Popular UniCare OME Plan to Increase 1.3%
March 3, 2022: The state’s Group Insurance Commission held their monthly meeting to vote on the plan design structure proposed at the January meeting, as well as vote on the plan rates for FY23. As we were anticipating from the January meeting the Commission voted to make no changes in the plan design, meaning members will see no increases to the copays and deductibles of the plans. The GIC did recommend changes in the mental health benefit that would improve access to services and bring parity of coverage to the fully insured plans.
After the plan design vote the Commission shifted its focus on the plan rates for FY23. The overall average premium increase for the upcoming plan year is 5.4%, this includes all non-Medicare and Medicare plans offered by the GIC. Delving further into the breakdown, the average increase of the six Medicare plans is 1.8%. The increase for the most popular Medicare plan, the UniCare OME, will be 1.2% or an increase of $4.72 monthly from FY22. This reflects the cost of the total premium for the plan, not the portion paid by retirees.
On the non-Medicare side, the overall average increase across the plans is 6.2%. The broad network plans range from 3.8% to 7.6%. Members in the most popular plan in that category, the Tufts Navigator will see a 6.6% for the individual plan and 6.8% for the family. UniCare, the only national plan, has an increase of 3.0% for FY23. These plans will also have no increase in the out-of-pocket costs as well.
Individual rates will depend on a members premium split. State retirees have three premium splits, depending upon the date of retirement: 90/10, 85/15 and 80/20. Active state employees contribute at 80/20 or 75/25, depending on the date of hire.
Rates for municipal retirees and active employees are set by the cities and towns. Teachers, participating in the Retired Municipal Teacher (RMT) program contribute at a set rate of 90/10 or 85/15.
Today’s meeting was the culmination of months long discussions and listening sessions regarding the plans and costs for FY23 and the news remains positive. Members in the UniCare OME plan will see a modest increase in premium along with no changes to the out-of-pocket costs for the upcoming year and while this is welcome news, we also recognize that any premium increase has added financial impact during this inflationary period. That’s particularly true for our members who have been retired for some time on relatively small pensions.
While the news that there will be no additional cost shifting to members for the next fiscal year, we remain concerned about the impact to those members who are not Medicare eligible and enrolled in an active plan. We continue to work with the GIC and the legislature to seek solutions for these members.
The GIC also announced the rates for the Retiree Dental plan. For FY23 there will be a slight increase to rates over FY22. This is a result of an agreement that was part of the contract executed with MetLife. The individual rate will be $28.79 and for the family $69.36. Members in the dental plan pay 100% of the premium.
A full breakdown of the monthly premium spilts will be contained within the May 2022 Edition of our newsletter, The Voice.