Panel advances health-plan trio

Some school rates would rise

Health insurance premiums would increase for some public school employees and fall for others under rates recommended by an advisory panel on Monday.

The changes mirror those adopted for the state employee plans in June and would replace plans now available to school employees with three new options.

The benefits subcommittee of the State and Public School Life and Health Insurance Board unanimously recommended the changes to the full board, which will vote on them today.

School employees who are now in the most expensive plan, the gold plan, would pay lower rates in exchange for reduced benefits under a new plan, the premium plan, unless they choose a different option.

Those in what is now the cheapest plan, the bronze plan, would pay more unless they move to a new plan option that would have reduced benefits.

The recommendations come after a special session of the Legislature passed laws earlier this month to prevent an overall increase of 35 percent in premiums for the 46,000 school employees covered by the plans.

Peggy Nabors, director of research and legal services for the Arkansas Education Association, the state's largest teachers union, said the subcommittee "did the best recommendation, given the scenario given to them."

Having better options would require more taxpayer funding, she said.

Under the subcommittee's recommendations, the 18,300 teachers and other public school employees now in the gold plan and the 5,000 employees in the silver plan would be moved into the new premium plan unless they made a different choice.

Like the current silver plan, the premium plan would have a deductible of $1,000 for individual coverage or $2,000 for family coverage.

Employees would pay up to about $185 a month for individual coverage or $841 for family coverage.

Those covered now by the gold plan, which has no deductible, pay a maximum $249.38 a month for individual coverage or $1,132.96 for family coverage.

Those in the silver plan pay up to $173.32 for individual coverage or $787.36 for family coverage.

Compared with the gold and silver plans, the premium plan would have lower copayments.

The copayment for a primary-care doctor's office visit would fall from $35 to $25, and the co-payment for a specialist visit would fall from $70 to $50.

Meanwhile, the rates for the bronze plan, which would be renamed the classic plan, would go up.

School employees would pay up to about $45 a month for individual coverage with the classic plan, compared with $11 under the bronze plan, and about $350 a month for family coverage, compared with $269.50 under the current bronze plan.

The annual deductible would remain the same: $2,000 for an individual or $3,000 for family coverage.

School employees also would have a new plan option, the basic plan.

The rates for the basic plan would be the same as those for the current bronze plan, but it would have a higher deductible: $4,000 for individual coverage or $8,000 for a family.

"The people that are dying here are the ones that were in the bronze plan,"said subcommittee member Jeff Altemus, deputy superintendent of the Marion School District.

Bob Alexander, director of the Department of Finance and Administration's Employee Benefits Division, has said that increasing the rates for the bronze plan is necessary to cover health care costs for those enrolled.

As premiums for the gold plan have increased in recent years, more employees with expensive health conditions have switched to the bronze plan, he said.

The benefits subcommittee rejected more conservative options that would have increased the premiums for the bronze plan even more.

Board member Tony Thurman, superintendent of the Cabot School District, said he hoped that future policy changes would eliminate the need for a larger increase.

"Our folks are getting hit hard, and we need to do everything possible to make it affordable as long as possible, as long as the program's going to be OK," he said.

The laws passed during the special legislative session will drop part-time public school employees from the plans starting Jan. 1 along with employees' spouses who can get coverage from their own employers.

The laws also limit coverage of weight loss surgeries and will eventually transfer money to the plans from school districts' payroll-tax savings.

A legislative task force is also exploring future changes, including combining the plans for teachers with the plans for state employees, letting school districts form their own plans and providing incentives for healthy behavior.

The plans covering state and school employees are now identical, but school employees generally pay higher rates, which Employee Benefit Division officials have said is because the state employee plans are more heavily subsidized with tax dollars.

The rates paid by school employees vary by district, because some districts contribute more than the $150 a month per enrolled employee mandated by state law. The minimum contribution will increase next year to $153 per enrolled employee.

Under the subcommittee's recommendations, some of the benefits for the school employee plans would differ from the state employee plan benefits for next year.

For instance, the state employees' premium plan will have a deductible of $500 for individual coverage or $1,000 for a family.

State employees in the plan will pay $104.78 for individual coverage or $484.34 for family coverage.

The state employees' classic plan and basic plans, meanwhile, will have higher deductibles than those recommended for the school employee versions.

The deductible for the state employees' classic plan will be $2,500 for individual coverage or $5,000 for family coverage. For the state employees' basic plan, the deductible will be $6,450 for individual coverage or $12,900 for family coverage.

For state employees in those plans, the state will make monthly contributions to a health savings account -- $25 a month for an individual or $50 a month for a family.

Money deposited into such accounts is not subject to federal income tax as long as it is spent on medical expenses.

To keep the deductible for the classic and basic plans for school employees lower, the subcommittee recommended against state contributions to health savings accounts for school employees in those plans.

But both school and state employees enrolled in the classic and basic plans will be required to have the accounts.

School employees "need to understand that they need to be putting money in [the health savings accounts] because those deductibles will come back to bite them," Altemus said.

State employees in the classic plan will pay $46.48 a month for individual coverage or $306 for family coverage. State employees in the basic plan will not pay a premium for individual coverage. The premium for family coverage under the plan will be $160.64 a month.

Like state employees, school employees who fail to see a doctor for a health screening by Nov. 1 would pay an extra $75 per month in premiums. Employees will be given credit for any doctor's visit involving a health screening since Jan. 1, 2013.

A Section on 07/29/2014

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