More doctors will be available to participants in the Uniform Medical Plan, which covers 25,000 people in Thurston County, but co-payments and other direct fees could increase.
The state Health Care Authority has contracted with a private company, Aetna, to run the plan starting Jan. 1. Although a private contractor has handled customer service for the state-run plan for more than a decade, Aetna for the first time will take over managing a network of doctors who accept the insurance.
State worker unions have agreed to language in their new, no-raises contracts that will keep employees’ share of monthly premiums at 12 percent.
That’s the share workers have paid for years, but continuing at that rate for two more years while the state reduces funding means the difference will have to be made up with co-payments and other direct fees.
“We may take a hit, depending on how things go with the point-of-service fees. But we look forward to the future when things may get better, and we wanted to keep that ratio,” said Tim Welch, spokesman for the Washington Federation of State Employees.
The Legislature provided enough extra money in the next two-year budget to cover a 3 percent annual inflation rate in health care costs. The Health Care Authority had expected an 8 percent rate.
With the budget complete and the 12 percent share locked in, the agency has asked insurance companies that run the various health insurance plans to propose changes to the plans to accommodate the lower inflation funding, said spokesman Dave Wasser.
How that will affect point-of-service payments likely will not be clear until the end of the month, and the final plans will have to be approved by the Public Employees Benefits Board, he said.
The authority signed a four-year deal with Aetna on Friday to run the Uniform Medical Plan. Until now, the state has simply offered doctors and other health care providers a flat rate through the plan, and providers have opted in or out.
That created blank spots in coverage, such as the emergency room doctors at Providence St. Peter Hospital in Olympia, who did not accept the plan, Wasser said. Under Aetna administration, members of the plan will have access to a larger, 30,000-provider network in Washington.
“It’s something that, obviously, with just a few people in the Seattle office, we can’t run a health plan for 180,000 people. We need a third party to do that work,” he said.
With a full-family coverage rate of $82 a month, Uniform Medical Plan is the most popular among public employees, with 181,000 members statewide. There are 16,000 users in Pierce County, 3,000 more in Lewis County, and 2,300 in Mason County.
The plan’s price isn’t expected to change significantly, and state employees have not been very concerned about the switch, said Welch, the union spokesman. “We’re OK with it.”