NOTE: CAPS has filed a grievance on behalf of all Unit 10 state scientists alleging that CalHR has miscalculated the state’s 2017 contribution rates for state employee health plans. While all health premiums are INCREASING, the state plans to DECREASE its contribution rates for 2017. This results from CalHR’s decision to drop Blue Shield NetValue and add United Healthcare in calculating the 2017 rates. The Blue Shield NetValue plan won’t be part of the CalPERS’ stable of healthcare plans in 2017. That’s CalHR’s reason for not using this plan in the top four largest plan calculation of the state’s contribution rates for 2017. But the result–taking out the NetValue enrollees and adding the lower premiums of the United Healthcare enrollees–brings down the average premium of ALL plans. CAPS contends that this violates the Unit 10 MOU. The state, CAPS contends, must use the Blue Shield NetValue premiums in calculating the State’s rates for 2017. If current NetValue enrollees don’t voluntarily switch health plans during the upcoming open enrollment (September 12 to October 7), they will be involuntarily placed in Blue Shield Access+ HMO. The state contends that the new plan has the “exact same benefits” as their current health care providers. The grievance is on a fast track to arbitration. See the grievance here: http://capsscientists.org/wp-content/uploads/Health-Plan-Grievance-summary.pdf
2017 Health Premium Rates
The CAPS MOU requires the state to pay 80% of the weighted average of the four largest health plans offered to state scientists by CalPERS. The chart below lists the health plan choices, state’s contribution and out of pocket expenses for each.
CalPERS members (that means YOU) must pay the difference between the state’s contribution amount and the premium for the health plan in which you are enrolled. Health plan premiums vary depending on the configuration of the plan. CalPERS annually negotiates with health plan providers over plan design and premiums.
Details on benefit changes to individual plans will come directly from CalPERS to individual members, or go to the CalPERS website. Open enrollment is held in the Fall, when current members can also elect to change plans. Any such changes would be effective January 1. Open enrollment in the state’s FlexElect program (administered by CalHR) is held at the same time.
You may be able to reduce your taxable income by estimating your medical expenses and setting aside out-of-pocket expenses pre-tax via the state’s Medical Reimbursement Program. This benefit is outlined in the CAPS MOU, Section 5.8 Pre-Tax of Health/Dental/Vision Premiums. It says, in relevant part “employees who are enrolled in any health, dental and/or vision plan which requires a portion of the premium to be paid by the employee will automatically have their out-of-pocket premium cost taken out of their paycheck before federal, state and Social Security taxes are deducted. Employees who choose not to have their out-of-pocket cost pretax must make an election not to participate in this program.”
In other words, out-of-pocket costs for health plan premiums are automatically deducted pre-tax, but there is an opportunity to set aside additional pre-tax funds for other anticipated qualified medical expenses. Get more information on the CalHR website.
|ANTHEM HMO SELECT|
|ANTHEM HMO TRADITIONAL|
|BLUE SHIELD ACCESS + HMO|
|KAISER Out of State|
|Out-of-Pocket Employee Cost|
|HEALTH NET SALUD Y MÁS|