APS to drop health care provider, increase premiums next year

Albuquerque Public Schools employees will see a double-digit increase to their health care premiums and have one less provider to choose from starting next year.

APS announced it is increasing premiums 13.5% starting Jan. 1 because of inflation and rising health care costs, among other factors. APS also will drop Cigna, a Connecticut-based health care and insurance company, from its list of providers once the parties' contract expires on Dec. 31.

APS spokesperson Martin Salazar, who only responded to written questions submitted by the Journal, said the district is self-insured — meaning that the money to pay medical, prescription drug, dental and vision claims comes from APS — and changes made to the school district's health care plans were done to "ensure the viability of our health care fund."

"We have a responsibility to our employees to ensure the fund remains solvent so we can continue to pay our employees' claims," Salazar wrote.

But some APS staff members who spoke to the Journal, including Sean Thomas, a teacher and executive vice president of the Albuquerque Teacher Federation, criticized the district for the health care plan changes.

"I always thought that it was a pretty good version of health care," said Thomas, a social studies teacher at Eldorado High School who has worked for APS for 20 years.

"But for the last decade, half of my career, it seems the cost of health care has gone up ... so it ... has become less and less of a good deal over time," Thomas said.

Health care changes

With the elimination of Cigna from its health care provider options, APS employees were asked to switch to one of the two remaining choices: Presbyterian Health Plan (which covers approximately 4,850 enrolled employees) and BlueCross BlueShield of New Mexico (which covers about 2,300 enrolled employees).

While the loss of Cigna will only impact about 150 APS employees, the narrowing of provider choices and the premium increase will affect all of the estimated 12,500 school district employees.

Another major change to APS's health care offerings is that the school district will only offer its employees an Exclusive Provider Organization (EPO) plan that will only include out-of-state, in-network access. The EPO stands in contrast to a Preferred Provider Organization, or PPO, which allowed members to see providers both in and out of network.

The open enrollment period was from Oct. 1-16, and APS is currently processing the submitted open enrollment changes, Salazar said.

The rising price of health insurance

In his written responses to Journal questions, Salazar acknowledged the rising cost of health insurance.

"We recognize ... that nobody likes these increases, but we don't control the cost of health care," he said. "This is an issue affecting employees and employers across the country."

But the increase does not sit well with Thomas, who has a wife and two children under his Presbyterian health care plan. Thomas believes the premium increase will hurt not just teachers but everyone who works for APS.

"It just creates another hardship, on teachers and all the professionals that work in education, to afford health care for themselves and their families," he said.

A raise is 'not enough'

Thomas and other teachers the Journal spoke with said they believe the 3% raise they were given on July 1 is not enough to help them pay for rising health care costs.

"It always seems like heath care (costs) are going up and up and up, and we're not getting any relief for that," Thomas said.

Salazar responded that all employees will continue to take home a portion of their raises even after the medical premium increases in January.

Information APS provided its employees and shared with the Journal shows that the amounts of take-home pay will vary depending on whether employees are single, have a family or the amount of money they make. But for families making up to $70,000 a year, they will keep just under half of the amount of across-the-board the 3% raise, the information said.

'An ongoing problem'

In responding to teachers' complaints that pay increases aren't keeping up with the increases in insurance costs, Salazar said compensation increases are set at the state level.

But Senate President Pro Tempore Mimi Stewart, D-Albuquerque — the sponsor of Senate Bill 1 in 2022 to increase teacher compensation by 7% — blamed the health care industry for increases in premiums "with no end in sight."

"This is an ongoing problem because of the health insurance industry — they are raising prices everywhere," she said. "It's a problem for the state, because state agencies are not able to keep up with the cost of insurance."

Stewart said the health care industry sets its own prices and there are several groups that try to negotiate prices lower.

"Mainly the IBAC (Interagency Benefits Advisory Committee) which includes APS, NMPSIA (New Mexico Public Schools Insurance Authority), the state workers and RHCA (New Mexico Retiree Health Care Authority)," Stewart wrote in an email. "Whatever they can squeeze out is what we pay for."

Since Stewart's bill was signed into law, the Legislature passed an additional 3% and 6% increase in teacher salary minimums, according to information she shared with the Journal.

During the 2025 legislative session, Stewart said lawmakers are going to try to pass raises for teachers to cover the cost of insurance.

"We don't know exactly yet what that will be, but we want to ensure that pay raises will be enough to cover that, and then some," she said.

Thomas said he would like APS to work with the state to find a way to lower health insurance costs for public workers, especially teachers, to help attract and retain teachers.

'We like the plans we pick'

Even though Thomas is not enrolled in the Cigna plan — and doesn't know anyone who is — he still understands why it may be frustrating to lose a health care provider.

"I do understand the fact that we like the plans that we pick as a family. People get comfortable — they know the doctor they can see, they know how they're covered; they get used to that," Thomas said, "and then they take away an option, and that creates obstacles for families trying to figure out what's the next best plan for them."

Thomas believes another "hardship" on APS employees, particularly those who enrolled in Cigna, will be to learn about the other health care coverage options.

"You have to revisit the details ... and I don't think that's always really communicated that well," Thomas said.

On Oct. 8-9, APS hosted a Wellness Fair at the Berna Facio Professional Development Center, in part, to assist with online open enrollment. Benefits specialists were available to answer questions. All APS medical, dental, vision, pharmacy, flexible spending, life insurance, long-term disability insurance, and voluntary retirement savings plan vendors had booths available to discuss benefit options.

'It is what it is'

Other APS employees the Journal spoke with seem ambivalent about the health care changes.

Cynda Bellamy, head teacher at Zia Elementary School, gets her health care through Presbyterian and said the premium increase jumped out at her this year.

"I was not a happy camper," Bellamy said. "But what are you going to do? There's not a lot you can do."

Bellamy's colleague, Rebecca Harmon, teacher of the visually impaired at Zia Elementary School, is on BlueCross BlueShield.

"(The premium is) a big jump. I'm shocked," Harmon said. "(But), as much as I hate the fact that it's going up, it is what it is."