By early August, school employees will be able to see exactly how much they’ll pay per month for health care plans offered through a statewide system being rolled out in January.
Which health care carriers are part of the system, which plans are available in employees’ respective counties and the exact cost for each tier — individual employee, employee and spouse, employee and children, or full family — still need to be solidified, according to David Iseminger, director of the employees and retirees benefits division at the state Health Care Authority.
“People are really anxious to find out that information, so it will be available before the mailings,” he said, referring to September’s distribution of enrollment information to all school employees.
At that point, the numbers will be definitive and rates for employees will not change for the 2020 coverage year, he said, unless an employee changes their plan by adding a new child to their coverage, for example.
The School Employee Benefits program will make full health care coverage available to all school employees from bus drivers to superintendents, as long as they work at least 630 hours a year. The system caps the cost of family plans at three times the amount an individual employee would pay, and employees contribute 15 percent of the cost of a standard health insurance plan.
Tom Fleming, chief financial officer for Educational Service District 105, a Yakima-based regional school support agency, said the program has one clear benefit.
“It will make full family insurance affordable, so that’s a good thing,” Fleming said. “As an example, a family could have $900 to anywhere to $1,600 out of pocket every month (for health insurance currently), and now it will be closer to $300. So it’s a significant savings for a full family.”
The employer is set to pay 85 percent of the cost of an average plan — a sliding rate that would decrease, for example, if an employee wanted a more comprehensive plan.
Through the end of June, individuals pay $994 per month for coverage, After that it increases to $1,056 for the 2019-20 school year. The HCA will base its invoices on this rate, and the state will provide this amount to districts to cover all state-funded employees.
Once enrollment ends in November, the HCA will provide a report to the governor with recommendations for additional funding in the 2020 supplemental budget based on clearer data.
The state budgeted an additional $329 million for the insurance program.
“It is possible or even likely that the program will begin in a deficit position and then that will be part of the consideration in the supplemental budget process for the Legislature,” Iseminger said.
If there’s a deficit, state supplemental funding will cover it, not school districts.
What districts are required to cover is the difference between the state formula accounting for multiple part-time employees filling one full-time position — for example, multiple bus drivers who work more than 630 hours a year and combine on paper as one full-time employee for funding purposes.
The state formula may not match the costs for part-time employees in every district.
Districts will also be required to pay the monthly individual employee rate for employees who are not state-funded.
For Rep. Chris Corry, R-Yakima, the approach does not fully fund the insurance program and it comes at a time when districts are already scrambling financially, due in part in a state cap on local school levies.
Corry said many local schools employ more staff than the state prototypical model recommends.
The state prototypical model determines how many teachers a district should employ based on enrollment. Often, districts say they hire outside the prototype — employing federally funded teachers, for instance — in order provide high-quality programs and meet graduation rate requirements.
That means districts would have to pay out of pocket for teachers who aren’t state-funded, Corry said.
The West Valley School District, for example, employs 305 teachers, while the prototypical model calls for 254, according to Randy Souers, the district’s human resource director.
Health care coverage for roughly 258 positions will likely be paid for by the state, using Legislature’s equation to account for part-time staff, Souers said. That would require the district to fund about 50 teacher health care plans.
“The real concern for me on that is (for) school districts who have to balance the budget, where do they cut? Are they going to cut two teachers to maintain parity? Because that impacts jobs,” Corry said.
“It’s a perfect storm. It’s mixed with the changes in levy funding mixed with the changes to statewide salary structure,” he said. “It’s a lot for these schools to be able to take in.”