No premium increases or changes in healthcare coverage for state workers in 2016

09/23/2015 07:36 PM

FRANKFORT – Due to lower than planned medical and pharmacy expenses, improved member consumerism, and continued wellness participation, the Kentucky Employees Health Plan is offering members no premium increases and the same health plan options and coverage levels as their current plans.

Department of Employee Insurance Commissioner Joe Cowles told members of the Interim Joint Committee on State Government on Wednesday that one of the biggest reasons for the same rates and coverage being offered is that the incurred claims per subscriber per month have gone down due mainly to wellness programs which are gaining enrollees.

In 2013, the average monthly medical claim was $641 per subscriber and $192 for pharmacy. That number dropped in 2014 to $595 medical and $179 pharmacy. To date in 2015, the average has dropped to $550 medical and $178 in pharmacy expenses.

The cabinet has seen the number of participants enrolled in wellness programs go from 16,768 in 2012 to 123,619 as of July 15, 2015.

Cowles told committee members that employees in his own office have taken advantage of some of the initiatives being offered.

“Just a staff member of mine the other day came into my office and said, Joe, some of the initiatives you’ve undertaken here got me engaged and I’ve lost 40 pounds in the last 6 months,” Cowles said. “She’s diabetic, and she said I can’t tell you how much this has changed my life.”

Some of the initiatives include the KHEP Promise Completion which has a 97.51% success rate involving 132,815 persons. Other initiatives include the 15 Day Dash Challenge in which over 11,731 members run a certain distance every day.

Beginning January 1, 2016, members can enroll in the Living Well Promise where enrollees receive a biometric screening that consists of lab work to test cholesterol and blood glucose; a blood pressure check; height, weight and waist circumference to learn Body Mass Index (BMI).

Diabetes is a major cost driver to the program, and with that in mind, Cowles instituted a diabetes prevention program in 2014.

“We became on the first states in the country to offer a diabetes prevention plan which is a 16-week lifestyle program, which was made a paid benefit in 2014,” Cowles said. “We’ve probably had 500 to 600 people engage in that program.”

The cabinet has also embraced technology to cut down medical costs for its members as well as the program.

LiveHealth Online allows members to access doctors online anytime by using their smart phone, computer, or mobile device with internet access.

Members simply register, and have access to in-network, board-certified doctors. It also allows doctors to ePrescribe utilizing local pharmacies where applicable.

“I feel very confident that this is going to save us money,” Cowles said. “The service is 50 dollars. That is around forty percent less expensive than a primary care visit.”

Rep. Mike Harmon, R-Danville, has firsthand knowledge of LiveHealth Online as he recently took advantage of the service when he had a bad case of poison ivy.

“I waited about 5 minutes, got in, I used my iPhone to show them, got a prescription called in and was able to pick it up that same day,” Harmon said.

Open enrollment for state employees runs from October 12 to 26.


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