Sunday, October 5, 2008

More about PEIP

Health insurance, like your paycheck, is a serious and often emotional issue. We have been researching the possibility of the Public Employee Insurance Pool for about 15 months as one of a few promising opportunities to improve the affordability of high quality health care for all our members. This is fundamentally important to the St. Paul Federation of Teachers for at least two reasons, one close to home and one grounded in our community.

The cost of health insurance has taken up more and more of that other serious and emotional issue, your paycheck. When the two most serious and emotional issues converge upon our members it leads to some untenable situations. Some members are taking home a few dollars on their paychecks after paying for health insurance. We also have members who have taken their healthy children out of our health insurance pool and insured them on the open market with catastrophic deductible plans so they can afford to keep working in the district. Sadly, we also have former members who have severed employment with St. Paul Schools for a job in a district that offers more affordable coverage, even when that means a cut in salary because the member still takes home more money at the end of the month.

Improving the health insurance situation of our members is a start, not a solution. The other reason this decision is fundamentally important to us is grounded in the same reason we chose to work in a public school district in the first place. We determined our talent and then sought out a career that would leave the world a little better than the way we found it. Similarly, unions are formed to improve peoples’ lives. Finding more affordable health insurance for us will not stop our work to improve access to affordable and high quality health insurance for our students and their families where we can. Strong public schools rely on healthy communities and healthy communities don’t exist where there are disparities in health care. We know that even when we are successful in attaining affordable health insurance, our working conditions will not improve until our students and their families have the same high quality, affordable health care that we have.

We are committed to continuing our work in partnership with Take Action Minnesota to create an affordable health care system for all in Minnesota. We will support the work of Education Minnesota for broad-ranging health care solutions. Most importantly right now though, we are dedicated to making the PEIP proposal a thoughtful decision among our membership.


jayfer rattrap said...

How do we know this PEIP is our best option? I have huge reservations right off the bat. First, we don't get the $20 healthclub discount so I can add that to my total cost per month. Also, how are the 'tiers' decided upon? What is the criteria? Am I forced into taking this insurance just because my union voted for it? What if I (like many others in this district) want to take advantage of my spouse's insurance elsewhere? My wife's district (#834) has taken the time to bargain a good insurance plan into their contract year after year. They are a much smaller district than us, yet they did it (and their insurance is still better than any PEIP coverage offered). Why can't we do that? Also, why are we changing the voting procedure for this vote (only yes and no counted; a non vote is neutral)? Lastly, what is up with this 'Calendar Year Deductible?' Seems it's just a way to disguise rates (our insurance doesn't have a fee like this). Also, the 'Annual Out Of Pocket Maximum' is misleading because, if you add the 'Rx Out of Pocket Maximum', it's actually $1,900 (more for family plan).

phall said...

My husband had this plan through the State of Minnesota until he retired earlier this year. I have on numerous occasions said to him, “Your insurance plan is awful.” He would agree. I would of course be comparing it to my excellent plan. (current St. Paul Schools)

It seemed to us that the tier system related to “quality of care” Tier one providers were ones we did not want to use etc. At one time he had been at a clinic and felt quality of care was excellent. Then there was a change in the level/tier for this clinic and it forced him to leave because of all the co pays for the new level. This was not just office visit co pays but also hospital etc. I feel the current St. Paul schools plan provides “quality of care” at all times.

You NEED referrals for everything!

We were surprised to find out that we could not get credit for health clubs.

It also seemed that this coverage was very expensive outside of the State, when you were traveling and away from your assigned clinic. I do not know how this compares to our current plan as we never tried it.

Fortunately (up to now) my husband has rarely needed to seek medical care and it seemed like I was always writing checks for co-pays and deductibles.

In looking at your cost/comparison table, it seems like I would be losing a lot for a small reduction in premium. I would be more than happy to pay more per month to keep the insurance that I have.

Amber said...

The cost savings of the PEIP plan more than cover the $20/month health care discount. The deductible confused me and frankly scared me at first, but with the savings that I would see every month, within a few months I will have the money to pay the deductible just in my healthcare savings.

I am honored that instead of sitting by while Health Partners continues to raise our rates in double digit percentages every year, my union spent more than a year investigating alternatives. This puts our health care decisions back into our hands. Because this is such a large pool, we will have more stable premiums. This plan is different from what we currently have, but we will save money and make it more possible for our families to get health care and keep healthy families in our pool. I am glad that my union is working for ME and for all members.

jayfer rattrap said...

Amber, actually, it would be more than a few months if you add 20 dollars per month (healthclub discount) plus the 140 dollars per year (called the 'Calendar Year Deductible' which our existing plan doesn't have). By the way, why are we continuing to blame Health Partners (I realize they are definitely not innocent) when it is our own bargaining that got us into this mess? We have to accept our share don't we? The question of smaller districts (with their smaller 'pools') being able to bargain a much better deal than us has still not been answered. Also, don't forget that I said Stillwater's plan is much better than the best plan offered by the state. How do you explain that?

SBM said...

I was on the PEIP plan and payed a great deal less every month. During that time I realize how good the insurance that we have with SPPS really was. We may pay a little more, but I have options and choice. PEIP was a nightmare - referrals for everything and with my daughter it became difficult to remain with the doctors I had with SPPS. It is up to your primary doctor who you are able to see since you need a referral. I strongly advise you to look at the fine print. Sometime when things look really good they are not. It will be a very sad day if we go into this plan with many regrets!!!!!

TAJ said...

I am concerned in regards to the pay you deductible first and you need a referal for everything. My husband is disabled and has a chronic condition in which he has lab tests on a weekly basis and sees his primary doctor at least once a month. While family coverage is expensive for my family PEIP would be a nightmare.

karen said...

I would like to hear more directly from those who researched the PEIP option as to why they are recommending it.

I see the charts where the overall insurance cost is lower, but aren't the deductables higher?

I tried the lower premium/higher deductable option for Health Partners. After one $300 office visit to check on lingering laryngitis (recommendation, "don't talk"), the potential benefit to returning to a higher premium/lower deductable plan was clear. I felt like I was gambling on good health.

I'd also like to hear more from people who have had positive experiences with PEIP.

fps said...

This is yet another example of
MCR promoting HER agenda at the cost of the TIME and MONEY of the SPFT union membership. People are SCARED and ANGRY about this plan and the potential for it to pass because people haven't taken the time to read the fine print and realize the implications. If people want to join PEIP, then allow them to do so out of their own choice. Let those of us who are satisfied with our current HP coverage keep what we have. The PEIP plan does NOT allow OUR health care decisions to be in OUR hands.

catherine2311 said...

Many of the cautionary comments regarding PEIP that I see here are ones that my colleagues and I have been discussing: no $20 health club discount to encourage wellness, the difficulty of trying to calculate what your costs could be due to so many variable factors (deductibles, copays, coinsurance) but most of all quality of care, and needing referrals for everything.

SPFT seems to be really promoting the switch to PEIP, and I fear that many people who do not have the time or expertise to carefully study the fine points will vote for PEIP based on SPFT approval. I also question changing the voting method--doesn't it weight this vote in favor of changing to PEIP? And why must we make this critical and complex decision on such short notice...and just prior to the November elections which may change everything regarding health care? Will the information sessions be positively slanted toward PEIP? Will the information sessions be detailed and transparent so as to allow all aspects of this choice to be easily absorbed? I urge everyone: please (quickly) take the time to inform yourselves--read all the information, talk to colleagues, go to an information session. While I applaud the Union for making this effort to deal with the rising costs of health care, I think that PEIP is not shaping up as a first-rate solution for us.

XXXX said...

After rereading all the posted comments, it is clear that every member needs to attend one of the informational meetings. Every family is different, with needs that many of us never imagine and that sometimes we totally understand. In order to know the facts, you need to hear them all and then vote. It is clear that choosing to leave the Health Partners system for Preferred One or Blue Cross would cause great change. Would those of us who plan to stay with Health Partners face hugh change? Maybe or maybe not. What I do know is that I can either save hundreds or thousand of dollars choosing from the PEIP proposal. What I like is that leaving the district plan puts us in charge of our health care to a greater degree than what exists at this time. With the continued cost increases from Health Partners, there is no guarantee that our "Distinctions" plan will continue to be an option in the future. The district will have a bidding process in 2009 for our health care and we may be forced to change providers with the district making the decision. I want us, the members of the union, to make decisions about our health coverage. I trust our 3600 members to thoughtfully and carefully decide what will be best for SPFT. Look, listen, and vote.