Some state workers upset by new HMO rates

Some state workers were upset to discover they'll have to pay $75 a month beginning Jan. 1 to keep health coverage through an HMO plan.

However, the head of the Employee Health Benefits Program said the change is necessary because state workers on the self-funded health plan have been helping to subsidize those signed up with the HMO.

Michele Fair, who works for Parole and Probation, said she was upset to discover the change because it could cost her and her husband a lot more when she has her baby in January.

"With the HMO it would have cost me $20," she said. "Now, its going to be $200 just for the hospital admit.

"And self-funded is not an option for me because, what if the baby has health problems?"

She wasn't alone. At least three other workers called to question the changes but didn't want their names used.

Jan Marie Reid, who runs the benefits program, said the change was made by the employee benefits committee "to level the playing field."

She said in the past, Hometown Health Plan has charged the state the full per-employee amount to provide just medical coverage for workers enrolled with the HMO.

"But the state plan also includes life, travel, long-term care, dental, vision and other coverage," she said. "So the plan was subsidizing those coverages for those in the HMO."

Reed said when the benefits program told HHP it had to cut back the per-employee amount to balance that out, the company decided not to sign up with the state again.

She said the majority of those in the plan, about 19,000, are in the self-funded plan and the remaining 5,000 in HMO's. About 3,000 of those are in northern and rural Nevada.

"The decision was that the plan won't continue to subsidize those people," said Reed. "But we did offer them the choice."

She said northern state workers can still get coverage through the St. Mary's Hospital HMO in Reno but that it will cost them $75 a month.

That raised another complaint from those who point out Southern Nevada state workers can still get HMO coverage without the extra $75 a month out of their check.

"Vegas is a totally different market and it does not compare to the cost of health care in the north," said Reed.

She said there are several competing HMO's in the Las Vegas area willing to sign up workers for what the state plan can pay, but that no one wants the contract in Reno because medical care costs are so much higher in the north. She said the St. Mary's deal was the only plan available.

Reed said there have been some changes to the self-funded program designed to make it more attractive to those workers now under the HMO including a lower annual deductible and co-pays for some more common services.

She said the program will be modified again next year to try make it a better deal for state workers.

"In truth, we need to try make northern Nevada more competitive," she said.