Mar 05, 2015

GIC Votes to Increase Rates, Copays, Deductibles

Starting July 1, state and Trial Court employees who get their health insurance through the Commonwealth will pay higher premiums and face higher copays and deductibles, after the latest votes by the Group Insurance Commission.
The GIC voted on March 4 to raise premiums for state workers enrolled in health insurance plans offered through the Commonwealth. All four union commissioners present voted against the rate hikes, including Richard Waring and Margaret Thompson from NAGE, but the other commissioners present voted in favor. In February, the GIC voted 10-4 to increase copays and deductibles.
“These increases and the governor’s proposed increase on the premium split add up to a real burden on state employees,” said Richard Waring, one of the NAGE members on the GIC. “The cumulative effect of these increases is going to hit a lot of working families very hard.”
“Increases like this can have a monumental effect on our lower-paid state workers,” added Margaret Thompson.
What it means
The details of the increases vary among the plans offered through the GIC, but the average rate increase for FY16 will be 5.7%. Much of that increase is driven by the rate hikes of two plans: Harvard Pilgrim at 9.2% and Tufts at 6.9%.
In addition, Harvard Pilgrim PPO and Tufts PPO will be converted into POS or “point of service” plans. POS plans require members to designate a primary care physician and to obtain referrals to see specialists.
Thinking of changing plans? Read this before you do
Those PPO-to-POS conversions, as well as the rate changes, may have some members considering a plan switch during the open enrollment period, from April 8 through May 6, 2015. The GIC has offered these tips for consumers considering a change in health care coverage:
  • Identify which health plan(s) you are eligible to join. Some plans may not have coverage in your geographical area.
  • When you’ve identified the plans you’re interested in and eligible to join:
    • Review their benefit summaries.
    • Weigh the features that are important to you and your family members.
    • Review the monthly rates.
    • Consider enrolling in a limited network plan to save on your monthly premium costs, if that plan will meet your health care needs.
    • Contact the plan to find out about benefits that may not be described in the GIC guide.
  • Find out if your doctors and hospitals are in the plan’s network. Call the plan or visit the plan’s website and search for your own and your covered family members’ doctors and hospitals. Be sure to specify the health plan’s full name, such as “Harvard Pilgrim Primary Choice  Plan” or “Harvard Pilgrim Independence Plan,” not just “Harvard Pilgrim.”
    • Your health plan selection is binding until the next annual enrollment, even if your doctor or hospital leaves your health plan's network during the year. The health plan will help you find another provider if that happens.
  • Check on copay tier assignments that affect what you pay when you get physician or hospital services.
    • Those copay tiers can change each July 1. During annual enrollment, check to see if your doctor’s or hospital’s tier has changed.

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