Updated September 27, 2021 - 7:36 am
A large cancer treatment group has stopped accepting new patients from a debt-riddled health insurance trust that covers thousands of Clark County teachers.
Some of those teachers told School Board members during a meeting Thursday that they have been dropped as patients by their medical providers for months due to their insurer’s nonpayment.
THT Health, which said it doesn’t have money to cover claims prior to July, could not answer why the millions of dollars in debt were accrued or how it would be repaid.
“It appears THT may be backtracking on a solution and leaving thousands of local teachers and their well-being at stake,” said Comprehensive Cancer Centers of Nevada, which has provided services in Las Vegas for more than 40 years.
The center said that it will continue to provide care to its established THT Health patients and that it wants to accept new members once a viable reimbursement for services is received.
“Promises have been made by THT and now is the time for action,” the company wrote.
Plan to cut debt
THT Health, a nonprofit overseen by the union, has said that it’s committed to providing quality health insurance for educators and “continues to have an open dialogue with Comprehensive Cancer Centers of Nevada.”
The trust asked the school district Thursday to increase its premium contributions for THT Health members by $160 a month.
“It’s scary,” the new CEO, Tom Zumtobel, told the School Board about the situation at THT Health. “The only way this could be solved is with a collaborative relationship.”
Zumtobel promised transparency and said he was working with creditors and attorneys to pay off members’ bills. He projected that the trust’s deficit would decline to $3.4 million in fiscal year 2022, down from nearly $43 million in fiscal year 2021.
He presented board members a plan that reduces internal expenses and increases teacher, union and district contributions. It also shifts 5 percent more of the cost of the bill to its members.
THT Health, which formed in 1983 and covers 34,000 district employees, has faced years of mounting debt and legal and financial issues, including a previous $10 million bailout.
Zumtobel, formerly president of the Culinary Health Fund, started June 15 after the abrupt resignation of the previous CEO, Michael Skolnik.
When THT Health’s founding administrators retired in 2014, the next administrators failed to implement transition plans and were fired, the union said.
In May, the school district provided a $35 million advance to the insurer. The trust negotiated about $13 million in settlements.
Though the School Board didn’t take action during the meeting, board member Evelyn Garcia Morales said she hesitated to continue to fund a trust that isn’t sustainable.
“I just find it incredibly concerning that an organization that is meant to protect its educators and licensed staff by offering health care benefits has failed the same employees it’s meant to protect,” she said.
Union seeks more district contributions
John Vellardita, executive director of the teachers union, told board members that the trust has not been adequately funded since 2010. The union asked the district in the past for an increase in premium payments before but was denied, he said.
“We were running out of assets, and this model was no longer sustainable in this market,” Vellardita told the board. “The missing ingredient was the contributions on the part of the school district.”
He called the all-educator model of health trust governance no longer effective and proposed a “blended format” that includes both educators and members who have expertise in health care and business finance.
Some teachers at the Thursday meeting accused the district of running a caste health care system by paying more in premiums for employees in administrative positions.
One, who had emergency surgery for an ovarian tumor, said she had to pay her own medical bills when she was sent to collections. Another stressed about unreliable care during a pandemic.
Kindergarten teacher Stacey Segal said she worried about the care of her son, who has a chronic disease.
“You hold the purse strings, and the purse is very full right now. You are the ones who can fix this,” Segal said. “I don’t care who’s to blame, because I can tell you who is not at fault: your hardworking teachers and their families.”
A lawyer for the school district, Fikisha Miller, said the district initially was unaware of the severity of the issue at THT Health.
“When it became more and more apparent, we tried to act as quickly as possible and make sure that we could maintain some form of coverage for our teachers,” she said. “We still don’t know how 45-plus million dollars wasn’t paid on time, and we still don’t understand why the teachers are the ones that have to suffer.”