Public Hearing

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The GIC's 2008 Annual Public Hearing was held on Wednesday, February 6, 2008 from 12:30 PM to 2:30 PM in Minihan Hall in the Charles F. Hurley Building in Boston. State employees and retirees were invited to express their views. The GIC described the following upcoming benefit changes:

GIC Public Hearing
February 8, 2008

Health Care Challenges Continue

Employers’ Likelihood of Making Benefit Changes Next Year
Mercer study:
Massachusetts Trends 500+ Employees
Expected premium increase for 2008
8.7% before making benefit changes
6.2% after making benefit changes
30% - average premium percentage paid for family coverage in PPO plans
22% - use salary-based cost sharing
Average co-pays HMO plans: $75 ER, $250 hospital, $20 physician office visit

State Budget - $1.3 billion gap; health care costs represent 45% of budget

GIC - Early Advocate for Improved Health Care Quality
Mental Health Parity
Leapfrog Group
Early Risk Intervention Program
Clinical Performance Improvement (CPI) Initiative

Others Have Joined the Cause
Medicare – won’t pay for “never” events
Mass Health Care Quality and Cost Council
Department of Public Health – regulations on hospital-acquired infections
Beth Israel Deaconess Hospital – quality, safety and patient satisfaction initiative
Partnership for Healthcare Excellence

What’s left to address health care quality and costs?
Look at the health care system itself
Get Providers to be part of the solution

Why is the GIC Pursuing the CPI Initiative?
Control cost increases for enrollees and the Commonwealth
Maintain comprehensive level of benefits
Improve health care quality and safety
Maintain participants’ choice of providers
Inform enrollees about provider performance
Encourage members to become active health care consumers

To Do List – Employees and Non-Medicare Retirees
During Annual Enrollment – Research your health plan options
Contact the health plans you’re considering to see which co-pay tier your doctors and hospitals are in
How to Lower Out-of-Pocket Costs – Employees and Non-Medicare Retirees

After Annual Enrollment
Don’t be a passive consumer!
Tier 1 providers are top value providers
Consider their rankings before you select (and save $) a provider
Before you visit a doctor or are admitted to the hospital (non-emergency), find out your co-pay for the doctor or hospital

Governor’s Budget FY09
Premium percentage based on ability to pay rather than date of hire
Proposal for state employees’ premium contribution:
Salaries less than $35,000 – 15%
Salaries $35,000-$50,000 – 20%
Salaries over $50,000 – 25%
State retirees held harmless; municipalities determine their own premium percentages
Final state enrollee premium percentage determined by legislature late spring

GIC Benefit Changes for FY09
All health plans out to bid – Medicare plans under special scrutiny
Mental health provider for Indemnity and Navigator by Tufts Health Plan out to bid – carrier could change
Health plan carriers and benefits and mental health carrier determined February 15

Benefit Changes July 1, 2008
Vision benefits standardized across all employee and Non-Medicare retiree health plans; one eye exam every 24 months
Indemnity Plan names will change to:
UniCare State Indemnity Plan/Basic
UniCare State Indemnity Plan/Community Choice
UniCare State Indemnity Plan/Medicare Extension (OME)
UniCare State Indemnity Plan/PLUS
Separate HMO enrollment form no longer necessary for Non-Medicare HMOs – simply use GIC Form-1

Benefit Changes 7/1/08Evolution of CPI Initiative Will Continue
Physician office visit co-pays will migrate to three tiers for PCPs and Specialists based on quality and cost-effectiveness standards:
3 star - Tier 1
2 star - Tier 2
1 star Tier 3

Possible Changes to Address Concern with GIC Budget
Increases in some co-pays or deductibles likely:
Outpatient surgery
Inpatient hospital admissions
No benefit changes anticipated for prescription drugs
Mental health outpatient office visit co-pays could increase to align with medical co-pays in some plans

Medicare Health Plan Changes
Plan options may change
No benefit changes anticipated with current plans still offered

Other Benefit Changes for State Employees
Opportunity to enroll in or increase optional life insurance coverage up to four times salary during year without a medical form within 31 days of the following family status changes:
Marriage
Divorce
Death of a spouse
Birth or adoption of a child
This enhancement will go into effect in Fall 2008

Municipalities May Now Join the GIC for Health Coverage
New Municipalities for July 1, 2008
Athol-Royalston Regional School District
Groveland
Gill-Montague Regional School District
Hawlemont Regional School District
Holbrook
Millis
Mohawk Trail Regional School District
Old Colony Planning Council
Saugus (January 1, 2008)
Southeastern Regional Planning & Economic Development District
Winthrop

Weigh Your Options
Annual Enrollment:
April 14 – May 16 for changes effective
July 1, 2008

How to Choose
Read your Benefit Decision Guide
Contact your current health plan and plans you are considering for additional benefit and provider details
See the GIC’s website
Attend a health fair

Make Your Decisions No Later Than May 16, 2008
Active state employees – give forms to your GIC Coordinator
State retirees/survivors – send forms to the GIC
Municipal/other new entity employees/retirees – send forms and required documents to your benefits office