Advocating for premier health, dental, and other insurance options for our members is an important priority for the IFO. High-quality health insurance has never proven more important than in the last eighteen months as we continue to battle a global pandemic. The IFO is part of the insurance coalition of state employee unions that bargain with the state for insurance benefits. Pat Arseneault, IFO Director of Labor & Equity, was one of the union representatives co-leading this round of insurance bargaining with representatives from AFSCME and MAPE. This year, the union coalition was successful in securing health plan improvements and ensuring little or no increases in employee co-pays, deductibles, co-insurance, and the maximum out-of-pocket limits. In addition, there will be only a modest premium increase for health insurance, and no premium increases for dental and other insurance coverage.
Below is a summary of the result of insurance bargaining and the changes that will be implemented in 2022. Please send any questions or comments to Pat Arseneault at arsen@ifo.org.
Health Insurance Coverage Improvements (effective January 1, 2022)
The effective date for insurance coverage for new hires will change from 35 to 30 days after hire. New hires will be covered under the state’s Group Insurance Program after 30 days of employment.
3-D mammograms will be included as preventative care.
Employees will no longer need a referral to an eye doctor for an eye injury or illness.
SEGIP will be able to make temporary plan changes due to a state or national emergency, with the agreement of the Joint Labor Management Committee on Health Plans (JLM). If the State or a federal government agency declares a state of emergency, terms of the programs administered by SEGIP may be changed for the period of the declared emergency and up to a 30-day run-out period, including changes to benefit design, enrollment and eligibility, waiver of out-of-network restrictions, changes to out-of-pocket costs, and extension of time frames for enrollment. The new contractual provision will allow SEGIP (with JLM approval) to make the type of important changes that were made in 2020 and 2021 to address health issues related to the pandemic without seeking legislative approval, such as waiving the waiting period for insurance eligibility and covering costs for testing and vaccinations.
SEGIP will develop a pilot project through the JLM Committee to expand infertility benefits offered by Health Partners. The pilot project is expected to be rolled out for the 2023 plan year.
The JLM Committee is tasked with making improvements to mental health care access. The Committee will work to improve the network of mental health providers, to better communicate mental and chemical dependency healthcare programs, and to include more BIPOC mental health providers in network.
Premiums
No increases in the employee share of premiums.
Currently, employees pay 5% of the total premium for single medical coverage, and 15% of the total premium for family medical coverage, and this will not change for 2022 and 2023.
Employees will continue to pay flat $13.50 per month for single dental coverage (approximately 33% of the premium for single dental coverage), and 50% of the total premium for family dental coverage in plan year 2022 and 2023.
Health Insurance Premiums increase 3% for 2022.
Employee premium monthly contribution for single medical coverage will increase by $1.10 per month from the current cost of $36.64 per month to $37.74 per month.
Employee premium monthly contribution for family medical coverage will increase by $7.52 per month from the current cost of $250.00 per month to $257.52 per month.
Dental Insurance Premiums will not increase for 2022.
The current employee premium monthly contribution for single dental coverage will remain at $13.50 per month.
The monthly contribution for family dental coverage will remain at $53.40 per month.
Short Term Disability Insurance Premiums will decrease by 5% for 2022.
Vision Insurance Premiums will not increase for 2022.
The premium for single vision coverage will remain at $5.76 per month.
The premium for family vision coverage will remain at $16.54 per month.
Health Insurance Plan Design Changes (effective January 1, 2022)
Changes for Emergency Room Visits are estimated to save money for a majority of employees.
Co-pay for emergency room visits will no longer be subject to the deductible.
For Cost Level 1, co-pay remains at $100.
Cost level 2 co-pay increases (from $100) to $125, and cost level 3 co-pay increases to $150. Cost level 4 changes from 25% co-insurance to $350 co-pay.
For 2022 and 2023, there are no other changes or increases in co-pays and coinsurance, no increase in deductibles for services, and no increase in the maximum out-of-pocket medical and prescription drug limits that employees will pay.
Open Enrollment Improvements for Short Term Disability and Dental Insurance
Short Term Disability Open Enrollment will occur every five years. The first open enrollment for short-term disability will be for Plan Year 2022.
Dental Insurance will have annual Open Enrollment for the next three years — in 2022, 2023, and 2024 Plan Years.