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Your Health Benefits: Endangered Species?

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by Mona Field, Social Sciences Division (writing as an individual member of the GCC Labor/Management Health Benefits Committee)

Headlines:   

¾         CalPERS to Raise Health Premiums 25% (Los Angeles Times, 4-17-02)

¾         Aetna Shares Rise 13% on Medical Plan Gains (Los Angeles Times, 4-26-02)

¾         Health Cost Hikes Growing   (Business Insurance, 12-10-01)

Approximately one in five Californians has no health insurance.  We are among the lucky 80 percent who have medical coverage.  Yet we now face the current double-digit inflation in health insurance premiums.

     The headlines tell the story: costs are skyrocketing and for some insurance companies, so are profits.

     But employers (including public entities such as GCC, now grappling with huge budget cuts due to the state’s crisis) are facing huge cost increases just to keep the same coverage. 

WHAT IS FUELING THIS EXTRAORDINARY INFLATION?

     Health care costs are rising rapidly due to increased use of medications (many of which did not exist until recently),  increased costs of hospitalization, a shortage of nurses (driving up the costs of recruiting and keeping nurses), the aging workforce (we get sicker as we get older), and the consolidation of the insurance and hospital industries.

     At this time in Southern California, there are only a handful of companies willing to write policies for health care plus the handful of HMOs that are still functioning (many have gone bankrupt).

      Like home insurance, medical insurance has not been profitable enough for demands of shareholders, and many companies are simply quitting the business or markedly increasing their premium rates.

WHAT IS THE ROLE OF OUR HEALTH BENEFITS COMMITTEE?

      Your Health Benefits committee, made up of union and management representatives, meets monthly with  our district insurance broker, Charlie Mason, and his associate, Kim Fossen.  Kim and Charlie provide excellent information and a great deal of hands-on service to employees who need troubleshooting regarding their insurance.

       We have been fortunate that Charlie, Kim, Menchie Braza from Payroll, and our contacts at Blue Shield and Kaiser have kept our individual problems at a minimum.  But they, and the committee itself, cannot control the skyrocketing costs. The committee recently voted to request bids from other companies.  It will take a few months for that process to be completed.  However, recent experience in local public agencies suggests that the insurance industry consolidation offers us a restricted set of choices and that insurers are not underbidding each other as they might have done in the past.

WHAT ARE OTHER DISTRICTS DOING?

       A comparison with other CC districts brings out some interesting data*, including the following:

       Most districts still provide full premium payments for employees.  However, at El Camino, which uses CalPERS to provide health coverage, only employees who choose an HMO get full premiums for themselves and their dependents. Employees who choose a more expensive (PPO) option then get full premium only for the employee; their dependents must pay 30 percent of the premium (in other words, money comes out of employee paychecks to cover spouses and other dependents).  At Coast College district, employees contribute one percent of their salary towards health coverage plus $500 towards dependent coverage (per year).  In some places, classified employees are restricted to the lower cost HMOs and must pay out of their paychecks to get more expensive coverage (Rio Hondo).  In some places, the cost of Kaiser is covered, but employees must pay the difference if they want a non-HMO system.

       In other words, the world of “fully paid premiums” is changing.  In the private sector, fully paid health coverage is nearly extinct.  Most employers require employees to pay a share of insurance costs.

WHAT ARE SOME OPTIONS?

       Options include: 

¾         Plan design changes:  increased  co-payments; increased deductibles

¾         Cafeteria plan: a set dollar amount per employee for a range of insurance options.  This plan usually includes some kind of TSA option for those who need less insurance and have “extra” dollars (GCC had this kind of plan many years ago).

¾         Find new providers (insurance companies) that charge less

¾         Charge employees a portion of premium out of their paychecks

           None of this sounds appealing, and anything relating to health benefits must be negotiated. The role of the committee is to get information from our broker, discuss options and report back to the negotiating teams for CSEA, the Guild and the district.  The committee cannot negotiate, but it can recommend.

           The issues will not go away.  You will inevitably be impacted. Watch for further updates. &

        *Thanks to Vicki Nicholson and her staff for compiling the data from other districts.