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I am an IBM retiree. As have several other firm, IBM is moving its retirees onto Medicare-

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I am an IBM retiree. As have several other firm, IBM is moving its retirees onto Medicare-based plans. My wife has gotten 9 years of skilled nursing care at home, as she is quadripegic, ventilator-dependent, medicated and fed through a gastric tube. The limits of all the new plans mean we will get far, far less financial support for her care, starting Jan 2014. Remedies? [e.g., "Justifiable reliance" has been suggested as a basis for action.]
Submitted: 1 year ago.
Category: Legal
Expert:  John replied 1 year ago.
Hi, thanks for submitting your question. My understanding of the situation from the WSJ is IBM plans to eliminate its Medicare supp plans and give retirees a stipend to purchase their own insurance. There are 110,000 retirees it plans to do this to.

When the courts are called upon to determine whether post-retirement medical benefits have vested, they focus primarily on the plan documents and Summary Plan Descriptions. If these documents unambiguously answer the question, the inquiry usually ends there. If these documents are ambiguous or internally inconsistent, however, the courts will look to ‘‘extrinsic evidence’’ (evidence outside the documents) to determine whether the employer intended to vest the post-retirement medical benefits. Such evidence may take the form of letters, summaries, or brochures issued by company human resources personnel, and even oral statements made by management personnel that may have occurred many years ago. Although this contractual analysis appears straight-forward, it often is complicated by separate contractual agreements outside the plan documents, such as collective bargaining agreements or early retirement buyout agreements, and by the existence of multiple versions of the governing plan documents and SPDs issued over many years. In practice, the contractual analysis provides a framework for what is otherwise a fact-intensive inquiry involving more art than science.

I'm reasonably sure that there may be a class action lawsuit against IBM in this instance and if there is any promise of unaltered lifetime benefits this will be exposed in that suit. It's impossible for me to tell you what rights you may have under the absent looking at all the plans, memos etc that you may have had through the years. The fact that you have come to rely on it may be a factor, but having an express document is far more powerful evidence. My advice to you at this time would be to seek out an attorney to pursue your rights in the matter and/or wait until you hear of a class action, there is a 6 year time frame generally in which you must bring a lawsuit.

I believe this answers your question. However, if you need clarification or have follow-up questions regarding this matter, I will be happy to continue our conversation – select the Reply to Expert or Continue Conversation button. If you are otherwise satisfied with my response, please leave a positive rating as it is the only way I am able to get credit for my answers. Thank you, XXXXX XXXXX wish you all the best with this matter.

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Customer: replied 1 year ago.

Yes, I will look for an opportunity to join a class-action lawsuit. Too difficult and expensive to launch an action on my own.


 


I joined IBM in 1983 partly for its medical plan. When I took their buy-out in 1993 I did so partly for their medical benefits, as my wife has multiple sclerosis. Some of their later communications indicated $billions set aside in separate fund to underwrite/guarantee the health plan benefits.


 


Legal remedies vis a vis IBM seem remote.


 


The Medicare Supplement Plan F [best option] has explicit limits on the number of days of skilled nursing care provided... roughly a quarter of a year. We've had nine years and hope to have much more.


 


Dealing with Medicare and whatever private insurer we go with appears to be our next option. Meanwhile, our costs are c. $1000/day.


 


Unless you have some advice on getting Medicare to extend its limits,


you have answered the question I posed. ["Remedies" broadly defined.]

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