Health Insurance 101

In this post I examine the health insurance plan included in the Teachers contract. I'm putting this out in an effort to get ahead of the negotiations that are ongoing. They need to know our feelings before any agreements can be made behind closed doors. Based on examining the following information and charts, I am going to contact my school board members and ask that they negotiate the use of one of the “yellow” plans in the next contract. I won't vote "yes" for anything else in March 2020.

These "yellow" plans not only save money for the participant on premiums but they include additional methods of covering out-of-pocket costs. Depending on which "yellow" plan is implemented, the total savings begin at about $113,000/yr and can be up to over $200,000/yr. With that amount of savings, we could afford to set aside some funding to cover higher deductibles for employees while still realizing a significant savings to the taxpayer. The employees themselves would save money on premiums that could also be used to help with out-of-pocket costs. I hope you will get involved and express your own position to School Board and Budget Committee members. This information should help you understand what you're voting on.  Currently, 54 out of 55 employees are on the Green (most expensive) plan. At the moment there are 13 employees on the family plan, 8 employees on the 2-person plan and 33 employees on the single individual plan. The taxpayers bear 82.5% of the total costs for teachers. Other employees percentages vary. Below is a chart of the cost sharing.

Here's a table with the numbers crunched down. It shows the total yearly cost of each plan and the possible yearly savings that can be realized by choosing an alternative to the current "green" plan that almost everyone uses. It's important to note that 17.5% of the savings goes directly back to the employees.

 Green planRed planYellow
choice plan
Yellow
no choice
plan
Orange plan
total yearly cost$913,164$845,082$799,584$701,046$616,836
yearly savings$68,082$113,580$212,118$296,328
taxpayer yearly savings (82.5%)$56,167$93,703$174,997$244,470
employees yearly savings (17.5%)$11,914$19,876$37,120$51,857

Wouldn’t it be cool if we could tell them what we are comfortable voting for, in advance? If our School Board members listen and advocate accordingly, they could count on community support. “No” votes, like what happened last March, don’t help the teachers or the kids.

It has always bothered me that taxpayers are never invited to listen in during negotiations of the contracts that folks will be required to pay. It’s a large part of the budget. Due to collective bargaining laws, we can’t even observe the meetings between our School Board reps, who are supposed to be representing the taxpayers, and the Union, which does a fine job representing their members.

Recently, a health insurance committee was formed to investigate insurance alternatives. The problem is, we are NOT being allowed to listen in on the presentations. Some of these presentations have come from competitors to the current "Schoolcare" plan. See my blog post:  http://talkingwakefield.com/transparent-you-is-or-you-aint/
To make matters worse, this committee that is supposed to be looking for alternatives is a completely stacked deck.....against the taxpayer! There are three folks who are there to represent the Union. Good for them. On the other side of the table is (1) the Superintendent. How the hell can he advocate cutting benefits that HE RECEIVES! Number 2 is Tracey (it's only a pizza box) Kolb.  Say no more, nudge, nudge, wink ,wink. And last is Relf Fogg, the lone wolf who really is advocating for the taxpayer. Often seen as the court jester, but recently doing all he can to give you all the facts. At the moment, the only time we seem to participate is at the polls. It's time to change that by getting involved in the decision making process . It's time to let them know what we will accept.....and what we won't. We already know what happens when we don't get involved.

We’ve all become victims of the charge more and give you less insurance companies. Most of us have had to scale back our coverage to higher deductible plans because of the cost. Not quite so for the affiliated school staff and administrators. They have a really great plan. They don’t want to give it up and I don’t blame them. However, it is time to give up this "cadillac" plan for more than one reason. In the future an "excise tax" (translation= a penalty) may be instituted to discourage folks from continuing with these expensive plans. Most folks don't know that in the last proposed Teachers contract, there was language that specified that the taxpayer would pay half of the excise tax! Read on for "just the facts".  Here is a chart showing the monthly and yearly cost of all the available "Schoolcare" plans and the number of employees. Below that is a summary chart showing deductibles and coverage.


The charts below show a more detailed benefit summary of the “Green” plan that 54 out of 55 employees have chosen. The current and proposed Teachers contract states that the district will pay 82.5% of these premiums. This is a zero deductible plan with minimal copay. Here is the benefit summary of the Green plan. CLICK ON THE THUMBNAILS for a readable view. Use the back button to return to the post. I wish I could have this plan!

Here is the benefit summary of the “Red” plan. It has a small deductible ($250 individual, $500 family) and a slight copay. We have one employee (individual) on this plan.

Now we come to other plans that are not mentioned in the contracts.  These are higher deductible plans with higher copays, resulting in lower monthly rates. No employees are enrolled in these plans. This one is "yellow choice". This has a $1250 single, $2500 family deductible and a higher copay.

This one is the"yellow no choice" plan.

The Orange plan. This has a $2000 individual, $4000 family deductible and higher out of pocket costs.

What coverage do the Town employees get?
Here is the most recent Summary of Town of Wakefield employee Benefits.
The cost of the health insurance for Town employees is $717.15 (one person)/month
1434.30 (two person)/month
1936.31 (family)/month
The taxpayers pay 88%.
Summary:

Full benefits document for Town employees:
Anthem Summary of Benefits_2019

J.M.

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6 Comments

  1. Anonymous said:

    Hi Jim
    Thank you for you hard work on this hot topic. I am a new budget committee member. My very first concern was their health insurance plan. I expressed my concern to the former Superintendent during my first budget committee meeting. Her comment was that it was something they could bring up in their next contact negotiations. She is now gone.
    One thing that bothers me besides the cost, is the fact that the benefits are not equitable. A teacher/staff with a family plans receives a much higher benefit(and cost to taxpayers) than a teacher/staff member that is not on the plan. It costs the tax payers over $20,000 per family plan and those that don’t utilize the plan receive $200 per month for not participating in the health plan. I am not advocating that we give the non-participants more, but I am advocating that the teacher bear more of the cost if they are getting more of the benefit.

    July 9, 2019
    Reply
  2. Anonymous said:

    I wonder if you would get further with a compromise of the “red” plan than the “yellow”. It seems to be an in between plan. Many other schools have plans and businesses have plans similar to that one. If I am reading the “yellow” plan correctly, prescription medication would be at full cost until the deductible is met. As someone who is on asthma medication, the idea that I would have to pay $600-$800 out of pocket until the deductible is met, and then $120-$160 per month after that fact would anger me greatly when there are plans out there will have much more reasonable costs. There are also teachers who may have families with one ore more members that are medications monthly as well. In the long run, the staff members would not be saving any money- they could potentially be spending quite a bit more. You don’t want people to have be deciding between putting food on the table or purchasing medications.

    July 9, 2019
    Reply
  3. Anonymous said:

    As a person who has had a $5000 deductible for years (as so many) I can’t say I quite feel your pain but you bring up an important point that needs to be clarified. Teachers will need to know the cost to them before they can accept any change. The “Red” plan needs to be part of the conversation, but there isn’t s significant savings and it may still be susceptible to the “Excise Tax” in the future. I have reached out to Schoolcare representative Jana Dalton for information on this.

    The Yellow plan has a $1250 single, $2500 family deductible BUT possibly half of that amount can be covered with an HRA. (A Health Reimbursement Arrangement (HRA) is an employer-funded account that helps employees pay for qualified medical expenses not covered by their health plans). And the teachers will also save on their portion of the monthly premium that can be used to offset out-of-pocket costs. Example: If you have a Green family plan now, according to the charts, you are paying $5074 per year as your contribution. ($28,998 X 17.5%). If you use the “Yellow Choice” plan, your yearly premium contribution would be $4439 ($25,368 X 17.5%). This would save you $635 per year.
    If you used the “Yellow no Choice” plan your yearly premium cost would be $3892 ($22,242 X 17.5%). This would provide you with a premium savings of $1183 per year.

    There is no sugar coating about it, dropping to a higher deductible plan is not going to be painless. My hope is that we can reach a compromise that will be the least painful to teachers and provide some relief to the taxpayers.
    Your Union Reps should be helping you understand this. If it was going to affect me, I would contact Schoolcare, lay out my known medical expenses and ask about the financial consequences. We’re not the only community struggling with this. The Union and our School Board should be able to reach out to other districts and look at examples of how this is being addressed. Examples of good alternatives should be brought to the table.

    July 10, 2019
    Reply
  4. Anonymous said:

    Jim,
    Thanks for the effort you have put into our school budget issues. Hopefully the taxpayers will take notice.
    I think our citizens should exert more effort to discourage the cost sharing on the health insurance excise penalty. The Federal Gov’t was attempting to discourage “Cadillac Health Insurance Plan” when they instituted the excise tax penalty. The excise tax is designed to be a deterrent, a penalty, a consequence of selecting the most expensive plans.
    Our school board allow the teachers to transfer ½ of the excise tax penalty to the taxpayers of Wakefield. A lot of our citizens can not afford health care, but we are required to pay our teachers for their health care insurance. On top of this the taxpayers are required to pay ½ of the teacher’s penalty tax. This is totally in the wrong, the excise tax penalty should be the sole responsibility of the teachers.

    July 10, 2019
    Reply
  5. Hamlet B. Porkwood said:

    Red plans are the most expensive plans i believe….

    July 10, 2019
    Reply
    • Hamlet B. Porkwood said:

      Wrong again….red is not the most expensive plan….

      July 11, 2019
      Reply

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