Health Benefits

Report from State Health Benefit Commission meeting (12/14/11)

The Health Plan – Don’t Be Confused

The plan is based upon the calendar year (December to December). However, the Legislature in its wisdom used the beginning of each fiscal year, i.e. July 1-June 30, as the time to change the percentages that people pay their health insurance premium. So year #1 rates are only good for six months. Which means this plan is really a 3.5, not 4 year, phase in.

Savings from a high deductible plan thus paying a higher percentage of premium is unlikely to save you money unless you essentially don’t use health benefits at all.

Savings from lower premiums will mostly accrue to the state – probably 90%. The entire cost of increased deductibles, co-pays and coinsurance will be borne entirely by the member (except for one of the high deductible plans in which the state puts a very small amount of money - $300. – into the members Health Savings Account.)

On behalf of the State Health Benefit Plan, Horizon is instituting prior authorization of pain management services.

According to Horizon, costs in the pain management area have significantly increased.  Supposedly, pain management has been increasingly expensive and there are a fairly high number of inappropriate treatments.

The institution of prior authorization of pain management treatment by Horizon is an attempt to address this issue. This is their response