On Friday, March 20th, the State Health Benefits Design Committee unanimously voted for a solution that finalized the Superior Court decision that unilaterally indexed retiree prescription copays in the years 2013, 2014 and 2015.
The committee was presented with three possible solutions to rectify the overpayment of copays in the aforementioned years. Unfortunately, the monumental task of calculating payments to members would have resulted in another year of delay in payments to our retirees and due to medicare regulations some members would have actually owed money to the federal government. This solution allows for compensation in that copays will be reduced or eliminated depending on the classification of the drug and the type of in which the member is enrolled for the period from July 1, 2015 through December 31, 2015 and will return to 2012 rates as a baseline for negotiating new plans for 2016.
The decision in superior court was a landmark decision, in that it gives the committee the authority on all levels to negotiate plans going forward which is especially important in this era of escalating costs in the health care realm. The committee, both labor and management have made a commitment to work together to create plans that provide better health care for both our retirees and active enrollees.
The terms of the retirees are as follows for the rest of 2015 are as follows:
For the period from now to June 30, 2015, copays will remain as they are currently.
For the period from July 1, 2015 through December 31, 2105 copays for $10 and $15 copay plans will be, see graphic.
The maximum out of pocket will be $1,351 per person which is the 2012 rate will apply for 2015.
Please notify your retired members of these pending changes.
Kevin C. Lyons Sr.