ILWU Longshore workers sue port employers group, others for over $100 million in unpaid health claims

ILWU Longshore workers sue port employers group, others for over $100 million in unpaid health claims
http://www.presstelegram.com/general-news/20150304/longshore-workers-sue...
By Karen Robes Meeks, Long Beach Press Telegram
POSTED: 03/04/15, 6:08 PM PST
LOS ANGELES >> Port dockworkers are suing terminal operators and ocean carriers along the West Coast for what they say are tens of millions of dollars in unreimbursed health claims.

The Pacific Maritime Association, along with Zenith American Solutions and Cigna Inc., the current and former third-party administrators of the employee health plan for International Longshore and Warehouse Union workers, are named in a class-action lawsuit filed last week in federal district court in Los Angeles.

The suit also names Pacific Maritime Association trustees who manage the plan, saying that they are not acting in the best interest of employees.

Officials with PMA declined to comment, and Zenith and Cigna did not return calls or emails seeking comment Wednesday. The union declined to comment, referring media calls to the office that manages the PMA health plan, which did not immediately respond.

The plaintiffs, Lorena Armijo and Kristen Andrich, who are married to ILWU Local 13 members covered by the PMA Plan, and Dr. Ralph Mayer, a Los Angeles surgeon who specializes in obstetrics and gynecology, are among the thousands whose claims have not been repaid even though care and treatment was deemed necessary and covered by the plan, the claim alleges.

The plan covers longshore workers along West Coast ports, including the ports of Los Angeles and Long Beach, and their families.

“I got involved because the PMA plan denied payment after I devoted my time and expertise. I saved patients’ health, dignity and often lives and was never compensated,” Mayer said. “The PMA plan promises their employees medical care, promises doctors payment and then denies both.”

Michael McClelland, co-counsel for the plaintiffs in the case, would not disclose what medical procedures Armijo and Andrich needed to be reimbursed for, citing health privacy law.

If PMA’s health benefit plan violated federal law, the port employers could be on the hook for as much as $100 million in unpaid expenses, McClelland said. Some 300,000 claims range from surgical procedures to steroid injections. Hospitals and surgical centers are owed millions of dollars, he said.

“The PMA health benefit plan agreed in past contracts with the ILWU to provide specific health care benefits to ILWU members and their beneficiaries,” McClelland said. “This case is about the PMA’s undeniable failure to honor its requirements under federal law to pay those benefits, which have resulted in devastating harm.”

The unpaid claims have forced doctors to drop patients while other patients opt not to seek necessary care, he said.

“People are not getting care to avoid paying for a bill they are not responsible for,” McClelland said.

PMA and the other defendants named in the lawsuit have 20 days to respond.

Contact Karen Robes Meeks at 562-714-2088.