Conference 7.286::digital

    If you want a good approximation as to what your current health care
    plan actually costs DEC, call John Hancock (yes, even for the HMOs) 
    and ask them for the COBRA cost; the amount you would pay to continue
    your coverage under COBRA (for example while on leave or after a TFSO), 
    which can be no more than 105% (or is it 102%) of the actual cost of 
    the coverage (ie you pay DEC 100% plus an administrative fee).
    
    re: opt-out amount a couple replies back; Since you can only opt-out
    of individual coverage, comparing the amount against the typical cost
    of family coverage (I believe you quoted $5K) is invalid.
    
    re: portion DEC pays; It was stated a couple years ago; as I recall 
    the numbers, DEC pays 75% of the cost of family coverage and 85% of 
    the cost of individual coverage, based upon the least cost plan in
    your market area (with an exception: if there is no HMO Elect option 
    in your area, DEC picks up a larger portion of the DMP plan cost). I 
    believe there was a note in here that discussed the change, including 
    both the before and after percentages (quite a furor at the time)...
    
    Dave

    re .17, .20, .25: As the order of magnitude of per capita health care
    costs in US is somewhere in the neighborhood of $5k, I believe .20
    might be closer.
    

    .21 Socialism? I think not...

    My wife is comp/benefits consultant in a firm that does HR
    outplacements.  After looking into what we pay for the HMOs in the
    central Ma. area, she has concluded that Digital has one of the 
    lowest % of contribution of any firm she knows.  Our out of pocket
    payments are much higher for the same HMO regardless of the family
    or individual circumstances.  She thinks the company is really poor 
    in this area.
    
    Mark
    

Re: .28

>     My wife is comp/benefits consultant in a firm that does HR
>     outplacements.  After looking into what we pay for the HMOs in the
>     central Ma. area, she has concluded that Digital has one of the 
>     lowest % of contribution of any firm she knows.  Our out of pocket
>     payments are much higher for the same HMO regardless of the family
>     or individual circumstances.  She thinks the company is really poor 
>     in this area.

I would be interested in the data.  I live in the Acton/Maynard area
and have Harvard Community as our HMO. Our co-pay ($3) per visit is the
lowest offered by Harvard Community. I have two friends who do
NOT work for Digital but have Harvard. They pay $5 and $10 as
co-pay.

Which HMO is your wife referring to?

Gim

    
        RE: .29
        
    >    lowest offered by Harvard Community. I have two friends who do
    >    NOT work for Digital but have Harvard. They pay $5 and $10 as
    >    co-pay.
        
        Co-payment is one way to control abuse of unnecessary HMO visit.
        You can't compare HMO cost based on co-pay. 
    

RE:.20

I took the opt-out number off my pay stub so don't say this isn't true.  The
opt-out program reimburses you for a benefit you don't need.  I assumed it is
the weekly contribution DIGITAL puts up for an individual.  I was paying
~$29/week for a family plan when my wife got a new job and had the same coverage
for ~$17/week.  Obviously her company is kicking in a lot more.

BTW, this is health only, not including dental, insurances, etc.

John

    
 >   I took the opt-out number off my pay stub so don't say this isn't true. 
 >   The opt-out program reimburses you for a benefit you don't need.  I assumed
 >   it is the weekly contribution DIGITAL puts up for an individual. 
    
    You are right.  It looks like DEC reimburses us on individual cost.
    But I have family, I save DIGITAL a lot more than the individual rate
    by opt-out.   I think DIGITAL should reimburses me a lot more than
    that.

Re: .32

Hmm - that reminds me of an old joke:


	Son:  Father!  I ran home behind the bus and saved the nickel fare!
	Father: (Smack!) Spendthift!  You could have run home behind a
	      taxicab and saved a dollar!


					Steve

My wife works part time (20 hours per week) and has access
to the same HMO that we picked through Digital.  After we
found out that it was significantly cheaper for her to sign
up we switched the coverage to come through her employer.
The cost is less, the deductables are smaller, and we get
the opt out refund from Digital.  It says a lot when a part
timer can get better coverage at a lower cost.

BC

>> I took the opt-out number off my pay stub so don't say this isn't true. 
>> The opt-out program reimburses you for a benefit you don't need.  I assumed
>> it is the weekly contribution DIGITAL puts up for an individual. 
> You are right.  It looks like DEC reimburses us on individual cost.
> But I have family, I save DIGITAL a lot more than the individual rate
> by opt-out.   I think DIGITAL should reimburses me a lot more than that.

	You should be thankful you're getting anything.  As it is I feel
	it's unfair that Digital is apparently paying more in dollars for
	those choosing family coverage, than those of us with individual
	coverage.  By choosing individual coverage Digital should be
	giving us the difference between what Digital's cost is for us,
	vs. those of you with family coverage.  Or at least increase the
	% of the cost Digital pays for individuals even more than it is already
	(let's say 85% to 100% :-).

    Re: Note 5099.6
    > Employees shouldn't have to continually re-evaluate health care.
    
    All of us should get into the habit of taking nothing for granted. We
    should, indeed, carefully evaluate every representation that
    affects us. This includes employee benefits statements and even bank 
    statements. There is no reason to presume good will.  Check the
    figures; find out what statements like "no change" mean. 
    
    The brutal truth, and it is not a new one, is that businesses 
    exist to make profits for their owners.
    
    

>                     <<< Note 5099.36 by TNPUBS::PHALEN >>>
>                         -< Take nothing for granted >-

>    Re: Note 5099.6
>    > Employees shouldn't have to continually re-evaluate health care.
    
>    All of us should get into the habit of taking nothing for granted. We
>    should, indeed, carefully evaluate every representation that
>    affects us. 
    
    
    There's a difference between what Digital has asked us to to and 
    our cousins in other companies in our industry have had to do.
    
    Changing benefits yearly with no replacement for "Current" benefits
    levels means we all have to "Worry" about what the right choice is
    this year. It's been that way for the last 4 years for me...
    
    In other companies the responsiblity for negotiating and providing
    good choices for health care benefits rests with the HR organization.
    
    If the plan stinks they should reject it out of hand...
    
    But I suppose that Digital feels I should have the freedom to choose
    an HMO that accepts chickens and hay in payment for the crystals they
    dispense...
    
    Why do I feel like we could have affordable better "Private" insurance if 
    we were to negotiate and act like a single large Group?  
    Why do I feel like Digital has gone way overboard in this HMO social and 
    economic experiment that provides non-standard levels of service between 
    HMO's and causes levels of service to change every year?
    
    John W.
    
    
    
    
    


    

    FYI,
    I caught a bit on CNBC last night about HMO cost. Seems some industry
    guru thinks HMO cost are going to take a 10% hike in 1998 at a national
    level.

    I'm intrigued by the Medical Savings Account (MSA) idea, which has
    apparently just been passed by Congress. From the little I currently
    understand about it, it promises to be less expensive (for both
    employer and employee), rewards the healthy, maintains the
    (capitalistic) idea of consumer choice, and is portable. I wonder if
    any of the Benefits Express folks are looking into MSAs?
    
    	BD�

re: .37
    
>    Why do I feel like we could have affordable better "Private" insurance if 
>    we were to negotiate and act like a single large Group?  

I suspect it's not all that simple.  For one thing, we have people all over
the map.  If Digital signed up with just one provider nationally, many
employees would be without service in the areas where that provider doesn't
provide.  Even on a local level, if they signed up with one provider best
suited to the area of the plant (Nashua, in my case), I might not be well
served, because I live 40 miles away in Exeter, and not every HMO available
in the Nashua area is necessarily available in the Exeter area, at least to
the same extent.

It's possible, too, that somebody things the current multiplicity of choices
fosters competition among providers and saves money.  I don't know if that
is true or not.

And it's also possible that one HMO's strong points serve some employees
better, while another's strong points server other employees better.  Again,
I don't know whether or not that range of choices costs us all more money.

So I think the reason we don't "negotiate and act like a single large group"
is because the health providers don't, either.

I think we need to recognize the whole health care business is a huge
tangle nationally.  We can't solve it unilaterally.

-Mark

    We (meaning Digital) are not eligible for MSAs.  To avoid a
    presidential veto and Democratic Senatorial filibuster, MSAs had to be
    limited to small companies, and only on an experimental basis.  Big
    labor is against MSAs reportedly because it would cause a run on the
    union run health benefits.
    
    Back in 74' when I was at Intel (back when Noyce ran the company not
    Andy) they had a cafeteria style plan where we signed up for health
    benefits on an as-needed basis.  They would also accept bills for
    outside services much like the DCRA works today.  At the end of the
    year you could take the money left over as cash (and be taxed on it) or
    let it ride.  It fit very well with the young and mobile work force of
    that time.  So the idea isn't really that new.
    
    /jim

Re: .38
>     I caught a bit on CNBC last night about HMO cost. Seems some industry
>     guru thinks HMO cost are going to take a 10% hike in 1998 at a national
>     level.

	That's what I was talking about in the last P of .1, fwiw

>    <<< Note 5099.37 by SCASS1::WISNIEWSKI "ADEPT of the Virtual Space." >>>
>                              -< Just my opinion >-
>    Why do I feel like Digital has gone way overboard in this HMO social and 
>    economic experiment that provides non-standard levels of service between 
>    HMO's and causes levels of service to change every year?

Because a large part of the variability is out of Digital's hands?
Because HMOs themselves are merging and forming and experimenting
with variations in coverage on their own?
Because government mandates on coverage change what must be charged?
Because what's possible medically is potentially so expensive that we 
can't, as a society, afford everything but we still want it?

Not to say that Digital doesn't have its own agenda, as each of us does,
but times are changing fast in this arena, and we're all along for the ride.

- tom]

>    <<< Note 5099.40 by R2ME2::DEVRIES "downsized: your footage may vary" >>>
>             -< it's not one big world; it's multiple miniworlds >-

>re: .37
    
>>    Why do I feel like we could have affordable better "Private" insurance if 
<>    we were to negotiate and act like a single large Group?  

>I suspect it's not all that simple.  For one thing, we have people all over
>the map.  If Digital signed up with just one provider nationally, many
>employees would be without service in the areas where that provider doesn't
>provide.  Even on a local level, if they signed up with one provider best
>suited to the area of the plant (Nashua, in my case), I might not be well
>served, because I live 40 miles away in Exeter, and not every HMO available
>in the Nashua area is necessarily available in the Exeter area, at least to
>the same extent.

    Excuse me... Bluecross, Aetna, John Hancock to name a few of the 
    national providers who could provide a polity anywhere in the country
    and because it's private insurance, allow Digital employees to use
    whatever doctors and hospitals they wished for treatments.
    
    From an employee pool of 50,000 the rates should be reasonable and
    less than the $450 per month (if I could get a 100 people in a local
    group) that I can get private insurance in Texas for.
    
    Before all the HMO issues we had private insurance (although Digital
    footed the bill via corporate-self-insurance, instead of negotiating 
    with a national provider. (Why did we go from private insurance to 
    HMO-Only Choices directly?  No one at DEC-HR can give me a real good 
    answer for that one...)
    
    HMO's are a very recent addition to the health care war and I'm still
    not convinced that they represent a better level of health care for 
    me and my family.
    
    
    
>It's possible, too, that somebody things the current multiplicity of choices
>fosters competition among providers and saves money.  I don't know if that
>is true or not.

    
    It should not be DIGITAL'S business to foster HMO competition, they 
    should be concerned about providing the best health care at the lowest
    costs.  
    
    After 4 years, I see very little difference between managed care HMOs
    and Private Health Insurance.. At least as far as the costs to my 
    family...
    
>And it's also possible that one HMO's strong points serve some employees
>better, while another's strong points server other employees better.  Again,
    

    They are all in the business of saving money and keeping you 
    "Content" so that you sign up again next year.  There is no 
    long term incentives to keep you healthy, they won't even prescribe 
    certain drugs after a period in the year because it may look bad
    on this year's summary report...
    
>I don't know whether or not that range of choices costs us all more money.
    
    When we diffuse our premium's we negotiate less effectively in the 
    marketplace.  That's the insurance biz...
    
>So I think the reason we don't "negotiate and act like a single large group"
>is because the health providers don't, either.

    But private insurance companies do... and they even offer managed
    care options as well..
    
>I think we need to recognize the whole health care business is a huge
>tangle nationally.  We can't solve it unilaterally.

    I don't care about national health care business, I care about providing 
    health care for my family by holding a white-collar job, with good 
    benefits, something that goes to the bottom line of my compensation
    package that I've negotiated with Digital to compensate me with.  
    
    From that standpoint (and again it's just my opinion) that if Digital 
    negotiated nationally with a private insurance provider as a Group
    for all it's employees, I believe the costs would be as good or 
    better then any/all of the HMO programs we now deal with with 
    much less administriva.
    
    The benefits would be better, the choices would be my choices for 
    health care, and I wouldn't feel like I'm going to a russian clinic
    everytime I take the kids to get a shot for the cold/flu...
    
    --
    
    As soon as we can solve the problem of managed care for those people
    who go to the emergency room because they're sad or lonely, or who 
    demand drugs, or cosmetic surgery of their doctors, then we might
    drive a national health care solution.  Until then I'd like to 
    managage my family's healthcare and not have some new-doctor every
    four weeks at the clinic asking me the same questions again and
    again...
    
    Am I bitter?  I am a little.. I was sold on this HMO thing to get
    my family off the John Hancock/DEC program and while it's not been 
    terrible, it hasn't been even close to the same. The costs fluxuate 
    yearly, the care is just ok.. and I know that I'm really picking the 
    whole tab up for this and Digital is providing very little to lighten
    my burden of health care either by negotiating strongly or even being
    an advocate for me to some of the HMO choices. 
    
    Now my HMO has taken out the 70/30 option I was paying extra for...
    Just not offered anymore to you "Digital" people.  So I'm now paying
    what I was last year with no Opt-Out Safty net if I don't like the 
    HMO's judgement.  What will it be next year?  Limit on the Number of 
    vists, increase cost of drugs, have to make appointments three weeks
    in advance?

    Since WE have to revist the HMO choices every year.. Digital should 
    have to as well...
    
    JMHO
    
    John W.
    

    I am in an HMO/Elect program. The Primary Care Provider in the HMO is
    one of 3 med centers in the entire county. The Primary is no longer
    accepting new patients. The second is not acceptable to my family
    [known history with the provider] and the third is 40 min. beyond where
    we live. {I drive thru Worcester MA to get to work, but can't use the
    same HMOs doctors because they are out of plan].
    
    I went out of plan for some treatment and the Dr put me on a med. Now I
    have 2 outside opinions that say I need a sleep apnea study. Back to
    the Primary Care Doc. He says, "You went out of plan, I will not be
    your doc unless you give up everyone else. Then I will start the
    testing program allowed by the HMO."
    
    This looks more like "HMO/OPT-OUT but you get to pay them anyway" then
    do the $300 deductible and the 70% co-pay, than the concept of
    HMO/Elect.
    
    Howard