My Health Care Coverage Plan as a Teacher in Virginia Beach with Obama Care. MAJOR Increases. THANKS President Obama. Important information about planned changes to the VBCPS 2014 Health Care Plans Posted on June 26, 2013 by lawicks The purpose of this communication is to advise school system employees of Health Care Plan changes that will go into effect at the start of the new plan year, Jan. 1, 2014. Since city and school plans mirror each other, city employees are being informed in a similar fashion through their Member Update publication. Why are plan revisions necessary? The short answer is that the cost of providing employee health plans is increasing, so we must adjust accordingly. As a reminder, the city and the schools have self-funded health plans, which means the actual cost of receiving services determines the cost of the coverage. The Benefits Executive Committee (BEC), which oversees the health care plan designs, made considerable efforts to hold costs down. In 2014, the school system will continue to pay 90 percent of the total cost of employee coverage (when the VBWellnessforLife incentive is earned by employees) and 60 percent of the dependent’s costs. However, the biggest driver of increased costs is the required implementation of the Affordable Care Act (ACA). For example, under the ACA, approximately 700 city and school employees will have to be added to the respective health care plans because they work 30 or more hours a week. In addition, the Individual Mandate associated with the ACA requires all individuals to obtain health insurance by Jan. 1, 2014. These two mandates will inevitably increase participation in the city and schools health care plans. This is important because two new required fees are being levied on the city and the schools that relate to our participation rate. One is a temporary reinsurance fee of $63 per health plan member to help stabilize insurance premiums in the individual market. The other is a comparative effectiveness fee of $2.06 per member annually. This fee is designed to help fund research on the outcomes and clinical effectiveness associated with medical treatments. All total, the additional cost of ACA to the city and the schools stands at an estimated $9.3 million. The BEC worked diligently to strike the right balance between keeping the plans as affordable as possible and dealing with the reality that the reserve in the health care fund is incapable of absorbing an increase of this magnitude. 2014 Point-of-Service (POS) Plan Revisions City and school employees will receive more in-depth details about the 2014 plan from the Consolidated Benefits Office during Open Enrollment. However, the BEC and the Consolidated Benefits Office want to share the major changes with employees now so that you can plan accordingly. There is some good news inherent in the revisions. Employees will no longer pay a deductible for physician office visits, specialists and urgent care services. However, other planned adjustments do involve some cost increases. Changes include: Annual deductibles are increasing for in‑network services, from $100 to $300 per individual and from $200 to $600 for those on the family plan While there will no longer be a deductible for physician office visits, specialists and urgent care services, the copay or coinsurance will still be required. Hospital inpatient copays are increasing from $250 to $500 Outpatient surgery copays are increasing from $100 to $250 Maternity Care global copay is increasing from $50 to $200.The copay for confirmation of pregnancy will remain at $40, and $200 will be the remaining amount paid for outpatient OB services per pregnancy. Pharmacy copays (prescriptions) are increasing in some cases* Preferred Tier: $10 maximum to $15 maximum Standard Tier: $25 maximum to $30 maximum Premium Tier: 25 percent coinsurance ($35 minimum) to 25 percent coinsurance ($45 minimum) Premium Plus Tier: 50 percent coinsurance ($50 minimum) to 50 percent coinsurance ($60 minimum) *Important Note: Prescriptions filled at a Preferred Pharmacy (Walgreens or Wal-Mart) will not pay the increased copay 2014 High Deductible Health Plan (HDHP) Plan Revisions The pharmacy change listed under the POS plan revisions is the only change being made to the HDHP plan for 2014. Helpful New Features Being Added to the POS and HDHP Plans The BEC and the Office of Consolidated Benefits have ensured that additional features will become part of the city and school health care plans. These include: MDLive provides employees with 24/7 on-demand access to board certified doctors anytime, anywhere. Real time video and phone consultations provide treatment, in a safe and secure environment, for a wide range of medical conditions, regardless of the employee’s location. MDLive can be used when: employees are considering the emergency room or urgent care for non-emergency medical issues; the primary care physician is not available; employees are traveling and in need of medical care; or during or after normal business hours and holidays Accordant Rare Disease Management is a program that offers disease management and case management services for people with rare chronic conditions. Members eligible for the program are offered services at no cost to them. This is a specialized program to help people manage their rare chronic illness. These conditions and their associated complications are managed by registered nurses. The program is designed to improve the quality of life for those who are ill, their families and caregivers, while reducing overall health care costs. 2014 Health Plan Rate Structure for School Employees Below are the 2014 semi-monthly rates for employees on the POS and HDHP plans for school employees (health care plan deductions are made over 20 pay periods for school employees versus 24 pay periods.) The rates below reflect what the semi-monthly deduction would be both with and without the VBWellnessforLife credit which amounts to $25 semi-monthly for school employees for total of $500 annually. 6-26-2013 7-57-17 AM Finally, as implementation of the VBWellnessforLife initiative continues, we believe that healthy behaviors coupled with the required annual health screening and attendant preventive and treatment measures will result in a healthier workforce, which will help improve the cost scenarios. Those who have questions about the planned changes may contact the Consolidated Benefits Office at 263-1060. Farrell Hanzaker Chief Financial Officer & Member, Benefits Executive Committee
Posted on: Mon, 01 Jul 2013 01:52:37 +0000
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