Q. What is the
decision-making process?
A. Our health insurance benefits run from January 1 through
December 31. Each fall the Insurance Committee meets with administration,
our insurance broker and representatives from other employee groups to
analyze our plan. Insurance rates often change from year to year depending
on various factors, including how many claims we submit throughout the
year and current industry trends. The Committee discusses the options
for any plan changes for the following year. Any proposed changes are
presented to the ATA for review and approval.
|
Q. Why do our rates go
up each year?
A. Several reasons:
1. Industry trends are that health care costs are going up about 10-11%
per year.
2. We are self-insured. That means that the premiums we pay are used to
pay our claims. In recent years, we have been fortunate to have lower
claims experience resulting in lower than industry average increases in
our premiums.
|
Q. Why doesn’t the
Board pay more of the annual premium?
A. According to our Professional Agreement, the Board will pay 97% of
the single insurance premium and 67% of the family insurance premium.
We get new rate information each fall, based on usage and inflation. There
is a provision in the Professional Agreement that states, “The Board
contribution for premium increases shall be capped at 6% per calendar
year. Any additional increase above the 6% cap shall result in increased
costs to the employee or immediate adjustments to the insurance plan to
bring the projected increase back to the capped amount or less”.
|
Q. What
are the premiums for job-share staff?
A. For single and family coverage, job-share staff pay the same premium
as full-time staff, plus 50% of the Board's contribution. |
Q. What
are the premiums for part-time staff?
A. For single coverage, part-time staff pay 75% of the full-time employee
single insurance premium. For family coverage, staff pay the difference
between the Board contribution (which is 25% of the single premium) and
the family premium. |
Q. Why is the percentage
increase higher for single coverage than for family coverage?
A. Even though the employee contribution for the single policy
goes up by fewer dollars overall than the employee contribution for the
family coverage, the percentage is greater because it is applied to a
smaller current contribution. Because of the Board’s 6% annual percentage
increase cap, per contract language, these employee contributions will
continue to increase substantially each year, unless our usage is less
than 6% or we make reductions in benefit levels of the plan to reduce
the increases to only 6%. |
Q. Since
the premiums are going up so much, can we renegotiate our salaries?
A. No. We cannot renegotiate salaries until the expiration of this contract
in 2010. Since we cannot predict the future, we always negotiate based
on the past trends. If insurance continues to eat up our salary increases,
we need to make it a priority to catch up in the next round of negotiations.
Until then, we need to do all we can to use our insurance wisely to keep
the premium increases to a minimum. |
Q. How can we hold
down the annual increases in insurance costs?
A. There are a number of ways we can keep costs down.
1. Don’t use the emergency room for non-emergency doctor visits.
The average cost of an emergency room visit to our self-insurance plan
is about $1,200.
2. Use in-network physicians and services whenever possible.
3. Ask your doctor if a generic drug will work as well for you instead
of using a brand name drug.
4. For drugs you use all year, order through our mail order program, then
you pay only one co-pay for a 3 month supply and the cost per prescription
is lower to our group. |
Q. What are formulary
medications?
A. Formulary medications are approved by an insurance plan, whereas
non-formulary medications are not plan-approved. That's not to say there's
anything wrong with non-formulary medications, but for any number of reasons
a plan does not include them on its formulary list. Here is a link to
the formulary
list for the various BCBS plans. |
