State employee insurance plan begins in July
The new plan takes effect
Cheatham said PEIAâ??s top cost increase stems from prescriptions.
So active members and retirees will both see a change in prescription coverage, from a fixed copay to a 20 percent coinsurance for each prescription. To avoid excessive costs, he said, patient cost for each 90-day prescription will be capped at
The plan he presented Monday, he said, is slightly different from what he presented previously, based on public employee comments from meetings around the state.
State employee premiums will increase by half a percent because the Legislature gave PEIA an additional
Salary index codes will be decreased from 10 to five, â??for administrative ease.â? They will go in
Within each salary range will be four levels of coverage, he said: Single employee, employee plus children, employee plus spouse and full family.
PEIA will base premiums on total family income if the spouse is employed, Cheatham said. It reflects ability to pay, and this amounts to a sort of spousal penalty, he admitted. In some cases, it might be cheaper for the couple to maintain separate coverage.
For instance, according to a chart he provided, a single employee making
Cheatham said that under the new plan, single employees and single employees with children will actually see their rates go down. â??Thatâ??s a good thing.â?
He anticipates that some employees, for privacy or other reasons, may not wish to divulge their total family income. They will be defaulted to the top income level. He also plans to introduce a bill to allow PEIA to obtain a salary range level â?" not the exact figure â?" from the state
He thinks that would reduce a lot of work for PEIA staff, but he admits he doesnâ??t know if the proposal will receive any support. â??Itâ??s an ask.â?
Starting
Delegate
Part of the reason, Cheatham said, is based on limitations on how PEIA can charge premiums.
And part is that an alternate proposal faced great opposition, he said. This was pay-by-the-person. PEIA knows what each additional family member costs to cover and proposed a plan with extra charges for reach extra person. But that proposal hurt large, low-income families.
One single teacher with four children, he said, told him how much her costs would rise. He suggested she could save money by putting her kids on the Childrenâ??s Health Insurance Program (CHIP), where they would receive better coverage.
â??I could have had my head chopped off,â? he said.
So they relied on a piece of state code that allows PEIA to consider ability to pay when setting up its premium structure, he said.
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