After sifting through records in the city’s human resources department and stumbling upon a new policy, in July of 2007 I conducted an interview with Northampton Mayor Mary Clare Higgins regarding a change she made to the city’s group health insurance eligibility criteria, a transcript of which can be found in the archives on ValleyAdvocate.com. From the transcript:
The Valley Advocate: “Your (new health insurance) policy went back to people that left with the understanding that they had this benefit. So it’s a retroactive application.”
Higgins: “That’s correct, and, and that’s the way we’re doing it, and you know, if people want to criticize me about that, that’s fine.”
Believing it was, “folklore,” that everybody with ten or more years of service with the city was eligible for health insurance when they retired; in the fall of 2005 Higgins quietly broke a longstanding city promise by retroactively removing health insurance eligibility from former vested employees that had not yet retired and opted into the system. Florence resident Doris Montgomery was one of those persons who had relied upon the city’s word in making her life’s decisions.
Due to declining health, Montgomery left the city’s employ in September 2002 after eighteen years of service as a cafeteria worker, but deferred her option to retire until age 55 or after though she feels she likely could have collected disability insurance had she applied. Before she resigned Montgomery had asked for and received a written letter from the city’s then assistant treasurer Heidi S. Sawicki, whose office formerly administered the benefit. The letter stated, “This is a follow-up to our conversation of last week. Upon your retirement, you will be eligible to join the city’s health insurance plan as a retiree. If you choose not to participate at that particular time, you will have the opportunity to join once a year, during our open enrollment period, usually in the month of May.”
Lacking advance notice to enroll in the program before the policy change, Montgomery received a letter after the fact from the city’s human resource manager, Glenda Stoddard, dated October, 2006, “This letter is to inform you that we have implemented a new policy relative to employee and retiree eligibility for the City of Northampton’s Group Health Insurance benefits. The content of this policy supersedes any other policy or information you may have. I have enclosed a copy of the policy for your review. This policy can be changed and updated as the needs of the City dictate.”
After reviewing the new policy Montgomery felt targeted so she hired an attorney to deal with the city. In January 2007 city attorney Elaine M. Reall wrote Montgomery’s attorney, Robert G. LaFlamme in part:
“I am sorry that Ms. Montgomery concluded that she was entitled to coverage based on her discussions with individuals not authorized to bind the City, either orally or in writing, in such a matter. M.G.L., Chapter 32B plainly states that any such eligibility for continuation of coverage is a creature of statute. My review of the situation outlined in your recent letter does not lead one to believe that the City has violated its statutorily mandated responsibility in this matter. Accordingly, the City’s written policy and the plain terms of Chapter 32B must control any City decision as to eligibility for health coverage.”
Mr. LaFlamme responded in part in March 2007:
“We do not agree with the position of the City of Northampton on this case. Again, not even considering Massachusetts General Laws Chapter 32B, the City of Northampton by its agent, the Assistant City Treasurer at the time of Doris Montgomery’s departure, stated in writing that Ms. Montgomery would have an opportunity to join the “Health Insurance Plan” during the enrollment period.
You indicated that the Assistant City Treasurer did not have the authority to bind the city but the facts suggest that this high level City Employee explicitly led my client to believe coverage would be available in the future, she put it in writing and Doris Montgomery detrimentally relied upon this representation when she left the City’s employ. Furthermore, this representation was made by someone in the know and with authority.
In addressing the new regulations put in place by the City in 2005, the City’s first alleged Policy Statement, I would opine that as a matter of law, the City is unable to retroactively abolish all previous responsibilities they were bound to by the adoption of this new plan.”
Communications continued behind the scenes and Higgins was not giving in. Reall wrote LaFlamme in May 2007 in part:
“The City’s decision as to Ms. Montgomery’s eligibility for group health eligibility was based on the lawful administrative guidelines in affect at the time Ms. Montgomery sought such benefit.” Reall further added, “It is my client’s considered position that the eligibility provisions adopted by the City of Northampton preclude Ms. Montgomery’s participation in its retiree health insurance plan.”
And so it went for about two years. After Montgomery challenged the city in court on April 23, 2008 Higgins backed down and finally allowed Montgomery to enter the city’s health insurance program. Montgomery paid about $1,600 in legal fees, only $500 of which was ultimately to be reimbursed by the city.
In retrospect, fighting for what she felt was legally hers caused Montgomery a great deal of physical and emotional distress and consumed a fair amount of her time. On several occasions she considered throwing in the towel and ceasing her quest for insurance coverage. However, having never earned much more than minimum wages Montgomery believes that she was under-compensated during her many years of service in the city’s schools and that the promised health benefits made it worth her while to pursue legal remedy.
Interviewed at her home recently Montgomery discussed the aftermath of her efforts, “Why do people have to go through this?” she asked referring to the trials and tribulations she went through in order to gain the promised health insurance coverage. When asked how she was treated by the mayor the former cafeteria worker said, “She made me feel inferior,” and further added, “she brought me to tears and became very upset when I tried to discuss procedures with her.”
When I asked her if she thought it was fair that Higgins would deal with insurance coverage for former employees on a case by case basis rather than through a formal policy, Montgomery replied, “I don’t think anybody should have to go through this and if anybody else wants to challenge her and they want to call me as a witness in court I would be happy to testify on their behalf, that that was what they were telling people at the time.” Regarding the new policy Montgomery added, “I think it’s an unethical policy or practice, whichever way you go, either or. Some places who have changed their regulations have put in grandfather clauses and grandfather clauses were something that the past generation used to do to be more ethical.” Sadly Montgomery concluded that, “I’ll never trust anyone in the city again.”
In a case of top-down policy making, Higgins locked in long time city employees of all types with her new policy; either they remain employed by the city until they formally retire or they risk having no health insurance in their golden years. Conversely under the Higgins administration elected part-time city council and school committee members and Smith Vocational School trustees are eligible for the city’s group health insurance plan immediately upon taking office, regardless of their tenure or how many hours they work.
As questions flit around the Higgins administration’s practices, access to the policy process in this case was limited. Besides Higgins and Stoddard, those involved in the policy’s formulation according to Higgins included the city’s solicitor, Janet Sheppard, and its past finance director, John Musante. Neither the city’s retirement board nor its insurance advisory committee had a formal role in establishing the policy not to mention the absence of any city council input or awareness, and it was not disseminated to the public via the media. In this case a former cafeteria worker stood up to the machinations of city hall and won one for the ordinary citizen.
