The board is continuing the budget process for 2017-18, with possible changes to health insurance. The 2017-18 health insurance possible changes would capture savings in health insurance premiums and reinvest of those savings into targeted compensation areas.
Below you will find more information about the current health insurance plans and the options available in the 2017-18 budget. Please reference back to this website for additional information as it becomes available.
The existing 3 carrier model provides a wide range of options for health care (coverage with Dean, GHC and Unity). Each plan provides the same levels of coverage but with different provider networks.
Employees currently pay between 1.25% and 10% of the HMO insurance premium, based on the employee’s unit.
- Governor Walker has proposed in the state budget that employees would be responsible for 12% of the health insurance costs (the exact definition of the 12% employee share of health costs is unclear at this time. We have defined it as a 12% employee premium contribution and will wait for a final definition if this item is included in the final state budget.)
- The 12% employee premium contribution will be based on the plan the employee is enrolled in, not a blended/averaged rate. Examples of the employee premiums can be found under the Additional Information section.
- A 12% employee premium contribution (EPC) may incentivize employee migration to the lowest cost plan and destabilize the 3-HMO model over time.
The district is exploring multiple options for health insurance and has narrowed down the options to 2, with the opportunity to reinvest any health insurance savings into employee compensation. Additionally, if the 12% EPC would be enacted, MMSD will reinvest the increase in premium contributions back to employee compensation.
If we continue with the 3-HMO model, there will be no changes to the structure of the health insurance plans offered. This option would provide the same network access as what is currently provided - through GHC, Dean and Unity health insurance plans.
With minimal plan design changes, the renewal premiums for the 3-HMO model aligns with the budget target. The plan design changes would be:
- $20 copay for all members
- Updated 3-tier RX from $6 / $15 / $30 to $10 / $25 / $50, and
- Emergency Room copay from $50 to $100
The 2-HMO model is a dual-choice model that continues to provide access to UW Hospitals and Clinics and the Dean SSM and St Mary's SSM providers through the GHC and Dean insurance plans.
- GHC would provide primary care through the GHC clinics and specialty care is normally referred to UW hospitals and clinics
- Dean would provide primary care and specialty care through the Dean SSM clinics and St Mary's SSM hospitals
If the district transitions to a 2-HMO model, there would be a transition period that would prevent health care from being interrupted. The transition will be handled carefully and based on the individual's health.
This change provides savings that will be reinvested into employee compensation through targeted and universal strategies.
This model was an initial option in the 2017-18 budget development process. It would have provided $5.5 million in savings with a 1-HMO model through GHC. We received feedback from employees and employee groups with concerns about this model, therefore this option has been removed from the 2017-18 health insurance budget options.
The links below provide you with additional information about the options available in the 2017-18 budget.
The final health insurance option has not been decided. If you haven't already, you can give your feedback regarding the health insurance options or the 2017-18 budget by filling out the out the feedback form.
Click Here for the feedback form.
If you have any benefit related questions, please contact the Benefits Helpdesk at email@example.com.