This is the time of year when email is jammed with business greetings. Saplings with flashing lights and stereotyped phrases from whatever subject has received or hopes to get money for a service or donation. Something different happened to the metalworkers. On the contrary, it can be said: a few days before Christmas, an official communication has arrived, without even many frills, according to which since last December 31 they have been paying for benefits that they will not receive or will receive only upon payment of other money.
The pre-Christmas message came from the mètaSalute insurance which manages the supplementary health care of metalworkers and says that the policies, which are substantially mandatory by the collective agreement of the category because based on silence-assent, are unilaterally revised downwards, without the possibility of withdrawal. .
Drastic cut in direct assistance services, scissors on daily allowances for rehabilitation and dental care, no longer free for non-dependent family members, while a ticket is introduced: 15 percent in cases of surgical interventions, 35 percent for dental expenses and 30 per cent for specialist visits and diagnostics.
But above all overnight it is said that the contractual fund, due to Covid-19, is in dire straits. Costs have exploded, hence the need to cut and share individual medical expenses previously covered in full. Without warning, a pre-bankruptcy situation was reached.
Insurance
What happened is not exactly explained. In fact, it is unlikely that dental care, the most expensive and most sought-after, has suddenly exploded with the pandemic, given that it is not covered by the public health service. And the management of the fund remained that of pre-Covid, in the hands of the Intesa San Paolo banking group after the purchase of Rbm-Salute insurance.
MètaSalute is a fairly recent contractual institution, it started in 2012 when the fund was established by the employment contract signed at the time only by Fim and Uilm, following the indications of the CISL which has always focused on strengthening corporate welfare and therefore on supplementary healthcare.
The insurance of metalworkers was extended in 2016 and therefore confirmed in the last contract, jointly signed by the three trade unions less than a year ago. Metalworkers – nearly 2 million workers, plus their families – are given the opportunity to take advantage of six different insurance plans to skip the grueling public waiting lists and also have benefits such as a free dentist or “health vouchers”.
An opportunity that is triggered by default since all the workers are registered unless they explicitly renounce, which however is not followed by any counterpart. This is 156 euros more per year, paid directly by the companies which, however, in this way have been relieved by claims for more substantial salary increases in the paycheck. In addition to the representatives of the three trade unions signatory to the contract, the Confindustria delegates – Federmeccanica and Assistal – and those of the managing bodies sit on the board of directors. And apparently it is in that place that the scissoring of health services and the cancellation of social services were decided, with communication after the fact.
La class action
Not all insured persons benefit from the health plans of mètaSalute. Indeed, in hindsight, only a negligible share of the metalworkers’ audience, around 10 per cent, has managed from 2012 to date to instruct reimbursement or direct assistance practices. And this is because disentangling the delaying bureaucracy of policies has proved very complicated.
So complicated that last year some kind of class action, through the Altroconsumo association, managed to wrest from the Antitrust a compensation penalty of 6 million euros, imposed on Intesa Sanpaolo Rbm Salute and Previmedical, which physically manages the reimbursement procedures, for unfair commercial practices.
The class action concerns over a thousand complaints for withdrawals of authorizations already issued for agreements, arbitrary delays in liquidations, applications of different rules for the same compensation and a general confusion of interpretation of the fund’s rules. All anomalies reported starting from 2018, when management should have already been run in.
It is precisely the difficulty in accessing services that works as a disincentive for the vast majority of insured workers to request their use, which suggests that it is not simply a matter of incompetence but a deliberate strategy to discourage users. Or at least to reserve access to a few. In any case, it is not this sanction that has worsened the accounts, being suspended due to an appeal to the Lazio TAR by the two convicted financial subjects.
Previous conventions
The fact is that mètaSalute has absorbed previous integrative health conventions already provided for in the second-level contracts of multinationals and large companies, and widely used above all by those who were once called “white-collar workers”, employees or technicians with degrees, and who now with the single classification no longer exists except as a level of the same category.
In these same large companies the practices, including insurance, are often still managed by internal administrative staff, according to procedures tested over the years. Then came Covid-19. And the use of services probably exploded also and above all in terms of per diem and rehabilitation treatments for respiratory diseases and the after-effects of the infection, as well as for private diagnostics when public health facilities went haywire due to the pandemic.
The fact remains that the vast majority of mètaSalute members cannot benefit from the services for which they are insured. Reasons for which the internal minority of Fiom “Riconquistiamotutto” is now asking to introduce the possibility of withdrawal for each single member of mètaSalute, with the corresponding payment in payslip of the contractual cost incurred by the companies. And with a view to no longer including supplementary healthcare in national contracts.
Nobody checks
Not even the analysts of Altroconsumo have been able to understand what the problems of mètaSalute are. Fund information is difficult to find because the supervision over them lies with the Ministry of Health, while that on insurance to the Insurance Supervisory Institute.
His own secretary general, Stefano De Polis, on the occasion of the fact-finding investigation on supplementary funds, admitted that: “With specific reference to the sector in question, the first problem we encounter is that consumers are not clear who is the person responsible for the health service that is provided and, therefore, of any disservice that may occur in relation to this service. The complaints and reports we receive refer in an undifferentiated way to insurance companies, health funds and mutual aid companies and even to the health service providers themselves, meaning the service companies that enter into agreements with funds and coffers and that they keep in touch with the health structures ».
And even more clearly Riccardo Cesari, of the same insurance authority, declared during the Welfare Italia Forum in November that “health funds and mutual funds are substantially lacking in adequate regulation and active supervision and this cannot fail to affect the proper functioning of the system, on its efficiency and, ultimately, on the confidence of families in supplementary health care “. Basically, no one controls and therefore you will never know where the workers’ money has disappeared.
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