Staff health care costs on the rise

In July, UNM’s Division of Human Resources issued a sudden change to the staff health care plan, requiring members to pay hefty out-of-pocket charges.

UNM employee Tom Rolland said the changes will move UNM’s health care to a “consumerism model,” which is really just a cost-shifting measure.

“To do this they have added in co-insurance, this is on top of co-pays,” he said. “It’s a new way to get more money out of the people who actually get sick or injured.”

He said HR increased the out-of-pocket maximums from $1,250 to $1,750 for individuals and from $3,250 to $4,750 for families.
UNM staff member Ann Rickard said staff was not informed of the change.

“The maddening thing about this change was that it was instituted without warning,” she said.

Staff must now pay the deductible fee plus 15 percent of the co-insurance toward the remaining balance, according to a statement issued by the Division of Human Resources.

Coinsurance is the percentage the insured party must pay after the insurance policy’s deductible is exceeded up to the policy’s limit.

For example, if an MRI procedure costs $2,000, the deductible is $200 plus an additional 15 percent of the remaining $1800, which is $270, totaling $470 under the consumerism model.

Coverage under the new model includes services such as outpatient procedures, inpatient hospitalization, nuclear medicine, MRI, CT and PET scans.
“What does this mean in reality?” Rolland said. “If a family member is seriously sick and gets a medical bill for, say, $40,000, then instead of paying $250 like it was a year ago, now you will be getting a bill for $4,750 that you will have to pay (to) UNMH, a friend of mine had his child get an appendectomy and the hospital stay was only one day. The total bill was almost $40,000.”

In comparison to the Bernalillo County Employee Sponsored Group Benefits booklet, state and city workers now have one comprehensive health care plan through Presbyterian. This fiscal year, Bernalillo County employees are seeing a 5.6 percent decrease in the premium costs.

UNM Human Resouces Employee Benefits Specialist Sheri Wharton declined to comment or give reasons for the recent changes made to UNM staff employee health care benefits.