After Monday night’s District 186 School Board Meeting, I have heard from nearly one hundred people who were severely disheartened in the manner in which our Insurance Committee’s recommendation’s were blatantly ignored and our individual and family’s District Health Insurance was minimized. First, I want to apologize for any additional stress this has brought to you and your families. It was unnecessary and highly insensitive, especially in light of your dedication to our communities and your own personal situations navigating the Coronavirus epidemic. Secondly, I would like to thank you for being brave enough to reach out to your SEA representatives and I fervently thank you for defending your rights as deserving and respected civil servants within our educational communities. Finally, I want you to know that I find it deplorable that an employer would diminish an employee’s health insurance benefits in the midst of a world-wide pandemic. The news of such an ignoble act has made its way to the local papers, the radio talk shows, and even the evening news (see below). SEA is in you corner and will not surrender your hard earned benefits without a fight.
The decision that the District and School Board made at the April 20th SPS186 School Board meeting was unprecedented, and established a new reality in which the School District clearly placed its need to be in a better fiscal position over your physical and mental health. This stark reality is of organization attempting to increase revenues entirely on the backs of the sick, the unlucky, and the medically in need and is wrong… plain and simple. The entire principle of health insurance is to make medical cost more reasonable and spread the financial risk to all. We, the collective, pay an up front premium to a health insurance company (BCBS) and that payment allows all of us to share “risk” with lots of other people who are making similar payments. Since most people are healthy a good portion of the time, the premium dollars paid to the insurance company can be used to cover the expenses of the (relatively) small number of enrollees who get sick or are injured. If we shift away from the model of equal premium increases and more toward higher individual deductibles, out of pocket increases, office visits, pharmaceutical expenses, and emergency room payments for those who may have to utilize health care, we shift the medical burden back onto the individual and not the collective pool.
Going down this pathway that the Board has elected endangers those within the pool who are working within our organization who are “financially fragile”. We are are hard-working professionals trying to get ahead, but life happens. Classically, when things have been tight, District health insurance has typically been part of our safety net and an appealing reason to work within the local public educational setting. When that safety net is taken away and deductibles and other non-budgeted medical expenses become insurmountable, people become gobbled up by their own medical bills. As we all know, this truly happens and is the all-to-common story of medical bankruptcy, often the beginning of the financial end for individuals and families; forever altering their life possibilities. If people cannot afford to use their insurance, it is no assurance at all.
The District openly claims they chose the pathway of increased prices on deductibles, out of pocket expenses, prescription costs, office visits, and emergency room visits to prevent YOU an increase in premiums. While on its face, that seems nice but 72% of our members are on the single insurance plan and a 5% premium increase for them would have equated to less than $23 per year. And for those on family plans, a 5% premium increase would have meant an increase between $234-$600 annually (or $9.75-$25 per paycheck). The District is conveniently leaving out the fact that if there is no premium increase to members, then there is no additional money that the District must contribute to the plan. The District pays for 95.5% ($9,540) of every member’s insurance (as a bargained benefit for you) working here in District 186. No premium increase for you = No premium increase for the employer. Your SEA Health Insurance Committee (and Ball Charter and SEIU) recommended a 5% premium increase to the Board of Education because it was a way to generate revenue for the fund in a manner shared by both employee and employer. Sharing is caring, and not sharing is well…. its obvious.
Furthermore, any District member who sees the new plan negatively enough to “move away from” taking District insurance, and has the opportunity to do so, saves the District $9,540 per year. Nobody would ever openly admit to purposely trying to encourage employees to get their insurance elsewhere, but it only benefits the District if it occurs. If eleven employees, who currently take District health insurance switch to their spouse’s insurance (state/city government, medical institution, university, hospital, firefighters, police, county, etc) or a government subsidized plan, the District would save $104,940 annually from those ten employees alone (not the Health Insurance Fund). On the flip side, there is no financial incentive for the School District to provide affordable coverage for its employees, keeping them on our plan and never has been. It has just been the right thing to do and for decades we have been able to count on the District to do so for us. I truly hope that hasn’t changed.
Interestingly, the District continues to toot its horn about the rebooted Employee Assistance Program (EAP) and the Memorial Choice savings for District employees. And I cannot deny that those are good things. But do not be duped… the District did not bring these to you out of the kindness of their hearts or alone. Your past SEA president, Crysta Weitekamp, worked diligently on the Memorial Choice concept along with the District to get it up and running. And the partnership that the School District has with Memorial Health Systems would not exist if the District and Memorial Hospital were not both receiving mutually financial benefits from the arrangement. As for the Employee Assistance Program, the District was guilted into bringing it back it through the collective bargaining process (after being stricken from the budget years ago as a cost savings measure). These were not gifts. They were peace offerings.
Last, and tragically far worse than employees even suspect, are the “care management” procedures that have been thrust upon us in this new health insurance plan ushered in by the Board. Prior Authorization, Step Therapy, Member Pay the Difference and Balanced Formulary Drug List are four processes which take medical decisions out of the hands of doctors and patients and allow Blue Cross Blue Shield (or some other insurance provider) to make decisions about what medicines are best for you and your family. These “care management” procedures will save the plan money but at a cost to all of us. Prior authorization will assuredly treatment delays and become an obstacle between patients and the treatments they need. Step Therapy will force patients have to live under the “fail first” protocol, only allowed drugs first that are cheaper first and must fail before allowing them to try a more expensive medication that does. We will absolutely be paying far more money for medications because of the Member Pay the Difference, having portions of costs (past the generic) of brand name drugs shifted back onto the user instead of the insurance. And if you need a prescription not on the new magical Balanced Formulary Drug List, you had better get your wallet out too.
After such a debacle, the natural reaction is to be angry and to give up hope. I would ask that you not do that, however. Rather, I would ask that you double down and commit to NOT giving up. In order to be prepared for the challenges ahead we will be demanding of the board, we are urging you and your colleagues do the following things:
- Read and understand our current health insurance plan coverage valid until 5/31/20
- Watch the April 20, 2020 SPS186 Board Meeting on YouTube and make your own assessment as to what happened. (The insurance voting portion from minute mark 22:20.)
- Review the updated version of my SEA Insurance blog post.
- Review the plan changes that were passed.
- Read the SJR, WMAY, and News Channel 20 stories to gain a better understanding of the issue.
- Encourage all members to call or email District 186 school board members, openly and respectfully sharing their thoughts and concerns.
TAKE ACTION ON THIS ISSUE. It might not adversely affect you now, but it is affecting your friends and district colleagues. We are in this together.
Tuesday April 28, your SEA Association Representatives will be gathering for a digital Union meeting. The lion’s share of the meeting will be dedicated to addressing this very issue. Please type up your concerns/questions and email them off to you representatives so that they may have them in hand and ready. We will still be addressing any other issues surrounding personnel items, students, packing up of rooms, remote learning, special education, intervention, community concerns, etc. The wheels may have stopped on your cars, but SEA know that you are working as hard as ever and both good things and bad things are occurring which may need memorialized or addressed.
Please continue to keep the faith, take care of yourself and your families, and remember that you have to be healthy if you are to be an effective and exceptional employee.
Stay safe and stay union strong!
– Aaron, SEA President
- Medical Bankruptcy Article – The Guardian
- Current Summary of Health Insurance Benefits (6/1/19 until 5/31/20)
- Current Health Insurance Rates (6/1/19 until 5/31/20)
- Current Highlights of Benefits (6/1/19 until 5/31/20)
- Recently Board Authorized Health Insurance Rates (6/1/20 until 5/31/21)
- Recently Board Authorized Health Insurance Highlights of Benefits (6/1/20 until 5/31/21)
- Blue Cross Blue Shield Benefit Booklet– (2018 and most recent edition on SPS186 website)
- Why Self Funded? BBG
- Self Funding Explanation