“Cost savings through our work at the legislature and decreased utilization during the pandemic allowed us to not shift any additional costs to PEBB members while expanding benefits and advancing equity in the 2022 plan year. We need to continue to fight for the quality, affordable health care our families deserve.” — Shaun Parkman, SEIU 503 member and PEBB Board Vice-Chair
The PEBB Board approved rates for 2022. We were able to use cost-savings from reduced health care usage due to the pandemic and efficiencies we created within PEBB to not have to shift any additional health care costs to PEBB members and expand benefits in the 2022 plan year. Specifically, co-pays and deductibles for all plans will remain the same. Premium shares will go up for some plans a small amount based on the overall rate increases coming in at a 3.3% increase for all the plans combined. Please take this short survey to let PEBB know what matters to you as we look to the future.
Containing Costs
Our country’s health care system is broken. We pay far more for poorer health outcomes than any other wealthy nation. Costs soar while the federal government continues to do nothing. SEIU 503 members prioritize access to quality, affordable health care when we bargain and have been able to consistently win some of the best coverage in Oregon. Even with our combined power, PEBB is still subject to market conditions as well as a state-imposed 3.4% annual cost increase limit on premiums. Operating within these confines, we push on how the system delivers health care to save money and buck the trend, pushing really hard on finding savings on the back end that won’t impact PEBB members through increased co-pays and deductibles.
The cost savings we saw from decreased utilization during the pandemic as well as our ongoing efforts around coordinating care to control costs means we are not seeing skyrocketing premiums for 2022. Further, our legislative work to control hospital and pharmacy prices and the work we are doing on the board to hold our insurance providers to strategies that lower costs means PEBB did not have to shift any additional health care costs to PEBB members and is able to expand certain benefits in the 2022 plan year.
Demand for elective procedures will increase and people will need to catch up on routine care as we return to more in-person appointments, which will lead to an increase in utilization and cost over the next year. As costs continue to rise, we need to continue to move away from a fee for service (quantity) model and shift to holistic, preventative (quality) plans that coordinate care and lower systems costs.
Here’s SEIU 503 President Mike Powers testifying at the Oregon Legislature in support of HB 2081, which adds enforcement mechanisms for the 3.4% cost growth cap that is essential to cost containment. We must continue to fight, fight at the legislature and fight at the bargaining table.
Expanding Benefits
Assisted Reproductive Technologies – People requiring Assisted Reproductive Technologies to expand their family have often had to pay tens of thousands of dollars and not all PEBB members were even eligible for such services. That all changes in the next plan year. The PEBB board approved a $35,000 annual maximum for ARTs that includes coverage for artificial insemination (including IUI) with no member cost share related to the ARTs so members will have normal cost share for basic treatment of infertility, including diagnostic testing to determine underlying cause. Fertility benefits coverage was also extended to out-of-network providers.
Vision – Vision therapy is now available for people requiring therapies that help with eye training.
Chiropractic Care and Acupuncture – The $1,000 maximum for spinal manipulation (chiropractic care) and acupuncture and visit limits for both were put in place for Kaiser plans to maintain the $10 copay.
Moving Forward
Please take a few minutes to respond to this survey to let PEBB know what matters to you as we look to the future. If you have any questions, please reach out to pebbreps@seiu503.org.