Insurance program for school employees is about to start working

I’ll have to switch doctors. It’s not fair. It’s too expensive.

And, the be-all, end-all complaint: The whole thing just won’t work.

As a member of the School Employees Benefits Board, you’d be hard-pressed to throw out a concern about the SEBB Program that I haven’t already heard. The nine-member board, of which I’m a member, has been passing resolutions to help get this show on the road since October 2017.

For years now, establishing a program to provide health insurance and other benefits for more than 150,000 school employees (not to mention their dependents) has simply been out of reach.

How do you come up with a program that works for an athletic director in Anacortes, a custodian in Colfax, a kindergarten teacher in Kittitas and a superintendent in Spokane?

By listening carefully, and that is what the SEBB and the Health Care Authority have done. That’s how I can tell this experiment is going to work. The amount of care and attention to detail that’s gone into this program is enough to impress even the staunchest critic.

Take the doctors, for instance. I’ve heard some concerns from employees that they won’t be able to see their regular doctor when SEBB benefits start. The truth is, over 90% of providers are in SEBB’s Uniform Medical Plan (administered by Regence) or Premera networks and won’t have any issues when SEBB coverage starts Jan. 1.

As for whether it’s fair, the introduction of SEBB benefits means thousands of part-time school employees will have access to health benefits – with the full employer contribution, like their full-time co-workers – for the first time. They just need to be prepared to work 630 hours a year. (That works out to 17.5 hours a week for the school year.) Those newly covered employees will pay the same premiums for medical insurance as everyone else, with no monthly cost for dental and vision coverage.

More employees with insurance, and more employees able to cover their families, make for healthier communities.

The cost, though, is the big question. Individual plans start at just $13 a month and top out at $116 a month. That’s a wide price range, but that’s to be expected with the variety of plans available – 17 total, and at least three in every county. Ninety-nine percent of school employees will have at least five plan options.

It might not mean much to a single subscriber, but just ask anyone with a family to cover how much the three-to-one tier ratio means. The Legislature wanted to ensure no one paid an unfair amount, so the monthly premium for a full family is only three times the premium for a single subscriber on the same plan – without exception. One of the biggest factors in implementing SEBB was making benefits more affordable for full families, and now, all around the state, that’s true.

One educator let us know she currently pays $172 to cover herself and her three children, while her significant other – and her children’s father – purchases insurance on the individual exchange.

If the couple were married, he’d lose his tax credit, and adding him as a dependent on the school’s current policy would cost the family an additional $974 a month.

Under SEBB, the five of them can get coverage from a low-deductible Kaiser Permanente plan for $147 a month. That’s over $820 a month in savings if the couple gets married, which works out to almost $10,000 a year back in paychecks and injected into the local economy.

One school vice-principal told us she’s currently paying $1,750 every month to cover her husband and children. During open enrollment, she’ll have the option to select a plan that saves her family about $1,500 a month. That money will be instrumental in helping send her two teenage children to college.

A school custodian explained that her husband is battling cancer and out of work. She’s not only keeping her insurance carrier when SEBB coverage starts on Jan. 1, but saving more than $800 a month in the process.

It’s a new endeavor for everyone involved, but the SEBB Program is long overdue. And now, with open enrollment going on until Nov. 15, it’s about to start working.