CalPERS Reconsidering Copay Hikes To Offset Higher Premiums
The health care consultant for CalPERS on Tuesday recommended that the state pension board increase copayments for its members to reduce premiums and help it remain competitive, the Sacramento Bee reports. The board last year rejected a proposal to increase copays.
CalPERS is reconsidering an increase as it negotiates next year's rates with its health plans, including Kaiser Permanente, Blue Shield of California and Western Health Advantage (Chan, Sacramento Bee, 3/14).
The recommendations include:
- Instituting a copay of $100 daily for inpatient hospital care, with a $300 annual limit;
- Adopting a $15 copay for outpatient or ambulatory surgery;
- Increasing the copay from $10 to $15 for a physician's visit, excluding preventive care;
- Capping out-of-pocket payments at $1,500 for individuals and $3,000 for families;
- Raising copays for generic and brand-name medications;
- Boosting the copay by $25 to $75 for emergency department visits; and
- Adopting a $15 copay for urgent care for all HMO plans (California Healthline, 2/22).
Milliman USA, CalPERS' consultant, did not estimate savings.
Labor officials said they are evaluating the findings (Sacramento Bee, 3/14). 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.