By SUSAN JONES

Members of the University Senate Benefits and Welfare committee had a lot to say at their February meeting about Pitt’s current health insurance offerings and how they might be updated.

Tom Songer, committee chair and a faculty member in the School of Public Health, said with health insurance premiums and out-of-pocket costs rising nationally, the committee needs to identify the key issues of concern for faculty and staff and relay that information to Pitt’s administration and the faculty and staff unions, since they’re also involved in setting health insurance benefits.

The committee members did not hold back on their opinions.

Co-pays and deductibles keep climbing

Julia Meade, Senate vice president and associate professor of pediatrics, said she’s noticed in her personal experience that the Panther Gold insurance option seems to be paying for less.

She said that in 2022 her husband had in-patient thyroid surgery and they paid $500 out of pocket, while recently she had a diagnostic mammogram performed as an outpatient and got a $579 bill. 

“When you consider the level of care provided between the two, there’s some real examples of how we are being expected to pay more for some of those services,” Meade said.

Those enrolled in Panther Gold pay a higher monthly premium, but have a lower deductible and annual out of pocket cost. The lower deductible also has increased from $300 to $600 for a family. Meade said with the costs rising, there needs to be a better pre-tax way to save money to cover these costs.

The problem is that there continues to be confusion about health savings accounts vs. flexible spending accounts. Both plans’ contribution limits are set by the IRS.

Savings accounts

HSA: Only those enrolled in Panther Basic — a health plan with higher deductibles of $2,000 for an individual and $4,000 for a family — can have a health savings account. The idea is that you can set aside money, pre-tax, to pay for medical costs not covered by insurance. The limit is $4,300 for an individual or $8,550 for a family. If used for qualified medical expenses, no taxes are paid on this money. The funds — which belong to the individual, not the employer — also can rollover from year to year.

FSA: Flexible spending accounts for health are available to those in Pitt’s other two plans — Panther Gold and Panther PPO. An FSA has a lower contribution limit — $3,300 — and only up to $660 can roll over to the next year. Amounts above that are forfeited at the end of the plan year. The money is accumulated pre-tax, but you can’t take it with you if you leave. 

HRA: Another option, which Pitt does not offer, are health reimbursement arrangements (HRAs) — an employer-funded plan that reimburses employees for qualified medical expenses. In most cases, the plans will reimburse your in-network doctor directly and is usually tax-free. UPMC offers this to many of its employees. The employer determines what can be reimbursed and if the money rolls over from year to year. If you leave, the money usually stays with the employer.

There are separate flexible spending accounts available for dependent care, mass transportation and parking, which are available to all employees. They each have different maximum contributions, but all are subject to the “use it or lose it” rule.

Dental disappointments

Members of the committee also expressed dissatisfaction with Pitt’s dental plans.

“I’ve had some significant dental work this past year, and found that the available plans that we have were pretty useless. I don’t know if anybody else has found the same thing,” said Judy Callan, an associate professor of nursing.

She said that although the United Concordia plans pay for basic cleanings and check-ups, but procedures like root canals and crowns end up costing the consumer thousands.

The Flex I plan pays 50% on endontics (root canals) and the Flex II plan covers 80%. Both plans cover new crowns or repairs at 50%, but only Flex II covers orthodontics (max of $1,500 lifetime per dependent).

“Is there a reason why we only have one company, or is it an option to try to get other companies that maybe are more competitive?” Callan asked. “Because I put out thousands of dollars this year on teeth, and it just seemed if you’re going to have a plan, it should at least be useful.”

Others had similar complaints about Pitt’s vision benefits. Onoe person suggested it was cheaper to take your prescription to Costco to get glasses.

More information needed

Michael Pinsky, professor of critical care medicine and a former Senate president (2009-11), suggested asking human resources to summarize how the costs and Pitt’s insurance coverage for medical, dental and eye insurance have changed over the past few years. He noted that in the past HR was very responsive to these requests.

If what Pitt has selected for insurance turns out to be “bad, then I would like to see an equivalent … of what other plans are out there, because we’re not the ones to make the decision. The University of Pittsburgh makes the decision on who they’re going to have as a carrier, … and we presume, and I think it’s true, that they have our best interests at heart.”

This type of information would be very useful, he said, particularly as open enrollment approaches later in the spring.

Prior to faculty voting to unionize in 2021, the longtime head of benefits in HR, John Kozar, would regularly give updates on benefits offerings and more to the Senate Benefits and Welfare committee. Because benefits are part of mandatory bargaining for those covered by the faculty contract, and are currently in status quo for the staff and graduate workers in the bargaining units represented by the United Steelworkers, communications between HR and the Senate have become more difficult.

Committee Chair Songer suggested that Pinsky was more likely to get a response from HR about costs comparisons, because he’s not a member of a bargaining unit. Medical school faculty are not part of the Union of Pitt Faculty’s USW local. Songer said they would summarize the discussion for Pinsky to take to HR, and that committee member Marcia Rapchak, a teaching associate professor in the School of Computing and Information, also could share the committee’s concerns with the faculty union.

Songer said he’s also curious where Pitt would rank as an employer benefit program in terms of health insurance, as compared to other universities. Pinsky noted that former Chancellor Mark Nordenberg would give an annual state of the university report to the Senate, which included where Pitt ranked on health care, salaries and more. He suggested that current Chancellor Joan Gabel might be open to doing the same thing.

Susan Jones is editor of the University Times. Reach her at suejones@pitt.edu or 724-244-4042.

 

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