Changes to state health plan raise employee blood pressure

Members will see increased deductibles and surcharges

As of January 2012, the Public Employees’ Benefit Board is making changes to benefit plans for state employees, which will impact approximately 3,000 workers at Portland State.

State employees who are members of the PEBB’s health insurance plan are being asked to voluntarily participate in a new program called the Health Engagement Model. According to PEBB, the goal of the model is to encourage members to make healthier choices and “take action in areas where simple steps can reduce health risks.” In addition to the HEM, there will be a $25 per month surcharge for smokers, and a $50 per month surcharge for spouses and other family members who opt out of coverage from their own employer in favor of family coverage provided by the member’s insurance.

Members will see increased deductibles and surcharges

As of January 2012, the Public Employees’ Benefit Board is making changes to benefit plans for state employees, which will impact approximately 3,000 workers at Portland State.

State employees who are members of the PEBB’s health insurance plan are being asked to voluntarily participate in a new program called the Health Engagement Model. According to PEBB, the goal of the model is to encourage members to make healthier choices and “take action in areas where simple steps can reduce health risks.” In addition to the HEM, there will be a $25 per month surcharge for smokers, and a $50 per month surcharge for spouses and other family members who opt out of coverage from their own employer in favor of family coverage provided by the member’s insurance.

Ingrid Norberg, communications coordinator for the PEBB, explained that to participate in the HEM, members go online to a secure website and fill out a confidential questionnaire. Member information is stored in a database, which is used to produce reports for the entire pool of PEBB members, but no information about any individual member is released.

“The most important outcome of taking the assessment is what the assessment tells you. For example, you may learn that you need to exercise more or quit smoking,” Norberg said. After completing the questionnaire, members take two online e-classes, and ideally take some action to improve health risks, but there is no penalty for failing to take action.

Members who participate in the HEM will pay $20–35 less per month, depending on their individual plan.

Phil Lesch, executive director of the PSU Chapter of the American Association of University Professors, questioned these new PEBB programs, asking: “Does the employer or state have the right to mandate healthy behavior?”

The HEM and the new surcharges are in addition to a new requirement, mandated by Gov. Kitzhaber, that all state employees pay 5 percent of their health insurance premiums. The classified workers’ union at PSU has already accepted this mandate as part of their contract settlement, and AAUP may face the same.

Mary King, an economics professor and the chief negotiator for PSU-AAUP, said the 5 percent contribution to healthcare premiums translates to “$49 to $208 per month depending on your family composition, which plan you pick, whether you smoke and whether you’ll participate in the HEM.”

State employees will also see increased deductibles and surcharges for certain procedures, such as hip, knee or shoulder replacement and endoscopies.

Bob Liebman, a sociology professor and member of PSU-AAUP bargaining team, said these increased costs represent a huge financial burden for union members, especially those who earn lower salaries. For example, an employee who makes $35,000 and has a family faces a 7.9 percent deduction from their pay. This is the same deduction as someone who makes over $160,000.

“It’s a big hit—bigger if you are low income,” Liebman said.

Liebman also noted that similar healthcare changes are clearly on the horizon for workers elsewhere.