CalPERS Considers Health Benefit Changes
CalPERS is considering several measures to address rising health insurance rates next year, including increased copayments for doctor and emergency department visits and hospital stays, the Sacramento Bee reports. Officials estimate that the proposed changes could save up to $64 million from current rates.
Experts estimate the HMO rate increase will be similar to the 8.7% average increase in 2006, but CalPERS officials declined to offer a projection.
CalPERS officials, who have been negotiating with health plans this week, will meet with pension fund trustees on Monday and Tuesday to discuss possible changes. The proposals include:
- Increasing HMO copays from $10 to $15 for doctor visits;
- Requiring members in PPO plans to obtain prior authorization for imaging procedures such as MRIs or CT scans;
- Creating a PPO urgent care network with a $20 copay;
- Implementing a new lower-cost Blue Cross of California PPO in some areas that would exclude high-cost doctors and reduce the current physician network by half;
- Eliminating HMO coverage in Colusa, Lake, Mendocino, Plumas and Sierra counties; and
- Replacing the HMO plan in Butte, El Dorado, Glenn, Mariposa, Napa, San Luis Obispo, San Mateo and Sonoma counties with a lower-cost point-of-service program.
The CalPERS board is expected to ratify a plan on June 21.
Union leaders have criticized the proposals, saying they shift costs to workers while not addressing the underlying causes of increasing health care costs (Chan, Sacramento Bee, 6/14). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.