Health Insurance Reform is Subject of Legislation

State employee health insurance reform is the subject of several bills making their way through the legislative process. HB 2324 (Murphey and Stanislawski) and HB2888 (Moore and Bill Brown) were introduced as shell bills and are still not in their final version after leaving the House.

“OPEA knew health insurance would be an issue this session,”said OPEA Executive Director Sterling Zearley.“Over the interim, a working group met and discussed reforms to processes and the agencies that deliver the program.”

The State Employee Health Insurance Working Group,consisting of legislators and the Insurance Commissioner, contracted with insurance experts Milliman Consulting to review the insurance infrastructure and recommend reforms. The report was requested to examine the functions of the Employees Benefit Council (EBC) andthe Oklahoma State Education and Employees Group Insurance Board (OSEEGIB) and to determine if a duplication of effort existed between the two agencies. HB2324 and HB 2888 are based on recommendations made by the consultants.

"We want to offer state employees a variety of health insurance options at reasonable costs," said House Speaker Chris Benge,R-Tulsa. "This legislation is still a work in progress as we seek to lowe rcosts to the state while maintaining, or possibly even improving, health care services to our state employees."

The study examined current practices and made recommendations for the most cost-efficient and cost-effective way to leveragestate dollars to ensure the highest level of health care for state and education employees at a competitive price.

The report concluded:

• The functions of OSEEGIB and EBC should be integrated to form a new organization focused not only on the payment of health and other insurance claims but also on the wellness of the covered individuals;

• With the merged agencies, one oversight board should be created that would include members from backgrounds including medical and employee benefits, as well as those from legal and fiscal backgrounds;

• Include a stronger wellness component, not only within HealthChoice consumers, but those with HMO plans as well;

• HMO’s should be competitively bid. The more expensive HMO plans, which are used to calculate the benefit allowance, are chosen by few employees; and

• More choice is needed in rural areas of the state

OPEA’s is working to ensure state employees don’t lose funds from their paychecks if the HMO products are limited to those with competitive prices. The bill, as is currently written, freezes the benefit allowance at 2010 rates and requires the HMOs to bid against each other. The freeze would prevent the benefit allowance from decreasing significantly if the HMO rate goes down because of competitive bidding. If the higher cost HMOs were eliminated, the benefit allowance would fall closer to the HealthChoice rate, reducing the funds state employees use for co-pays and deductibles.

“The goal is to improve the infrastructure and provide choice to more state employees without reducing the benefit allowance state employees count on to help pay their bills, concluded Zearley.”

8 comments (Add your own)

1. Tell me the truth wrote:
I understand the need to bring costs down as I am one of the "few" employees as quoted in your article that carries the more expensive plans. As a single employee I am still out of pocket several hundred dollars in addition to the state allotment to keep this coverage. I pay more because I have been through cancer treatment and even with the most expensive plan I was still out thousands of dollars. If I had had any of the lesser plans it would have been financial ruin.

March 15, 2010 @ 1:57 PM

2. Lance wrote:
Once again, a bill to help State Employees. and the results....we'll somehow get screwed again out of something. Let me personally thank the legislators who came up with this. You guys are doing a great job of running off talented individuals who will not hesitate NOT to work for the State. This piece of legislation tied in with pay raises should be enough to put us at number 50 (last) for State employee compensation. I get more convinced everyday that once you become a politician, you get more out of touch with the real world. "Let them eat cake" is our representative's attitude.

March 15, 2010 @ 3:08 PM

3. Melanie Justice wrote:
I'm wondering why I can no longer fill a three month prescription, but must pay the same for only one month? I guess is it a way to cut costs, and I can sympathize with that, but it would have been nice to have been warned the change was coming.

March 18, 2010 @ 12:11 PM

4. Jennifer Wild-Isley wrote:
This freeze is a bad idea. The benefit needs to continue to go up every year. We were not worried about it decreasing.

March 18, 2010 @ 12:15 PM

5. Out of Pocket. wrote:
Our out of pocket costs are more expensive in 2010 than in 2009; therefore, it's not the 2010 costs we'd like to see "frozen". We'd like to see costs reduced, not maintained. Additionally, many of us have to make use of HealthChoice and the more expensive counterparts in order to go to our physician of choice, which happens to be in the rural area. Now, we're penalized further for preferring our options at a reasonable price.

March 18, 2010 @ 12:22 PM

6. Lauren Johnson wrote:
Competitive bidding could cause insurance companies to offer the same benefts or better benefits at a reduced cost. On the other hand it could cause the insurance companies to offer no-so-good coverage for a price of their choosing. I understand the bill examining the functions of the EBC and the OSEEGIB and attempting reduce elimination of duplicate efforts. But putting the cost and benefits of health insurance coverage into the hands of the insurance providers is not a wise decision. In a sense we are at their mercy, and as an employee of the state a ball that importatant should always be in our court.

March 18, 2010 @ 12:38 PM

7. Lisa Watson wrote:
I have several chronic health conditions so will not use an HMO for my health coverage. I have no choice but to use Health Choice. It should now be called No Health Choice since raising the office deductable to $50 a visit. I am coming closer to understanding why our clients use the ER for routine health care-- they can't afford the co-pays!! Our legislators really don't care about the "little people" once elected.

March 18, 2010 @ 1:31 PM

8. Anon wrote:
Where is the cost savings coming from exactly? Why don't people compare the Healthchoice rates to what other states have and the national average? And why don't the legislators show the actual cost savings their legislation will provide, in the form of the savings to the monthly premiums? I bet they can't produce that figure, so all this legislation will do probably is mess up the benefits (reduce what is covered), not lower the premiums, and freeze the benefit allowance. Who wins? Just the legislators that will later say they passed healthcare reform. We see how well that is going right now at the federal level (sarcasm). Why do you think the HMOs are on average so much higher but fewer benefits and strict approvals? Profit, which is not an issue for the state plan.

March 18, 2010 @ 4:20 PM

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