Thousands of CU employees may have to choose between cost and convenience when a major health insurance provider is no longer an option under university benefits starting July 1.
Employees who currently use the PacifiCare Extended Network for benefit-provided health insurance will have to switch plans this summer. Provider UA Net will discontinue its long-time partnership with PacifiCare’s Extended Network.
“Part of this change will have a significant impact on cost,” said Mark Stanker, assistant vice president of payroll and benefit services for CU. “Many employees are asking, ‘If I’m going to be impacted from a convenience standpoint, what is the trade-off in terms of cost?'”
Employees who currently use physicians and other healthcare providers under the PacifiCare Extended Network may no longer be able to access their doctor if they enroll in the revised UA Net plans.
“Employees are mostly concerned about the convenience factor with having physicians in the PacifiCare plan in Boulder,” said Gena Trujillo, director of benefits administration.
But Stanker said that many of the providers who practice under that network would still be accessible.
“The majority of providers are still going to be available to employees, but not under the PacifiCare plan,” Stanker said. “We have many of those same providers that are part of the Great-West healthcare plan and some of those providers that are in the Kaiser plan.”
In Boulder, about 2,200 faculty and exempt employees insure only themselves with their benefits plan; 800 employees insure both themselves and a spouse, and 750 insure an entire family.
“The distance for pediatricians has been a concern, having to drive a distance to see a pediatrician,” Trujillo said.
Stanker said one of the main decisions employees make when picking a healthcare option under a benefits package is whether to choose a health maintenance organization or preferred provider organization plan.
HMO plans require that a monthly premium be deducted from an employee’s paycheck. Each doctor’s office visit typically requires an additional co-pay.
A PPO typically has a set deductible that must be paid out-of-pocket before receiving treatment. After paying the deductible, a PPO user will usually receive “co-insurance,” which provides the user pay for only a percentage of their procedure.
Stanker said that a PPO could theoretically save employees money, part of trading the convenience of an HMO for the lower cost of PPO plans other than PacifiCare.
PacifiCare has said it will no longer offer its Extended Network through its commercial HMO plan because it would not be cost effective.
