New health plans on the horizon
UMCSC to offer array of consumer-choice insurance plans in 2018
By Jessica Brodie
United Methodist pastors and lay employees have a big change on the horizon when it comes to health insurance, but conference leaders are hoping the change will bring more choice and more affordability overall.
For 2018, the South Carolina Conference Board of Pension and Health Benefits is switching to a new program called the HealthFlex Exchange, a private insurance exchange administered by The United Methodist Church’s Wespath. The plan features six HealthFlex medical plans (paired with prescription drug and optional dental and expanded vision plans) that enable participants to choose a plan that fits their personal medical needs and budget.
All six of the plans feature the same health plan partners (Blue Cross Blue Shield of Illinois, OptumRX, United Behavioral Health, VSP for vision, with the additional of Cigna for optional dental coverage), and there will be no need to change doctors, hospitals or pharmacies. The plans will also include more customer support and the same wellness incentives currently offered.
“We felt it would be a win-win situation,” said the Rev. David Anderson, conference pensions and health benefits officer. “It’s a way to control costs for the local church and provide clergy and lay employees with an array of options.”
Anderson said depending on the plan they choose, some people might pay more for premiums, some about the same and some far less, plus the expanded vision coverage and new dental coverage is very welcome news for many.
“It gives participants more choice than they had before,” Anderson said. “One of the biggest problems is escalating medical costs. This is a very attractive alternative to what we have.”
The Rev. Christopher Lollis, chair of the conference BPHB, said he hopes people understand the distinction between a private exchange like this and the Affordable Care Act exchange.
“This is not pushing our participants off on the Affordable Care Act,” Lollis said, noting that offering an option-rich private exchange is what a lot of large corporations do, and it gives participants much control and choice.
“I think the best advantage to this is that over the years we have been locked into plans that have been selected by the Board of Pension and Health without (the board) really understanding the different needs of the participants in the conference,” Lollis said. “We just got what we got.”
But the HealthFlex Exchange will give the participants the ability to select the best fit when it comes to health plans.
“If you’re a healthy person and young and have no issues whatsoever, you may not need the feature-rich, benefit-rich plans, and selecting a different plan will be a lot more affordable for you,” Lollis said.
‘Good time’ given rising health costs
Anderson said the switch to the HealthFlex Exchange is coming at a good time given the health insurance cost increase that is in line with the national trend—and given that the current premium rates were projected to see only a small increase.
“Total premium rates only went up 4.1 percent due to the pooling of large losses,” Anderson said, noting the rates go up based on our losses, and the loss ratio was 116 percent last year. “With the increase so small, we thought it would be a good time to make the change.”
He said the BPHB has been exploring different options for healthcare considering the 40 percent “Cadillac tax” imposed on programs exceeding a certain dollar amount. The BPHB felt the HealthFlex Exchange would be a much better option for South Carolina churches, clergy and lay employees.
Three types: PPO, consumer, high-deductible
The six plans encompass three types: PPO, consumer-driven and high-deductible.
One option is a traditional PPO plan with co-pays; it is the most expensive option for monthly premiums but offers the lowest deductible and out-of-pocket costs.
Two options are consumer-driven health plans. These feature moderately priced premiums with moderate deductible and out-of-pocket costs and allow participants to use a health reimbursement account.
Three options are high-deductible health plans that allow participant to use a health savings account; they feature the lowest-priced premiums.
These plans are only for active clergy and lay employees; the exchange does not apply to retirees aged 65 or older, Anderson said.
The conference only has proposed rates for 2018 right now; official rates will be available by the fall. Proposed rates range from $682/month to $2,511/month depending on the plan and who needs coverage, plus any optional dental or expanded vision coverage. On the low end, it’s proposed as $682/month for participant only; $1,365/month participant plus one; and $1,868/month participant plus family. On the high end, it’s proposed at $915/month for participant only; $1,835/month participant plus one; and $2,511/month participant plus family.
Heavy emphasis on education
Anderson said the biggest challenge is the education piece, but he and the rest of the BPHB team feel confident that with the strong support from Wespath and with heavy trainings scheduled for October, participants will be in a good position to make their new health plan elections during open enrollment in November.
By October, the conference will have full information on rates and will hold informational meetings to help people determine the right plan for them. Anderson said Wespath has a “phenomenal” online support tool that helps with this. It asks a series of questions, and based on a person’s response, recommends the plan they should consider.
“We do have a default plan, but our goal is that everyone selects the right plan for them,” Anderson said.
Lollis agreed. “It’s not like you’re out there alone trying to decide what to select,” he said. “There’s a lot of education between now and open enrollment.”
The HealthFlex Exchange plans will be included in pre-conference materials and presented at Annual Conference.