NTA EBulletin: May 18, 2025

Tufts Late Rejection of Payments:

Follow Up

On Friday afternoon, NPS HR Support sent out the following email regarding Tufts denial of payment for health insurance claims:

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We are happy to share that Tufts will begin reprocessing all health insurance claims ranging from 2021 - 2023 starting May 19th. Please note that it could take up to three weeks for all claims to be reprocessed.

If after this time period, your invoice has not been processed, please reach out to Human Resources for further assistance. 

Thank you for your continued patience and cooperation.

NPS HR

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I had not yet read this HR email at the time I included a post about this situation in Sunday's EBulletin. Today, I have been able to independently confirm this information with the City of Newton's Human Resources Department and the City's CFO. Most of the denied claims should be paid this week, but the Tufts' insurance representative said it may take up to 3 weeks for all of them to paid.

I would like to emphasize once again that Tufts took it upon themselves to deny these payments, without reaching out to the City of Newton first to ask them how the City would like to handle them. 

Chris Walsh's Retirement: Save the Date

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Please mark your calendars: Chris Walsh's retirement party will be on Tuesday, June 17.

RetirementPlus Update 

(Updated 5-18-25)

The state House of Representatives completed its budget debate last week. During floor debate the MTA had a major victory with the adoption of language to create a new, one-time opportunity for teachers to enroll in RetirementPlus. This provision was added during the amendment process with the strong support of the MTA and is nearly identical to the version that passed the House at the end of last session. The MTA is urging members to contact their senators to ask that the Senate follow the House by including this critical priority in its version of the budget. Visit massteacher.org/retirementplus for more information and to send an email to your state senator!

Health Insurance 

(Corrected from April 27, 2025)

In previous versions of this update on Health Insurance costs, I said that health insurance rates went up over 13% last year. This is incorrect. Rates went up 13% the year we switched from Tufts and Harvard to Blue Cross Blue Shield, in July 2023. They went up 7% this year, and will go up 11.2% next year--that's over 31% in three years.

Members have asked: When would this increase come into effect? July 1, 2025.

For retirees on Medicare. The increases to Medicare Supplemental Health Insurance have not yet been determined. They could quite possibly be higher than those for active employees. The increases will come in effect on January 1, 2026. 

Tufts Late Rejection of Payments:

Charges for Services from Medical Providers

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Many of us (including me) who previously had health insurance through Tufts have been billed by our medical providers because Tufts has refused to pay a claim, say that we had other insurance at the time the claim was made, or something like that.

HR sent out an email in mid April informing you not to pay those invoices. Don't pay the bills. If you do, it is highly unlikely you will ever recover the money.  You may want to contact your provider and ask them not to send the bills on to a billing agency if you haven't already.

Unfortunately, this whole situation is a mess. The city of Newton HR office is aware and taking steps to make it right. Tufts (Point 32) is not cooperating; In fact, they are being a pain in the neck.

The issue is that Newton is self-insured, and after a year, Tufts sent back the remaining funds that they held to pay back any late claims. Then, when new claims came in, rather than go back to Newton and tell them they needed additional funds, they simply rejected the claims without informing the City of Newton they were doing so. (This is a simplification; some claims were rejected for other reasons. In my own case, the claims had been approved, but the provider appealed the payment amount, prevailed, and Tufts had to pay them more, after we had switched to BCBS).

I am in contact with the City HR employee working on this issue. We will get it resolved. But the wheels are turning way to slowly.  

If this has happened to you, feel free to let me know by responding to this email. Please do not send medical documents or bills to me. 

Health, Dental and Vision Insurance

Open Enrollment Ends May 30

Some things you can consider when making the choice to enroll in the NPS/City of Newton dental and vision insurance plans.  

Blue Cross Blue Shield Dental

BCBS dental insurance replaced Guardian dental insurance on July 1, 2024. There are two options: high and low. The NPS school pays 50% of the low option; if you choose the high option, you pay the full cost of the difference yourself.

History: The NTA negotiated for the NPS to pay 50% of the cost of "low option" dental insurance in the 2000s, under then president Ken Hamilton. The choice to move to BCBS dental in 2024 was decided collaboratively between the City of Newton and representatives from the city's unions (The Insurance Advisory Committee (IAC)), which includes the NTA). The choice was made on through of a competitive bidding process. Part of the basis for choosing oBlue Cross Blue Shield was the price; part of it was that the provider network for Blue Cross Blue Shield dental is very large, and covered almost every provider that had previously been covered under Guardian, and many more.

Plan Basics: There are a number of differences between the low and high options:

• high option plan pays 60% of the cost of Bridges, Dentures, Crowns and Implants; the low option pays nothing towards these services;

• the high option pays up to $1,500 (lifetime maximum per individual) towards orthodontic services; the low option pays nothing;

• the low option pays a maximum of $750 per year per member; the high option pays a maximum of $1,500 per year per member;

• the deductible for the low option plan are $25 for an individual/$75 for a family; the deductibles for the high option plan are $50 for an individual and $150 for a family.

You can compare the plans here; you can see pricing here.

Altus Vision Insurance

Altus Vision Insurance began being offered by the City beginning in July of 2023 when the City changed to Blue Cross Blue Shield for its dental insurance. Employees pay the full cost of premiums. The rates that Altus Visual charges should be better for the plan offered than you would be able to find on your own because the City negotiated for a group rate.

History: As with our dental insurance carrier, the choice to offer Altus Vision was decided collaboratively between the City of Newton and The Insurance Advisory (IAC). The choice was made on the basis of a competitive bidding process.

When the City and the IAC chose to offer this plan, we were looking primarily at dental, then vision. Altus offered both a dental and vision plan. However, we ended up choosing BCBS for dental insurance, but they did not offer vision. Of the vision insurance providers that made bids to the city, we thought Altus Vision was the best. 

Plan Benefits

You can view what the Altus Vision plan offers here. A couple things to bear in mind:

• through our BCBS health insurance, we are already covered for yearly vision check-ups;

• if you need non-elective surgery or any major medical treatment for your eyes, that too is already covered by your health insurance.

Since you would be paying for the vision insurance entirely on your own, I believe you would need to do a cost benefit analysis of whether you would pay more or less in premiums than you would save on glasses, contacts, etc. 

*****

In solidarity, 

Mike Zilles, President

Newton Teachers Association