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Palm Beach County new health care provider


Palm Beach County school district employees protest switch to new health care provider: LAURA GREEN

Author: Individual Health Insurance

More than 21,000 employees and about 14,000 dependents are enrolled.
For seven months, it seemed that everything made school secretary Linda Loomis sick. She spent weeks in the hospital with high fevers and pneumonia, only to be get sick again as soon as she bounced back.

After treatments that would have cost her $3,000-a-month without her district provided health insurance, Loomis is stable.

But she’s concerned that a proposed change in school district health care providers could cost her the specialists who finally diagnosed and treated her. Three of the five are not currently in the Blue Cross Blue Shield Network.

On Wednesday, Loomis begged the school board not to change from United Healthcare.

“I don’t want to start out with another team,” she said.

She was one several speakers at Wednesday’s board workshop who suffer from chronic illness or are the sole health insurance provider for a family member who does. Each asked the board not to approve the change.

Superintendent Art Johnson is recommending a switch to a nearly identical plan provided by Blue Cross because, he said, it is the only way to keep costs steady for employees. Employees would have to pay roughly $30 more a month to stay with United Healthcare.

More than 150 employees sent emails, warning that the district is about to accept inferior care in exchange for a better price.

Board member Monroe Benaim, an eye doctor, solidified worries that employees may have to go outside of the network if they want to keep their doctors.

He tried to join Blue Cross Blue Shield’s HMO network when it looked like the district was switching, but was rejected, he said.

The board delayed a vote on the change Wednesday after complaints that employees had not been given proper notice or an opportunity to ask questions before the deal was approved.

“The Blue Cross plan may be the greatest plan,” school board member Frank Barbieri said. “It’s all in the perception. If we want the employees to feel they are part of a team as the district moves forward (there can’t be) edicts coming down from the administration.”

Johnson turned the blame on the unions that represent school employees. They were part of the committee tasked with deciding whether to switch firms, he said.

“If there’s a failing here, it’s not on the district,” he said.

The district, which is self-insured, pays 100 percent of employee’s health insurance and subsidizes as much as 60 percent for dependent coverage, depending on the plan.

More than 21,000 employees and about 14,000 dependents are enrolled.
For seven months, it seemed that everything made school secretary Linda Loomis sick. She spent weeks in the hospital with high fevers and pneumonia, only to be get sick again as soon as she bounced back.

It took a team of specialists and countless tests to discover that Loomis’ body could not fight off infection; she had a rare immune disorder.

A question and answer sheet covering a range of issues, including doctors and prescription drugs, will go out to employees next week, said Dianne Howard, director of Risk & Benefits Management.

“We do want them to have the information and be comfortable about this,” she said. “We understand that medical insurance and medical care is very important to everybody.”

The district has also secured a promise that Blue Cross will recruit many of the United Healthcare network doctors who are most popular with county employees. If it does not, the company risks a $500,000 penalty.

Already, Blue Cross has lured 22 of the 87 most used providers, said Howard Gruverman, chief executive officer of Edify LLC, the benefits consulting firm that helped the district choose Blue Cross.

Currently, United Healthcare has about 950 primary care physicians enrolled in Palm Beach County to Blue Cross Blue Shield’s 400 to 500, Gruverman said.

The board will vote on the insurance switch in two weeks.

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Palm Beach County new health care provider
Palm Beach County new health care provider

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