Premium increases ahead for state employee health plan

Workers who enroll for full family insurance option will see largest jump

by Andy Marso

Most Kansans who work for the state are facing increases in their insurance premiums next year, especially if they have their spouse and children on the state employee health plan.

As the open enrollment period for 2016 nears, information about employee options published online this week showed hikes of 23 percent and 19 percent for families in the state’s two low-deductible plans and 166 percent and 152 percent for families in the two high-deductible plans.

Laura Calhoun, who works in corrections, said the premium increases will be especially hard to absorb for state workers who haven’t seen many pay raises in the last decade.

Calhoun said she has cut her cable television and carpools to work to save money, but the cost of necessities like water and electricity continues to rise, along with the health care premiums.

“That’s a large increase for a lot of us,” Calhoun said. “How are we going to fit that into (personal) budgets that don’t increase? The numbers don’t lie: I’m basically taking a pay cut to stay working for the state.”

The State Employee Health Plan covers workers at public colleges and universities as well as those in state government.

Eligible employees may choose between plans from Aetna and Blue Cross and Blue Shield of Kansas.

Both companies offer a “Plan A” with a lower deductible and a “Plan C” that combines a higher deductible with a health savings account. All state employee plans are administered under the Kansas Department of Health and Environment.

According to a KDHE presentation posted online, in past years the state employee health plan had used reserve funds to reduce cost increases for members.

But the reserves are approaching their target floor of approximately $59 million, so increased expenses now must be paid through new plan revenue.

Sara Belfry, a spokesperson for KDHE, said in an email that the premium increases were the result of higher premiums to the state and projected growth rates in health care costs.

“The Health Care Commission and its actuary believe reserve funding now is at an appropriate level to maintain the financial stability of the health plan,” Belfry said. “But the excess funds that had been used to protect state employees from growing costs associated with health are no longer available, resulting in the premium rate increases in the current plan year.”

Expenses rose more than expected last year, due to more demand for health care and higher costs. The major cost drivers included increased use of emergency rooms, inpatient care and physician services, and higher prescription drug costs.

Sky-high price tags for new prescription drugs, especially those that treat hepatitis C, are contributing to premium increases across the health insurance industry.

Premium costs for state employees who enroll only themselves, themselves and their children or themselves and their spouse are all increasing some or staying the same in 2016.

But the largest increases will be for family plans that cover the state employee, his or her spouse and their children.

Aetna’s low-deductible family plan will go from $212.93 per pay period (every two weeks) to $261.56. The low-deductible plan from BCBS of Kansas will go from $192.15 per pay period to $229.50.

The increases are even more dramatic in the high-deductible family plans, with Aetna’s plan going from $49.67 to $132.25 and the BCBS of Kansas plan going from $45.73 to $115.25.

Calhoun said she understands health care costs may be rising but doesn’t think it justifies the increased burden on state workers.

She said she does her best to keep her medical costs low, but she and others who work in 24-hour residential facilities like state prisons and hospitals are exposed to a lot of germs and have shifts that sometimes mean they must seek care in emergency rooms because nothing else is open.

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