Qualified High Deductible Health Plan

A more AFFORDABLE, ACCESSIBLE, and CONSUMER DRIVEN approach to health insurance.

The WHY

Why is the District proposing this plan and provider?

  • Premiums are more affordable and offer savings to both the District and employees.

  • Encourages consumer driven approach to health insurance. Individuals have an incentive to be more involved in their medical spending and are encouraged to find high quality low cost care.

  • Transparency is included. The District does not have any access to private medical information or even individual claims data. The District and the Health Insurance Committee, made up of employee representatives, will have access to aggregate information used to evaluate the plan.

  • Employees and the District are paying tens of millions of dollars each year for health insurance, both parties deserve to know more about how those dollars are being effectively managed.

Why should Employees consider this proposal?

  • Employee premiums are less for almost all situations, which allows for additional tax advantaged savings if the employee choses. The lower premiums also give access to health insurance for more employees who can afford the current rates.

  • The premium split will be 90%/10%, meaning that future increases will be proportionally less for employees than the current structure.

  • Individuals have access to savings which are owned by the employee, never expire, grow over time, are tax free and transferable after employment.

  • Coverage includes medical, vision, dental and orthodontia.

  • Decision regarding the plan will be made by employees and the District, not by another entity for which no information or influence exists.

How is it more AFFORDABLE?

The qualified high deductible health plan offers employees an opportunity for significant savings, especially over time in many ways:

  • Employees, depending on their current plan election, would save as much as $4,737 annually on health insurance premiums.

  • The District will contribute $1,500 to an employee's Health Savings Account annually.

  • Out-of-pocket expenses as compared to current coverage do not create large risk for employees when considering other options for savings.

  • The proposed change to the premium cost share to 90/10 has the District paying a proportionally larger share of any future premium increases.

See how plan savings can add up over time.

The larger deductible and out of pocket limits for a high deductible health plan can be scary. Jumping to the worst case scenario is a natural reaction, especially when evaluating change. However, when you review and estimate year over year savings with a more typical medical spending scenario you can see that these savings will more than cover a year where the worst case scenario occurs, even in just a three year period.

How is it more ACCESSIBLE?

Over the last five years PEHT health insurance premiums have increased by almost 25%. Under the current collective bargaining agreement employees are and will continue to be responsible for half of that increase. You can see the impact these increases have over time on the premium costs both for employees and the District. Over this same five year period the number of employees who are waiving health insurance has also increased. The premium savings and District provided HSA contributions make health insurance accessible for these employees and their families.

Health Premium Increases since FY 2018

What is CONSUMER DRIVEN?

High Deductible Health Plans encourage healthy living, routine preventive care, and comparison shopping for high-quality, low-cost medical services. Efforts that employees take to save money effects them more directly by reducing out-of-pocket expenses. While premium dollars go to the insurance company regardless of how often you need access to care, health savings account dollars are there when you need them, and grow when you don't. The HDHP and HSA structure encourages employees and their families to have greater insight and involvement in evaluating their spending by giving them the direct benefit of savings.

HDHP Advantages

High Deductible Health Plans encourage healthy living, routine preventive care, and comparison shopping for high-quality, low-cost medical services. Efforts that employees take to save money effects them more directly by reducing out-of-pocket expenses. The HDHP and HSA structure encourages employees and their families to have greater insight and involvement in evaluating their spending by giving them the direct benefit of savings.

Evaluation of Plan Performance

In addition to employees, the District and Association will also have the information and tools available to be good consumers of health insurance. We will be able to evaluate the plan's performance, review plan offerings, structure and cost, and shop for alternatives to ensure we are getting the best value for our health care dollars. This does not include access to private health information. Your family's medical information and individual's spending is not provided nor available to the District.

Understanding a Qualified High Deductible Health Plan

A Qualified High Deductible Health Plan, is not a reduction in benefits. The proposed plan offers full coverage for medical expenses including vision, dental and orthodontia coverage with, only in some cases, a higher deductible.

MSBSD QHDHP HP $1500 Benefit Highlight.pdf

Medical/Vision Plan Summary

Review the medical, vision, and prescription drug plan summary details to the left.

Dental Summary.pdf

Dental Plan Summary

Review the dental plan summary details to the left.

HDHP Common Misconceptions

In addition to having medical, vision, dental and orthodontia coverage the District's proposed HDHP also includes preventative care, virtual care, medical Travel Benefits and a listing of prescriptions covered in full.

Preventative Benefits.pdf

Preventative Care

Continuing to access preventative care is important for health and wellness. The above listed preventative care are provided at no cost.

2021 Premera BCBS Alaska - CDHP Preventive Rx - Covered 100%.pdf

Prescriptions

Some prescriptions are covered at 100% even before your deductible is met. See the list above.

2021 - Virtual Care Bundle Primary Care PBC AK.pdf

Virtual Care

Premera offers a variety of virtual care options to support convenience and limit costs.

Comparing Premera's HDHP and PEHT Plans

Its important for members to understand how the plans compare and how they will impact their family's overall health care spending. The below comparison provides a general summary of the coverage and how it differs, as well as the premium savings. The Premera Summary Plan Descriptions are above and we encourage you to review those documents as well.

The Benefits of Health Savings Accounts

Triple Tax Advantage

Health Savings Accounts offer a variety of benefits to employees as a savings tool and set funds aside to cover qualified medical expenses.

Why an HSA.pdf

Why an HSA

HSA and FSA Differences.pdf

HSA vs. FSA

Learn more at americanfidelity.com

Additional information and Resources

Premera BCBS Alaska - 2021 Find a Doctor Flyer.pdf

How can I check if my doctor is in network?

medical transportation flyer.pdf

Are the opportunities for savings outside of Alaska?

Centers of Excellence.pdf

What are centers of excellence?

Health-Presentation CEA Final.pdf

March 17, 2022 Presentation to CEA Bargaining Team

Medical Plan Review for CEA.pdf

Individual Employee Cost Impact Summaries

These summaries outline out-of-pocket estimates for employees and families under a number of scenarios for each plan design. Incorporated here are a comparison of medical spending, premium savings, and HSA contributions.

Questions

If there is any additional information that you'd like to see presented, a question that you have about the proposal, or would like to understand more please contact Katie Gardner at Katherine.Gardner@matsuk12.us or via phone at 907-746-9264.