February 05, 2011

City of Worcester Health Insurance

Received some information from the City of Worcester regearding their health insurance and compared it to the State GIC offerings.     The City currently offering 3 plans:

  1. Blue Cross
  2. Fallon Direct (smaller network)
  3. Fallon Select (larger network0
Really can not compare City of Worcester Blue Cross versus the GIC, since Blue Cross is not offered through the state.  Lets just focus on Fallon.    Through the GIC effectiv July 1st, 2010
  1. Direct       421.72/1002.48
  2. Select     504.48/1201.16
Through the City of Worcester also effective July 1, 2011, which is broken into two groups (non-settled employee groups versus settle employee groups).  Not sure what that means? 
  1. Settlled Direct   448.06/1154.43
  2. Non-settled Direct   479.86/1231.49
  3. Settled Select    551.75/1422.29
  4. Non-settled Select    588.74/1525.64
Before everyone starts saying we need to join the GIC, we need to make sure we are comparing apples to apples.  Comparing the plans there are some differences, here are the major ones:

  1. Calendar year $250 deductible with the GIC    .   Anything outside a routine office visit goes towards the deductible; for example, you are hospitalized.  A GIS subscriber would first pay the $250 deductible then you would pay a $200 co-payment for a total of 450. The City of Worcester, on the other hand, would be $250.    This deductible goes also towards diagnotic testing.   Lets say you go to the doctor and he orders an MRI.    A GIC subscriber would pay the $250 deductible then a $110 co-payment for a total of $360.  A City of Worcester employee, on the other hand, would pay 0.
  2. City of Worcester copays 10/20 (Primary/Specialist). GIC 20/25 (Primary/Specialist)
  3. City of Worcester prescriptions (10/20/35).  GIC   10/25/50
  4. City of Worcester emergency room 75.  GIC  100
My suggestion would be that the City of Worcester should get a quote at renewal from Fallon that mirrors the benefits from the GIC making it an apples to apples comparison.    


Jahn said...

So a teachers aide or Head Start baby sitter working only 36 weeks per year & earning a 17,000 annual wage could get a family health ins. plan that costs the city 13,000 to 14,000 a year depending on the type of plan.

THEN...THEN...THEN...Add in the pension, the life insurance, 5 or so sick days, couple of personal days.............viola.......the benefit package surpasses the amt of the wage.

We have to slay the 2,000 lb dinosoar in the room...........and this beast is city employee compensation.......nipping a million here and million there is only putting some Super Glue on a bursting dike.

City labor is also inefficient............meaning that paying someone 8 hrs pay to work only 5 hours aint a good idea if you're the one paying the freight.....or paying them 14 hours pay to watch TV and sleep also aint a good idea when teh city is technically bankrupt.

zed said...

Will never be apples to apples because the state is a larger subscriber base.

The city negotiated and the unions bargained in good faith so if the city got a rotten deal blame the manager.

Won't even respond to the work performed rant cause it's nonsense.

Bankruptcy is also at the manager's door so look at his administrators, their perks and budgets.