Health Insurance Update, September 2003:

The rising costs of health insurance has resulted in some changes in the county’s 2004 health insurance plans. At the open enrollment, you are going to have several options. It is important that you review out of pocket costs and benefit changes when you get your open enrollment packet. Here is a summary of some of the changes.

Health Partners will now only have one premium for singles and families. However, the tier you chose will determine how much of an office co-pay you will have. Tier one will be the “Classic” Health Partners clinic network. These are primarily the old Group Health Clinics with some additional clinics in greater Minnesota and Western Wisconsin. If you chose this tier, you will have a $5.00 co-pay for all office visits. Health Partners will reduce the office co-pay for the employee and all family members in the plan if the employee completes a health risk assessment.

Health Partners Tier 2 will be the Health Partners “Choice” network. This option includes all of the “Classic” clinics and additional clinics such as Park Nicollet, Fairview, Health East, Aspen, Alina, and about 35 additional clinics in Greater Minnesota and Western Wisconsin. If you chose this option, you will have a $20 per visit office co-pay which can be reduced to $15 if the employee completes the health risk assessment.

Only about 7% of county employees have completed the health risk assessments since the program began earlier this year. The assessment is a wellness program that is designed to improve the overall health of county employees thus decreasing our risk pool and controlling our medical insurance costs. Health Partners believes this will help control costs over a long period of time and is committing resources to wellness programs. You can complete an assessment during open enrollment or by logging on the the Health Partners web site at www.healthpartners.com. If you have already completed an assessment, you do not need to do it again. 2004 Premiums both tiers: Single $310.29 Family: $869.11

Blue Cross will now have two options. Aware Gold will be available again, but the premium will be increasing by 13-15%. This would have been a larger increase but the benefits have been changed. One difference will be that the prescription formulary will be closed. This means that members of this plan will have to take generic drugs if available. If you still want the brand name, you will be required to pay the difference of the cost of the brand name in addition to the co-pay. The Emergency Room co-pay will rise from $40 to $50. Without these changes, the cost of Aware Gold would have gone up 21% from 2003. 2004 Premiums: Single: $408 Family: $1021

The Second Blue Cross Called Aware $300 Comprehensive Major Medical. This option will be just over 5% more than the Current Aware Gold premiums. The major difference is that members are required to pay a $300 annual deductable for singles and 20% of major medical expenses up to $1500 for an individual and $3000 per family. Preventative care is always covered at a 100%. This plan provides freedom of choice for doctors and clinics but does make the member pay a significant portion of major medical costs. This plan would work well for an individual or family who have little or no medical problems but who want to have the freedom of choice for the services they receive. The Single Premium will be Single: $381.50 Family: $945.00

What will the out of pocket costs for premiums be? That is completely dependant on the current contract negotiations. For 2003 the County’s contributions are $300.58 per month for single coverage and $570.94 per month.