Update on Orthodox Health Plan rates and renewals
In a letter addressed to participants in the Orthodox Health Plan, Archpriest Eric G. Tosi, Secretary of the Orthodox Church in America, provided an update on the plan and announced renewal rates.
The text of Father Eric’s letter reads as follows.
“As a member of the Joint Orthodox Health Insurance Committee, the OCA recently attended a meeting with the other participating Orthodox jurisdictions on the Orthodox Health Plan [OHP]. Over the past seven years, the OHP has been able to keep the annual renewal rates well below the national average. This was due to the proactive use of preventative care, taking advantage of in-network discounts, and the judicious use of the reserve fund. As such, the OHP has been well-managed and funded.
“However, due to loss ratio and other factors, this year’s rate increase was to be 29.2% assuming no changes in coverage. The Committee consulted with the advisors and providers to review plan alternatives that would bring the rate increase under 10%. To do this, the Committee considered a number of funding and coverage changes. The Committee then approved the following benefit changes, effective May 1.
“1. Increase of Individual Deductable to $1,000 per calendar year from $400.
“2. Increase of Family Deductible to $2,000 per calendar year from $800.
“3. Increase Office Visit Co-pays to $35 (primary care) and $45 (specialist).
“In addition, to comply with the Health Care Reform Act, coverage has been expanded to dependents up to 26, regardless of status; eliminated some annual maximums for essential services, and improved the preventive/wellness benefit by eliminating any deductibles or co-pays (now 100% coverage for in-network preventative care).
“Therefore, the new monthly premium for a single member will be $899 and for a family will be $1895. This includes medical, vision, dental and prescription drug benefits.
“For a historical perspective, attached is a graph showing the OHP rate increases since 2005 compared with the original Aetna formula increase and the national average.
“Although the Committee is not pleased with the 8% increase, we are thankful that we were able to keep our annual renewal rate well below the benchmarks. This is the first major increase in a number of years. We thank you for the opportunity to serve you and we assure you that we continue to work diligently to keep costs down and to provide the best possible health coverage for our participants.
“If you have any questions, please do not hesitate to call GDC Financial at 1-800-785-4432 or myself at the Chancery Office at 516-922-0550 ext 129.”
A PDF of the letter and a graph can be found here.