PEBB Increases Cost Sharing to Plug Budget Hole

Mid-year plan design changes take effect April 1
By: 
David Rosenfeld
March 8, 2011 -- The Public Employees Benefit Board voted unanimously last week to increase cost-sharing to its 127,000 members beginning April 1.
 
The mid-year benefit reductions came in response to increased enrollment and an estimated $10.9 million budget shortfall to pay claims in 2011.
 
The changes signal the PEBB board, made up of labor and management representatives, is willing to make concessions. In an opening bid with union representatives over state employee benefits in 2012, Gov. John Kitzhaber proposed a cap on the state’s contribution to health coverage at about $1,200 per month.
 
Changes approved by PEBB on March 1 include the following:
  • The board added a $500 co-pay for certain specialty services such as hip replacement, knee replacement and bariatric surgery.
  • It imposed a $100 co-pay for emergency room visits where the patient is not admitted to the hospital was approved.
  • The board placed a limit on alternative care visits such as chiropractic, acupuncture and naturopathy, limiting them to 60 covered visits or $1,000.
  • Member cost sharing for dental crowns was increased from 25 percent to 50 percent.

 

  • The board also voted to end a rural subsidy to 18 counties that paid out-of-network providers as if they were in the statewide plan network regardless of whether they comply with the plan’s quality requirements. Beginning April 1, those providers will be subject to out-of-network charges.
For more information from PEBB click here.

For related story click here.

 

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