Educators Health Alliance Board OKs 2013-14 Rates, Benefits
Premiums for the Blue Cross and Blue Shield of Nebraska health care plan used by nearly every Nebraska school district will increase by an average of 6.4 percent next Sept. 1.
The Board of Directors of the Educators Health Alliance approved the rate plan in October.
When the 2013-14 premium year starts on Sept. 1, 2013, it will mark 11 straight years with increases of less than 10 percent. In the past seven years, the increase has been 8.8 percent or less. Rates did not increase in 2011-12, and went up by just 2.99 percent this past Sept. 1, all well below national trends.
“The EHA continues to work diligently to achieve the rate stability and increases below health insurance industry averages that our members expect and deserve,” said EHA Board Chair and Auburn Board of Education President Beth Kernes Krause.
NSEA formed the statewide Blue Cross and Blue Shield health care network 45 years ago. A 12-member board representing NSEA, the Nebraska Association of School Boards and the Nebraska Council of School Administrators governs the health care plan. NSEA retains six of the 12 voting positions.
Previous rate change announcements have come in the spring. However, with an accelerated bargaining calendar set by new state statutes, this new timing will allow negotiators to account for the 2013-14 rates when bargaining for that school year contract begins after Nov. 1.
NSEA Associate Executive Director Neal Clayburn is the immediate past chair of the EHA Board of Directors. He said the bargaining calendar as set by the new statute has made the rate projection process more difficult for actuaries.
“In order to accommodate that new bargaining calendar, they’re projecting out 23 months,” said Clayburn. “Previously they projected out 18 months. That’s a huge difference.”
Eligibility Verification
The 2013-14 rates reflect modest changes to deductibles, coinsurance and copays in order to keep pace with inflation and keep rates as low as possible.
Ultimately, the active employee rates will increase by 6.25 percent for all rate and benefit categories.
The EHA will hire an independent firm to make certain the plan covers only eligible individuals. The State of Nebraska and the University of Nebraska health insurance plans recently completed a similar process.
The co-pay for an office visit to a family doctor will fall from $35 to $30. The co-pay for a specialist will be $50. The co-pay for a visit to an urgent care site or emergency room will be $75. Those changes will bring the EHA plan into line with other, similar plans.
Out-of-pocket expenses for health care options for active NSEA members will increase by $150, said Clayburn.
Meanwhile, rates for Early Retiree/Direct Bill members will increase by 9.4 percent, following expiration of funds from the Early Retirement Reinsurance Program (ERRP), a part of the Patient Protection and Affordable Care Act that temporarily kept early retiree rates in check. Further, the early retiree plan members will see a premium holiday. They will not see a bill in December 2012, thanks to the ERRP program.
Dental Rates
The dental rates will rise by 5.94 percent for all participants, including active and early retiree categories.
Kernes Krause said the EHA Board was particularly pleased that the rate increase will be reasonable in light of the rate pressures on health insurance plans. These pressures result from medical inflation and provisions of the Affordable Care Act, including expansions in coverage to dependents to age 26; the removal of copays for nearly all preventative services and coverage for women’s preventative services; and health insurance excise taxes beginning in 2014.
Kernes Krause said the board is hopeful that preventative services will result in lower costs in the long term. In the short term, she said preventative services are adding to the cost, citing a 53 percent increase in EHA preventative services expense in the last 10 months.
The EHA plan covers more than 70,000 education employees, early retirees and their dependents.
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