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State health plan for schools changes under Affordable Care Act

Gainesville school board to offer incentive for employees to decline coverage

POSTED: October 8, 2013 1:16 a.m.

As Georgia teachers prepare for upcoming open enrollment for health insurance, the Gainesville school board got a crash course on what changes are in place to comply with the Affordable Care Act.

The most obvious change is, instead of multiple options, the only provider is now Blue Cross Blue Shield of Georgia.

“We had several options (in the past),” said Gainesville Superintendent Merrianne Dyer. “United Healthcare most notably.”

That may mean a change in doctors, though David Hatter with Arista Consulting Group said that should not be significant.

“There was about a 97 percent overlap (between plans),” he told the school board at its Monday work session.

The school system has contracted with Hatter for a consultation during the health plan transition.

“Most of the talk among your employees in this upcoming enrollment will be, ‘Where’s the plan that I was in?’” Hatter said. “It’s not there anymore.

“They may remember a promise that was made to them a long time ago: ‘You can keep your plan,’” he added. “And so what I want you to know is that this plan has been very well designed, but the employees won’t initially like it.”

The new state plan, which Dyer said has different tiers, is designed to reflect the look of the insurance marketplace under the Affordable Care Act.

Hatter said there’s a cost savings opportunity for the system if employees find it’s cheaper to join a plan outside of what’s offered through the schools.

When open enrollment begins later this month, a financial incentive will be available for Gainesville employees to consider other insurance options.

“It stems from this idea that the schools are now at a local level on the hook for all of the employer’s portion of the funding for classified employees,” Hatter explained. “This has been increasing over time. In this next fiscal year ... it will increase to the point that there will be very little, if any, subsidization from the state.”

Classified positions require no state certification. Certified employees, such as teachers, have most of their employer portion of health insurance paid by the state.

“Your certified employees are significantly higher in your monthly contributions, but the state is largely, nearly completely, funding that expense,” Hatter explained. “However, this smaller but fast-growing expense for your classified employees is fully funded by the board.”

Other insurance options include joining a spouse’s plan, going on Medicare or remaining on a parent’s plan if the employee is under 26.

A financial incentive would encourage employees with one or more of those options available to them to not sign up under Gainesville, ultimately saving money for the school system.

Hatter said a large percentage of employees do not elect coverage. He attributes the decision to employees’ spouses having better plans.

Employees will receive kits to inform them of the incentive, as well as information on how to register during open enrollment.


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