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State offers workers generous plans

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POSTED August 12, 2014 7:18 p.m.

SACRAMENTO (AP) — Health insurance plans offered to state employees in California and elsewhere are relatively generous, with government picking up a large share of deductibles and co-pays, according to a report released Tuesday.

The report by The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation was a first-of-its kind survey of state government health insurance plans nationwide. It found that state plans paid on average 92 percent of a typical enrollee’s health care costs, which is equivalent to the best offerings — “platinum” plans — that the public can purchase on one of the new health insurance exchanges.

In California, Pew found that figure was 95 percent and that 68 percent of plan members had no annual deductible.

Putting the report into a broader context that can make the data easily understood is difficult.

Pew researchers said direct comparisons between states are tricky because myriad factors are in play, including wide differences in the cost of health care delivery across the country, and in the age and health of people in the insurance plans.

Direct cost comparisons to plans offered to employees in the private sector also not available, said Maria Schiff, the project director.

For example, Pew said the average monthly premium for a state government health care plan in 2013 was $963, with states picking up 84 percent of the cost and workers picking up 16 percent. In California, the average monthly premium that year was $1,092, with the state paying 77 percent and employees paying 23 percent.

Pew used the actuarial firm Milliman Inc., which did not have similar premium data for the private sector, Schiff said.

Private companies have been shifting more of the cost to employees as health insurance costs rise, offering higher-deductible plans and requiring greater co-pays for visits to primary care providers and specialists. The Pew report said state governments have been slower to offer high-deductible health plans.

The Pew report sought to quantify for the first time state employee health care costs nationwide, which it said is second to Medicaid in the amount of money state governments spend on health care. Its study found that 45 percent of state employees across the country were enrolled in plans with no deductible.

That includes some plans offered in California, including a Kaiser HMO plan that enrolls 40 percent of state workers. According to Pew, that plan had no annual deductible, $15 co-pays for office visits and an annual out-of-pocket maximum of $1,500.

The state offers nine different health care plans, including six HMOs, that provide various levels of premiums, deductibles and co-pays, said Bill Madison, a spokesman for the California Public Employees Retirement System, which administers the state’s health program.

“It gives our members more of a variety to choose from so they can find something that will fit within their cost range and still provide them the adequate health care they are looking for and deserve,” he said.

The total cost of health care premiums for employees of California state government, municipalities and school districts for 2014 is projected to be $7.7 billion, up from $7 billion two years ago, according to CalPERS.

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