CalPERS Trustees Approve First Copay Increase Since 2002
CalPERS trustees on Wednesday approved a host of proposals aimed at controlling premium rate increases but rejected a recommendation by its Health Benefits Committee to raise copayments for brand-name prescription drugs, the San Francisco Chronicle reports.
Higher copays for prescription drugs were projected to save about $30 million next year.
Trustees approved a recommendation to raise copays from $10 to $15 for a physician's visit (Colliver, San Francisco Chronicle, 5/17). CalPERS officials estimate that the increase will generate $27.7 million in premium savings next year (Chan, Sacramento Bee, 5/17).
Under the plan approved by trustees, copays for physician appointments will be waived for preventive care, annual physicals, and pre- and postnatal care (San Francisco Chronicle, 5/17).
CalPERS trustees also approved a proposal by Blue Shield of California to withdraw its HMO for CalPERS members from El Dorado, Napa, Lake and Plumas counties (Sacramento Bee, 5/17).
The four counties are considered among the most costly for health care services (California Healthline, 5/16). CalPERS officials estimate that the withdrawal would generate $30 million in premium savings for the remaining 356,000 Blue Shield HMO members in other counties.
Trustees also approved a recommendation for a new low-cost physician network for HMO and PPO CalPERS members in 17 counties, including Lake and Napa counties.
The network will have fewer physicians than other plans, but members will face lower premiums. Adding the smaller network is projected to save $2 million to $17 million (Sacramento Bee, 5/17).
None of the changes will apply to CalPERS Medicare plans.
CalPERS is scheduled to approve the premium increases in June.
The move will mark the first time that CalPERS has raised copays since 2002 (San Francisco Chronicle, 5/17).