School employees start to enroll in new statewide health insurance program

Spokesman-Review (Spokane, WA)

Oct. 9--Drew Yanuszeski has done the math. He estimates that his family will save $300 a month in health insurance costs starting Jan. 1, 2020, when the statewide school employee insurance plans take effect.

Yanuszeski is the principal's assistant at Spokane Public Schools' Franklin Elementary School, and his wife teaches in the district as well. They have two children, and previously, he said, the family paid about $500 a month to cover everyone. No longer, however.

Washington state school employees, regardless of job title, who work more than 630 hours in a school year now have access to health insurance and other benefits after the School Employees Benefits Board Program opened this month for enrollment.

Depending on the county, the majority of school employees will have the option of at least two carriers and at least four plans. Premiums for health insurance through SEBB range from $13 a month for the cheapest individual plan to $348 a month for the most expensive family plan. Carriers and plans will vary depending on the county, not district.

"This is substantially cheaper," Yanuszeski said.

This could be due to the new ratio implemented in the SEBB plans. Family coverage premiums cannot exceed three times the cost for a single-employee premium on the same plan. Additionally, school employees with children will not pay per child. Premiums remain the same regardless of the number of children a parent claims on their plan.

"It became so challenging to cover dependents, and we have people paying $1,500, $1,600, $2,000 a month," said David Iseminger, director of the Health Care Authority's benefits division. "The most they will pay with this is $348 a month, so we are getting lots of families surprised and wondering if they are understanding the premiums correctly."

The Health Care Authority, which is administering the program, estimates that SEBB will cover 140,000 to 150,000 school employees. When dependents are factored in, it could mean 250,000 to 300,000 total Washingtonians covered by the new program.

Enrollment opened through an online portal on Oct. 1 and continues until Nov. 15. Eligible school employees in Spokane County can choose among 13 different plans from Kaiser Permanente, Premera and UMP.

Previously, all 295 school districts in the state offered different benefits for employees, with some paying much higher premiums than the SEBB program and others paying nothing out-of-pocket for insurance. Not all districts offered coverage or partial coverage to part-time employees, which will be the primary driver of new costs for school districts under SEBB. The fiscal impact of covering part-time employees with the same medical coverage as full-time employees varies depending on the district.

In the West Valley School District, Superintendent Gene Sementi says the program prevented him from using nine permanent substitute teachers the district usually employs, because he could not afford to pay their benefits.

He estimates that the West Valley School District will pay for benefits for about 42 employees, who did not receive them previously. Working 630 hours is equivalent to a typical half-day school employee role, like bus drivers and nutrition or maintenance workers.

"The more part-time employees you have, the greater the costs," Sementi said.

The new SEBB program requires auto-enrollment for any eligible school employee who does not go into the SEBB portal to sign up. The state auto-enrolls each eligible person in a $33 a month individual health plan, with the smoker designation adding an additional $25 monthly charge. This cost is passed on to the school district, ultimately, which Sementi predicts will make for a few tight upcoming fiscal years.

If school employees have TRICARE or Medicare, they do not have to enroll in a SEBB plan, but they must waive coverage through the portal. They must also enroll in dental, vision, basic life, death and long-term disability insurance, with no premium for them but with a bill for the school district.

"We still have to pay for it," Sementi said.

The Legislature did appropriate more funds for the state-funded positions this year, but districts will still have to cover the costs of locally funded staff benefits. Spokane Public Schools is anticipating a $1 to $1.2 million budget impact from the program, said Linda McDermott, associate superintendent of support services. She anticipates the district will do a lot more strategic hiring and tracking of employees' hours as a result.

"We want to be strategic and intentional around the assignment of employees," she said. " If they meet the threshold, we should see if their assignment can become more full-time versus more part-time employee."

Rep. Timm Ormsby, who is the chair of the House Appropriations Committee, said the intention of the program is to ensure consistency of benefits statewide and enable school district employees access to similar coverage as that of state employees.

Previously, part-time employees in some districts could be eligible for benefits but would have to pay a lot of their paychecks back to the district for health insurance. This new program eliminates that possibility, Ormsby said.

"It was a once in a generation opportunity to expand beyond the (Washington) Supreme Court's charge and provide more universal consistency in this area as well," he said.

SEBB came out of the state's efforts to comply with the McCleary v. Washington court ruling, which forced lawmakers to address equity and funding statewide for schools.

It is too early to say if the state appropriated enough funds for state-sponsored positions through the program, Ormsby said. Enrollment numbers will be the real tell, when they are collected in the coming weeks.

"The benefit is not that it costs less money to the state," Ormsby said. "But the benefit is offering a consistent health care benefit to our public school employees and knowing that the state is doing our part in being a model employer to indicate what employees' expectations should be for health care in the workplace and government's role in providing health care."

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