USNH Trustees Approve Medical Plan Changes
By Lori Wright, Media Relations
June 8, 2011
The administrative board of the USNH Board of Trustees approved changes to the medical plan for nonunionized employees recommended by the System Policy and Personnel Committee (SPPC) May 26, 2011.
“As we learn more about the implementation of self-insurance, joining a pharmaceutical collaborative and implementation of the medical changes, I will be sure to provide that information to you,” said David Proulx, associate vice president for finance and interim assistant vice president for human resources.
The changes are effective Jan. 1, 2012. The changes, which are estimated to save USNH $2.035 million, are as follows:
- Annual deductible for qualified services* $200 for individual and $400 for family (no deductibles currently).
- Physical/speech/occupational therapy: $10 copay (no copay currently). Also includes cardiac rehab visits.
- Specialist office visits: $25 copay ($20 copay currently).
- High-tech imaging: $50 copay (no copay currently). Includes MRIs, CAT scans and PET scans.
- Out of pocket maximum: $1,500 individual and $3,000 for family (no maximum currently). Includes deductible and nonpharmacy copays.
- Change to USNH Waiver process: Medical waiver payment reduced from $800 to $550. Employees covered by USNH medical/dental plan are not eligible for the waived coverage payment.
*Services that qualify for the deductible are: ambulance; diagnostic lab/x-ray; high-end radiology defined as CT scan, PET scan, MRI, MRA, and nuclear medicine; outpatient surgery defined as day surgery, inpatient admission; outpatient diagnostic and therapeutic scopic procedures (i.e. not a preventive service) such as colonoscopy, endoscopy, sigmoidoscopy, voluntary sterilization, and termination of pregnancy; and skilled nursing facility.
In addition, the administrative board voted to endorse the development of an option to provide incentives or pay backs to employees on co-pays for those who choose lower cost providers for high-tech imaging.
The board also voted to endorse the development of proposals for a vacation and earned time “buy out” or cash out program to limit the financial impact on employees due to the loss of the $500 Healthcare Reimbursement Account or HRA in fiscal year 2012.
Finally, the board voted to charge the Benefits Cost Containment Committee, HRPAC, and the SPPC with development of a USNH plan design that incorporates best practices and are contemporary and cost effective.
“Thank you for all of your input over the past few months on these difficult and complex decisions. Nobody is happy that we are in this position or with the reductions; however, I am encouraged and impressed with the level of engagement on these issues that you have exhibited. I sincerely appreciate your efforts,” Proulx said.