FAQ

With the change to the Health Care Authority plan, can I keep my same doctor?

The proposal is to consolidate the purchasing of health care. In that case, a School Employees Benefits Board would oversee the procurement of health care plans and would be tasked with minimizing disruption to existing networks of care. It is likely that any plan would include most of the current providers; but it is unknown whether all current providers would be available in a single plan until such a procurement is conducted.

How about my daughter, who I cover on my insurance: Will she be able to keep her doctor in Chicago? Or, is she expected to be able to fly back here just to see a doctor?

All state plans provide for coverage for children residing in other states (e.g., college students). The situation would be similar to the current situation and would depend on the plan: If someone enrolls with GHC today, they have some but limited coverage out-of-state since GHC is an HMO. Those enrolled in “PPO” plans such as Premera would have the kind of coverage available today.

Can my local association still negotiate money to lower my premiums? I know they have really worked to keep the rates as low as possible and they have done a great job the last few years!

While premiums would be set by the School Employees Benefits Board, local bargaining units would continue to bargain local contributions to the costs of health care. For example, employees are currently assessed $67.61 per month for retiree coverage. A bargaining unit could negotiate local funds to offset this cost.

Won’t costs increase for K-12 enrollees who will bear the brunt of reduced benefits and increased cost shifting?

Under the proposal, employees who currently pay nothing or very little for individual coverage would have to pay more . . . or select a lower cost plan. However, employees who purchase dependent coverage would see their monthly premiums decline. Some school employees today pay $800 to $1,200 per month to cover family members. Their payments would decline under this plan.

Won’t costs increase for school districts who will be on the hook financially if the state miscalculates funding?

School districts support the bill believing that it will provide efficiencies and greater predictable costs than the current situation.

Won’t costs increase for he state to set up and administer a new program. The current estimate of $20 million is significantly understated.

The costs of setting up a new program can be amortized over several years. The real question to ask is whether the start-up costs are worthwhile because the program saves money on an ongoing basis.

The premise that the state’s plan for educators is going to save the state money is false. The idea that the state would force teachers into a healthcare system that already has backlogs and cost cutting practices that harm patients is wrong in so many ways.

The bill does not propose moving educators to PEBB – that is incorrect. The bill proposes establishing a board with school employee reps to oversee the consolidated purchasing of health care. The current system is fragmented and expensive and lacks transparency on how health benefits are purchased. The bill would fix that.

Will my co-pay increase?

Under the bill, a School Employees Benefits Board would oversee the procurement of health care plans and would be tasked with reducing costs to employees and minimizing disruption to existing networks of care. The bill requires the Board to provide options to employees on cost-sharing. Plans with richer benefits would be subject to greater cost-sharing.

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