Arkansas lawmakers have approved latest medical health insurance premium rates for state employees and public school employees. The Worker Advantages Division Oversight Subcommittee on Wednesday took motion allowing lower rates to take effect, following last week’s approval by the State Board of Finance.
In the subsequent calendar 12 months, state employees will probably be expected to pay $172 a month, while public school employees pays $221 a month, in line with a spreadsheet provided by the Worker Advantages Division (EBD). There are different rates for workers who include their spouses or children on their plan.
Concerns about United Healthcare
Former Superintendent of Lafayette County School District Winston Simpson, who’s now retired, shared his concerns with lawmakers in regards to the United Healthcare’s Medicare Advantage Plan.
A contract had been approved by legislators this summer after it was found lawful. Last month, Benister filed an objection claiming United Healthcare was unfairly awarded the contract with the state.
“The [request for proposal] requires that any vendor be a 4 star or more vendor, Benister is just not a 4 star vendor,” Mitch Rouse, director of the Office of Transformation and Shared Services, said when asked in regards to the disqualification by lawmakers in a previous meeting.
Jake Bleed, director of the EBD, has said the Medicare Advantage through United Healthcare may help save the state money, while keeping advantages for workers the identical.
In his memo, Simpson said he was anxious in regards to the plan denying some coverage. He cited a study done by the US Department of Health and Human Services that found 18% of payments denied by Medicare Advantage would have been approved by Medicare.
Kirsten Schatten, strategic consultant for the Segal Group, said the human resources consulting firm, which was hired by the state for $611,000, has looked into the potential of denials by in-state providers, which refers to places like hospitals, pharmacies and individual doctors.
“There is a very high percentage, high 90’s, I don’t exactly remember, it might be 99, are either in network or accept out-of-network basis,” Schatten said.
In keeping with GoodRx Health, when an insurance company is accepted by certain providers the provider will provide their services at a reduced price, which is known as in network. Out-of-network refers to insurance firms that don’t have contracts with providers to get a reduced rate.
Schatten said United Healthcare is working with providers who don’t accept the plan. When asked by Sen. Linda Chesterfield, D-Little Rock, about what motion will be taken if the state doesn’t just like the plan, Bleed responded by saying the contract has clauses for that scenario.
“We will probably be watching that as a problem. We will definitely make use of the performance guarantees and other protections we’ve got within the contract within the event that this goes flawed,” Bleed said.
Bleed has said there may be a clause within the contract with United where the corporate has to report how much it’s spending on advantages for members.
“In the event that they keep an excessive amount of, they pay it back to us. I believe we’ve got really good guardrails to ensure that the savings don’t end in less advantages for our members,” Bleed told lawmakers last month.
Bleed has also said employees could have the choice of selecting to be covered by Medicare Advantage. Enrollment will begin in October and employees could have the choice to opt out of the plan and back to their original plan in the event that they do not like it.
In an interview with KUAR News, Simpson said one other concern with Medicare Advantage is the federal government doesn’t provide enough oversight. He hopes the Office of Worker Advantages Division will fill in that gap.
Pharmacy Advantages Managers
The state can also be seeking to add a pharmacy profit manager (PBM) as a strategy to get monetary savings. In keeping with the Commonwealth Fund, PBMs are firms that help negotiate drug prices for health insurers and enormous firms.
During Wednesday’s meeting, lawmakers were scheduled to debate the means of finding a PBM, however the discussion was cut short.
Prior to ending the meeting, Rep. Jeff Wardlaw, R-Hermitage, said the Segal Group felt not noted of the means of finding a PBM. The firm reached out to the Bureau of Legislative Research (BLR) about its concerns, which was relayed to Wardlaw and Sen. Terry Rice, R-Waldron.
To debate the problem, a duplicate of an email was shared amongst lawmakers. Prior to discussing the e-mail, Rouse warned lawmakers certain information couldn’t be discussed while the bidding process is going down.
“There has not been a vendor that has been chosen for this PBM, under procurement law we will not discuss the small print of what’s been submitted,” Rouse said.
Wardlaw followed Rouse’s warning by calling a break to talk with Jillian Thayer, legal counsel for the BLR.
Wardlaw said in an interview after the meeting he wasn’t able to talk about what information was in the e-mail that caused the meeting to finish. He said the e-mail was the rationale for the meeting ending early.
Rouse said his office will restart the bidding process to seek out a PBM.