FUESD implements revised healthcare plan with FETA

The governing board of the Fallbrook Union Elementary School District (FUESD) approved a memorandum of understanding with the Fallbrook Elementary Teachers Association (FETA), finalizing an agreement on the healthcare plan that will be offered to teachers within the district.

According to Dennis Bixler, assistant superintendent of business services, the district was required to look at the health plan offerings for FETA for 2011. For 2010, employees had the choice of three plans: Kaiser HMO (no monthly out of pocket premiums), PacifiCare HMO (currently very low monthly out of pocket premiums), and PacifiCare Point of Service.

For 2011, employees no longer have the option of the Point of Service Plan and the out of pocket costs for the PacifiCare HMO increased substantially. Instead of the POS, the district will be offering a PPO and will continue to offer two HMO’s, Kaiser and PacifiCare.

“The group we get our insurance through, the California Schools Voluntary Employees Benefits Association (VEBA), has changed its HMO plans tremendously,” said Bixler. “VEBA has been looking at cost-containing measures and at improving the quality of healthcare, so they set up a three-tier system within the HMO.”

Bixler stated that the VEBA has ranked the most efficient medical networks with the lowest cost as Tier 1 networks, and the least efficient networks with the highest cost as Tier 3 networks, with the remaining networks in Tier 2.

“Our employees will have to choose one of the three networks within the HMO plan for their own coverage. We have made it clear that there will be no increase in the district’s funding, and that we are looking for the lowest cost to the district,” said Bixler. “The plan was rolled out and accepted by the employees. They understand that we’re still in tight fiscal times. The decision was more technical than anything else.”

Bixler stated that depending on which network employees choose, there will be some changes to the out-of-pocket charges teachers will pay.

“If the teachers select a provider from network one, their costs for their family out of pocket will go from $12 to $87 a month,” said Bixler. “If the employee goes with a provider from the third network or with a PPO, the price change will be nominal. However, we have very few families in that group.”

Very few concerns were brought up about the healthcare change, which will be implemented in January and carried through until the end of the year.

“The concerns that some brought up came from individuals wanting to keep (certain) doctors and having to pay an increased cost to do so,” said Bixler. “Overall, most employees seemed satisfied with our decision because they see a method to try to contain costs and provide some choice. This really shows the development of competition between medical networks. For the first time, we are getting a chance to see how the state and insurance providers rate medical providers. As the consumer, we can make choice between paying a lot of money for a provider that doesn’t get better results than a lower costing provider. The Fallbrook Elementary Teachers Association, the classified association, CSEA Chapter 307, and District Administration actively worked together to determine the best medical plans to offer employees at reasonable costs for all.”

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