STAFF WRITER
Two of five health maintenance organizations offering health carepolicies to public employees have reduced their premiums for familycoverage for next fiscal year, but the Public Employees InsuranceAgency still has the lowest rate.
Even so, PEIA Director Robert Ayers says he does not expect alarge number of employees in HMOs to switch back to PEIA'sfinancially strapped indemnity or fee-for-service plan.PEIA's family premium, starting July 1, is $48 a month foremployees making between $18,001 and $30,000. Ayers said nearly 70percent of the employees are in that salary range.Carelink, an HMO with financial problems of its own, offered thelowest family rate of the five HMOs at $53.06 a month, compared withits current $64 premium for that salary bracket.'The rates are lower. But the benefits are different,' said BobDeitz, Carelink's acting president and chief executive officer.Carelink, like CAMC, is owned by Camcare, which has put $36million into the HMO the last four years, according to CAMCPresidentPhil Goodwin.Carelink is up for sale.Next fiscal year, the HMOs were given the option of offering oneof their commercial policies, with different benefits than PEIA has.Only the Health Plan of the Upper Ohio Valley chose to stay withPEIA's benefit package.The commercial policy Carelink offered public employees was lowerin premiums in most areas, Deitz said.When it comes to benefits, Deitz said, 'it's pretty much selectiveshopping.'Insurance Commissioner Hanley Clark, along with Ayes and Deitz,says public employees should compare the benefits and prices.Clark's agency approved the premium rates.Clark said public employees need to shop around to determine thepolicy that is best for them.The other HMOs' monthly premium for family coverage in the $18,001to $30,000 salary range were: PrimeONE, $90.26, down from $124.04;Optimum Choice, $144.28, up from $100; Ohio Valley, $89.48, up from$65.68; and Advantage/Qualmed, $134.34, up from $90.76. The currentpremiums apply to the $18,001 to $22,000 bracket.For single coverage in the same salary ranges, Carelink droppedfrom $20 to $12.96 a month compared with increases in the otherHMOs'premiums that were: PrimeONE, $14.96 from $13.66; Optimum Choice,$15.06 from $5; Ohio Valley, $27.40 from $17; and Advantage/Qualmed,$22.32 from $5.PEIA's monthly premium for single coverage is $10, effective July1.PEIA has 98,000 policyholders and covers 204,000 employees andtheir dependents. Ayers said PEIA has 36,000 family policies, but hedoesn't know how many families the HMOs cover.Ayers said PEIA's family premiums are not where they should be anda solution has to be found.Carelink has 16,500 of PEIA's enrollees, Deitz said.Carelink is given an 18 percent 'straight discount' on the billsit pays to CAMC, according to Deitz, who said that is less thandiscounts given by Thomas Memorial Hospital in South Charleston andCamden-Clark Memorial Hospital in Parkersburg.Goodwin said CAMC gives some discounts, mostly to those that arewilling to talk about managing the risk through wellness andprevention programs.Most HMOs want to negotiate a discount, but not many want to talkabout managing the risk with CAMC, he added.Goodwin said CAMC made some initial loans to Carelink when itstarted up and has some notes.To contact staff writer Fanny Seiler, call 348-5198.
