State health rates jump again
Kansas Health Care Commission rate increase will take effect in January
Rates for all health insurance plans will be available
Faculty and staff already coping with this year’s meager pay increases
will also see insurance rates rise for all state employees.
The increase announcement coincides with open enrollment in October and
will affect paychecks beginning in January 2004. Full-time KU employees
who insure their entire families will see rate changes between $18 and
$67 semimonthly. Full-time employee member-only coverage changes will
range from less than $1 to $28.
The increase in premiums follows a change in the way the Kansas Health
Care Commission determines employer premiums. To encourage efficient plan
selection, the commission based 2004 employer premium contributions on
the most affordable HMO or PPO in the region.
Under the new formula, PPO plans (Kansas Choice, Kansas Prefer and Preferred
Health Systems) are seeing larger increases than HMO plans (Coventry Health
Care, Preferred Plus Kansas and Premier Blue).
Other changes include:
PPO changes to deductible/co-payment/co-insurance:
Out-of-pocket expenses will change for all plans. For PPO plans the network
deductible has been eliminated but the non-network deductible will increase
to $500 single/$1,500 family. Kansas Choice and Kansas Prefer will have
tiered co-insurance amounts: 50 percent until half the co-insurance maximum
is reached and 30 percent until the full co-insurance maximum is reached.
Preferred Health Systems’ co-insurance will be 50 percent until
the maximum co-insurance is reached. The co-insurance maximums vary depending
upon the plan, whether network or non-network services are used and single/family
HMO changes to deductible/co-payment/co-insurance:
Changes to out-of-pocket expenses for the HMOs include office visits,
which will increase from $10 to $20 for a primary care physician and $30
for a specialist. There will be a 10 percent co-insurance for designated
services with an annual co-insurance maximum of $1,000 single/$2,000 family.
The annual inpatient deductible of $200 single/$400 family will change
to $200 per admission plus 10 percent co-insurance.
New lab card service: Kansas Choice and Kansas
Prefer plan participants will have the option of using a lab card service,
LabOne, for outpatient lab work covered by the medical plan. When LabOne
is used for lab tests, the cost will be covered at 100 percent with no
co-payment, no deductible and no co-insurance.
Preventive care allowance: Kansas Choice
will have a $300 per person preventive care allowance for services provided
in-network. This feature already was available in the other PPOs (Kansas
Prefer and Preferred Health). The first $300 per person is covered in
full before being subject to the plan’s co-insurance for services
such as well-woman and well-man care, periodic adult physical exams, routine
hearing and vision exams.
Dental plan changes: Delta Dental has been
awarded a three-year contract. Changes for 2004 include an increase from
$35 to $45 in the deductible for major services and an annual maximum
benefit level increased from $1,500 to $1,600. Participants will be able
to use the national network of Delta Dental plan providers for all services.
Prescription drug plan changes: AdvancePCS
Prescription Drug Program changes include an increase in the co-insurance
amount participants pay for preferred brand name drugs from 30 percent
to 35 percent, for non-preferred brand name drugs from 50 percent to 60
percent, and for special case medication the $70 co-payment will increase
to $75. The maximum co-insurance/co-payment will increase from $2,400
to $2,580 for generic, preferred brand and special case medications only.
Vision plan changes: The Superior Vision
enhanced plan coverage for progressive lenses has been changed to a flat
dollar amount up to $165, and coverage has been added for high index and
polycarbonate lenses up to $116. The basic vision plan benefits will remain
Health Risk Appraisal (HRA) continued: The
HRA program will be offered again in 2004. Faculty and staff need to enroll
online to participate and receive a $5 semimonthly health plan premium
discount. Faculty and staff who elected to participate in the HRA program
during 2003 but did not complete the program will not be eligible during
Open enrollment information for health insurance, flexible spending accounts
and the Health Risk Appraisal program will be distributed to benefits-eligible
faculty and staff in late September. Open enrollment is Oct. 1 through
31 and is available online.
Faculty and staff must log in during open enrollment to change, add or
drop health plan election for 2004, change coverage elections or add or
drop dependents from coverage; to register for the Health Risk Appraisal
program and receive a $120 annual premium discount; or enroll as a new
participant or to continue participating in the dependent care and/or
health care flexible spending accounts. Participation for those currently
enrolled will end Dec. 31, 2003.