JOSA LAMONT | INTERIM NEWS EDITOR
Faculty has been experiencing lapses or shortcomings in its original health care plans over the last two years.
In 2012 , the benefit committee hired a new third party health care provider to officiate contracts from the existing 1985 health plan.
Be cause of errors in translation from the original language to the new provider’s, faculty are experiencing unintended benefit losses.
“I think we had some hiccups with the starting of the plan … and I think (administrators are) responsive to it,” said Bill Bogle Jr, a member of the benefit committee and RCCD controller.
The benefit committee is made up of district faculty and members from the California Teachers Association. It has been working with the third party representative from Keenan & Associates to bring the health plan up to standards set by the 1985 plan, and new standards from the Affordable Care Act.
The health plan has changed third party health care providers four times since 1985, the last being to Keenan & Associates, grandfathering contract plans each change.
Following the appointment of Keenan & Associates, claims that would have been covered under the 1985 plan were not being covered with the new care provider.
Additionally, there were unsigned contracts from 2009 and 2011 that were not addressed with the CTA when they were written up.
According to Deborah Yorba, a Keenan representative, the changes made to the grandfathered plan were due to language changes in the health care industry over the years since the original composition. As language changed in the health care industry, the older plan became outdated and some benefits were unintentionally lost.
The losses are being addressed directly between Yorba and the committee to maintain coverage.
The benefits its committee reviewed roughly 75-80 percent of the list of issues that arose, according to Bogle.
After the committee approves the language and benefits of the coverage, and all ACA requirements are met, the new contracts will be written and placed before Cynthia Azari, Interim Chancellor. The contracts will later will be reviewed by the board and put to vote for approval.
Claims filed in 2013 under the altered plan’s contracts will be readdressed under the grandfathered coverage standard so the plan integrity is maintained for people who may have made claims before ACA standards increased coverage Jan. 1.
The ACA requirement has added benefits such as birth control with no co pay, improvements in women’s health coverage and child immunizations.
Additionally, the $1 million lifetime cap was removed, preexisting conditions no longer mean coverage can be limited and dependents can be covered until age 26.
The vision plan has also been added to the health care plan for faculty and is going to begin coverage sometime in February or March.
While it has some administrative costs, it will be billed to employees.
The vision plan experienced hurtles earlier this year but having been voted on and approved by the benefits committee, it will now proceed to be instated.
“(The health plan) didn’t lose any benefits, it’s gained a few benefits,” said Bogle.
The benefits committee also instated a more formal catastrophic insurance plan in June that allows employees to donate their sick time and vacation time to a pool.
Employees who contribute time can draw sick or vacation time from the pool in the event of an emergency or illness.
