TVEA Insurance Advisory Committee 

 

 

Insurance Advisory  
 
A Message from your insurance advisory committee 
March 2016
Why do insurance rates continue to rise?

Increase in health care premiums is tracked directly with the growth in underlying medical costs. Thus, as health care costs increase, so do premiums. One of the biggest culprits of rising health care premiums is the rise in use of expensive specialty drugs.  It costs anywhere from $500 million to $2 billion to bring a new drug to market.  Those costs, of course, must be borne by consumers.  New enrollees in the health care system under the health care reform law may also be causing premiums to increase, as medical providers shift costs to the private sector to make up for low reimbursement rates under Medicare and Medicaid.  People have unhealthy habits. About half of the cost of treating chronic diseases, such as heart diseases, are attributable to obesity, smoking and other unhealthy habits.  Chronic diseases account for 75 percent of all healthcare costs. Advancements in medical technologies, such as MRI, CT scans, robotic surgery, are growing rapidly.  These high-cost procedures improve the quality of care, but they also push up costs for consumers.

 

What is the IAC doing to try to limit these increases?

Each year the IAC looks at several agencies to see which one can give us the best medical, dental and vision rates. Currently we are with SISC.

 

Who is SISC?

Self-Insured Schools of California (SISC) was established in 1979. It operates as a public school Joint Powers Authority (JPA) administered by the Kern county Superintendent of Schools. The staff members are certificated and classified public school employees covered under the same benefit programs as its membership. This gives them a unique and personal perspective into how best to serve its members. Self-Insured Schools of California (SISC) has grown into the largest public school pool in the United States. SISC represents 400 educational agencies in 40 counties in CA with 300,00 members. Their size allows them to obtain the best benefits at the lowest cost for their members. This large pool gives them tremendous bargaining leverage with health care vendors (Anthem Blue Cross, Kaiser, Delta Dental, VSP).   SISC provides a very cost effective rate environment which reflects its commitment to preventing losses and controlling expenditures.

 
A Message from your insurance advisory committee
March 2015

TVEA has completed its study and review of Insurance Rate Structures.  The review had to do with whether TVEA should continue to seek composite rates in which all members pay the same for coverage despite the number of dependents on a policy versus tiered rates in which members pay for insurance on a per person basis.

 

In addressing this issue, the TVEA Executive Board voted yesterday to continue to direct the Insurance Advisory Committee (IAC) to seek the best composite rates they can secure for TVEA.  This decision was based on three primary factors:

  • The results of the member survey run from 3/6/15 to 3/12/15  For a link to the full survey results you can click here.

  • Our member demographics as far as employee plus multiple dependents mirror the results of the survey.  For example,
     

According to data provided by TVUSD Risk Management in January 2015, 787 out of 1199 members reporting have multiple dependents on their policy.  Roughly two-thirds of members, a strong supermajority benefit from Composite over Tiered Rates.

  • Our parent organization, CTA strongly encourages Composite Rates.  According to a February 2015 Advisory, CTA suggests:  “Health and Benefit plans shall be uniform and shall consist of Composite rate for all unit members.  The plan shall not include Tiered Rates, opt-outs, cafeteria style plans, or cash-in-lieu provisions”
     

TVEA realizes that our efforts to check the pulse of membership has led to some dismay amongst various members.  Health Insurance is a contentious issue nationwide and there has been some spill over to our local association.  The Executive Board had no prescribed agenda other than to do our due diligence in examining the needs of our members. While we have an obligation to respond to the needs of most of our members, the thirty percent of members favoring examining tiered rates have been heard as well.  By no means was this a complete study of the Insurance area.  As the TVEA IAC moves forward, more member feedback could be needed to weave our way through the intricacies of insurance benefits. 

 
Commitee Members

 

Lynn Breen, TLES - Chair

Frank Bantle, VES

Heather Polk, GMS

Mike Dunbar, TVHS

Mark Koscielak, CHS

 

 

Meeting Dates

 

 

Documents

 

 

2010 - present

2010 - present

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