Guild gets more details on health care for 2017

Union leaders met with the Company late last week to continue the conversation about health care for 2017.

The Guild’s Executive Board will discuss this further and decide what to do next at its regular monthly meeting at 5:30 p.m. Wednesday at its office on the second floor of the Albany Labor Temple, 890 Third St., in Albany. Members are always welcome to attend and give their input.

The union leaders sought information on the differences in the maximum out-of-pocket costs under the two plans. The shortest version is: MVP would be less expensive than Blue Cross if an individual gets sick within a family. It would be more expensive if an individual gets sick in an individual plan or if two people within a family get sick and both hit their individual maximums.

Under the current plan, the aggregate maximum is $3,425 for an individual and $6,850 for a family. Under the MVP plan, an individual faces an embedded maximum of $4,000 and the family embedded maximum is $8,000.

The best way to understand this is to share examples of a family affected by illness or injury.

FAMILY COVERAGE, ONE INDIVIDUAL HITS THE TOP OF THEIR DEDUCTIBLE

Under the Empire plan, the deductible is $4,000. (Employees pay the first $750, the Times Union reimburses the rest.) Once an individual hits that $4,000, that person becomes liable for 10 percent of medical costs up to $2,850. The maximum out of pocket, then, is $6,850 minus the company reimbursement of $3,250 for a total of $3,600.

Under the MVP plan, the individual would not face additional expenses after hitting that initial $4,000. The total out-of-pocket would be $4,000 minus the $3,250 reimbursement for a total of $750. That’s the best scenario. The cost is $2,850 less.

FAMILY COVERAGE, SECOND FAMILY MEMBER HITS TOP OF DEDUCTIBLE

Under the Empire plan, the result would be exactly the same as above, for a total of $3,600.

Under MVP, the second family member would also have a $4,000 maximum deductible. (A family would have a total maximum of $8,000.) So the cost of two very sick people in a family would be the original $4,000 deductible then paying 10 percent of medical expenses up to another $4,000. Of that $8,000, a total of $3,250 would be reimbursed by the company. The total out-of-pocket is $4,750 or $1,150 more than Blue Cross.

INDIVIDUAL WITHOUT FAMILY HITS TOP OF DEDUCTIBLE

The deductible for an individual is $2,000 under both plans. Under the Blue Cross plan, once a person started paying 10 percent of health care, their maximum liability would be $1,425. That’s $3,425 minus the Company reimbursement of $1,250 for a total cost to the individual of $2,175.

Under the MVP plan, the individual has the $2,000 deductible. The person would then be liable for up to $2,000 more once they hit the 90/10 split. That’s a total cost of $4,000 minus the $1,250 company reimbursement for a total cost of $2,750. That’s $575 higher than under Blue Cross.

So far in 2016, three individuals and 7 families hit the maximum out-of-pocket cost.

If we stayed with Blue Cross, the weekly premium taken from paychecks would rise $5.54 from $58.90 to $64.44. Moving to MVP would cause a weekly increase of $4.04 to $62.94.

Eight Guild members opted last year to take a new option the Company presented. Under that program, employees pay for the first $3,000 of medical expenses out of pocket for a lower weekly payroll deduction for individuals and couples. Under that plan, the weekly cost would rise from the current $20.54 for singles to $23.93 and from $40.06 for couples to $46.66. (The rate for families would be $69.40, higher than the main plan.)

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