The annual discussion of health care costs for next year kicked off Thursday, with the Company proposing a move to MVP because it provided a less expensive rate than Empire Blue Cross.
f we stayed with Blue Cross, the weekly premium for most workers would rise from the current $58.90 a week to $64.44. Moving to MVP would cause a weekly increase of $4.04 to $62.94. The deductible would remain at $750. Dental would remain with Cigna, which also would become the provider if you needed health care outside the area.
Eight Guild members opted last year to take a new option the Company presented, and the Guild agreed to support as long as it was an option and not the main choice. 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 go from $59.58 to $69.40, more than the plan with a lower deductible so no families should take that plan.)
The Company also provided a side by side comparison of the current Blue Cross and MVP plans. You can see that document here.
The biggest difference is the out-of-pocket maximum. 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.
Here’s a handout from the Company explaining the difference between an embedded and an aggregate maximum.
(An earlier version of this post confused an embedded deductible and an embedded maximum. My apologies for the confusion.)
UPDATE: The Company offered this further description of the difference:
“The current out-of-pocket maximum with Empire BC’s plan is aggregate. This means if someone is enrolled in family coverage, the entire $6,850 has to be met before the plan will pay 100%. It doesn’t matter if one person hits the $6,850 on their own or if a combination of family members hit the $6,850 out-of-pocket maximum. The MVP plan has an embedded out-of-pocket maximum. Therefore, if 1 family member reaches $4,000 the plan pays 100% for that family member and the entire family would not pay more than $8,000 total. With Empire any family member with claims would accumulate toward the $6,850 out-of-pocket maximum. With MVP no one family member would ever pay more than $4,000 out-of-pocket.”
The only other substantive difference appears to be a $5 increase in the coinsurance after deductible for brand medications to $30. Generics would still have a $10 copay after deductible, and non-preferred brands would still carry a $50 co-pay after deductible.
The Guild is examining the differences to determine whether the two plans meet the test of being “comparable.” If they are not, a vote of the membership is required to approve the change. If they are comparable, then no vote is required.
Please let your Guild officers know what you think or what questions you have by contacting us directly or emailing us at email@example.com.