SPFE and Teamster SPPS Employees Vote on Health Insurance Provider
The Saint Paul Federation of Educators and Teamsters Local 320 are in the midst of conducting a vote of their membership about transitioning from SPPS’ current healthcare provider, Health Partners, to the Public Employees Insurance Program (PEIP).
Under the Health Insurance Transparency Act (HITA), unions have the right to participate in the Public Employees Insurance Program (PEIP) if that is the chosen option of the majority of members.
In light of that vote, the following information has been compiled to help all employees understand the process and potential outcomes.
Why did the District select HealthPartners over PEIP?
The selection process included representatives from all Labor unions as well as Administration. After a thorough review of the results a vote was conducted. The vote was 9-7 to stay with HealthPartners. There were many concerns including the requirement for members to choose a Primary Care Clinic, increases in out-of-pocket costs, no rate guarantee, impact to early retirees who were out-of-area, and administrative concerns.
Part of the reason SPPS only agreed to a 2-year contract with HealthPartners (as opposed to a longer term) was due to the desire to explore a move for the entire population to PEIP for 1/1/2021. During the RFP process, SPFE and Teamsters indicated that even though the committee did not recommend a move to PEIP, they would support the decision made by the committee.
Do I have to participate in the vote if I’m represented by one of the involved unions?
You are not required to vote. However, we strongly believe that all affected employees should take part in this process as employee health benefits are incredibly important. Regardless if you plan to vote for or against the change, please vote.
If the involved unions vote to change plans, what happens to the current plan and pricing?
All the current rates will need to be recalculated to account for the reduction in employees covered by our plan. In addition, the current rate caps will be voided and repricing of benefits would need to occur. Most likely the recalculation will result in an increase in cost for SPPS employees remaining with HealthPartners.
Does the move to PEIP have to occur now?
No. The district currently has a two year health insurance contract agreement on medical benefits that is in force through December 2020. At the end of the current agreement period, the same option to convert to PEIP will exist for the district, just without the penalties and pricing impacts associated with a change mid health insurance contract agreement period.
If SPFE and Teamsters move to PEIP in January 2020 the District will breach the current contract with HealthPartners and owe an early termination fee of approximately $4 million. The District has not budgeted for this cost.
If the total premium is lower under PEIP doesn’t the District save money?
Many of the union members contemplating moving to PEIP are in a bargaining agreement that provides them with a specific amount of money to buy all of their benefits regardless of the actual cost. So when premiums are lower the District does not spend less.
Can I keep my primary physician?
Yes, in most cases. The HealthPartners clinics are part of the network offered by PEIP. Referrals would be needed for specialty treatment provided outside of the primary care network. The state and PEIP do not cover 3D mammograms under the preventive benefit.
Are there any other impacts of having to get a referral to see a Specialist?
Needing to see a Primary Care Physician prior to seeing most specialists will lead to increased out-of-pocket costs, may delay care for a member due to the requirement of needing a referral, and may result in more missed time from work.
For a person currently enrolled in the Copay plan who moves to the PEIP Advantage plan the increased cost will be at least $30 but could be as high as $280 if the person had not met their Advantage Plan deductible.
For a person currently enrolled in the HSA plan who moves to the PEIP HSA Compatible plan the increased cost will be approximately $170 (average cost Primary Care visit).
Does this change mean my benefit choices will roll over from year to year?
No, this move will still mean that there is an active open enrollment process every year to make benefit selections.
I go to a HealthPartners and/or Park Nicollet clinic and I see they are in Cost Level 1. Will that change?
The State of Minnesota negotiates with all of the providers and that determines what cost level the clinic will be in. Your provider cost level may change from year-to-year. This could mean that seeing a provider next year could have increased cost over current PEIP costs. Currently, the State of Minnesota is conducting a RFP that will determine the clinic cost levels for 2020.
I am enrolled in the HRA plan and have an account with dollars. Do I get to keep those if we move to PEIP?
The HRA account is part of the current health plan offering and is accounted for in the cost of that specific plan. If a decision is made to leave that plan, you will no longer have access to your HRA dollars.
We currently have one HealthPartners ID card, will that be the same?
No, you will have an ID card from your medical carrier and an ID card from CVS for prescription drugs.
PEIP has had an average renewal increase of 2.5% over multiple years. That sounds a lot better than what the District has had?
The Districts average trend over a similar timeframe has been 2.9% with no plan design changes. The average renewal increase reported by PEIP does include plan design changes.
Will the District have a voice in plan design?
Plan design is determined by the State of Minnesota.
How does this impact early retirees?
Early retirees are able to enroll in PEIP at the same rate as active employee.
What are the service areas under PEIP?
The service area includes all of Minnesota and parts of North Dakota, South Dakota, Wisconsin and Iowa. Out of area coverage (point of service) is available for employees, dependents, and retirees who reside outside the PEIP service area at a different benefit/cost level.
Where can I view the schedules of benefits for each plans? http://www.innovomn.com/employeeplan.php