Pitfalls and Precautions is a series that aims to educate teachers on professional conduct issues by highlighting situations addressed by the ATA Professional Conduct Committee.
Educating kids is a tough gig, and teachers need the support of their benefit plans to make their teaching career a little easier and less painful. Teachers can access many supports from their extended health care plans, including prescription medication, physiotherapy, massage therapy and other services. They also have access to excellent dental and vision programs as well as extended disability and life insurance.
From time to time, a small percentage of teachers find creative ways to file claims for services that were not provided or that were paid for by another benefit plan or agency. Such actions are nothing short of fraudulent. Many health plans, especially those like ASEBP, are not-for-profit trusts that provide sustainable and holistic health benefits to teachers and other education workers. By defrauding the benefit plan, these unprincipled people cause premiums to rise for the employers, who in most cases pay for all the benefits.
In a recent case, a teacher submitted fraudulent claims over a period of several years, and an audit determined that this teacher had defrauded the benefit plan of thousands of dollars. In addition to suffering employment ramifications, the teacher also had to pay back the full amount to the benefit provider. A hearing committee of the ATA’s Professional Conduct Committee also issued a letter of severe reprimand as well as a fine.
If you are ever unclear about what is covered or not covered by your benefit plan, be sure to call the ATA’s Teacher Employment Services program area or look on the benefit plan provider’s website for answers.
ATA Staff Officer
