Conference 7.286::digital

    Didn't see the benefits DVN - I'm in a remote office (Mobile, AL) -
    and since DEC does not have an agreement with any HMO's here, I'm not
    given any of the 'choices' that the powers that be are crowing about.
    
    The only plans available for my family are Medical Plan 1 & 2, and as
    anyone with children should be able to confirm, in the absence of an
    HMO plan, plan 2 is the only way to go (we've had one of our kids in the
    hospital frequently, and 20% of what they charge is too much!).  So,
    being given no more choices than before, we've stayed with plan 2.

	RE: .0


	Would someone please summarize the DVN broadcast!?!

	I couldn't make it over to a DVN site to see it, and I'm sure there
	are thousands of other people out there that couldn't either!


	thanks.


	kathy

    re: .2
    
    See note 1128.170
    
    re: .0
    
    The medical benefit changes are being discussed in topic 1128.

    The biggest info I got out of the DVN was the cost of the HealthNet.
    
    See note 1128 for more.
    
    Living in Colorado Springs (one of the 4 HealthNet areas) the choices
    are ...
    		HMO family plan 	$11.62
    		Healthnet F.P.		$16.62
    		J.H. #1			$21.75
    		J.H. #2			$34.00
    
    I presently pay $7.50 @ week. My son is out of state and therefor
    HMO family plan is out. Healthnet would allow me to get medical
    attention for my son at 70% instead of 80% coverage. Deductable
    would be $750 with max out of pocket of $7,500. 
    
    If I lived 60 miles away my insurance would be going up $1.00 to $8.50.
    
    I can not afford anymore Digital Benefits like this one. I will be
    forced to continue with JH #1 and take a 300% increase verses living
    60 miles away and getting approx 10% increase.
    
    The HealthNet cost was by far the biggest news in the DVN.
    
    	Greg
    
    

    re .4: HMO family plan         $11.62
           Healthnet F.P.          $16.62
    
    The HMO associated with these charges was not identified so yours
    in Colorado Springs could be MORE or LESS than the numbers given.
    You will not know the cost till you receive your package in the mail.

	Yeah, I don't know why they don't just call it a pay cut...which is
what it amounts to. We all know that health care costs are going up. I really
have my doubts about their little chart which shows the slow increase in cost
of HMOs vs. indemnity plans...but that's besides the point. I'm wondering
what percentage of the increased cost is going to be paid by Digital vs. the
employees. Since my out-of-pocket cost is going up by 300% too, is this also
true for the company for my health benefits? Seems hard to believe that costs
could have risen that quickly. I think we're all having to pay for health care
management incompetence and collusion between the health insurance industry
and medical profession. I also think the employees are being asked to take on
the brunt of the expenses.

    My reaction of the broadcast was mixed.  First, I couldn't believe the
    amount of anger and frustration which were being displayed from both
    the callers and the audience (although I can absolutely understand the
    frustration).  My weekly cost for family coverage is only going up by
    $3.00 a week since the so called "on the cutting edge" Healthnet plan
    has not hit my area yet.  I will be paying $20.50 a week instead of
    $17.50 a week which represents a 17% increase.  This means that my
    yearly outlay for healthcare will be at least $1666.00 if all of my
    family needs to go to the doctor.  Times are getting tough.
    
    Peace,
    
    Mike

    According to a report (supposedly for Personnel and Management) I
    received last week, Digital is paying the same dollar amount whichever
    option the employee chooses.  This is according to a little chart shown
    approximately (not quite to scale) as follows:
    
    
    	 Total Cost
    	+----------+
    	|          |
    	|          |
    	| Employee |	 Total Cost
    	|  Share   |	+----------+
    	|          |	| Employee |
    	|          |	|  Share   |
    	+----------+	+----------+
    	|          |	|          |
    	| Company  |	| Company  |
    	|  Share   |	|  Share   |
    	|          |	|          |
    	|          |	|          |
    	|          |	|          |
    	|          |	|          |
    	|          |	|          |
    	|          |	|          |
    	|          |	|          |
    	+----------+	+----------+
            DMPs       HealthNet/HMOs
    
    It implies (if to scale) that the Company share is about 3 times the
    employee share with DMPs and about 9 times with HealthNet and HMOs.
    
    -  David

    RE; -1  I wonder what the cost difference is between the DMP and the
    HMO plans.  I would hypothesize that the HMO's are quite a bit cheaper,
    thus saving the company money.  I also wonder if the savings the
    company is experiencing is worth it in relation to employee
    satisfaction.  In the broadcast it said that only 28% of employees are
    using the HMO plans which idicates to me that employees enjoy having
    the freedom of choosing their own physicians.  
    
    Peace,
    
    Mike

For the current year, Harvard Medical HMO was about $17 more per week
than John Hancock/DEC Plan 1.

I suspect that those fortunate enough to have healthy families opted
for the lowest cost plan.  With prices as indicated in previous replies,
I suspect that the HMO's will have the higher percentage next year.

Would you conclude next year that employees perfer HMO's?

    I guess we'll have to wait until next year to see what happens.  I
    suspect that this will have some effect on the numbers, but I believe
    that alot of people will stick with John Hancock for the reason I have
    stated, me included.
    
    
    Peace,
    
    MIke

>        <<< Note 1263.11 by MAMTS5::MWANNEMACHER "let us pray to Him" >>>

>    that alot of people will stick with John Hancock for the reason I have
>    stated, me included.

I think the bigger reason is that, in the absence of any real reason 
TO change, people will stick with whatever plan they have had.
It can be passivity, contentment, risk aversion, conscious preference
or any number of other status quo-seeking factors.
Why bother with the hassle of changing doctors (whether you really like the
one(s) you are using or not) if you don't use medical services often?

Imbalance in the costs will  BE the reason to change for many people, which
is what the Company is trying to do.

- tom]

Re .13: Interesting. I read the statement as implying that the cost (to the
employee, of course) of the "cheaper" health plans is going to rise as soon
as enough people switch. Sort of like cable TV. 

After all, if Digital's cost is the same regardless of plan, one of the
following will have to happen with each now-cheaper option:

- It's as profitable as the rest because it has healthier members ("HMO" =
  "Healthy Members Only"??). ("Healthier" here is defined as "costing the
  plan less" (:-).)  But if more "high-cost" people switch, what happens?

- It's not as profitable as the rest, which causes its management to raise
  charges (and/or cut benefits, which is in effect a rise in cost from the
  employee's perspective). 

    I think that right now, Hancock costs the company more.  That is the
    reason that the cost of Hancock is going from 17.50 for family to 34.00 
    for family when the Healthnet plan exists.  The Healthnet plan gives
    you the option to choose your own physician, however it makes it very
    cost ineffective to do so.
    
    Mike

    After reading some of the notes it's clear some of you are unclear on
    some of the points of both the new benefits and the Digital Medical
    Plan.  We, the employee, do not purchase medical insurance from Hancock
    we purchase it from DEC--every bill is paid out of DEC's profits and
    only the paperwork is handled by Hancock.  And, under the Health Net
    you can only go outside of the HMO when the HMO doctor makes a
    referral, not when you decide to.
    
    I can understand why DEC is attempting to steer employees toward an HMO
    but I wonder if they fully realize the consequence to those employees
    if they are sick.  
    
    Too many times HMO doctors have either misdiagnosed health problems or
    denied that they exist.  Our family health problems existed right 
    enough but we had to go outside of the HMO at our own expense for them 
    to be diagnosed and treated.
    
    With this in mind, even the inflated cost of the Digital Medical Plan
    is cheap in comparison with the REAL cost of an HMO.
    
                    

    re: .16
    
>                                               And, under the Health Net
>    you can only go outside of the HMO when the HMO doctor makes a
>    referral, not when you decide to.
    
    The statement quoted above is incorrect.  Imdemnity coverage under
    HealthNet is NOT contingent upon approval/referral by the HMO.
    Subscribers to traditional (i.e., "lock-in") HMO plans DO require
    approval by the HMO before utilizing outside medical resources,
    except in emergency circumstances (as defined by the HMO), in order
    for the cost to be covered by the HMO.
    

    I stand corrected--thank you note 17.
    
    My (miss)information came from the Benefits Bulletin "Digital Health
    Care Choices", page 3, and I quote (fairly accurately).
    
    "The Digital Health Net program is like an HMO, your care is
    coordinated by your primary care physician within the HMO. (I read that
    to mean you had to get approval from your HMO doctor before going
    outside of the HMO.  I should have read the next more carefully.) 
    But, if you decide to go outside of the HMO you may choose any
    provider....  
    
    My only excuse for not reading more carefully, I was so worried and 
    angry over the enormous increase in cost I was seeing double when I read 
    it.
    
    

RE:                     <<< Note 1263.18 by WJOUSM::GASKELL >>>
                         -< One out of two ain't bad! >-

>    "The Digital Health Net program is like an HMO, your care is
>    coordinated by your primary care physician within the HMO. (I read that
>    to mean you had to get approval from your HMO doctor before going
>    outside of the HMO.  I should have read the next more carefully.) 
>    But, if you decide to go outside of the HMO you may choose any
>    provider....  
    
     AND  for that fexibility of going outside of the HMO - and be 
     reimbursed at 70% of reasonable & customary - you pay an extra 
     $5 a week (family plan) over the regular HMO fee.
    

Interesting note, it will cost me about 50 cents more to have Healthnet
this year than it did to have just Matthew Thornton last year (for the
family plan).  Or, conversly, I will be baying $4.50 less to leave it as/is.

Does anyone know if the Healthnet option provides better options for care
when traveling, especially when you are out of the country ??