The Purchasing & Insurance Committee of the Williamson County Commission met Tuesday night, May 24. The results of this meeting were mostly positive. This in my opinion was a direct result of the willingness of so many of you to contact members of the committee with your emails and calls to express concerns over possible changes to our insurance. I know that your personal stories helped to prevent the loss of benefits and were instrumental in maintaining access to our physicians and hospitals of choice.
Here is a rundown of the results of the meeting:
The committee voted to make no changes to the hospital or physician network. This means that the St. Thomas hospital network and its physicians will remain!
The committee voted not to increase the spousal surcharge.
The committee voted to make no change to the grandfathering rule for employees hired prior to 2007 whose spouses have coverage with Williamson County.
The committee voted to enact the proposed changes regarding specialty medications. This means that for medications that cost $600 or more you will only be able to get a 30 day supply at a time. At the end of 30 days you can then obtain a refill if prescribed by your doctor.
The committee also voted to enact a change for prescribed medications that are also available over the counter. Medications that are also available Over-the-counter will not be covered. Examples would be Allegra, Prilosec.
The committee voted to enact the changes for step-therapy. I did my best to understand this change but there are some aspects that I didn't quite grasp with the information provided. Basically it works like this: if your doctor prescribes a medication he/she must first prescribe a preferred brand, or generic, or over-the-counter medication. If this initial drug therapy proves ineffective then the doctor may prescribe other medications. There are provisions for the doctor to override the step-therapy for certain medical conditions. I am sure that more information about this change will be included in our open enrollment packets this fall.
The committee voted to hold off on a decision about eliminating Walgreens and CVS from pharmacy coverage. Dr. Looney was at the meeting and advocated for employees having a voice in this possible change. He will be sending employees a survey about keeping Walgreens and CVS coverage. If the county cuts coverage for Walgreens and CVS it could see a savings of around $150,000. This equals about $30 per employee. Dr. Looney will be asking school system employees if they would prefer to pay a one time charge at the beginning of each school year of $30 in order to keep Walgreens and CVS coverage.
Again, I want to thank those of you who contacted members of the committee and various commissioners to express your concerns with the possible changes to the insurance program. As I stated before, I have no doubt that your contacts were instrumental in the committee deciding to leave the hospital/physician network and spousal areas of our coverage as is.
WCEA will continue to remain engaged and keep you informed of any future proposals.
Williamson County Education Association
URGENT - POSSIBLE INSURANCE CHANGES!!!
We have received more information on the potential changes to the insurance benefits package.
The following Hospitals would be out of network under the proposed changes:
St. Thomas West, St.Thomas Midtown-Baptist, and Murfreesboro Medical.
The proposed changes are outlined below:
Change the network from OAP to Local Plus.
a) St. Thomas (West, Midtown – Baptist, and Murfreesboro Medical) would be out of network
b) Ascension Physician Network will be out of network
c) Baptist Health Group would be out of network
d) Murfreesboro Medical Group would be out of network
Four changes to Pharmacy benefits were proposed:
a. Exclude 2 drug classes that have moved to “over the counter” status & removes certain high costs drugs
b. Step therapy – promotes use of clinically proven (trying less expensive drugs vs. the higher cost of other medicines
c. Limited National Networks – three different options
i. No Walgreens
ii. No CVS
iii. No Walgreens or CVS
d. Specialty Pharmacy Utilization Management – limit those drugs that cost $600.00 or more a month for more than 30 days. As an example a cancer drug that costs $1000.00 a dose would be limited to a 30 day supply.
Changing the working spouse rule. The suggested changes are below:
a. Increase the monthly surcharge for covering spouses that have insurance available at their job. It is currently $100 per month.
b. Remove the employees who were grandfathered that covered their spouses prior to 1/1/07
c. Make all spouses ineligible that have access to insurance at work
d. Allow employees to opt out of insurance and give them $100.00 month incentive for each month of non-enrollment.
The Purchasing and Insurance committee will meet TUESDAY, MAY 24 to vote on the recommendations of the Purchasing and Insurance Committee. I urge all employees to contact the members of the Purchasing and Insurance Committee to express your concerns with these possible changes to our benefit package.
Do you have physicians and specialists in the St. Thomas Network, Ascension Physicians Network, or Murfreesboro Medical Group you don't want to lose?
Do you live outside of the county where access to the remaining network hospital facilities will be limited in your area?
Do you have a spouse under our current plan who is employed elsewhere and therefore could lose coverage under our plan or be forced to pay $1200+ dollars more each year for coverage here.
Do you worry about losing access to pharmacies like Walgreens and CVS that are open late?
Time is short for us to communicate our concerns. Please do not delay. Below is contact information for members of the Purchasing Insurance Committee.
Let your voice be heard!
Purchasing & Insurance Committee Members
Mayor Rogers Anderson firstname.lastname@example.org
Paul Webb email@example.com
Brian Beathard BrianB@williamson-tn.org
Sherri Clark firstname.lastname@example.org
Matt Williams email@example.com
A link for contact information for Members of the full Williamson County Commission