PEBB Continues Discussing Health Engagement Model
Though still in the planning stages, the board eliminated the lowest-value plan from consideration
June 8, 2011—Numerous questions and confusion as to how the Public Employees’ Benefit Board’s health engagement model will be implemented were at the forefront when the board discussed the new health plan in more detail yesterday.
Staff are moving forward with plan design details and building an infrastructure to communicate with members in order to be able to offer such a plan next January to the state’s 150,000 employees and dependents, said Joan Kapowich, administrator.
Called the “health engagement model,” this new plan is being created to actively engage members in improving their health. Although open to anyone, it’s primarily aimed at people with chronic health conditions, such as diabetes and those with risk factors due to obesity and smoking.
Members will be required to complete a health risk assessment and biometric screening. No one will be required to lose weight or stop smoking. Rather, the goal is to provide classes and other information enabling people to develop closer relationships with their providers and make healthier choices.
Discussions with the Department of Justice are underway to determine whether the new plan could potentially violate HIPAA and other federal and state health laws.
“We haven’t heard of any stops,” Kapowich said.
The online contract that employees must complete to participate has not been ironed out. “We do need to be explicit and say that [a member] is giving permission,” to cooperate in the plan, Kapowich said.
That will help PEBB determine if members are fulfilling the requirements. For example, people who are obese might have to take a Weight Watchers class. Likewise, someone who smokes could have to take cessation classes.
If an employee decides to participate but doesn’t meet the requirements, they could be kicked off the plan and required to pay higher out-of-pocket costs for their medical coverage.
Those costs could reach $1,644 a year. “We’ve done some research about what it needs to be so people take action,” and be involved, said Wendy Edwards, PEBB’s operations officer.
Kapowich doubts many people will not follow through. The state of Illinois has a similar program, she said, and has only seen a 4 percent drop off rate.
Kaiser Permanente and Providence Health Plans will provide the coverage and together currently offer six plans which have various benefit design options for full-time and part-time employees and retirees. The board has yet to decide the benefit reductions to balance its budget.
“This is where we’ve been spending a good deal of our time, and lack of sleep,” Kapowich said. “It’s somewhat involved.”
It’s still unknown which health plan will be offered. For example, employees could select a higher value plan, with fewer co-payments and deductibles, if they participated in prevention activities and improved their health.
Kapowich agreed that more work needs to be done. “It’s hard to come at it cold,” she said.
The board did remove the lowest value plan from consideration in future discussions. “[It] is going to be very, very scaled down,” Richards said.
“I’m not sure if I’m comfortable reducing the number of options,” said Rich Peppers, board chair and assistant executive director of SEIU Local 503, who still voted in favor of removing that plan from consideration.
For The Lund Report's PEBB coverage, go here.
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It sounds unconstiitutional that the government is telling its workers they must attend Weight Watchers (on their time). Why Weight Watchers? PEBB has made it extremely difficult to even signup. Did Weight Watchers win some sort of government contract?
Sounds like we are moving towards not really having many choices that our government is going to be making our choices for us - not impressed so far