Missouri state employee health plan loses enrollees

DAVID A. LIEB, Associated Press Writer

Originally published December 13, 2010 at 5:59 a.m., updated December 13, 2010 at 7:43 a.m.

Enrollment in Missouri’s health care plan for state workers and retirees has fallen almost 5 percent after the state announced it was making budget-cutting changes that would result in higher out-of-pocket costs for participants.

Beginning Jan. 1, the Missouri Consolidated Health Care Plan is switching from a co-pay to a deductible model, charging families more for covering multiple children and eliminating coverage of some health services.

Records provided to The Associated Press show the number of people covered by the health plans has dropped by 4,855 in the past few months after the changes were announced. That puts the total people covered just a little below 100,000. It’s not clear how many of those people now will have no health coverage, have joined a family member’s plan through the private sector or will be covered under the government-funded Medicaid program for low-income families.

As a result of the dropouts, health plan administrators will be able to avoid seeking a large funding increase from legislators.

Agency records indicate that the health plan is budgeted to get $410.9 million from the state during the current fiscal year, which runs through June 30. A preliminary estimate had forecast that funding needs to grow to $428.9 million next fiscal year. But a revised funding request approved this past week by the health plan board — which takes into account the lower enrollment figures — now projects the agency to need $411.3 million from the state in the upcoming fiscal year.

Administrators for the health plan intend to survey members about the reasons they decided to drop out.

Cost increases may be the obvious answer for some.

“It’s disappointing that many state workers responsible for providing care to other Missourians are now unable to afford health coverage for themselves and their families,“ said Joe Lawrence, spokesman for the American Federation of State, County and Municipal Employees in Missouri. ”As the economy turns around, AFSCME hopes the administration and (the health insurance agency) will work on plan changes that provide the affordable plans state employees deserve.“

In the past, most Missouri employees and retirees were covered under co-payment plans in which they pay a flat amount — such as $25 for a doctor’s visit or $100 for an emergency room visit — and the state health care plan picks up the rest.

But that option is ending and participants had to choose one of several deductible insurance plans for 2011.

Under one option, employees must pay their first $600 of medical bills each year, then are responsible for 10 percent of their additional medical costs until they reach a maximum total out-of-pocket expense of $1,500, after which the state plan would cover the rest. For family coverage, that deductible would be $1,200, and the maximum total out-of-pocket expense would be $3,000.

Under another option, employees willing to pay higher monthly premiums can have a deductible of $300 and a maximum out-of-pocket expense of $1,200. Family coverage for that plan carries a $600 deductible and maximum out-of-pocket expense of $2,400.

The state health plans also will eliminate coverage for stomach reductions and fertility treatments, start charging families more money for covering multiple children and will rely more on generic drugs.

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JCsleeper 2 years, 5 months ago

This could be due to staff reductions, employees switching to better coverage provided by their spouse's insurance, or just decding this plan isn't worth the premiums. Those on the low end of the pay scale may qualify for Medicaid. Statistics of MO state full time employees living at or below poverty levels receving income assistance might make an interesting article.

usmc00 2 years, 5 months ago

wa wa wa. State employees are LAZY and there is way to many of them. We would be miles ahead if they switched things to contractors for the state. Things will be done quicker and with less cost. They can pay like everyone else does.

misshoneybee 2 years, 5 months ago

The state contracts jobs out all the time. The contractors are also extremely overpaid. I know this for a fact because the husband of a very good friend of mine works for a company that the state contracted out to perform a job. He should have been paid-$18/19 an hour. He was paid $48 per hour.

Be careful what you wish for, you might get it.

By the by, my husband is retired military, and will soon retire from the DOC in less than 6 years. He is a state employee and is NOT lazy. How can you lump all state employees in one catagory? HP keeps your roads safe, and I have yet to see a lazy trooper. MoDot has been working pretty hard lately to improve the roads. I have rarely had a bad experience at any state agency that I have needed information from. However, you are entitled to your own opinion.

misshoneybee 2 years, 5 months ago

If the state and union would be separated, then there would be money saved because her husband would have been paid his regular wage.

If the state and union were not so cozy, he and his crew would not have been paid those wages. That is a fact

usmc00 2 years, 5 months ago

I am happy for your husband. The great that he served his country. The hp is corupt an lazy as well. If you don't belive me look at the crash reports on troop F and tell me what wrecker company get 95% of the calls. Your right not all state workers are lazy I am sure. But the majority are. I do not know much about modot other then the fact its like most state jobs very political. They hired a person from within to inspect construction projects with no experience or dregree in this work. What is wrong with that picture.

misshoneybee 2 years, 5 months ago

Yeah, you are right about that wrecker thing. But wouldn't the alleged 'corruption' a little higher up the HP totem pole? However, I could be wrong...

Thank you for your service for our country as well. Our military servicemen and women are very unappreciated for the sacrifices they make and the jobs they do.

sandradandme64 2 years, 5 months ago

State workers are not lazy ! We are over worked and underpaid !

herewego 2 years, 5 months ago

It is a shame that our Governor and Legislators DO NOT have the same health insurance as the rest of the State Workers. Oh, and I guess while they're at it, paid at the same rate!

There are lazy workers everywhere, want to see lazy look at any employer that has 100,000 + employees.

Gotigers 2 years, 5 months ago

What a great idea 'herewego'. Wouldn't it be interesting if the lawmakers had to participate in the programs they vote for. Hmmm....

JCLifer 2 years, 5 months ago

Usmc does have a good point. The state seems to coddle low-perfoming workers and managers don't have the balls to do anthing about them.Doesn't matter how hard anyone work- pay is based on seniority or cronyism.
To top it off the administration and management treats employees like children.

herewego 2 years, 5 months ago

Regardless of your 'opinion' of state workers, this article was about the insult to anyone (state employee or not) of offering this to anyone for their health insurance, especially in todays economy and in the most part the lowest paid employee in JC. Stick to the point, --how gov jay stuck it to the employees again. Not you personal opinion of their performance, or lack of. In a way it sounds like usmc00 is jealous of all the perks they get, everyday a snack day, but it is hard to pay that first 150 doctor visit out of you pocket, could you do that?

misshoneybee 2 years, 5 months ago

My husband switched to TriCare last year from the state health insurance plan. Yeah, his deductible is $150 for him and $150 for each dependent. But I have a feeling that deductible will change soon. But it's better than that state junk.

usmc00 2 years, 5 months ago

I think Jays is doing a fine job. He is trimming the fat but one problem I have is that he needs to get rid of more the bosses not the just worker bees. And the the pay they get is low because most have nothing more then a HS diploma or GED. How can they expect to make much money. If they did have a degree they would be smart enough not to be a state worker and be in the real world of work in the private sector like myself. I get all the perks of a state worker minus the free retirement program but the state changing that too. I myself have the normal ol 401k that the company matches up to 4%. Your alls uncle Jay needs to make it fair on all playing grounds buy taking away the retirement for politicians for only one term. It needs to be a minimum of 2 and they should have the exact benifits as the worker bee person.

But I still think we would all be better of making the state jobs contracted. You all would make more but do more work and it would lower the states budget all in one.

JCLifer 2 years, 5 months ago

"And the the pay they get is low because most have nothing more then a HS diploma or GED"

Huh? The place my close relative works is 85% professional staff with advanced graduate degrees. Even most of the secretaries have associate's degrees, and several have bachelor's degrees. Their wages are at least 40% lower than comparable private sector jobs.

Treehouse nailed it when they said you all are lucky to have all these professional workers in this little town, They could easily go elsewhere and make more money, but many are in public service because they want to make a difference. Jefferson City is lucky to have these people working here and spending money here. Also, because they are here, they help raise the average IQ of persons who work in Jefferson City.

JCLifer 2 years, 5 months ago

The lowlifes who rip on state workers are just jealous that they could not get hired by the state. Even NT reporters and JC Chamber people long for having a state job- the same one they rip about in this newsrag every other day.

online_editor 2 years, 5 months ago

General reminder: Please don't post repetitive insults and taunting. Please ignore it when any of the other participants post repetitive insults or taunting. Be sure to focus comments on issues. Thanks. --Rick Brown, online editor, News Tribune

scoobydo 2 years, 5 months ago

No, he was just stating a fact!

richg 2 years, 5 months ago

Welcome to my world of health insurance. This is the type of health insurance costs I have had for years. Why should the state employees plan be any different?

yonomo 2 years, 5 months ago

So what you're saying is that all businesses, private or government, should have EXACTLY the same benefits on all levels? That makes no sense. How would a business expect to stand out?

JCLifer 2 years, 5 months ago

She sounds like a typical liberal communist.

scoobydo 2 years, 5 months ago

Is that a nicer way of calling someone a teabagging repuglican?

JCLifer 2 years, 5 months ago

Maybe you should have gone to school to get some technical skills or an education so you would be more employable. You union members have had it too good for years. Fortunately karma is kicking in and you are getting your comeuppance.

JMO 2 years, 5 months ago

What astonishes me is the name-calling and insults flying over a story about state health insurance! Good heavens people, grow up! If you have never worked in a state office then you have no more business saying state workers are lazy or uneducated than I do saying that about some factory workers when I've never worked in a factory. And education or lack of it has nothing to do with the fact that Missouri pays its state workers less than virtually every other state in the US. (I believe last I looked, we were 49th, but that was a couple of years ago.) Yes, I work for the state. I happen to be on my lunch hour in case anyone thinks I'm wasting time. There isn't a single person in my office who isn't pulling their weight. Are there perks? Sure. We have a retirement plan and sick leave and paid vacation and the office is generally a pretty relaxed place, but we don't have a party every day. We also have more work than employees to do it. The new insurance plans aren't great and they are more expensive. But I'm paying for it, because health insurance is the one thing you really can't be without. On the up side, you can run the deductible thru cafeteria plan (or a health savings account with one of the plans) and spread them out. On the down side, prescription drugs don't count toward the deductible, which is many older worker's highest expense. Frankly, I'm just glad to have a job and insurance. But if I could find better insurance somewhere else, I'd take it!

JMO 2 years, 5 months ago

I came to civil service from the private sector more than 15 years ago, largely because I had a very young child and I knew I wouldn't need to work weekends, evenings and holidays and I would have a steady income and time to be with him. While I admit, as a professional, I am fairly well-paid for a state employee, I would certainly have earned more elsewhere, but the schedule made up for it. Actually, over the years I've put in quite a bit of overtime, but a good portion of it is paperwork I can do at home and, of course, I'm no longer needed at home as I once was so working extra, which has become a necessity as the workload has increased but the number of employees has not, is no longer an issue. I stayed because my work is very rewarding and I feel I perform an important public service. Although it's not physical labor, it's hardly "easy" and I certainly don't "work at my own pace". We have deadlines like any other office, hence the overtime. All that being said, most of the clerks in my office are not paid well and we have a large turn-over. I can't speak to why the ones that do stay choose to, but at least one has told me she came to this job because she had young children and needs the insurance. Believe it or not, some actually do like their jobs, pay notwithstanding.

JMO 2 years, 5 months ago

I'm sorry, I actually meant that as a reply to usmc00, but I hit the wrong reply button. You've said nothing directed at me that I have found offensive at all.

gzc721 2 years, 5 months ago

I have to agree with richg. Many, many people lost the ability to have an HMO plan years ago. I know that paying for the first $600 out of pocket may seem steep, but try going without health insurance. What I have seen of the plan (and yes I have actually read it), it isn't horrible. Higher than what you are used to, but necessary.
If you don't like the fact that they are raising the health insurance, try looking at it this way. They could have fired a bunch of people to make up for the shortage of money or they could charge you more and change your health insurance and STILL offer you the ability to have insurance. I don't think that state workers are lazy, but you do get SEVERAL paid holidays off that the rest of the working world doesn't, paid SICK and VACATION every month, and many other benefits. Higher premiums and deductibles suck, but it is what it is. Deal with it and be happy that you have work and have health coverage!!!

JMO 2 years, 5 months ago

I would like to point out that I don't see state employees posting here complaining about the cost of insurance or the changes to the plans. The comments have largely been people who don't work for the state attacking state workers for being lazy or feeling entitled. In fact, the article doesn't quote one single state employee one way or the other. It's sad that a simple article about the changes in state benefits prompted rants about the work ethics of civil servants. If you can't address the topic, you really should not be commenting at all. That being said, I believe I'll rest on this topic entirely.

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