Understanding your Health Plan: Read JEA’s health plan documents
Updates from the Health Committee:
Open Enrollment closes Friday, June 17 rather than June 15, and if you are already on HDHP, you DO NOT need to fill out new forms due to the dental change.
Here is the slide show that Rhonda shared with us at her presentation. As she says on slide 9, beginning on Monday, May 9, you may log into (or set up an account at) www.mibenefits.com to make changes to your health plans.
- The Rep Council has approved our new health rates. Click here to see what you will be paying next year. PEHT prices have increased less than 5%, and we have applied the $250,000 overage from people moving to the HDHP Employee Only plan and tier (remember that those people’s plan cost only $813, so the remaining $821 benefits everyone else), so for 2022-2023, you will not see an increase in what you pay. Thank you to those who were willing to do that!
That said, it is unlikely that we will ever have an overage like that again, so be aware that costs are likely to increase in 2023-2024.
- The most important change in coverage is that HDHP Value Dental ($500 preventive only) has been changed to Dental B, which affords $3000 worth of coverage. Also, Plans C, F, and HDHP no longer have an ER deductible, an inpatient deductible, or a prescription co-insurance cap.
- If you are thinking of making a change, some things to be aware of:
- Legacy has only five PT visits whereas the others have 20
- Legacy has $2000 dental whereas the other plans all have $3000
- Only Legacy and Plan C have ortho
- If you are moving to a plan with a higher deductible, any deductible that you have already paid this year (beginning January 1) will be applied to your new plan. With that in mind, if you have medical things that you know you need, and you want to move to a plan with a higher deductible, you might want to get them done before July 1. People already on HDHP might want to wait until July 1 for dental work. Timing can matter!
- Plan F has six primary care visits with a $25 co-pay, which is not subject to the deductible
- Deductible for HDHP in all categories other than Employee Only works differently than for other plans. For plans C, F, and Legacy, when a family member hits the individual deductible of $264.75 for Legacy, $500 for C, and $1500 for F, PEHT begins paying 80% of covered costs. With HDHP, if someone reaches the $1500 individual deductible, he keeps paying until the entire family’s deductible bills hit $3000.
- Plan your medical care keeping in mind that your expenses run from Jan. 1-Dec. 31, which means that if you’re having a high expense year, get as much done in that year as you can if you are on a higher deductible plan like F or HDHP
- Keep in mind that different plans have different deductibles and out-of-pocket limits, but past those limits, you are covered 100% for in-network services under every one of those plans
4. To help you decide what plan works best for you:
- Look at coverage on the four plans at https://pehtak.com/plans/juneau-education-association. Or for a quick look at coverage, deductible amounts, etc., click on this document.
- Check what plan you are on currently – Click here for instructions.
- Then check your health insurance usage: Click here for instructions on how to do that.
- Apply your past usage numbers and any costs you know you have coming up into the various options, then look at the cost of each plan to decide what might work best for you.
- The open enrollment period is May 9-June 15. You will receive an email from Kelley Fink with the plan costs and contact information to make an appointment with American Fidelity to help you set up a Flex plan or Health Savings Account to help with costs. If you are not making any changes, you do not need to do anything, but if you want to make changes in plans or tiers, May 9-June 15 is the time to do it.
- A number of you have expressed interest in a meeting with Rhonda Kitter, PEHT CFO, so I have scheduled an in-person meeting with her for Tuesday, May 3, at 4:15 in the library at JDHS. Please join us! In addition, if you have more specific questions (not about claims – for that, call PEHT at 907-274-7526), contact me, and if there’s enough interest, we could also schedule a meeting with me, Ricky Bass, and others to help you make decisions.
- We are once again asking that if you are not currently electing health care with PEHT, you consider coming back – on the HDHP Employee Only plan – to benefit the rest of the membership. Every person who enrolls in HDHP Employee Only brings $758 to the JEA pool, which benefits everyone else with their costs. Click here for the updated version of last year’s explanatory letter. Many times, you can also be on your spouse’s health insurance plan and be covered by both plans. Click here to see how that would work with a Sample Scenario. Now that we’ve had a year of some people doing it this way, we have some folks willing to explain how it worked for them. Steve Morley, Taylor Young, and Jay Lloyd can talk about this with regards to a spouse also insured with PEHT, and John Wade and Chris Heidemann can talk about it with regards to a spouse employed with CBJ and the state, respectively. We’ve also been told that it will work with the state retirement system and the federal government. If you are not sure if it will work with your spouse’s insurance plan, ask your spouse’s insurer how they would handle the Sample Scenario.
- Click here to see the answers to questions that members asked on the Health Care Survey.
- All Preventive Care by preferred or approved providers should be 100% covered. This includes mammograms, pap smears, prostate exams, colonoscopy, annual biometric screening – cholesterol, diabetes, blood pressure, height, weight, well-baby exams, vaccines, flu shots. If you are retiring and moving to state health care, preventive is not covered.
- Sword Physical Therapy is a virtual option, which is free for all plans. Attachment explaining it is below.
- Air Medevac:
Medevac costs for Alaskans can be extremely high. It is important to understand
your options before something happens to you or your family that requires an air
ambulance. Here are some important facts you should consider:
- There are four air ambulance services that operate in Juneau: AirLift Northwest, Guardian Flight, LifeMed, and Medevac Alaska.
- LifeMed and Medevac Alaska are covered by our insurance – there is no need to become members of these companies.
- You may not be able to choose which company if you are being medevaced; it depends on which plane is available at the time.
- Air ambulance costs for Guardian Flight and AirLift Northwest are covered by our insurance at 125% of the standard Medicare cost, but those companies typically charge much more than that. If you are not a member of those companies and you are told you will be flying with them, you may call the number on your health care card to see if the Public Health Trust can negotiate a lower cost with the company. However, that is not typically successful and may STILL result in a medical bill that is extremely high and in some cases in excess of $100,000 depending on the circumstance. We have members who have ended up with HUGE medevac bills.
- JEA members are strongly encouraged to purchase membership for Guardian Flight AND AirLift Northwest because a membership could save a tremendous amount of money for families in the event that someone is sent out on a Guardian or Airlift NW flight.
Guardian Flight ($125/year): http://alaska.guardianflight.com/
AirLift Northwest ($60/year): https://www.uwmedicine.org/airliftnw
If you have any questions about health care, I am happy to address them or to direct you to someone who can help you. Reach out to me at this email or at my school email – email@example.com.
Thank you for taking the time to read this.
JEA Health Chair