The Blue Cross Blue Shield Association’s National Labor Office (NLO) partners with organized labor and the independent Blue Cross and Blue Shield companies around the country to serve the distinctive healthcare needs and goals of unionized workers. Each year, the NLO names a “Labor Representative of the Year” to honor individuals who have best delivered the services and expertise organized labor expects.
This year’s representative of the year is Mike Nowak of Excellus BlueCross BlueShield in upstate New York, which serves a vast stretch of the state, encompassing 31 of New York’s 62 counties. Nowak started his career as a high school history teacher, where he was a member of New York State United Teachers and served on its bargaining team.
We spoke with Nowak recently about the challenges and opportunities of serving union workers at a time when healthcare coverage is changing rapidly and is often a central issue in collective bargaining.
Q. Why do you think it’s important to have a representative dedicated solely to serving organized labor members? Do union members have specific needs and goals when it comes to their healthcare?
I think it shows we have an understanding of labor’s unique philosophy.
In organized labor, health and welfare funds exist solely to ensure that those members have a consistent set of benefits that follow them from job to job. In a union like the electricians, carpenters or bricklayers—the skilled trade unions—you may switch from employer to employer throughout the year, depending on where the work is. With a health and welfare fund, the goal is to maintain a consistent level of benefits no matter how many times the employer may change. They want to assure a consistent level of pay and benefits so the member has continuity between employers.
Their goal, obviously, is also to secure for their membership the highest quality benefits they can. The best benefits at the best possible value—that’s a recruiting tool for unions, as well as any employer.
Many of these jobs involve physical labor, and the work is outside. These skilled jobs are very demanding. They want to keep members as healthy as they can for a multitude of reasons. If they’re not on the job, they’re not earning a wage, and the project is not being completed in a timely way.
Q. You were a member of a union yourself. How did that experience influence the work you do now?
I have some credibility immediately when I say, ‘I’ve been there; I’ve been in your position.’ It helps me build relationships over a period of time and allows me to be successful in helping them represent their members.
Nobody in a union is automatically a benefits expert—you’re an electrician or a teacher or a bricklayer. So, somebody can be an electrician today, but tomorrow, he may win a leadership election and be in charge of a $20 million [health and welfare] fund. Many of them have limited knowledge of how things like healthcare work. So, this is where we can really provide a service to both the leadership and the membership.
Q. At Excellus BlueCross BlueShield, you serve a significant number of organized labor members in the manufacturing sector and the trades, as well as public sector employees such as municipal workers and teachers. These are very different groups—do you see any difference between their healthcare goals and needs?
They’re all after the same goal—the best benefits for members at the best value. The way that they get there is quite different.
In a public-sector union, you’re working with a different set of circumstances than someone who is an electrician or a carpenter. In that situation, their employers must be competitive for jobs that require a bidding process—the employers have to go out and win business against non-union contractors.
A public school has a general idea of what the budget is ahead of time. Public sector unions can bargain from a different position and over a different length of time. There isn’t always the same risk associated with this process, in that a school doesn’t face the same challenges of securing business.
The end goal is the same; the road you travel to get there is unique to every union. That’s part of the strength of the employer-based system of coverage. We have that ability to look at different things, different circumstances and adapt the approach, the benefit packages, to fit the situation.
Q. Based on your work with labor as well as with the companies that employ them, what do you think are the key benefits of employer-based health coverage, and what can be done to strengthen this part of our system?
A lot of labor unions have benefits that exceed those of others and, obviously, they do not want a system that reduces those hard-won benefits. They like the ability to partner with us to find creative solutions to the issues they face.
In most negotiations, an employer has a limited amount of funds to work with. All of those dollars in that pool have to be accounted for. How much should be devoted to awarding a raise? How much toward health insurance? By partnering with labor, we are able to tailor solutions that will allow them to maintain a high benefit level and, hopefully, put more of those available dollars toward raises. We can often work collaboratively with both the employer and the union to reach a solution.
A lot of what we do is protecting and preserving the benefit levels a union has.
Q. You spend a significant amount of your time on the road, covering a vast territory in upstate New York, yet you still find time to go to union events like clambakes, picnics and other after-hours events. Why do you spend your free time this way?
A lot of our meetings are in the evening because that’s when people are available. In the labor sector, if you’re honest and fair and upfront with them, they will do the same thing for you. Each of us commits to something, and we both deliver. So, if they’re nice enough to invite me to clambakes and other events, I am more than happy to go! In addition, it gives me an opportunity to sit down and talk to everybody about something other than health insurance and show that we’re real people.