Tentative Agreement on Health Benefits

TALB and the District have reached a tentative agreement on Health Benefits. Negotiations will continue on salary and contract language. The next date for negotiations is March 23rd at the District Office.

All 3 insurance carriers (Kaiser, Blue Shield HMO & Blue Shield PPO) have significant rate increases for our benefit year 2017-18, which will start July 1st, 2017. The largest single driver of increased costs was due to escalating pharmacy utilization. The agreement contains costs under the District Annual Maximum (DAM), which will avoid monthly premium payroll deductions for health insurance. Health Benefits has been bifurcated from the remaining issues at the bargaining table to allow time for Open Enrollment, scheduled for May. The plan modifications are necessary due to escalating costs of health insurance.

Click the button below to download a copy of the tentative agreement on contract language changes (see pages 3-4).

K-12 and CDC/Head Start – HEALTH AND WELFARE BENEFITS – EFFECTIVE July 1ST 2017:

  • Kaiser Foundation Health Plan
    • Physician Visit: $10.00 co-pay
    • Prescription Plan: (100 Day Supply): Retail Generic and Non-Formulary co-pays are $5; Retail Brand co-pay is $10 effective 7/1/2017
       
  • Blue Shield HMO Plan
    • Office Visits: $10.00 co-pay
    • Prescription Plan: Blue Shield HMO has mandated a new structured pharmacy plan.  The HMO is moving away from “generic”, “formulary” and “non-formulary” to Tier 1, Tier 2, Tier 3, & Tier 4. Effective January 1st 2018, Blue Shield will transition to this pharmacy change.
       
  • Blue Shield PPO
    • Emergency Room Visit: clean up contract language, current plan design.
    • Pharmacy: $5.00 Generic co-pay (Mail order remains $0)
    • Diabetic Medications: Due to a rise in diabetes diagnoses, medications shall be filled in a 90 day supply through Mail Order or 90 day supply through Walgreens.

Health Plan Modifications

  1. Effective 7/1/2017, the prescription drug Arestin will be excluded from the plan.
  2. Teladoc Program: A telephone and videoconferencing technology to provide on-demand remote medical care via mobile devices, the internet, video and phone services will be integrated with the medical plan effective 7/1/2017; $40 consult fee, deductible/coinsurance applies.
  3. Rational Med Program: A health and safety program to alert physicians of safety risks for their patients will be implemented for members effective 7/1/2017.
  4. Advanced Utilization Management (With Step-Therapy) Program: An enhancement to the existing clinical rules with additional prior authorization, drug quantity management and step-therapy will be effective 7/1/2017.

TENTATIVE AGREEMENT – FREQUENTLY ASKED QUESTIONS

Why bifurcate Health Benefits from negotiations? For the past 5 years the Health Benefits Committee has worked to find savings within the overall costs of health insurance to avoid having to make monthly premium deductions for health insurance. If the membership ratifies the changes, savings can be implemented for this July 1st 2017 which will give health benefits a narrow cushion from hitting the District Annual Maximum (DAM). If modifications are not made, the District Annual Maximum could potentially be hit by July 1st, 2018. Given the status of the ACA (Affordable Care Act) being repealed it is unclear if vendors will see an opportunity to increase rates for 2018-19. HBC meets monthly during the school year to keep abreast of all potential savings and increased costs on the horizon.

WHAT WILL HAPPEN IF THE TALB MEMBERSHIP REJECTS THE TENTATIVE AGREEMENT? The terms of the Tentative Agreement won’t take effect and we will return to the bargaining table. However, Health Benefit costs could exponentially explode for July 1st, 2018.

SHOULD I VOTE IN FAVOR OF THE TENTATIVE AGREEMENT? Each TALB member must make their own assessment of how to vote, but we strongly encourage every member to vote. The Bargaining Team recommends a YES vote on the agreement.

WILL THERE BE A RAISE? We return to the table on March 23rd. The Bargaining Team is working for a fair salary settlement.

WHO IS ON THE TALB BARGAINING TEAM? Bargaining Chair: Corrin Hickey – Lakewood H.S., Bargaining Members: Mark Ennen – Newcomb K-8, Donna Gerren – Roosevelt E.S., Gerry Morrison –McBride HS, Maritza Summers – Mann E.S., Kevin Quinn – Edison E.S., Christine Kelly – MacArthur E.S., Sybil Baldwin – CDC, Maria Garcia – Head Start.

Calendar for Health Benefit Ratification

March 15th all Member Q & A meeting @ TALB – 4362 Atlantic Avenue, Long Beach, CA from 4:30 p.m. to 5:30 p.m.

March 15th – March 17thRatification Vote – Results Posted Monday March 20th.