In a line of work that puts personal health at risk every day, it’ s crucial to have the facts about health benefits. Just the facts.
Under Chapter 78, law enforcement officers are required to contribute 1.5 percent of salary to health benefits. David Beckett and Kevin Lyons helped explain some of the important facts about health benefits that can help define the differences between health insurance plans and put a focus on costs to assess when determining how much members should pay for health benefits. Some of the information vital to making those decisions includes:
• There are two types of health benefit plans: State Health Benefits Plans or private insurance plans. These options allow for different limits of control of the plan. In a private insurance plan, there is more room for negotiation and control, but it comes with a higher cost. It’ s more money to be part of a private plan.
• Out-of-network visits drive healthcare costs. Out-of-network visits require patients to pay the difference of what the insurance company is willing to pay and what the doctor charges. Once a patient goes out of network, doctors control the costs. Insurance will only cover the standard for the service.
Health benefits
DAVID BECKETT, David Beckett Law KEVIN LYONS, NJ State PBA Health Benefits Coordinator
2017 NJ STATE PBA Collective Bargaining Seminar
• When negotiating health benefits, it’ s important to get information from the members to find out roughly how many people are actually going out of network. If that number is less than what the unit has accounted for in the past, money can be saved.
• Prescription coverage cost is increasing quickly. It’ s important to advise members to use generic brands. Whenever members opt for drugs that are not generic, it costs more. The goal for a plan is to get to 85 percent generic. One way to address this is by issuing a mandatory generic provision under which an employee must take a generic unless there is a medical reason for using a brand-name drug.
• One of the primary drivers increasing healthcare costs are people between the ages of 45 and 65, because they have more need for medical care.
• It’ s important to make sure that local government is not forcing active employees to pay for retired employees. The pool should be split. If the pool is not split, then younger members are paying higher rates that compensate for the needs of retired members.
• The 2-percent cap does not apply to health benefit savings achieved by negotiated plan changes, so such changes cannot increase or decrease the amount available for salary increases in any proceeding before an interest arbitrator. d
www. njcopsmagazine. com ■ FEBRUARY 2017 47