Unanswered Questions re: Insurance
Do these plans have a layoff benefit?
If I go on LTD, will you continue to pay for and cover my insurance premium for 2 years?
Will you continue my benefits in the event of a school closure?
Will you provide me with a personal advocate like Grace Romzick, or will it just be an agent from your company?
Does your office have a medical doctor-director and a staff of RN’s to check special cases?
Will 19-25 year old kids be covered at no extra cost?
Will it cover kids who are college students and beyond age 25 at no extra cost?
How do these plans cover chiropractic visits?
Can I still get my prescriptions filled through mail order at only $8.00 per year?
Will we still have the 50 visit allowance covered by the plans for Psychologists?
Do the prescription plans have a PD-MAC Rider? How much could a name brand prescription cost me if it has this?
Do these plans cover home health care?
Do you cover foreign exchange students?
Who can authorize changes to the plan? Does the employer have any unilateral change authority? Can you prove this to me in writing?
Will the plan language specifically state that “no changes can be made to this plan without the agreement of the parties through the collective bargaining process?”
Since the district is already unilaterally doing this to us now, isn’t it reasonable that they intend to do it again in the future?
Isn’t it true that in order to contain costs, even with your plans, you have to cut benefits that individuals actually use or you have no actual savings?
Can you actually guarantee the district savings over time compared to MESSA without modifying these plans at all or making me pay more each month for the premiums? (if yes: “Are you willing to guarantee us a plan that will always be comparable MESSA for the next 10 years and also always cost less, no matter how sick our employees might get from year to year?”)
How did you happen to put together 2 plans, after the fact, that cost exactly the amount of money the district had in their insurance proposal prior to bringing these plans to the table? Are these really honest prices?
Do you have copies or examples of how medical claims data for us can be formatted and reviewed by the district in order to decide which benefits they might want to cut to save money at a later time?
Could my name be on any of these documents? The amount of health care costs I incurred? Could the names of medications we are taking be accessed by the district? Could the names of Physicians or the clinics we seek treatment from be on any of these documents?
This is a pretty small town, if there is a $500,000 bill for an premature birth from one of our probationary teachers, won’t it be pretty easy to put 2 and 2 together?
Why does the district insist they be the policyholder? What power do they obtain be declaring themselves such?
Which employee for the district is going to be responsible for receiving, viewing, etc. Protected Health Information? Is the district going to make sure that, whoever this person is, they have a logging mechanism to track this person’s viewing of individual PHI?
How often will those logs be audited?
How are complaints handled if we have complaints about our own PHI being accessed or used by those within and from outside the system?
Does your reporting system have web access? (if yes: Are your firewalls to protect from outsiders accessing my PHI fail-safe?)
Isn’t it true that one of the main reasons the board and administration like your plans compared to MESSA is the ability to access claims information and then remove the benefit levels that are costing too much?
How many different teachers groups does your agency currently cover?
Can you provide a 10 year rate increase and plan coverage history from any of your clients that have been with you that long?
If no, for how long of a time could you provide this data?
