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Health and Wellness is Top Priority

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What are the priorities of the Group Insurance Board? Member health and wellness, and making the state’s group health insurance program more efficient top the list. These issues will be at the forefront as the GIB addresses health care changes for 2017 and other longer-term initiatives at its meeting on February 17, 2016.

Among the changes to be considered by the GIB is whether to transition from the current fully-insured model for health care to self-insurance beginning in 2018. The board is not focusing on any benefit changes for members at this meeting.

Last year, the GIB directed its health care benefits consultant, Segal Consulting, to research and make recommendations in two reports on strategies for total health management, self-insurance, data management and cost containment.

What is self-insurance? Under a self-insured model, the employer (rather than an insurance company) assumes all risk and pays claims. The employer also contracts with a third-party administrator for managing provider networks, collecting premiums and processing claims. For participants, the self-insured plan typically offers the same benefits and levels of service as a fully-insured plan. Currently the state self-insures pharmacy and dental benefits, which are administered by Navitus and Delta Dental, respectively.

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