State Health Insurance - USM Forum -- Message Board

Date: Jan 3, 2006

State Health Insurance

Date: Jan 3, 2006

Thanks for the heads-up Mitch. It would be nice if HR would provide faculty and staff with an annual update on changes in our benefits....

Date: Jan 3, 2006

My son (married, one child) lives on the West Coast. His insurance premiums are astronomical. He says that a growing number of people in his area are no longer buying regular health insurance, but instead are keeping major medical only and paying for the doctor visits and Rx themselves. Some of his friends say that's cheaper for them.

This isn't really a solution, and it isn't practical for everyone.

Date: Jan 3, 2006

More information:

For comparison purposes:

My yearly premium is $5,724. If I switch the wife and kid to Miss BC/BS outside the state plan, a yearly premium of $4,968 will cover them with a $500 individual deductible (saving $756 in premiums). Having individual deductibles (lower than the state plan too) again for all family members may save money if med services are used. A $250 deductible is also available at a lower rate than the state plan. More important, co-pays in network kick in before the deductible ($15 for GPs, $25 for specialists). I think these premiums, should be re-imbursable from a cafeteria plan. Caveat-individual circumstances may vary (smokers may cost more, and so forth). Also, BC said whether one can switch off the plan mid year depends on our HR folks and any cafeteria plan agreements they have (apparently being in a cafeteria plan may hinder switching before open enrollment). I'm planning on contacting HR for more details (my info could be wrong) later this week.

Date: Jan 3, 2006

Does your cafeteria plan reimburse the premiums or does it just deduct them pre-tax, which saves you some $$ on your income tax?

Date: Jan 3, 2006

Mitch wrote:

Hello all: The spouse just read our new benefits book, and there is a change that will cost many of us this upcoming year if you have family insurance (if we read it right). There is no longer an individual deductible for family plans. There is only a family deductible of $2,100. What this means is that for non-catastrophic health care costs, a family may have to pay a heck of a lot more out of pocket next year. For example, I believe my premiums for my spouse and two kids cost me about $6,000 last year (I'd have to check for an exact number). I think the individual deductible was something like $750 in 2005. The spouse broke her ankle in November and needed several surgeries (a bad situation, but not catastrophic). We had few other medical expenses in 2005. If the same event occurred in 2006, it would cost me over $1,000 more in out of pocket expenses this year. The spouse is so not happy, and she is looking into non-state employee BC/BS. If we switch, at least the individual deductible would again apply to me (which was also increased), and perhaps we can get a better deal on the wife and the one kid left who would be eligible for family insurance (the other graduated). Just another thank-you for public employees in MS from the folks in Jackson--and this move will add to the burden of recruiting and retaining faculty and staff.

These comments can be evaluated only when compared with the health care benefits provided to public employees in the other states.

Date: Jan 3, 2006

As someone said earlier, it would be good if HR would give some help on this. I know for a fact that Russ Willis knows a lot about it--and about the benefits of staying with the clearly expensive state plan.

Date: Jan 3, 2006

Error of the remote reciprocal wrote:

These comments can be evaluated only when compared with the health care benefits provided to public employees in the other states.

Colleagues who have moved to or from PA and TX say our health benefits are inferior. As to other states, I don't know. The plan for Forrest General employees (another major employer in the area) is better also. My brother is a social worker in MD for a fed agency. His plan is far better. When I was looking to move to NIH, the health benefits were far better. I don't know of a plan for a state or fed employee that is worse--though it is always possible that there is such an animal. If you know of one, feel free to provide this information.

Date: Jan 3, 2006

Thankfully healthy so far wrote:

As someone said earlier, it would be good if HR would give some help on this. I know for a fact that Russ Willis knows a lot about it--and about the benefits of staying with the clearly expensive state plan.

My guess is that the benefit is that major health factors will not affect one's premium under the state plan because we are "self-insured." Thus, one can smoke to one's hearts content without fear of increased premiums.

Date: Jan 4, 2006

LVN - I found out the hard way that insurance premiums are not paid through the cafeteria plan (per IRS regulations). When I asked about this, the HR people told me they were, but the claim was rejected. I found out about this too late to schedule other procedures - like eye exams and dental work - prior to Jan. 31.

BTW - there has been a ruling that the cafeteria plan dollars can be carried over into the first quarter of the new year, but your institution must request this. Does anyone know if this has been done?

Date: Jan 4, 2006

The docs are feeding at the troughs. A smaller model Mercedes would help us all.

Date: Jan 4, 2006

Battered and Poor wrote:

The docs are feeding at the troughs. A smaller model Mercedes would help us all.

Invictus' healthcare rule #1: If you're doctor drives a pickup truck, you're in good hands.

The only physician I have regularly used who drove a Mercedes had a rather classic model. He rebuilt it from the frame-up himself. Which leads me to rule #2: If your physician rebuilds cars or does cabinet work or drives a tractor during his off-hours, you're also in good hands.

Date: Jan 4, 2006

Although I no longer work for USM, I felt compelled to add my 2 cents (which will not help offset any of your rising healthcare costs). I left USM for a less secure position at Penn State several years ago, because I could no longer tolerate the administration's lack of appreciation for its faculty. When considering what the change in position would mean to my family financially, I discovered that, not only would I see a significant rise in salary from the move, I would also see more in my monthly paycheck because of savings in healthcare premiums and retirement contributions. At USM, I lost close to $500 monthly for a family health plan (with signficant costs still coming out of my pocket when services were delivered), and USM matched my 7% retirement contribution. Now, I pay approximately $250 for a far superior plan, and Penn State adds 9% to my 5% contribution monthly.

I haven't regretted the change for even one moment.

Date: Jan 4, 2006

Brian wrote:

USM matched my 7% retirement contribution. Now, I pay approximately $250 for a far superior plan, and Penn State adds 9% to my 5% contribution monthly.

7% + 7% = 14% at USM. 9% + 5% = 14%. It looks like you are stashing away the same % for retirement at Penn State as you did at USM. Did your USM contributions go to PERS or to TIAA/CREF?

Date: Jan 4, 2006

And you have a good football team.

Date: Jan 5, 2006

Funny Numbers wrote:

Brian wrote: USM matched my 7% retirement contribution. Now, I pay approximately $250 for a far superior plan, and Penn State adds 9% to my 5% contribution monthly. 7% + 7% = 14% at USM. 9% + 5% = 14%. It looks like you are stashing away the same % for retirement at Penn State as you did at USM. Did your USM contributions go to PERS or to TIAA/CREF?

Even though the total is the same, the extra 2% saved from Brian's pocket can be invested in a 403B plan. If this is done, he gets a 16 v 14% contribution for the same out of pocket costs--and a tax benefit to boot by using a deferred comp plan.

Date: Jan 5, 2006

At USM, my retirement was going into Aetna (an available option at the time). At PSU, I'm with TIAA-CREF. You are correct that the percentage of my salary going into retirement is the same at both institutions, however more is coming from PSU than from my paycheck.

Date: Jan 5, 2006

Brian wrote:

At USM, my retirement was going into Aetna (an available option at the time). At PSU, I'm with TIAA-CREF. You are correct that the percentage of my salary going into retirement is the same at both institutions, however more is coming from PSU than from my paycheck.

Getting back to your Penn State health care plan, Brian, do you have "freedom of choice" in terms of your health care providers, or must you adhere to some HMO, HBO, PDQ, or QVC?

Date: Jan 5, 2006

Brian wrote:

Although I no longer work for USM, I felt compelled to add my 2 cents (which will not help offset any of your rising healthcare costs). I left USM for a less secure position at Penn State several years ago, because I could no longer tolerate the administration's lack of appreciation for its faculty. When considering what the change in position would mean to my family financially, I discovered that, not only would I see a significant rise in salary from the move, I would also see more in my monthly paycheck because of savings in healthcare premiums and retirement contributions. At USM, I lost close to $500 monthly for a family health plan (with signficant costs still coming out of my pocket when services were delivered), and USM matched my 7% retirement contribution. Now, I pay approximately $250 for a far superior plan, and Penn State adds 9% to my 5% contribution monthly. I haven't regretted the change for even one moment.

And Brian was a huge loss to our department!!! Glad you are doing well, Brian. Go Penn State!!!!

Date: Jan 5, 2006

Funny Numbers wrote:
Getting back to your Penn State health care plan, Brian, do you have "freedom of choice" in terms of your health care providers, or must you adhere to some HMO, HBO, PDQ, or QVC?

Penn State offers approximately 12 different health options, including several HMOs, PPOs, etc. Because PSU is by far the largest employer in town, virtually every medical practice in the area is available through multiple health plans. I pay next to nothing out of pocket.

Date: Jan 5, 2006

Brian wrote:

Penn State offers approximately 12 different health options, including several HMOs, PPOs, etc. Because PSU is by far the largest employer in town, virtually every medical practice in the area is available through multiple health plans.

Does Penn State offer any single medical plan through which,as you say, "virtually every medical practice in the available" or does each have its own limited set of providers?

Date: Jan 5, 2006

Funny Numbers wrote:

Does Penn State offer any single medical plan through which,as you say, "virtually every medical practice in the area is available" or does each have its own limited set of providers?

Please let me rephrase my fuzzy question. What I meant to ask is this: When you say you have "freedom of choice," does that mean you have the freedom to choose among a dozen or so plans each with its own set of providers, or freedom to choose your provider regardless of the plan in which you're enrolled?

Date: Jan 5, 2006

Funny Numbers wrote:

Funny Numbers wrote:
Does Penn State offer any single medical plan through which,as you say, "virtually every medical practice in the area is available" or does each have its own limited set of providers?
Please let me rephrase my fuzzy question. What I meant to ask is this: When you say you have "freedom of choice," does that mean you have the freedom to choose among a dozen or so plans each with its own set of providers, or freedom to choose your provider regardless of the plan in which you're enrolled?

Freedom of choice refers primarily to number of plans, but there is considerable choice within individual plans. Specifically, you may choose to go with an "in network" provider and have virtually all of your expenses covered (with no deductible), or you may choose to go "out of network" and pay a deductible and a little more out of pocket. Your out-of-pocket expenses are capped at about $1500/year. Obviously, if it is important to you to have a particular physician and that physician is not "in network," your benefits are not as attractive (as they would be "in network"). However, the $250 you save each month on your family premium should help to defray some of the added expense for going out of network.