FAQ
Learn more about health care premium "holiday"
February 2006 -
The sound fiscal health of OCSEA members’ health care plan allows for a premium “holiday” – a month where no premium is due – in both 2006 and 2007.
Check out the frequently asked questions and the answers below to learn more about this union-negotiated benefit enhancement.
- Who is getting the health care premium holiday?
- How many state employees are in those plans?
- What about the 5% who are enrolled in Paramount, The Health Plan and Qualchoice?
- Explain why only plans that are self-funded will give the premium holidays.
- Is there any way a Qualchoice, The Health Plan or Paramount enrollee can get a premium holiday?
Q. Who is getting the health care premium holiday?
A. Employees enrolled in Ohio Med, UHC and Aetna will get a one month health care premium holiday in the fall of 2006 and the fall of 2007. [ top ]
Q. How many state employees are in those plans?
A. 95% of employees are in these three plans. [ top ]
Q. What about the 5% who are enrolled in Paramount, The Health Plan and Qualchoice?
A. Those employees will not get the holiday premium, because these plans are fully-ensured products and as such are not part of the Health Benefit Fund. Only plans that are self-insured, which makes them a part of the Health Benefit Fund will give these premium holidays. [ top ]
Q. Explain why only plans that are self-funded will give the premium holidays.
A. Ohio Med, UHC and Aetna are self-funded plans. That means that the state takes all the monthly premium payments it makes and state employees makes for these plans and puts them into the Health Benefits Fund. From this fund the state pays the health care claims that state employees and their dependents in these plans have. For a number of reasons the fund balance is too high so the excess is being used to grant the premium holidays. The money in the fund only applies to Ohio Med, UHC and Aetna. Since employees in Paramount, The Health Plan and Qualchoice are not a part of the Health Benefit Fund, they cannot get the premium holiday. [ top ]
Q. Is there any way a Qualchoice, The Health Plan or Paramount enrollee can get a premium holiday?
A. The only way would be for the employee to switch to Ohio Med, Aetna or UHC during the next open enrollment this spring. Since the first premium holiday will not be paid until the fall of 2006, employees can switch plans during the next open enrollment and enroll in one of the three plans that will provide the premium holiday. [ top ]
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