Arbitrator: City can verify dependent coverage under Health Benefits Program

In 2010, San Antonio firefighters represented by IAFF, Local 624 had a "passive" enrollment during the open period of the City's health care plan. Employees were not required to affirmative confirm dependent coverage; if a firefighter did nothing coverage would continue for previously listed dependents. That same year the City arranged for an outside consultant to audit the health care plan. That audit concluded that appropriate documentation for dependent family members, including birth and marriage certificates, was missing from some employees records.

In 2012, in order to confirm or verify that dependents covered under the family medical plan remained eligible, the City notified employees that they must actively enroll during the annual open period. The Union challenged this action and, after a period of litigation, the dispute was submitted to Arbitrator Maretta Comfort Toedt for resolution.

The Union raised a number of claims in support of its grievance. Initially it asserted that the City's action in requiring verification of dependent coverage violated the Maintenance of Standards provision of the cba. The Union argued that the "standard" in question was the Company's practice of never previously having conducted  audits of covered dependents. Arbitrator Toedt rejected this contention, noting:

"Freedom from audits” does not fall within the parties’ definition of a standard, privilege, or working condition. While the City may not have conducted audits for the purpose of verifying eligibility for dependent coverage in the past, this is not the same as a standard, privilege, or working condition. I agree with the City on this point; the grievance does not properly identify a standard, privilege or working condition as contemplated under Article 9. 

The Union also claimed that the Company's conduct breached the cba's guarantee that health care benefits for active Fire Fighters "shall not be terminated, altered, modified or reduced during the term of the Agreement." The Arbitrator concluded that the Union's reliance on this provision was misplaced. She observed:

While Article 25, Section 3 provides that the City will not terminate, alter, modify or reduce health care benefits during the term of the Agreement, it does not prohibit the City from determining eligibility and terminating coverage for individuals if they no longer meet the eligibility criteria for receiving those benefits. [footnote omitted]

Finally, the Arbitrator concluded that the benefit plan's Master Contract Document, which was incorporated into the cab, "implicitly but clearly entitled the City to conduct reasonable inquiries from time to time to confirm eligibility and to determine coverage."

Arbitrator Toedt declined to rule on the stipulated question of whether the City had the ability to discipline or terminate employees for failing to provide dependent coverage information, noting the absence of any lie case before her. She noted :

The most that I can say is that any case in which an employee is disciplined or discharged for failing to provide such information must be decided on a case-by-case basis by the arbitrator to whom it is presented. The City must prove the facts underlying the discipline. That arbitrator must determine whether the discipline or discharge was for just cause, which may include, among other considerations, whether notice was provided, progressive discipline, the appropriateness of the discipline, and possibly other due process issues. I can say no more than that I have interpreted the language of the CBA/MCD to mean that the City can request such information without violating either the CBA or the MCD. 

The San Antonio Express News reports on the case, and links to Arbitrator Toedt's award, here