Menomonee Falls School Board officially OKs health insurance plans

Oct. 30, 2012

Menomonee Falls - After numerous discussions, the Menomonee Falls School Board on Monday officially approved the district's health benefit plan that will offer employees three options with varying deductibles and employee premiums.

Open enrollment for the new benefit plans begins Jan. 1 as the district moves to self-funded insurance through Humana, its current carrier.

The Personnel Committee has been working with human resources and Willis, an insurance consultant, for two months to design differing plans for employees.

"The main thing we wanted to do is we have to save money, but we wanted to offer employees choice," Human Resources Manager Ken Kuberka said. "Not everyone's family or personal situation is identical so we put together a three plan option - some of which have lower deductibles, but cost more on your paycheck, others have higher deductibles, but you're saving money on your paycheck."

Preventive care is covered 100 percent in all three plans, according to School District documents. All three plans have the same prescription program, as well as office, urgent care and emergency room co-pays.

Plan one is a traditional preferred provider organization plan and has the highest premium and a $250 deductible for singles. The deductibles in each plan double for families. This plan is the most similar to what employees currently have, Kuberka said; however, it does introduce coinsurance. This means the employee is responsible for 20 percent (in network) of the bill after the deductible is met, but it is capped at $500 maximum per family to limit liability.

Plans two and three are consumer-driven plans with higher deductibles, according to documents. The employee pays less for premiums from their pay checks through contributions; however, the deductibles are higher. The third option has the highest deductible, but lowest premium. The second and third options also include a Health Reimbursement Arrangement, or HRA.

Plan two is a $1,000 deductible for singles and $2,000 for families. It also has 20 percent (in network) coinsurance and an HRA. An HRA is a health benefit plan that reimburses employees for half of their deductible expenses.

Plan three has an individual deductible of $2,000, $4,000 for families, but the lowest employee contribution rate. Because deductibles are higher in this plan, once an employee meets his or her deductible, they are covered 100 percent (in network), with no coinsurance. It also has an HRA.

The monetary amounts set aside for the HRA were approved Monday; however, specifics of the program have yet to be discussed. School Board member Lori Blodorn said they have yet to decide program details including rollover funds.

"That's a discussion we will have going forward, it is not part of the decision tonight," she said.

The proposed employee premiums are set so the School District's contribution is the same under all three plans.

"The district is putting in identical for each employee no matter what they select," Kuberka said.

By changing to self-funded health insurance, the district could save up to $750,000; however, the total savings will depend on which plans employees choose and their health care spending throughout the year.

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