Modernized health care benefits in labor unions: A Q&A with Glenn Di Biasi

The benefits industry talks a lot about what benefits can be offered through employers. However, health care benefits for union workers is often overlooked. Glenn Di Biasi, the Fund Administrator for the UFCW National Health and Welfare Fund with the United Food and Commercial Workers (UFCW) union, has shared his thoughts on creating better access to health care resources for union workers.

How are labor unions different in how their membership receives health care benefits vs. non-union employers? What is the current state of health care benefits in labor unions today?

Health care benefits negotiated through the collective bargaining process are generally known to be more comprehensive and affordable, given that the Funds administering the benefits are more intimate with membership needs and are chartered as not-for-profit. Recent economic factors, such as rising health care costs and lack of access to health care resources like mental health treatment, have added challenges for union leaders in providing the best health care for their members. These challenges are not unique to union leaders. Challenges in health care benefits today touch nearly everyone in the ecosystem, but I’m confident that the bargaining power of union leaders, and their dedication to serving their members, can help tailor health benefits, keeping costs low and ensure the highest quality care.

Labor unions have evolved significantly over the years. What are labor workers wanting out of their health care benefits today? How has this changed over the years?

In recent years, high-profile unionization campaigns have put a spotlight on better wages, improved working conditions and more time off. These benefits are key in supporting our union workers, but health care benefits cannot go unnoticed. With declining membership rates in some precincts, union leaders need to think about growth and recruitment very differently and prioritizing optimal health care benefits is absolutely a part of how they’re doing that.

It’s important to note that the pandemic has created a shift in the way we perceive our own health, and therefore the way we look at the health care benefits we receive from employers. A survey by McKinsey confirmed that worker trends, like the “Great Attrition,” have put pressure on and raised awareness for employers on the importance of health benefits.

Union workers are depending on union leadership to provide them with health care benefits that fit their specific needs. For example, our Fund largely represents essential workers who kept the economy moving during the COVID-19 pandemic — think of essential food products, manufacturing, processing and distribution. This absolutely factors into our areas of focus — mental health services, for example, and telehealth that allows them to find care on their schedule and widen provider and facility access. Also, it impacts their expectations for service — they’ve put it all on the line for their jobs, and they deserve high-quality, high-touch care and service in return.

What is your advice to union leaders and fund administrators on choosing a health care partner that can meet the needs of their workforce?

Employers are taking a closer look at their health care benefits packages than ever before. A recent survey by WTW found that nearly 9 in 10 U.S. employers are looking to change their health care vendors as soon as this year. But it’s not as simple as making a switch. There is a lot of complexity in health care and in choosing the right partner. For union leaders, a well-vetted health care partner can be a huge differentiator to drive recruitment and satisfaction.

Here are my main pieces of advice when searching for a health care partner:

• Evaluate the needs of your workforce to better understand the quality of care and services needed from a health care partner. Important factors to evaluate include member services, clinical expertise available and access to health care resources like complex care plans for long-term disease or illness care. You want a partner that understands your membership — it seems obvious, but a union that represents grocery workers is going to have different needs than one that represents teachers, for example, because the population makeup and the demands of the two jobs are so different. You need a health care partner that gets this.
• Identify a partner that can truly be an extension of your organization — values are of high importance in the decision-making process. When I was evaluating a potential pharmacy benefits management partner, I vetted several PBMs. At the time, we had an existing partnership with EmpiRx Health. After thoroughly vetting through the PBM, I made the decision to continue working with them, and among the top reasons for this was their values and their high-touch service — we literally have a single point-of-contact that my members know they can rely on to help navigate any clinical or service needs. A pharmacy benefits manager, as with any health care partner, holds a great deal of responsibility for your workforce. It’s essential to find a partner whose service model aligns with your workforce and is reliable for your members.
• Last but not least, cost is key — you don’t need to sacrifice high-quality care for lower cost. Union leaders and fund administrators should evaluate the cost of premiums, deductibles and co-pays as well as the overall value of the benefits offered. But this can’t come at the expense of quality care because that wouldn’t meet your members’ needs. It’s not an either-or situation.

Where do you foresee labor unions in the next 5 years? How can health care benefits evolve the labor industry and improve the issues at hand today?

Labor unions were formed out of a necessity to protect workers’ rights and interests. While many union leaders focus on wages and salaries, health care benefits must be prioritized as well. Over the next five years, labor unions with increased membership will be the ones that continuously prioritize health care benefits.

Additionally, labor unions will begin recruiting new members from many industries that tend to do well during challenging economic times. At UFCW, we represent workforces in the distillery, winery, grocery, food and cannabis spaces — this allows our union to grow alongside these industries and tap into workforces that have gone unrepresented. This will bring new populations with new needs and expectations into the union fold — health care benefits will need to evolve and adapt accordingly.

Lastly, with costs of health care rising and a lack of access being a persistent issue, unions should take on a greater role in addressing economic inequality and social justice issues. This could include advocating for policies that address wealth and income inequality, fighting for racial and gender equity in the workplace and working towards the societal goals of sustainability. To do so, they might draw in industries that have historically been difficult to organize, such as the gig economy and tech companies.

How can health care benefits in labor unions set a precedent for other industries?

Labor unions are uniquely positioned to create innovation in health care benefits and set a precedent beyond unions.

Collective bargaining, which is the process of labor unions negotiating health care benefits with employers, often incubates innovation. On one side, you have an employer wanting to contain costs, and on the other, you have organized labor officials who want to ensure they have proper access for their union workers. This cost vs. access dichotomy competes and fuels positive change. This isn’t just applicable to labor officials — but to employers everywhere.

The collective bargaining process allows for union leaders and employers to find the best solution that has the heart of the member at court. We’re constantly finetuning this process with our partners and adapting to the ever-changing health care ecosystem.

For example, at UFCW National Fund, we partner with an organization collecting oncology data. Cancer is among our top three biggest claims that we see in our population. We transform the oncology data to actionable, meaningful intelligence for our members — based on their diagnosis, we determine who their best provider would be and the best facilities.

As another example, we’re working on a partnership with an organization that will help facilitate kidney transplant before or soon after dialysis begins. Instead of finding a better way of delivering dialysis, this solution helps find ways to access kidney transplants sooner and avoid the cost and negative impact of dialysis altogether.

Labor unions are currently in the midst of innovating the way health care benefits are negotiated, leading to better health outcomes while containing costs.