OPEA Weighs in on Plan to Revise Health Insurance

 

 The Oklahoma Public Employees Association recently attended the third meeting of the State Employees Health Insurance Review Working Group.  The group is charged with looking at suggestions and proposals to make the insurance system for state employees more cost effective.

 

OPEA was the only organization representing state employees to attend.  Dr. David Kendrick, Associate Provost for Health Strategies at the University of Oklahoma, gave a detailed presentation on medical management.

 

“Dr. Kendrick’s presentation regarding plan design and medical management were informative,” said OPEA’s Deputy Director Scott Barger.  “Changes to the way we do business in Oklahoma could certainly save money, but many of the suggestions Dr. Kendrick suggested will take considerable planning and education.”

 

Kendrick suggested incentives between the employee and the employer were closely aligned.  “Generally speaking, if it is good for the employee it is good for the employer,” he said.  “Employees are concerned about cost and so are employers.  Both have more in common than you think.”

 

Kendrick told the working group that the state has several ways to help influence the struggle to control costs and maximize benefits.  “There are several models out there in which the company, in this case the State of Oklahoma, can put incentives in place to encourage a change in behavior that represent risk to the system.  You can also offer environmental changes to the workplace that help improve the quality of life.”

 

Dr. Kendrick walked the group through several different companies who have reformed their insurance offerings to control costs.  Safeway, the most prominent plan to gain national attention, utilized a series of cost incentives around the four largest contributing conditions to insurance utilization, obesity, cardiovascular disease, cancer, and diabetes.  “Seventy-four percent of all healthcare costs stem from these four conditions,” said Kendrick.  “To help control costs, Safeway discounts employees’ portions of insurance premiums based on their performance, and improvement, on four tests that measure tobacco usage, weight, and blood pressure and cholesterol levels.  Participation is voluntary but if the employee does not test, they automatically are given the highest premiums.”

 

According the Kendrick, Safeway was able to reduce costs by 30% over three years and the company’s obesity and smoking rates were 70% of the national average.  

 

 

State Insurance Commissioner Kim Holland said health, medical and dental care costs the state, state employees and retirees just under $1 billion a year. 

 

Senator Bill Brown, co-chairman of the working group said:  “State employees and educators could help reduce costs by taking better care of themselves. The state spent over $65 million last year on the top 25 prescription related to high cholesterol and acid-reflux, and blood pressure.”

 

“OPEA will continue to be involved with this working group to monitor the discussions and protect the interests of state employees,” said Barger.  “This is just another reason your membership in OPEA is so important.  If you are not a member and cannot see a reason to join, look no further than the cost of your insurance for motivation to join with us.”

 

 

The working group will meet again on the following dates and times:

 

Tuesday, September 8, at 10:00 a.m., Room 412C

Tuesday, September 22, at 10:00 a.m. (tentative)

Tuesday, October 6, at 10:00 a.m. (tentative)

Tuesday, October 20, at 10:00 a.m. (tentative)

 

 

 

 

 

 

14 comments (Add your own)

1. SUPPORTIVE! wrote:
The problem in Oklahoma is HEALTHCARE COST!!!!!!!!!
Healthcare costs are driven up by LIFESTYLE CHOICES!!!!!!!!!!!

We in the US spend more on insurance than anyone and we lag in life expectancy. We consume more junk food than anybody else making us very unhealthy. Obesity rates in the US are at 40% of the population. The obese population cost 40% more in healthcare and medications.

Bring down healthcare costs and you bring down medical insurance costs!

Why not sponsor a bill to incentivize the plans like the Doctor is talking about? I am tired of paying for people who enjoy smoking, or having high cholesterol when quiting and some exercise would help them live a more fullfilling life!

Tue, August 4, 2009 @ 2:18 PM

2. Sue Boyle wrote:
I was just checking today to be sure that OPEA was aware of the working group that is reviewing the State Health Insurance. Now that I know you are on board, it makes me feel better.

Tue, August 4, 2009 @ 2:52 PM

3. FattCatt wrote:
The high cost of health care is not because of rising claims being filed…it’s the greedy insurance companies. This year it has been reported that the majority of health insurance companies received RECORD PROFITS! In a time when everyone else is tightening their belts these jerks are raping all of us for every dime we have…and don’t get me started on the pharmaceutical companies.

These companies have gone long enough with no regulation, oversight or any kind of auditing to keep them honest. This excuse of "rising claims being filed" is a lie and we all know it!
The health insurance business is a huge buffet for the “fox in the henhouse!”
It’s time to stand up to these greedy jerks…our lives depend on it.

Keep them honest as much as you can OPEA and thanks for being there to represent state employees.

>*x*<

Tue, August 4, 2009 @ 3:21 PM

4. concerned wrote:
I think that OPEA should have the Pacifcare & Aetna Co. drop from the list and check into cheaper Health Insurance rates. This is ridiculous. I used to have Pacificare, but the prices have soared. Companies do not have to charge like they are. This is price jacking on health insurance benefits! Surely there are other group insurance companies with reasonable rates to pick from. Who is going to take out the Pacificare Plan? NOT I. It is too expensive. I don't make that much and I'm sure there are alot of others that can't afford it.

Tue, August 4, 2009 @ 3:38 PM

5. Dump the HMO's wrote:
Why can't we dump the HMO's all together? We have a good plan in Health Choice. It seems that if we were all enrolled in just one plan we could get a better deal! The HMO's only serve the city areas anyway.

Tue, August 4, 2009 @ 3:55 PM

6. J wrote:
Do not Dump the HMO's. I take Global Health and I can afford it and am very Happy with it. Dump aetna and Pacificare>

Tue, August 4, 2009 @ 8:48 PM

7. Bob Smith wrote:
It is important to remember that a majority of the members are enrolled in HealthChoice. This program (like a majority of other large employers) is self-funded meaning the funds to pay the claims come from the State ie tax dollars. There is a small cost to administer the claims and provide customer service; however, more than 90% of the plan's costs go to pay doctors,drugs and hospitals. There are no "greedy" insurance companies to blame.

Thu, August 6, 2009 @ 11:47 AM

8. Patriot wrote:
"The high cost of health care is not because of rising claims being filed…it’s the greedy insurance companies. This year it has been reported that the majority of health insurance companies received RECORD PROFITS!"

Record profits yes, but their profit margin is very small compared to other companies.

Fri, August 7, 2009 @ 3:03 AM

9. Max power wrote:
This is in response to Supportive.....blame it on the obesity rate huh!I am not obese but have some friends that are..you want me to tell you what is costing the state money..you are not gona want to hear it...IT IS THE PEOPLE THAT DOUBLE COVER THEIR SPOUSES AND CHILDREN TO GET AN EXTRA 200.00-300.00 A MONTH ON THEIR CHECK..there is no telling what that costs the state...if you are one of those people,I don't want to pay for that..so you want to talk about a lifstyle choice..try bring home a few hundred less each month..got'a go lift some weights now...475 lbs is my max on the bench...but I guess I'd better start lifting less..you might think I'm obese..have a nice day...God Bless America and Oklahoma

Sat, August 8, 2009 @ 9:52 PM

10. Lou wrote:
Put a 50 cent per gallon tax on gas and a 50.00 tax on every gross sale of condoms, either way we're screwed.....Lou

Sun, August 9, 2009 @ 5:38 PM

11. FattCatt wrote:
Bob Smith & Patriot,

I respectfully disagree...profit or profit margin what's the difference a profit is a profit.

The Plan operates as a non-profit yes, a public entity risk pool. In 2007, approximately 95% of premium contributions were paid out for member claims. The Plan’s five percent (5%) administrative cost ratio has historically compared “very favorably” to other public and “private” plan ratios of 11-18% or more.

Health Choice operating expense was $780,000,000.00 in 2007 and an income of $820,000,000.00 giving them a profit of 400,000,000.00.

Not so bad of a profit for one year wouldn’t you say?

Check the numbers yourself at:
http://www.sib.state.ok.us/PDFfiles/HC_Highlights.pdf


>*x*<

Mon, August 10, 2009 @ 3:59 PM

12. FattCatt wrote:
Sorry $40,000,000.00 to many 0's lol

>*x*<

Mon, August 10, 2009 @ 4:12 PM

13. tom dunning wrote:
This legislative group wants to limit your choice of health plans further and they want to eliminate healthcoice. One of the study group's members is my rep and he's very transparent about his motives.

Health Care costs are hammering state employees and also agencies since the legislature doesn't fund agencies for the portions of our premiums picked up by the state.

But, i fear state employees will lie down and accept whatever is given to them. That's our track record.

Wed, August 12, 2009 @ 8:53 AM

14. FattCatt wrote:
I hate to say it Tom but, your right.
The majority of State employees today are willing to allow our Congress to keep screwing us every year and Congress knows it.
The problem is we have had so many retire and the new hires do not understand the importance of OPEA and being a member.
Even if they were not members the next generation of State employee's are so complacent and lets face it just plain LAZY, they won't even show up for Lobby Day!
They are willing to wait and do nothing until they have to get up and have no other choice but, to go look for another job or file unemployment…as long as State employees do nothing Congress will do nothing.
I have been introducing OPEA (I keep apps. at my desk) to all our new hires but, they are not interested in doing anything to insure they have a future with the state.
If it’s the cost, could OPEA create some kind of special offer to join? Maybe give the first year of membership at $5.00 a month for their first year then $15.00 after that…just to get them involved. I really don’t know what the answer is but, as long as there is know interest by State employees to stand up for themselves State officials won’t have to worry about us making any noise.

Said it before and I going to do my best to keep pushing it:

LOBBY DAY 2010 BE THERE!

>*X*<

Thu, August 13, 2009 @ 8:34 AM

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