not honest or forthcoming. City of Eugene and AFSCME L-1724, 124 LA (BNA) 1724 (Henner, 2008).
     The Office of Personnel Management now authorizes insurance carriers participating in federal employees health benefits plans to reimburse physicians who screen their patients for substance use behavior (alcohol, illicit drugs, and prescription drug abuse) and to provide intervention programs. Office of Natl. Drug Control Policy News Release (4-7-2008).
     The mere fact that a county sheriff has chosen to participate in a group health plan managed by a city does not make the city the "employer" of county correctional officers. City of Boston and AFSCME C-93, #MUP-03-3880 (Mass. Emp. Rel. Bd. 2008).
     Eighth Circuit overturns a city's unilateral discontinuance of health insurance premium payments for retired public employees as required by a bargaining agreement; Art. I §10 of the U.S. Constitution prohibits the impairment of contracts. AFGE L-2957 v. City of Benton, Ark, #07-1589, 2008 U.S. App. Lexis 1416 (8th Cir.).
     Arbitrator finds that management violated the bargaining agreement by unilaterally adding a spousal surcharge or additional payment for health coverage. City of Painesville and IBEW L-673, 123 LA (BNA) 1563, FMCS Case #06/58893 (Cohen, 2007).
     Arbitrator holds that management violated the bargaining agreement by charging higher medical co-payments without improving the coverage. Hamilton Co. Sheriff's Dept. and FOP Ohio, FMCS Case #06/00964, 123 LA (BNA) 851 (Dissen, 2007).
     Massachusetts appellate court concludes that it was lawful for a town to fire an at-will animal-control officer after she requested enrollment in the town's health insurance plan. "Mere eligibility for the insurance does not in any way protect the employment status of a town employee." Parker v. Town of North Brookfield, #06-P-167, 68 Mass. App. Ct. 235, 861 N.E.2d 770, 25 IER Cases (BNA) 1283, 2007 Mass. App. Lexis 157.
     Arbitrator rejects a grievance that the county deducted too much for medical insurance; "for at least fifteen years prior to the instant grievance, the county has administered the opt-out provision in precisely the same fashion." Cuyahoga Co. and Ohio PBA, FMCS Case #050926/59407, 122 LA (BNA) 1808 (Ruben, 2006). [N/R]
     A police officer, who was injured in an automobile accident, was entitled to retain money paid to him under an underinsured motorist claim. Although the village paid his medical claims, it was not entitled to a lien on his insurance recovery. Musgrove v. Amer. Prot. Insur. Co., #12865/04, 2006 NY Slip Op 6566, 2006 N.Y. App. Div. Lexis 10877 (2006). {N/R}
     Appellate court holds that a city did not violate the Equal Protection Clause when it denied a retired firefighter's claim for health benefits. Sellars v. City of Gary, #05-3858, 453 F.3d 848, 2006 U.S. App. Lexis 16965- (7th Cir. 2006). {N/R}
     Employee's claim that the group health insurance policy provided by a public employer did not cover in vitro fertilization, does not establish a prima facie case of disability discrimination. Knight v. Hayward Sch. Dist., #A106449, 132 Cal.App.4th 121, 33 Cal.Rptr.3d 287, 2005 Cal. App. Lexis 1339 (1st Dist. 2005). {N/R}
     Seventh Circuit holds that the due process rights of retired officers were not violated when the county required retired sheriff's deputies to pay higher health care premiums than required by currently employed deputies. Germano v. Winnebago County, #04-3319, 2005 U.S. App. Lexis 6075 (7th Cir. 2005). {N/R}
     Arbitrator holds that management did not violate the bargaining agreement when it stopped paying for health insurance for a pregnant police officer who was on FMLA leave, and ineligible for group coverage. Vil. of Huntley, IL and Metrop. Alliance of Police C-207, 120 LA (BNA) 949, FMCS #040218/03758-A (Cox, 2004). {N/R}
     Arbitrator holds that management did not violate the bargaining agreement by requiring new enrollees in the health plan to document the status of persons they claim as dependents. Enrollment procedures are an administrative matter and the process does not confer a benefit on employees. Milwaukee Bd. of Sch. v. Teachers Educ. Assn., 120 LA (BNA) 279 (Winton 2004). {N/R}
    Arbitrator holds that management violated the bargaining agreement by unilaterally imposing deductibles on employee medical benefits. The terms "deductible" and "coinsurance" are not interchangeable. City of Middletown and IAFF L-336, 120 LA (BNA) 8, AAA Case #52-390-00845-03 (Braverman, 2004). {N/R}
     EEOC approves a final regulation that allows employers to reduce or end health benefits when a retiree becomes eligible for Medicare or under a comparable state retiree health plan, without violating the Age Discrimination in Employment Act. Age Discrimination in Employment Act: Retiree Health Benefits, 29 CFR Parts 1625 & 1627, RIN 3046-AA72, 72 (40) U.S. Law Week 2640 (2004). {N/R}
     Employers will be able to reduce or eliminate retired workers' health benefits after they qualify for Medicare, under a revised Rule of the Equal Employment Opportunity Commission. U.S. E.E.O.C. Notice of Proposed Rulemaking: Age Discrimination in Employment Act -- Retiree Health Benefits, 68 (134) Fed. Reg. 41542 (July 14, 2003). [2004 FP Jun]
     Arbitrator holds that a county did not violate the collective-bargaining agreement when it negotiated a new health plan. Some employees were disadvantaged by the changes, and others benefited. Clark County [Ohio] Sheriff and FOP, 118 LA (BNA) 1493, FMCS #02/04119 (Graham, 2003). {N/R}
     Arbitrator holds that a sheriff's dept. violated the bargaining contract when it unilaterally changed the health insurance plan, based on the recommendations of a cost containment board. Lucas County Sheriff's Office and Ohio PBA, 118 LA (BNA) 929, FMCS Case #03/06631 (Coyne, 2003). {N/R}
     Arbitrator rules that management violated the bargaining contract by changing the health insurance carrier, increasing firefighter co-pay costs. City of Glenpool, Okla. and IAFF L-2990, 118 LA (BNA) 761, FMCS Case #020827/15296-8 (Neas, 2003). {N/R}
     Supreme Court declines to review an en banc appellate decision that held, 9-to-3, that the government was not obligated to honor medical claims of veterans that had enlisted with a promise of lifetime medical benefits. Schism v. U.S., #99-1402, 316 F.3d 1259 (Fed. Cir., en banc 2002); cert. den. #02-1226, 2003 U.S. Lexis 4404, 71 Law Week 3750 (2003). {N/R}
     Federal appeals court splits 9-to-4 to deny VA hospital benefits to retired service personnel who enlisted between 1941 and 1956, even though they were told by military recruiters they would receive free lifetime health care if they stayed in the service 20 years. In 1995 the Pentagon ended those benefits for veterans over 65 because they are eligible for Medicare. The majority found that the recruiters had no authority to make those promises. Schism v. U.S., #99-1402, 2002 U.S. App. Lexis 23769 (en banc, Fed.Cir. 2002). {N/R}
     Arbitrator sustains a grievance that a new health plan, which allowed the employer's premium payments to remain constant, but caused employees' out-of-pocket expenses to skyrocket, was not an equivalent program. Coles County 911 Board and IL FOP Labor Council, FMCS Case #010502/10114-A, 117 LA (BNA) 462 (Petersen, 2002). {N/R}
     Arbitrator holds that a Township violated the bargaining agreement when it raised drug prescription costs from three dollars to $15 per prescription for generics and $30 for brand name drugs. Olmstead Twp. and Frat. Order of Police, 117 LA (BNA) 540, FMCS Case #00120/00854-6 (Van Pelt, 2002). [2002 FP Dec]
     Arbitrator holds that a city did not violate the CBA when it increased fees for ER visits and changed the payment system for prescription drugs. "Substantially similar benefits" should refer to changes that apply to a plan as a whole, and not to minor provisions. Elk Grove Village and Prof. Firefighters L-2340, 117 LA (BNA) 152 (Nathan, 2002). {N/R}
     Arbitrator rules that a city did not violate the bargaining agreement when it had to replace the dental coverage with a more expensive policy, which required a worker co-payment. The contract was silent on dental plan coverage. Oklahoma City and FOP L-123, FMCS #01/05071, 116 LA (BNA) 1502 (Moreland, 2002). [N/R]
     An employer complies with its duty under COBRA, 29 U.S. Code §1161-1169, by sending a letter to an individual's last known address by certified mail, even when the employer knows that the individual did not actually receive the letter. Degruise v. Sprint, #00-31320, 279 F.3d 333, 2002 U.S. App. Lexis 1116 (5th Cir. 2002). [N/R]
     Federal court in Seattle orders an employer to cover the cost of prescription contraceptives in its insurance plan. Erickson v. The Bartell Drug Co., #C00-1213L, 141 F.Supp.2d 1266, 85 FEP Cases (BNA) 1569, 2001 U.S. Dist. Lexis 7550 (W.D. Wash. 2001). [2001 FP 120]
     City, for valid financial reasons, could not unilaterally change the benefits paid on its health plan, where the bargaining agreement prohibited a reduction of benefits. Arbitrator holds that past practices were not controlling. Norman (City of) and FOP L-122, FMCS #00/15703-8, 115 LA (BNA) 827 (McReynolds, 2001). [2001 FP 83]
     Arbitrator finds that management violated the bargaining agreement when it adopted new health plan that increased the employee co-pay from $10 to $15. Muskegon (County of) and AFSCME C-25, L-570, AAA # 54-390-00712-00, 115 LA (BNA) 1239 (McDonald, 2001). {N/R}
     Wisconsin arbitrator holds that a town violated the bargaining contract, which provided that management could change insurance carriers provided that benefits remained equivalent. Oconomowoc (Town of) and Wis. Prof. Police Assn., Grievances #98-311 and 00-220, 115 LA (BNA) 169 (Petersen, 2000). [2001 FP 83-4]
     EEOC holds, in two cases, employers violated Title VII and the PDA by not providing prescription benefits to women for contraceptives. www.eeoc.gov/docs/decision-contraception.html [2001 FP 24-5]
     Federal workers now allowed 4 hours time off for some health screenings. White House Executive Dept. Memorandum, “Preventive Health Services at the Federal Workplace” (Jan. 4, 2001). [2001 FP 25]
     Health plan that excludes infertility treatments does not violate the ADA or PDA. Krauel v. Iowa Med. Ctr., 915 F.Supp. 102; 69 FEP Cases (BNA) 182 (D.Iowa 1995). [1996 FP 88]
     Federal appeals court holds that ERISA does not prevent an employer from reducing the maximum benefits for AIDS related illnesses from $1 million to $5,000. McGann v. H&H Music, 946 F.2d 401 (5th Cir. 1991); cert.den. 113 S.Ct. 482 (1992). {N/R}
     Township that agreed to pay retired employees’ medical insurance could not unilaterally terminate obligation. Newport Twp. v. Margalis, 532 A.2d 1263 (Pa. Cmwlth. 1987).
     Recipient of medical benefits was entitled to due process before termination; commission of a felony did not eliminate these rights. Knudson v. City of Ellensburg, 832 F.2d 1142 (9th Cir. 1987).
     COBRA's Public Health Amendments requires state and local governments to continue health insurance to former employees, their ex- spouses, and certain dependents under specified conditions. Consol. Omnibus Budget Reconcil. Act, P.L. 99-272 Sec. 10003 (April 7, 1986).
     City could not require married employees to be covered under same health policy if issuance of second policy increased benefits. Fraternal Order of Police v. City of Columbus, 24 Ohio App. 157, 493 N.E.2d 983 (Ohio App.).
     Domestic Partners: See topic by that name, with several cases relating to health insurance.