By Holly McCray
The new year will bring a change in the health insurance network for the Oklahoma Conference’s self-insured medical plan.
Beginning Jan. 1, Blue Cross Blue Shield of Oklahoma (BCBS) will become the statewide network for the Conference’s Health Benefits Plan, which insures active Oklahoma United Methodist clergy members and lay employees.
Their claims for hospital or physician services now will be processed through the BCBS network. The Kempton Group will continue as the Plan’s administrator, issuing payments. New ID cards are being mailed to participants in the Plan, for use beginning Jan. 1. Until then, use your existing current card.
An exception to the network change is the retiree Medicare Supplement Plan, which The Hartford will continue to maintain. A few other exceptions are noted later in this story.
Services will expand
The switch to BCBS was primarily driven by long-term cost savings offered by that network for the Health Benefits Plan, according to Brian Bakeman, Conference Treasurer.
Additionally, new services provided by BCBS will enhance the Plan. Among them:
The largest network of hospitals and physicians in Oklahoma.
National and international coverage as the medical claims provider.
Free online health and wellness tools, such as personal health risk assessments and a confidential advisory program, "Ask A (Nurse, Trainer, Dietitian, or Life Coach)."
Free stop-smoking and weight management programs, with personal coaching.
Discount programs for vitamins, fitness and weight centers, and more.
The free 24/7 Nurseline, available in English and Spanish.
Some of these were announced in a December letter sent out by Jan Tofani, the Health Benefits Plan director.
Board weighs choices
The Conference Board of Pension and Health Benefits, chaired by Mouzon Biggs Jr., has oversight responsibility for this Plan. The board conducted a lengthy review before deciding to partner with BCBS.
Nationally, health care costs continue to rise. Yet the Conference long has been committed to offering as a benefit health insurance that is both comprehensive and affordable.
As a self-insured plan, ways to cut costs are limited, said Rev. Dr. Biggs. Personal responsibility for healthy living practices is the best way, he noted. "We have an older census. Our biggest single cost is for pharmaceuticals."
The board also considered the numerous health insurance networks that negotiate costs with physicians and other suppliers of health care.
"Our board asked a nationally known actuarial firm to compare networks for us in Oklahoma," Biggs said. The firm responded that "if we changed networks, we might save a half-million dollars."
He continued, "We decided BCBS is the strongest network that meshed best with the providers we have (doctors, hospitals, etc.). BCBS is bigger, stronger, negotiates tougher for reductions in cost—and that savings comes to us, to our Plan."
Biggs said the Conference Plan will also see major savings through the BCBS stop-loss insurance program. Stop-loss insurance is applied to catastrophic costs incurred for medical needs such as organ transplants and certain premature births.
Advisers projected that, overall, the new partnership with BCBS "may save us $1 million if we have the same health record experience next year," Biggs said. "That’s why we’re shifting."
Some programs unchanged
Some healthcare programs will not change, such as The Hartford supplement for Medicare, noted earlier in this story.
Prescription drug coverage will remain with MaxCare.
Kempton also will continue to maintain the Flexible Spending Account (FSA) and Health Reimbursement Arrangement (HRA) programs.
VSP and Delta Dental will continue to provide voluntary vision and dental insurance, respectively.
As the Conference transitions to working with BCBS, plan participants are encouraged to learn more at www.bcbsok.com.
Rates change in 2011
Delegates at the 2010 Annual Conference, in late May at Tulsa, approved higher premiums in 2011 for the Health Benefits Plan, as well as increases in office visit co-pays, prescription drug co-pays, and deductibles.
Each church’s contribution will increase 8.6 percent to the Health Benefits Fund, which is one of the Ministerial Support items within the Apportionment.
For individuals, both active participants and retirees, the monthly premium will rise 10 percent. The co-pay for an office visit will rise from $20 to $30. Individual deductibles will be $1,250.
Extensive information can be found at www.okumc.org/healthcarebenefits.