Why has the union not considered negotiating a higher contribution for single, two-party, and three-party payers in order to remain with CalPERS?

Why has the union not considered negotiating a higher contribution for single, two-party, and three-party payers in order to remain with CalPERS? Also, adjunct faculty are able to receive medical after 1 year of consistent employment. How come part time classified employees are not given their $500 contribution to purchase medical if CalPERS will not insure them?

ANSWER

CSEA 262 has considered all options for Medical benefits including an increased benefit with CalPERS. However, because we use Interest Based Bargaining the District had no interest in increasing the benefit amount for Health and Welfare while staying with CalPERS. The CalPERS rates are not constant or affordable. Some of the CalPERS plans had a double-digit increase percentage for 2020.

Adjunct faculty are covered under a different section of the Education Code, and therefore afforded different options. Also they are require to purchase their coverage from ASCIP and not CalPERS.

The $500 that was negotiated was a Health Savings Account (HSA) plan in conjunction with a high deductible Bronze plan. Therefore our members had to prove they were covered by a high deductible bronze plan. The HSA funds could not be used for premiums, but to cover out of pocket cost associated with medical care like co-pays etc. We are negotiating for a better option.

 

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My daughter got accepted to University of Oregon and I don't believe they offer Kaiser. Would she still be covered, and if so, how?

I plan to enroll back in Kaiser when open enrollment comes around. However, my daughter got accepted to University of Oregon and I don't believe they offer Kaiser. Would she still be covered, and if so, how?

ANSWER

Yes, please see the response from SISC:

Attached is the Kaiser Permanente Visiting Member Services Brochure; this brochure should answer most if not all questions the member may have related to coverage for their Oregon bound college student. The subscriber will simply need to call the travel number in the brochure and request a “Guest Membership” for her college student.

Here’s is a link to the Oregon Area Search page for Kaiser locations: https://healthy.kaiserpermanente.org/oregon-washington/doctors-locations#/search-form

 

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Is there detailed documentation for Kaiser, specifically about emergency services, that we can look at?

Is there detailed documentation for Kaiser, specifically about emergency services, that we can look at? The info on Kaiser's website doesn't answer my questions.

ANSWER

Yes, per SISC please see the current Evidence of Coverage (EOC) [link below] for your review.


Evidence of Coverage for SISC - SELF-INSURED SCHOOLS OF CALIFORNIA

 

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What would happen if the college goes to a 12 month deduction instead of a 10 month deduction?

As an 11 month, 35 hour a week permanent classified employee what would happen if the college goes to a 12 month deduction instead of a 10 month deduction? In the month that I don't receive a paycheck would I owe the college the amount of my cost or would that be spread out over the 11 months I do receive a paycheck?

ANSWER

If there is a benefit deduction it would be spread out evenly per the number of months you work. This would be a change in current practice where the paycheck for the last month worked receives a double deduction.

 

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When will we see a detail cost comparison between CalPERS Kaiser and SISC Kaiser?

When will we see a detail cost comparison between CalPERS Kaiser and SISC Kaiser? A line by line detailed comparison, not like the one shown on the Research and Resources page.

ANSWER

Cost comparisons will be provided when the SISC rates are posted. The rates should be posted sometime during the week of 5/20.

 

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What are the details of the Kaiser with SISC vs CalPERS or when will that be made available?

What are the details of the Kaiser with SISC vs CalPERS or when will that be made available?

ANSWER

The Kaiser plan coverage is the same with both CalPERS and SISC. Plan rates (the premium cost of the plan) will be available for review after the informational meeting when the rates are posted.

 

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In the future, will we have the option of having more health providers available to us?

It was said at the last meeting with the SISC representative that new incoming districts to SISC only have the option of having two health providers (Kaiser/Anthem or Kaiser/Blue Shield). If we are to continue with SISC in the future, will we have the option of having more health providers available to us (similar to where we currently have 6 different health providers available)?

ANSWER

If there is a move to SISC, provider options would be Kaiser or Blue Shield of California. There will be 6 plan options available to choose from. The majority of our membership participate in Kaiser and Blue Shield of California. Members who are currently with Anthem, Health Net, United Healthcare and PERS PPO plans will need to choose either a Kaiser of Blue Shield of California plan.

 

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Does any of the health benefit options cover surrogacy and/or IVF?

Does any of the health benefit options cover surrogacy and/or IVF?

ANSWER

Per SISC: There is no coverage under the Blue Shield plans for IVF and surrogacy; Kaiser plans cover basic artificial insemination which does not include IVF; surrogacy is covered by Kaiser, but there are limitations based on surrogacy guidelines.

 

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Do single employees MUST now choose Kaiser in order to avoid paying out of pocket cost?

"Q&A states: 'If the Chapter chooses to move to SISC, the District contribution would be increased to cover the cost of a Kaiser Family plan. This new funding structure will ensure Single payers have no out of pocket cost due to an increase in rates.'

Does this mean that single employees (that previously had fringe benefits (pocketed the difference)) MUST now choose Kaiser in order to avoid paying out of pocket cost?"

ANSWER

No. If the membership moves to SISC, Single payers can choose between Kaiser and one other provider (Blue Cross or Blue Shield) with no out of paycheck cost. Single payers who have the fringe benefit will most likely be grandfathered into the new contract with SISC.

 

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Will there also be an opportunity to vote for "CalPers" for those employees who do not wish to move to SISC?

When CSEA puts the Health Benefit to a vote for either Kaiser/Anthem or Kaiser/Blue Shield, will there also be an opportunity to vote for "CalPers" for those employees who do not wish to move to SISC?


ANSWER

The advisory vote between SISC Kaiser/Anthem and Kaiser/Blue Shield is a standalone vote. Once the results are tallied, there will be a ratification vote held for the membership to choose to either stay with CalPERS or make the move to SISC. After the informational meetings on May 16, 2019 all members should be equipped with all the tools, information and cost estimates they will need in order to make an informed decision about which third-party health plan administrator the membership will use going forward.

 

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I want to keep my current doctor. Will I have the option of a PPO?

I want to keep my current doctor. Will I have the option of a PPO? I currently have United Health Insurance and I like it. I do not have any dependents on my policy.

ANSWER

Yes, SISC does offer PPO plans which is part of the mutually agreed to criteria. Please utilize the “Find your Doctor” tools to confirm your doctor is currently covered under Anthem Blue Cross and Blue Shield of California. The results from the search could influence how you vote on the current survey that closes on Monday May 13th. The links to find your doctor have been incorporated into the survey.

 

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What is the likelihood of the district bundling all 3 coverages?

It seems we have been focusing on health but I recall dental and vision was mentioned previously. What is the likelihood of the district bundling all 3 coverages?

ANSWER

It is subject to negotiations. Per the survey results from our membership, there was interest in a comprehensive benefits package that included medical, dental, and vision.

 

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Will Dental and Vision be included in that full coverage negotiation for single-parties and families?

If we move to SISC, and full medical coverage is negotiated and agreed upon, will Dental and Vision be included in that full coverage negotiation for single-parties and families?

ANSWER

A comprehensive benefits package that includes medical, dental, and vision is an interest of CSEA 262 and is subject to negotiations. That being said, the mutually agreed to criteria includes keeping our members whole. If there is a move to SISC, the District contribution would have to be enough to cover dental and vision for Single party members to meet the mutually agreed to criteria.

 

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Why are we not able to negotiate what's included in the SISC plans?

At this point I've asked for a specific coverage to be included in the SISC options but the response has been that they don't offer such coverage in any of their plans. Why are we not able to negotiate what's included in the SISC plans?

ANSWER

Generally speaking, if coverage is offered through a third party provider like SISC or CalPERS it can be incorporated into a plan. You can’t force a provider to include coverage that isn’t offered.

 

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Can't the district insure itself independently to tailor plans for employee needs?

Why does Mt. SAC need to have a benefits administrator at all (SISC, CalPERS, etc.) if it limits our plan options - can't the district insure itself independently to tailor plans for employee needs?

ANSWER

A self-insured structure was an option proposed during the RFP process but it did not meet the mutually agreed to criteria. The District could pursue a self-insured structure but it would have to be negotiated, be sustainable, and the infrastructure would have to be put in place, none of which the District has any interest in doing.

 

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I want to know if it is possible to enroll into Kaiser but have a separate option for mental health coverage?

I want to know if it is possible to enroll into Kaiser but have a separate option for mental health coverage? I really want to enroll into Kaiser but their mental health department is of no good use since it is very impacted and it takes months to see a mental health professional. With SISC could we have an option to have alternative mental health coverage while being enrolled with Kaiser?

ANSWER

Per CECHCRs: No, there is not a separate mental health coverage option through SISC. Each carrier has its own mental health benefit as part of its medical benefit plan.

 

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I have heard that . . . we won't be receiving COLA for the next few years, is that true?

I have heard that if we choose another health insurance provider, and the premiums are 100% paid by the college, that we won't be receiving COLA for the next few years, is that true?

ANSWER

No, this is incorrect. Salaries are a separate article from Health & Welfare and are negotiated separately. If COLA were to be used to fund Health & Welfare, the Chapter would have to vote to approve it as a funding source. The Negotiations Team has not received the authority from the Chapter to use COLA as a funding source.

 

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If single payers will eventually pay out of pocket, will family rates also increase?

If, as predicted, single payers will eventually pay out of pocket due to rising costs (I assume that's the reason. If it isn't the reason, then why would single payers eventually pay out of pocket?) then will family rates also increase? Will they increase at the same rate? Or will single payers only increase to catch up with the out-of-pocket expense that families have?

ANSWER

Under the current CalPERS structure, 2-Party and Family payers currently pay out of pocket. These cost are expected to increase as well. Currently 2 plans offered to Single payers exceed the District contribution when including the vision and dental plan. If the Chapter chooses to move to SISC, the District contribution would be increased to cover the cost of a Kaiser Family plan. This new funding structure will ensure Single payers have no out of pocket cost due to an increase in rates.

 

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