Orange-Ulster School Districts Health Plan
Harriman, NY 10926
Trustee meetings – The Board of Trustee meetings are held every third Tuesday of the month at 9:00am in BOCES’ Administration Conference Room #1, on Gibson Road in Goshen.
Appointment of Trustees – Each participating school district is entitled to membership on the Health Plan Board of Trustees. The Superintendent or his/her designee is the representative from each school district. It is important to have a letter on file from each school district indicating the name of the Trustee whether it is the Superintendent or the designee. The Trustee can be changed from time to time at the discretion of the local school district’s Superintendent.
While all districts are entitled to be represented on the Board of Trustees and each has an equal opportunity to voice their opinion on issues pertaining to the Health Plan governance, only participating districts of the Sole Supervisory Districts of Orange and Ulster Counties are allowed voting rights. This clause was added to the Plan when the Plan decided to allow participants by districts who were no members of the Sole Supervisory Districts of Orange and Ulster Counties. The underlying reason for this was that in the event districts outside of Orange County became more numerous than Orange County districts, the Orange County Plan would still be governed by the school districts of Orange County. In addition, it would be difficult to obtain a quorum to hold a meeting and a quorum to pass any Plan resolutions.
Duties and Responsibilities of Trustees
Duties of Trustees – The Board of Trustees is a policy making Board. Their primary responsibility is to determine premium rates, levels of benefits, and types of coverage available. In addition, they are responsible for employing service providers to carry out the various functions of the Plan. For example: Claims Administration, Utilization Review, providing providers of physician and hospital networks, Plan management, auditing services, actuarial services, accounting and financial processing services. A simple majority is required to hold an official meeting and a 2/3 majority is required to approve Plan changes such as rate increases, and changes to benefit levels.
Plan and Local Responsibilities – Trustees have two (2) major categories of duties and responsibilities: A) Plan responsibilities, and B) local school district responsibilities.
Plan Responsibilities – The specific Plan responsibilities are outlined in the Plan By-Laws. Each Trustee is expected to keep the welfare of the whole Plan in mind when they make Plan decisions. This requires that a Trustee set aside their individual school district issues and act on behalf of the Plan.
Local School District Responsibilities – The Plan recognizes that each school district has their own set of unique circumstances with respect to bargaining units, eligibility for Plan participation, as well as different capabilities and resources for administration of the Plan at the local level.
Each Trustee is the link between the Plan and their school district. It is the responsibility of each Trustee to communicate to their school district Plan activities and disseminate Plan information. Therefore, the Trustee must establish procedures within their respective school district to transmit Plan information to those individuals (key personnel, school board members, and enrollees) that need the information.
In addition to Plan eligibility requirements, each school district may have minimum requirements based upon their contractual agreements. It is the responsibility of the Trustee to keep all enrolls informed of local rules and regulations.
Committee System – Because the Plan allows each school district to have representation on the Board of Trustees, it is difficult to carry out the various duties and activities required by the Plan in order to operate successfully. As a result, the Plan has implemented a number of Committees to deal with specific issues and make recommendations to the full Board of Trustees for action.
Committee Structure – Each Committee is made up of six (6) or seven (7) members: Committee Chairman, Chairman of the Board, Plan Administrator, and several Trustees.
Selection of Committee Member – The Chairman of the Board of Trustees annually appoints Trustees to each Committee. The Chairman tries to ensure that every school district has participation on several Committees. All Trustees may participate on any Committee that they have an interest in. They are also able to sit in on Committee meetings if a specific interest or need arises.
Committee Reports – The Committee Chairperson reports to the Board of Trustees the Committee’s activities at the monthly Board of Trustees’ meeting following the Committee meeting.
The Committee meetings are held at the Health Plan office in Harriman. The number of meetings of each Committee will depend upon the needs of the Plan.
The Health Plan uses Committees to make recommendations to the Board for their action. Trustees are expected to participate on various committees. All Trustees are eligible to participate on any committee they have an interest in.
The use of Key Personnel is a significant concept in the successful operation of the Plan. Each school district is encouraged to designate at least two (2) people, usually the individuals are responsible at the local school district for administration of benefits, to work with the Plan in order to make the operation of the Plan as smooth as possible for their enrollees. The Plan holds periodic Key Personnel meetings to educate these “key” individuals in the school district about the Plan operation.
Responsibilities of Key Personnel – The Key Personnel in each school district are those individuals that handle the day-to-day activities of administering the school district’s employee benefits. In the smaller school districts, health coverage may be only one of many benefits offered to employees. In the larger school districts, there may be one or more individuals devoted to working with health coverage.
Duties of Key Personnel – Among the health coverage duties of the Key Personnel will be providing Health Plan information to employees, enrolling new employees for coverage, notifying the Health Plan of changes such as addition of new dependents, change of status, terminations.
In addition to routine duties, Key Personnel the person responsible for the dissemination of the Plan printed material to school district enrollees and they should be familiar with Plan benefits. They will also act as a resource along with the Trustee of each school district to assist enrollees with Health Plan issues.