State workers, retirees object to single plan, higher-out-of pocket costs for state health insurance

State workers, retirees object to single plan, higher-out-of pocket costs for state health insurance

September 9, 2013

By Walter C. Jones  The Florida Times Union

ATLANTA | Private-sector employees affected by Obamacare won’t be the only ones seeing changes in their health insurance on Jan. 1.

The half-million state workers, retirees, teachers and school workers will also see their coverage revised when 2014 begins.

State officials boast that premiums are being held in place, but some critics complain that they’ll still be paying more out of their pockets because of limits on coverage.

“The main message that we want to convey and we’re trying to convey is for most members the premiums will stay the same or go down,” said Pam Keene, spokeswoman for the Department of Community Health that oversees the State Health Benefit Plan.

One key way to hold premiums down, she said Monday, was the department’s decision to contract with just one administrator for employees living outside of metro Atlanta.

Traditionally, employees had a choice between two insurance companies. Although they both offered the same plans, each had its own network of doctors and hospitals.

Some observers say the competition between the companies provided them reason to maintain peak service.

“The competition came in during the bid process,”Keene said. “That’s how we got these rates.”

She estimates the resulting savings will be more than $200 million next year.

However, the department still plans to have two insurance companies administering claims in theAtlanta area.

Rep. Ben Harbin, R-Evans, said he’s gotten complaint calls already from teachers and state workers about the lack of choice.

“People are going to have to change doctors, possibly hospitals, because people don’t have a choice, and it’s a decision made by some bureaucrat in Atlanta instead of families around the kitchen table,” he said.

The number of administrators is less of a concern to the Georgia State Retirees Association than the reduced coverage, according to its treasurer, B.J. Bennett.

“I take real issue with the statement that the premiums are not going to go up for employees,” she said.

Comparing the current plans to next year’s alterations to reflect federal health-reform requirements is complicated, Bennett admits. But her analysis shows that since 2011, the maximum out-of-pocket expense for deductibles and co-insurance has doubled in some cases. And what employees and retirees pay for prescription medicines no longer count toward their maximum.

Bennett sees only one solution, convincing elected officials to pitch in more taxpayer money to subsidize the employee premiums rather than education, jobs, tax breaks or other policy options.

“The governor and the legislature would have to have some heat on them,” she said. “As long as there’s not a lot of heat, they’re going to put the money where they want to put it.”