Conference 7.286::digital

    
    
    	That is interesting...I joined healthsource last June and shortly
    	thereafter my premiums went from $18/wk to $26/wk..THAT's a
    	un-healthy increase in anyones book!  Now you tell me they are
    	going  up again to $32/wk???? This is criminal if we have the 
    	number correct.  That's almost 100% in about a 6 month span?
    	Can this be correct???  I'm soon to be/am disgusted if it is!
    	Talk about out of control...

    
    
    	I am confused...It's bad but not quite as bad.  I actually joined
    	a year ago last JUne and it increased during the last year from
    	$18 to $26.  i thought that was a big jump at the time.  Another
    	one so soon seems unreasonable.

    Last year our weekly family premium went from 10.xx to 20.xx and I was
    told by Health Network of Co/Spgs that their rates went up less than
    5%, and that Digital was raising the rest of the way on it's own.
    
    This company is no longer (and has not been for a long time) "employee
    friendly" ... :^(
    
    rick
   

    I looked up the choices in VTX and I think the right words to describe
    my feeling is "sticker shock".
    
    I have been using Bay State Health care for the past two years and have
    seen rates go from about $17 to $32 to $40.65 for 1994. Bay State HC is
    now beyond affordable.
    
    I need to explore the choices for me and my family. The viable choices
    that I have are Tufts ($26.58), Harvard (HCHP) $18.24, and HMO Blue
    ($32.53).
    
    Does anyone have any experiences with the above mentioned HMO's. In
    particular I am interested in anyone who has used the HCHP Chelmsford,
    MA center. 
    
    I would like to hear good stories as well as the bad. 
    
    Joe  

Mine is going from $9.38 to $13.71  about 46% increase.

It would be nice to get a raise to off-set this cost.

My Healthsource premium would go up the same 21% as in .0.  I suspect that this
is not due to Healthsource raising their rates (they showed record profits
last year) but Digital contributing less.

Now who in this company gets 21% raises?  (Well, yes, Bob Palmer comes close
at 20%, but how about the rest of us?)

				Steve

	Reading through the document that came interoffice mail today, what
	appears to happen is that Digital sets their funding level based on
	the lowest cost option. We pay the difference between Digital's
	base level and the actual cost. So if the least expensive option
	goes up little or nothing but the other options go up more those of
	us who choose the more expensive options see a big jump. I wish the
	company would provide real numbers rather then hypothetical ones.

	But I can see how one groups total increase of 5% could amount to
	a 21% increase in employee cost. Of course understanding and liking
	are two different things.

			Alfred

    It's relatively easy to get an idea for the 'real' numbers. Ask your
    PSA for the COBRA costs of the various options. This is the cost you 
    would pay under the COBRA laws which allow you to continue coverage for 
    a period of time after you leave the company. Under these provisions you 
    pay the full cost of the coverage plus an optional administrative fee.
    
    For example, as I recall, total cost for DMP1-Family in 92 was $750/mo.
    
    Dave

    
    For the privelege(?) of being able to choose my own doctor here in
    NY, last year my weekly went from $23 to $83. This is for Digital
    Plan 2.
    
    Marc

    My HMO (Harvard Community Health Plan, Acton) is going up from $3.64
    per week to $4.17 per week. That's 15%. Seems like a lot to me. 2 or 3
    years ago I wasn't paying anything. Good job I don't have a family I
    guess. Family prices seem like they are a lot higher absolutely.
    
    Dave

    	Here in Atlanta our new Open Season will show that John Hancock
    Plan 2 will increase it's premium from $16.00 to $43.00(268% increase).
    The only available HMO is Kaiser. My wife has a coworker who at one
    time had Kaiser and a misdiagnosis caused a very tragic situation for
    her infant. Needless to say, my wife is a hard sell to convince that we
    go to Kaiser. I am really left with no choice. I cannot afford
    $43/week. Hancock Plan 1 is $96/week now.
    	Does anyone have any opinions of Kaiser; especially here in the
    Atlanta area. Hopefully, in the future more choices wil be available so
    I won'f feel that I have been painted into a corner.
    
    Regards, rick

    Reply to .11
    Rick:
    
    All HMOs are good so long as you donot require high quality
    specialists, which is what may have happened in the case of the infant
    of your wife's friend. HMOs use your physician as the gate keeper to
    keep the cost of specialists down. If you donot like it now, wait when
    uncle Bill's national health care plan takes hold. The only reason why
    this country has the best medical care in the world is the quality of
    specialists it has. By limiting access to specialists we are limiting
    the quality of health care we receive. Kaiser has good reputation in
    California and it is the biggest HMO here. I would strongly suggest you
    to look at the staffing of your local Kaiser hospital. If they donot
    have what you may be looking for, be prepared to pay out of your pocket
    if and when you need a specialist. 
    
    Vern Dutta.

	I am using Harvard Community Health Elect, where I can 
	get cheap coverage when I want but can also get any care
	I want (even if HCHP doesnt agree) AND chiropractic for	
	a 30% copay.

	1993	$ 24.64/week
	1994	$ 26.52/week	   a 7.6% increase....


	not bad at all, considering the others...

	I would have to use over $33,000 of elect coverage to make this 
	plan cost more than the Digital Medical Plan 1, which I used for
	5 years.  So I do get the best of both worlds, as I see it.

	Bob

    Reply to .11
        Rick:
    
     I hate to make bad news worse but your numbers were a little off.
    JH plan1 will be $96 a week plan2 is $107 a week. Sticker shock
    does not describe a jump for $29 to $107 for the same coverage.
    
     That buy the way is $5600 a year for health insurance. I don't 
    know about anyone else but that leaves me little choice go with
    the Kaiser HMO or pay big bucks for good health care.
    
    Gary

re .13:

>	I would have to use over $33,000 of elect coverage to make this 
>	plan cost more than the Digital Medical Plan 1

I think you've made an error.  You haven't taken out-of-pocket maximum
into account.

    It is not true that HMOs mean you can't get specialists.  Last year my
    wife came down with chicken pox just before our daughter was born.  We
    have Pilgrim.  They got for us the best specialists that could be
    found.  Both my wife and the baby were mortally threatened.  But now,
    thanks to the help of the specialists and support from Pilgrim, both
    are in excellent health.  And, I didn't have to go bankrupt in the
    process.
    
    Steve

    After reading several of the entrys in this string, I feel lucky that
    my coverage, MD-IPA in Maryland, only doubled. From $10.22/wk family
    to 21.06/wk family.
    
    	fred deady

>                     <<< Note 2739.11 by SAHQ::FLAHERTY >>>
>                 -< Hancock 268% increase/No real alternative >-
>
>    	Here in Atlanta our new Open Season will show that John Hancock
>    Plan 2 will increase it's premium from $16.00 to $43.00(268% increase).

A nit perhaps, but the INCREASE from $16 to $43 is "only" 168%, not 268%.

This common mistake makes it difficult to talk through alternatives.
we need to take care not to muddle the comparisons any more than they
already are.

Pedantically yours,

- tom]

Am I thinking correctly?

 The Fallon HMO-Elect is increasing from $14.42/wk for family coverage
  to $21.41/wk for family coverage.

 That's still not even NEAR the DMP-2 costs!

 In view of the company's continued decline and current state
it should re-incorporate itself as a Non-profit organization,
then at least we would be able to claim tax deductions for 
all of the reduced benefits/increased co-payments.

 dave

HMOs vary in quality as well as in approach.  Healthsource NH lets you choose
your own doctor from hundreds in the state, and I've had no problem whatsoever
in getting specialist referrals (even out-of-plan!)  Indeed, the other day
my physician insisted that I go see a specialist without my asking to do so.

It's likely that the Matthew Thornton Health Plan, which Digital uses in
southern NH as its "HMO Elect" program, is cheaper for Digital - no surprise,
as it's a clinic-based program that, from many reports, exemplifies all that
can go wrong with HMOs.

FWIW, the 93-94 21% increase comes on top of a similar size increase from
92-93.  My yearly cost just for premiums will be nearly $1700 for my family
of three.  If I paid my typical medical expenses entirely out of pocket I
wouldn't come close to what I'm paying in premiums, much less the $2K or so
that Digital supposedly puts in. Where does all this money go?

				Steve

    re: .18
    
    Of course, Fred, you may feel less lucky about the price doubling when
    you consider that this may be the last year you can even _get_ MD-IPA.
    We've received a notice that unless MD-IPA fits some administrative
    standards that Digital demands, it will be discontinued next year.
    
    This makes me very upset, since I don't know of another HMO which has
    any real presence in my area (North Central MD).  Since we only have
    one car now (which I take to work) and can't afford another, this means
    that my family will may no longer be able to get prompt medical care.
    We have a few MD-IPA doctors within walking distance of home which my
    wife and children currently use, but I know of _no_ physicians signed
    up with the other health plans offered.  The closest clinic-based HMO I
    know of is about 20 miles away.
    
    I'm thrilled...
    
    -- Russ

    The Matthew Thorntopn HMO Elect fee is going up only a small amount;
    still in the 20's/wk for family coverage.   We would not belong to
    MT HMO without the "elect" option.
    
    A lot has to do with which doctor you get.

Just to throw a contrary note in here...

Our family coverage (ChoiceCare of Ohio) will go *down* this year, from $15.37
to $11.39, a *decrease* of 26%.

And Cincinnati, OH was just rated the best place in Noth America to live
(health costs being just one of the benefits).

Bruce  

    RE: .21 If I paid my typical expense I wouldn't use my whole cost
    either. But I would have paid more when I had my carpal tunnel
    operation. And the year when both my wife and I had to have ortoscopic
    surgery on our knees would have been a killer.
    
    Hopefully we'll have a better year and all our money will pay for
    someone else operations.
    
    			Alfred

Are there any HMO Elect HMOs that aren't the clinic type?

Re: .12

>                                                      The only reason why
>    this country has the best medical care in the world is the quality of
>    specialists it has. By limiting access to specialists we are limiting

Since when has the US had the best medical care in the world?

Just curious,

Ceri

    I don't think many would deny it's at least one of the best - for those
    who can afford it (out of pocket, through medical insurance or
    whatever).
    
    However, it's the most expensive in the world too on a per capita basis
    (including those who cannot afford it).
    

>It's likely that the Matthew Thornton Health Plan, which Digital uses in
>southern NH as its "HMO Elect" program, is cheaper for Digital - no surprise,
>as it's a clinic-based program that, from many reports, exemplifies all that
>can go wrong with HMOs.

Not that this paragraph doesn't demonstrate a certain lack of first hand
experience but ...

  What does 'being cheaper' have to to with 'a clinic-based program that, from 
many reports, exemplifies all that can go wrong with HMOs' ?


Further, Although there will always be some negative experiences with any HMO
or other health care system, that is not to say that that is typical behaviour
for it. I've read some of the negative stories on MT and other HMOs but as
always there is more than one side to every story.

MT is a very good healthcare provider and much better than the 'specialists'
I had seen when I had John Hancock (that includes Layhe (sp?) clinic).
And you don't get any surprises in billing such that you can with other
providers such as HealthSource since the provider is closely tied with the 
institutions that provide the care.

BTW: MT went up $.96  a week for 1994.

    Some of those outside providers report that HealthSource is hard to
    do business with from their end as well.  It is very difficult to
    get them to pay, or they make you go through all kinds of
    administrative hoops.   Some providers now refuse to do business
    with them.
    
    (Not rumor; my wife works for one of these providers...)

Re: .27

"Clinic" based medical services are not always bad.

We have Harvard Community Health Plan with the Elect option in the greater 
Boston Area. A number of the HCHP 'clinics' are local medical groups that 
contract their services to HCHP. We use Dedham Medical Associates. The reason 
for the elect is to be able to continue to see a chiropractor and as a security
blanket if there ever is a major disagreement with HCHP. 
(My wife also sees a podiatrist from time to time)

The 'clinic' environment has a real benefit in that our records are available
to any specialist, the covering physician when our Primary is not avaiable,
or the Urgent Care group in the evening or on weekends. An aditional
benefit is that we have most of the services that we need in one building.
I think that the fact that the group we deal with also deals with the general
public in addition to HCHP helps keep the quality up. 

My wife has heard grumbling from some of her fellow workers(not Digital) 
regarding their experiences at some of the HCHP owned facilities and the 
level of service.

Once we got over the culter shock of leaving our personal physician and friend 
of 20 plus years, we have been please and very comfortable with the level of
service we have received at DMA through HCHP.

Fred

	Ex[eriences with any health plan will vary. In my case, I had good
	luck wiht Harvard Community Health Plan (HCHP) in MA, but did not
	like the NH facility that I had to use once I moved up here. My
	experience (and that of my wife) with Matthew Thornton has been
	universally positive.

	FWIW, the rate for Matthew Thornton is going from $14.25 to $15.21
	this year.

	Roy

Re .33, clinics being better because records are available to all doctors:

We've had experience with a different clinic in which phone calls during the
same day went to different doctors, and the later one had no record of the
earlier call. This can be critical in determining whether the condition was
getting worse and needed treatment. (I don't remember any more details than
this, and that the second doctor was rude about being called. I thought that
came with the job.) We continue to use the clinic for pediatrics because those
doctors have been good. However, both my wife and I see doctors in the Boston
area.

BTW, DMP2 is going up 30% from $83 to $107.77 

                     <<< Note 2739.19 by REGENT::POWERS >>>
                -< it's important to use the right arithmetic >-

>                     <<< Note 2739.11 by SAHQ::FLAHERTY >>>
>                 -< Hancock 268% increase/No real alternative >-
>
>    	Here in Atlanta our new Open Season will show that John Hancock
>    Plan 2 will increase it's premium from $16.00 to $43.00(268% increase).


	I just received my package ( ALF ) and my Digital Medical
	Plan 2 goes up from $ 29.73 a week to $ 107.77 a week. That's
	an increase of $ 78.04 a week. I'm not a happy camper.

	Red 

    .4
    
    HCHP, Boston (HArvard Square I think) is VERY good.
    
    HCHP, Acton Medical Assoc. -- Mostly don't get to see your own doctor
    				  in under 4 days wait, you have to see
    				  who ever is around.  Weekend coverage
    				  very poor.
    
    HCHP, Concord Hillside     -- Spotty.  Some good doctors some who
    				  should retire (IMHO).  Office staff
    				  could use a few lessons in tact
    				  and customer service.
    

    ... but if I read this correctly, CMHC will be going up to about
    $45/week for family coverage; about $900/mo if you go COBRA, and
    approximately $1,800/mo to keep it after COBRA expires.
    
    

I switched from CMHC to Tufts last year, kept all six of our doctors, saved
some cash every week, and couldn't be happier with the plan. We've had no
trouble at all with PCP's, specialists in the plan, and getting referrals out
of the plan.

Chris

    
    HMO Blue / Biodyne horror stories. I'll pay more and go elsewhere!
    
    Their treatment of my family during our emergency was abusive, at 
    best. My child was taken by ambulance to the hospital, the ER staff
    requested admission and Biodyne refused! She was evaluated by another
    ER staff in another hospital, who requested admission and Biodyne 
    refused again! Their Drs who overrode the ER staff refused to explain
    their decision to me, would not even talk to me! I threatened legal 
    action, they let her stay 2 nights,  and released her against
    the recommendation of the hospital! Needless to say I lost PLENTY of
    work hours and digital lost plenty of productivity from me for the 
    several weeks it took us (my husband, son & I) to keep her under the
    constant care she needed until she stabilized. She had to go in to 
    the Dr twice a week for a month. We had 2 more emergencies in that
    time with her.  I get so upset thinking about them. They were so
    rude and arrogant about the whole thing. I complained to HMO blue and
    the woman said to me "Well, HMO blue isnt for everyone". My brochure
    indicated full coverage for the very services that we wre refused!
    
    If you have a problem with services please complain to your "Human
    Resource Assistant" and tell them you want to know how to escalate
    your complaint. And then please escalate it!
    
    /K
     

    A couple of weeks ago, I read a newspaper article (NYTimes?) about the
    quality of care in NY-area HMOs.  The writer had been covered by his
    wife's insurance, but her employer dropped his family coverage, and he
    was stuck in his employer's fallback plan, HIP.  He described a dingy,
    roach-infested clinic in a rundown part of Manhattan where a
    barely-lucid "doctor", smelling of booze, performed the most cursory
    and useless of examinations.  If I remember, he eventually paid out of
    pocket to get a real doctor, since he needed medical care.  I notice in
    HCCZ_US that HIP is Digital's choice in the NY area...
    
    Once upon a time, when I was young and single and had no particular
    health problems, I belonged to HCHP (Kenmore).  The Cambridge center,
    btw, never had openings, so I have no idea how good it was.  I almost
    never saw a doctor; anything not obviously life-threatening was treated
    entirely by NPs.  Opthamalogic care was a bad joke (little better than
    "how many fingers am I holding up? Your glasses are still okay."), so I
    took to paying out-of-pocket for my own eye care.  HCHP runs two plans,
    btw; the inside-128 clinic plan ("discount doctors' plan") works
    differently from the outside-128 private-group plan which they bought a
    few years ago.  Either way you get bubkis choice.
    
    Now that I have a family, I am getting good care via Bay State, but the
    price is getting outrageous!  Almost all of Boston's good doctors will
    take Bay State, though it's often hard to get Bay State to pay up. 
    They recenty addressed a nastygram to my two-week-old infant, who,
    while very bright, had trouble reading it himself.  I see no
    alternatives, at least not unless/until we get a sensible
    Canadian-style medical insurance SYSTEM in this country!
      fred

    [For karma's sake, I suppose I should speak well of a different service
     provider in this note.]
    
    I'm a member of HCHP (Somerville MA) now and had a coincidental cluster
    of health problems and accidents late last year that required trips to
    several specialists with some ongoing visits, and my regular eye exam
    fell in the same period.
    
    I was fairly satisfied (B- to B+) with everyone I saw and if you ignore
    the travelling to other sites--which I do; I don't mind driving
    around--the only trouble I had was in finding out that one specialist
    took more vacations than I did [;-)] and that his secretary didn't like
    scheduling beyond eight weeks in advance. A call to Member Services
    cleared that up right away, though.

Please, this is not the place to tell medical horror stories.  Please limit
your discussion to the change in premiums.

Thanks,

Bob - co-moderator DIGITAL

    I wish I could figure out why the actual//COBRA costs aren't just
    communicated directly with the employee portion info. Given these 
    days of employment uncertainties, the cost to continue coverage 
    after termination//TFSO is a factor to consider during enrollment
    since you can't change it afterwards...

    And as long as I'm in here, wasn't there some kind of schedule for
    making 'HealthNET' coverage (the "HMO//Insurance" combo) available
    across the entire US? Some of us are still waiting...
    
    I'm not _unhappy_ with the HMO here or its pricing (as .-? said,
    it has actually gone down here), but I really wish I also had
    that insurance coverage for service outside the HMO and/or for
    the things the HMO excludes from its services.
    
    Dave

So can anyone explain why my current weekly premium for JH Plan B (~$27)
will be increased by 250% (~$107)?  I'm really between a rock and a hard
place on this.  I can't afford that kind of premium, yet I need to provide
my family of 4 with the level of health care they (we) deserve.  

This is so depressing...

-Andy

    
>So can anyone explain why my current weekly premium for JH Plan B (~$27)
>will be increased by 250% (~$107)?  I'm really between a rock and a hard
>place on this.  I can't afford that kind of premium, yet I need to provide
>my family of 4 with the level of health care they (we) deserve.  

    My assumption is that Digital didn't have one of their "nifty" HMO
    Elect plans in your area last year but now they do. What Digital has 
    been doing is to keep the employee costs low on the JH plans in areas
    without an HMO Elect plan. Once they make an HMO Elect plan available
    they can save considerable money moving people to HMOs so they apply
    this little economic kicker to help people make the "right" decision.

    		Alfred

    re: .46
    
    To put it a little less sugar coated than Alfred did...
    
    Digital doesn't want anyone in the DMPs.  It costs too much.  They can
    force you to change to an HMO by making the the DMPs unaffordable for
    99% of the employees.
    
    You can also be sure that none of the SLT or our zillions of VPs have
    to worry about that.  I'm sure that medical benefits are just one of
    the many items that are negotiated between the individual and Digital.
    
    Bob
                         

Re: .37

Were your experiences with all three facilities personal or 
second hand information?

>     HCHP, Acton Medical Assoc. -- Mostly don't get to see your own doctor
>                                   in under 4 days wait, you have to see
>                                   who ever is around.  Weekend coverage
>                                   very poor.

We've been using Acton Medical for over 8 years. The doctors have
two offices: one in Acton and one in Littleton. They also have
days off during the week. If you call and their calendar is 
filled for the day, AND they are  in Littleton the next day and off the
following day, you'll have to wait the 3 days.  In this case,
we have had no problems in seeing the doctor of OUR choice in the
Littleton office.  The doctors will provide you with their
schedule including weekends if requested.

Referrals to specialists have NOT been a problem.

Acton Medical has doctors in the office on weekends. Of course,
you may not get the doctor of choice then. I'm not sure what
.37 meant when weekend coverage is poor.

Gim 

    I just got my benefits package and I found out that my coverage
    (family) under CoMED HMO in N. Jersey went from $16.06/Week to
    $34.61/Week (more than 100% !!!!!!!)  This is OUTRAGOUS.  It almost
    completly wipes out my increse (20 month).  What is causing this
    upward move in prices ???  If this rate of increse continues, Health
    coverage will be more than my salary in a couple of years!!!!!!!!
    
    Who do we turn to (hillary :') )  to find out why this is happening ??
    
    
    
    		Jeff 

>  <<< Note 2739.46 by ALFAXP::MITCHAM "-Andy in Alpharetta (near Atlanta)" >>>
>
>So can anyone explain why my current weekly premium for JH Plan B (~$27)
>will be increased by 250% (~$107)?  I'm really between a rock and a hard
>place on this.  I can't afford that kind of premium, yet I need to provide
>my family of 4 with the level of health care they (we) deserve.  

Well, it's exactly as .47 and .48 explained it.
We in GMA went through it two (?) years ago, and it was CXO and environs
last year.  It's the October flurry in this file every year when the plan
hits a new area.
Where's the NEXT greatest concentration of employees - where's NEXT year's
flurry going to start?

- tom]

>    <<< Note 2739.48 by ROWLET::AINSLEY "Less than 150 kts. is TOO slow!" >>>
>    
>    You can also be sure that none of the SLT or our zillions of VPs have
>    to worry about that.  I'm sure that medical benefits are just one of
>    the many items that are negotiated between the individual and Digital.

I don't think so.  Isn't it part of the ERISA or COBRA laws that all employees
have to be eligible for the same plans with the same levels of coverage
for the same prices?  

- tom]

    From a strictly dispassionate point of view, when you are trying to
    decrease your total employee headcount, it does no harm to 
    cut or devalue employee benefits. Benefits cuts save short-term costs
    and the inevitable resignation of some employees saves medium- and
    long-range costs.

                     <<< Note 2739.11 by SAHQ::FLAHERTY >>>
                 -< Hancock 268% increase/No real alternative >-

>    	Does anyone have any opinions of Kaiser; especially here in the
>    Atlanta area. Hopefully, in the future more choices wil be available so
>    I won'f feel that I have been painted into a corner.
	
Rick,
The assertions about Kaiser are just not true. My wife is a family
physician with them here in Atlanta and she is *never* told not to refer 
out to specialists. Her best judgement is asked and honored by each 
individual case.  The problem is with the individual front-line physician
who commonly feels that if s/he refers to a specialist, then they will 
be viewed as incapable of dealing with the case. This *is* a personal
prima-dona problem and not one caused by the employer. I can't speak
for other HMO's, but after having my wife tell me story after story
of ego-maniacs that want to do everything when they can't for the
last 7 years, I can speak of this one with a little personal knowledge.

You need to find a good "front-line" physician and I think you will
be quite satisfied with their service. I can recommend several DEC
employees who are very satisfied with them right there at ALF if you
are interested.

Regards

Manny

Some HMOs have a "profit sharing" plan with their doctors.   Any
money left over at the end of the year is distributed as a bonus.
This is supposed to encourage cost-awareness.   It is not hard to
imagine the results.

    Well, here in NJ US Healthcare has dropped the premium from 28.01 to
    $18.71 (or something like that). This is about a 40% REDUCTION in
    premium costs. Looks like I'm one of the few winners in this.
    
    re:-.1
    
    Well, I question profit-sharing also. However, if they are simply
    looking at the bottom line at specialist costs, they are ignoring
    malpractice costs. If they try and save money this way, other costs
    such as malpractice will rise. This will reduce profit-sharing more
    than sending people out to a specialist.

>CVG::THOMPSON "Who will rid me of this meddlesome priest?"
>    My assumption is that Digital didn't have one of their "nifty" HMO
>    Elect plans in your area last year but now they do. What Digital has 
>    been doing is to keep the employee costs low on the JH plans in areas
>    without an HMO Elect plan. Once they make an HMO Elect plan available
>    they can save considerable money moving people to HMOs so they apply
>    this little economic kicker to help people make the "right" decision.

As I understand it, Digital contributes a flat rate towards health benifits
for every employee in a particular region and that this rate is calculated on 
lowest cost option in the region. Anyone wishing to select a higher cost 
option is given the oportunity to do so. 

>ROWLET::AINSLEY "Less than 150 kts. is TOO slow!"
>    Digital doesn't want anyone in the DMPs.  It costs too much.  They can
>    force you to change to an HMO by making the the DMPs unaffordable for
>    99% of the employees.
 
It doesn't cost Digital any more or any less if you chose one option over 
another. The employee pays the difference between what Digital contributes,
which is the same for every employee, and the actual cost of your healthcare
selection.

>SOFBAS::SHERMAN "C2508" "It's the P&L, stupid." 
> From a strictly dispassionate point of view, when you are trying to
>    decrease your total employee headcount, it does no harm to 
>    cut or devalue employee benefits. Benefits cuts save short-term costs
>    and the inevitable resignation of some employees saves medium- and
>    long-range costs.

I am continuously amazed at the imagination of the contributors to this 
conference. This practice of re-evaluating health care options has been going
on for at least the 9 years I've been with DEC. I don't think they were trying
to 'decrease headcount' or 'devalue employee benifits' back then. They were/are
trying to control health care costs by including some competition into the 
equation.

>  Who do we turn to (hillary :') )  to find out why this is happening ??
 
  I like her plan. Take over all the health care costs for the country and
  remove any incentive to being frugal about their health care requirements.
   Then wait for the country to go BANKRUPT because of the rising cost of
  health care, file for bankrupcy, and wipe out the US debt. 

  Sounds like a good plan if your into world wide depressions ...

Don't blmae Digital for the increase, blame to folks that raised their rates.

    I clearly remember being told by someone in HR that, in fact, the
    pricing of the DMPs relative to the HMO plans was adjusted just as
    described; it is kept low in areas where the HMO Elect isn't available,
    and then rises (perhaps to an equal-Digital-contribution level?) when
    HMO-elect becomes available. (this might have enve been in the Benefits
    Bulletin the first year this all started). 
    
    Straight insurance plans are indeed more expensive than managed-care
    plans. This is not news. No conspiracy there.
    
    ...tom

>    And as long as I'm in here, wasn't there some kind of schedule for
>    making 'HealthNET' coverage (the "HMO//Insurance" combo) available
>    across the entire US? Some of us are still waiting...

They're expanding as fast as they can.  It's generally to your disadvantage
for HMO Elect to be instituted in your area.  HMO Elect (in the areas that
have it) is more expensive than DMP1 in areas that don't have HMO Elect.
HMO Elect has a higher copay, deductible and out-of-pocket max than DMP1.

Here are some examples:

		     Individual		Family
DMP1 (no HMO Elect)	3.09		17.16
HMO Elect (NY)		7.26		26.71
HMO Elect (Boston)	7.23		26.52
HMO Elect (NH)		6.37		23.49
HMO Elect (SoCal)      10.87		34.27
HMO Elect (Chicago)	6.67		24.04

re: .57

>It doesn't cost Digital any more or any less if you chose one option over 
>another. The employee pays the difference between what Digital contributes,
>which is the same for every employee, and the actual cost of your healthcare
>selection.

With the DMPs, once you hit your out-of-pocket maximum, the rest comes directly
out of Digital's pocket since the company is self-insured.

With the HMO plans, the costs are born by the HMO, and ultimately reflected
in the rates the HMO charges.

For example, say Digital contributes a flat amount/employee for health benefits,
and an employee needs $100,000 of medical care.

Under the DMP, the employee pays up to his out-of-pocket max.  If that's
$3,000, then Digital pays $97,000.  (Assuming none of the charges exceed
the JH R&C guidelines).

Under an HMO, the employee pays his co-pay, Digital pays $0, and the HMO
pays the rest.

Now, as an employer, which plan would you want your employees to choose?

Bob

    there are other alternatives.
    
    consider some companies go to a high deductable insurance that is
    cheap.  the deductable is $3000.   very affordable insurance [read NOT
    self insured].
    
    the company GIVES the $3000 to the employees to cover the deductable
    AND allows the employees to keep the difference.  Guess what?  The
    employee is now a cost partner.
    
    for companies that implemented this plan, the rates for the insurnace
    for the 2nd and next years was cheaper as less claims were filed.
    and for those who really needed insurance, it was there.
    
    the only way we are going to get health care costs down is to make
    consumers partners, not raise the rates thus giving them no
    *individual* decisions/controls.
    ed

    
.58>  I clearly remember being told by someone in HR that, in fact, the
.58>  pricing of the DMPs relative to the HMO plans was adjusted just as
.58>  described; it is kept low in areas where the HMO Elect isn't available,
.58>  and then rises (perhaps to an equal-Digital-contribution level?) when
.58>  HMO-elect becomes available.
    
    That's correct. For the first year or two after the push started to HMOs,
    there were none available in the Fitchburg MA area. During that period
    my DMP contribution remained stable, while a coworker's skryocketed
    because he lived in the HCHP area. And it was in the literature that
    was distributed at the time.
    

           -< Pre-emptive move on HMO's/Digital's aprt >-
    
    Here is what I understand seems to be going on in the last few years
    as well as coming few:
    
    - Digital (read all employers) is trying to get away from having to
      manage/administrate health care accounts for employees. The cost of
      administration is high and the headaches in dealing with changing
      scenario (claims, technology, laws etc) is too great/costly. It is
      an area they much rather do without.
    
    - Not all the cost increase passed on to us is coming from HMO's.
      Digital wants to limit the amount they will pay for employee's
      (or their family's) health care. So wherever the HMO cost is too
      high, your share is high. If you try to get an explanation as to
      where the increase is coming from...you will probably get the
      run-around.
    
    - HMO's (and this is a wild hunch on my part) may be increasing the
      premiums as a pre-emptive move to Mr (or Mrs) Clinton's package.
      They know they will be burdened with covering currently non-covered
      items as well as patients. If their costs are high now, they cannt
      be blamed for increasing the costs then (due to those reasons).
    
    My advise (if within your control): Practice prevention, stay away
    from doctors as much as possible and take good care of your health.
    
    -Atul

re .60:

With HMOs, DEC knows exactly how much they're paying.  With DMP, they estimate
how much they're going to be paying -- including amounts over the out-of-pocket
max.  If they do a good job of estimating, .57 is correct.

re .63:

There was an article in the Boston Globe the other day about rate increases
in area HMOs.  They're in the 5% range this year.  Someone quoted in the
article (perhaps an HMO official?) said that fear of Hillary is keeping
increases *down*.

    We went through the big decision point about two years ago. It was obvious
  that Digital wanted its' employees to switch to HMOs where possible. Why?
  HMOs were less expensive than the old Hancock plan.

    It was great the first year as it cost me LESS and no deductable and I had
  the same doctors. Such a deal!

    The second year my increase was close to 300%!!!!! Surprise!!!!!

    This years' increase is around 8%!

    If you've got to have insurance I guess you can run but you can't hide.
   Some plans are cheaper (in the same area) but my guess is that you can 
  hop onto a different plan and get hit next year with an increase.

    It sure doesn't help the economy as your dollars flow more and more to
   healthcare. You buy less and less and the economy gets no better.


    - Bob

>With the DMPs, once you hit your out-of-pocket maximum, the rest comes directly
>out of Digital's pocket since the company is self-insured.

>For example, say Digital contributes a flat amount/employee for health benefits,
>and an employee needs $100,000 of medical care.

>Under the DMP, the employee pays up to his out-of-pocket max.  If that's
>$3,000, then Digital pays $97,000.  (Assuming none of the charges exceed
>the JH R&C guidelines).

Huh?

    Well hold on to your hats folks... y'all think health care is bad now,
    wait until the new health care package goes into effect... You not only
    will be paying *your* health care costs, through taxes you will be
    paying for someone not even working... My guess, you health care costs
    will double... 
    
    Just my opinion!
    
    Bob
    

    
    Re: .64
    
    Yes I did see the Boston Globe article. However, that is more of an
    average increase. It varies from employer to employer. I wonder how
    much did Digital's HMO costs went up? Anyone know? If they only went
    up 5%, how come some of our premiums went up 100%? I know Digital's
    part did go up, but not by 95%!
    
    More details will help shed more light.
    
    -Atul

    
    I just checked mine, I have Tufts. It's going up by $1.22 per week, not
    really that outrageous I feel.
    
    I have used an HMO since they were offered and left John Hancock. I
    have the same doctor I have had for years and have had no problems with
    referrals. So, I'll stick with it.
    
    Mary
    

Our family coverage for the Kaiser HMO will be dropping from $15.88/week to
$14.34/week.  We have had no problems with the HMO system, so actually saving
$1.54/week isn't a problem.

Dave

    I got less worried about Bill & Hillary's health care reform when I saw
    a blurb in my Saturday paper. Sen. Paul Wellstone D-?? submitted a
    proposal to the Senate to make the Senate's health care program the
    same as the one proposed by B&H. They turned it down flat. Sen. Arlen
    Specter, recently diagnosed with a brain tumor, say he wouldn't have
    been able to get an MRI under the B&H plan, so he couldn't vote for the
    change, since the change may have killed him.
    
    So, I think it'll be a long and bitter fight. If government officials
    aren't covered under the same plan, there is no way I'll accept the B&H
    plan. I'll make sure my representatives know that. The only exception I
    might make is for the President himself, but NO ONE else, not even
    his/her family.

    The economics are warped by cost-shifting, both within Digital and
    outside.
    
    Within Digital's plans, the rates we pay HMOs and PPOs (and thus which
    we pay) is experience-rated, meaning that they charge us based upon
    how much we used them in the past and how much they expect us to use
    their services.  Digital does not pay the same per employee as, say,
    Gillette.  So in the case of the $100k/year worker, the HMO eats the
    $97k this year, but socks it right back to us in the following year. 
    
    HMOs market themselves to healthy customers (hence the name "Healthy
    Members Only").  This means their average cost per member is lower than
    average.  The sicker fraction of the population cannot use them (as the
    HMO Blue representative so clearly pointed out in an early reply), so
    they are stuck in the indemnity plans.  This raises the average cost
    per member of the indemnity plans, so more people leave, leaving only
    the sickest... it's a positive-feedback loop, an unstable system. 
    That's why DMP is so high:  The only people who take it are the ones
    who would make use of it. 
    
    Under the B&H plan as it exists, and for that matter under some of the
    counter-plans offered by politicians in even closer thrall of the
    insurance industry, experience-rated policies for smaller employers are
    replaced by "alliance" plans which average many together into one,
    more average, rate.  This is in effect a reinsurance company, adding
    another level of bureaucracy, but it saves smaller employers who are
    essentially kicked out of the system now when one employee gets a
    costly disease.  The plan (I haven't seen the final details released
    today) may allow large employers to remain self-insured, though.
    
    Now, the cost-shifting that makes today's non-system more expensive,
    for the country as a whole, than B&H, Single-Payer, or any other real
    reform plan that offers UNIVERSAL coverage (and thus this doesn't help
    with the Republicrat plans):  Today, the uninsured quarter-or-so of the
    population doesn't get zero medical care.  They get zero preventive
    care. But when they're desperately ill, they go to the emergency rooms. 
    These are not allowed to turn away patients just because they can't
    pay.  By then, a simple illness may become an expensive one, so the net
    cost is raised dramatically.  This cost is averaged into hospital bills
    paid by the insured (via insurance plans), as a fairly large
    percentage.  So universal coverage, by steering people away from
    emergency rooms, will drastically lower hospital costs.  In Digital's
    case, some HMOs negotiate marginal-rate contracts with hospitals that
    do not pay the full share of this, so the DMP and other indemnity plans
    pick up even more of this cost of uninsured Americans.
    
    Needless to say, I get rather nauseated by drivel like that in .57,
    which reflects the rantings of fearmongering politicians and vested
    interests (overpaid specialists, insurance parasites, drug peddlers,
    etc.) who fear anything that will control the costs that they are now
    profiteering from. :-(

    
    If you are on the DMP and want to switch to HMO's, must they accept you
    even with pre-existing conditions?
    
    If I understand the VTX thing correctly, my deduction is going from $8
    something to $40+ something.
    
    p.s. I'm on LTD, does this make any differences.
    
    "jackin' the house", Bob (who has received NO benefits package info)

    Kaiser in Atlanta.  I used to have Kaiser in Atlanta, and went to John
    Hancock.  To me, Kaiser is like going to county public health clinic.
    My hancock went from $29.73 to $107 a week.  I am on variable comp.  I
    exceeded budget.  Yet for some b.s. reason, I will not receive my
    incentive pay.  Bottom line, less pay, insurance rate thru the roof,
    this company is starting to leave a bad taste in my mouth.
    
    Why should I have to pay $108 a week for John Hancock, when someone 4
    miles away from me (different zipcode) gets to maintain it for the
    same price.  They are not in a HMO territory?  EVeryone should pay the
    same price for JH insurance, regardless of if your in a HMO territory
    or not.  This whole thing stinks of discrimination, based on zip code!
    
    What's next, make the check payable to Digital for coming to work.  Pay
    electric bills for power usage in your cubicle.  Pay for parking
    places.  Monthly service charges for badgereader usage.
    
    DEC is gone.  Digital is here, and it certainly isn't a pretty picture.
    But thats ok, all our vp's and boardmembers will just vote pay
    increases for themselves for such sterling performance of this company.
    
    Just letting some steam go.  This insurance thing really bites.  I hate
    Kaiser.  They suck!  A bunch of quacks if you ask me.  Their solution
    to the problem is a prescription for painkillers via the "physician's
    assistant".
    
    
    QUACK QUACK QUACK!!!
    
    Bob "who just doesn't care anymore" Harris
    

    re: -.1 
    
    (little flame on)
    
    If they made the rates the same for all JH subscribers, then all of us
    would be paying $107 a week, not the reverse.  That's what I call
    discrimination.  Those that have a CHOICE, and CHOOSE the more
    expensive, so be it; but there's LOTS of us out here who aren't 4 mi.
    outside the ZIP, who have NO access to an HMO; ultimately, NO CHOICE
    except JH.
    
    I don't like it either.  I have been requesting access to an HMO for
    two years with no success...... KAISER or otherwise.  Anything but JH.
    
    (Little flame OFF)
    
    BR....JP

    Last year I saw my JH premiums jump from $22 per week to $83 per week
    form me and my family of 4.
    
    I was offered two HMO plans (being in a major city) and the ability
    to continue using JH at the much higher rates.
    
    My wife and I chose Cigna Elect because it gave us a little comfort
    that if we truely had an emergency we could opt out for and 20%
    deductable on any medical treatment WE felt was required.
    
    The "Clinic" is fine -- but we would prefer our old private doctor
                            (Somehow they never particpate in the plan
                             you're in)
    
    Our medical issues have been minor this year.
    
    The Doctors are all very young, capable but young... 
    (just my observation...)
    
    I was leary about the HMOs but after a year -- It's Ok.. but I'm 
    still not pleased I have to subject my family to the Clinic, but 
    we do it because of the difference in costs of the private insurance
    plan.
    
    I've worked hard, and thought I was developing "professional class" of
    skill sets so that I would have a good Salary and Private Health 
    Insurance for my family, no matter who I worked for... My added value 
    would cover me for private insurance costs.
    
    The biggest dissapointment hasn't been the loss of company car, or the
    elimination of the bonus programs or anything to do with money.  The 
    biggest dissapointment has been the loss of private medical insurance
    because emotionally it makes me feel like I'm not successful enough 
    to provide that critical benefit and PROFESSIONAL totem to my family
    as a symbol of my success.
    
    We use the HMO program not because we like it, not because it saved 
    us any money (premiums are continually increasing), but because it's
    the only way we can afford any healthcare in our budget.
    
    I look at other companies and wonder how they continue to provide
    private health care to their employees... Most still do....
    
    John Wisniewski

    Can you identify a trend?
    		
    		Indivdual    Yearly
    Year  	Weekly      % change	
    -----	---------   ---------
    1988	$1.67		
    1989	$1.98	        +19%
    1990	$2.95           +49%
    1991	$3.17            +7%   
    1992	$0.07	        -98%    (seven cents!)
    1993	$1.41	     +1,914%
    1994	$3.90	       +176%
    
    regards,
    mpr

    
    
    RE: .77 Maybe it's just that you're old, John. ;')
    
    
    
    Well I've seen my pay increase after 21 months eaten up by the increase
    in healthcare costs and increase in life insurance costs.  Not to
    mention increases in tax rates, etc.  It is very, very frustrating.
    
    Mike

    I tend to have a little different perspective on health care costs
    because I've been on the management side. I spent three years of a
    school district budget committee watching helplessly as insurance costs
    grew. I also spent the last 6 years on the board of a private school
    were we finally had the option of giving raises or maintaining the
    level of healthcare without additional cost sharing. There wasn't money
    to do both. So I sympathize with Digital management. It's not an easy
    task and frankly it's not going to get easier without major changes
    in the healthcare system in the US.

    So I don't like to see my contribution to health care go up. Especially
    when I haven't seen a raise in a year and a half. But I'm realist
    enough to know that that's going to continue to happen until either 
    Digital starts making good money or the system is changed. I've got a
    lot more confidence in Digital to make a profit than I have that the
    system will change. (My confidence is Digital is *not* at an all time
    high either.) This is the world we live in.

    			Alfred

    	Isn't this really our quarterly pay cut???
    
    8>(

There's so much doom and gloom here. From the perspective of a single person
with no dependents:

1. I'm glad the company is trying to control health-care costs. In contrast to
   other nations, the US so far has expected business to take care of health
   care costs: if there's a problem, business has to solve it. So Digital (and
   a lot of other companies) are trying to do what in other countries is done
   by the government. 

2. I was squeezed into an HMO and thoroughly like it (Harvard Community Health
   Plan at Acton Medical Associates). The doctor I have there is the most
   progressive I've ever had, and I feel that the service I have for my
   (fortunately petty) medical problems is better than I had "on the outside."
   I honestly feel that my health-care situation is better now than it's ever
   been. 

3. Note 2739.72 by CARAFE::GOLDSTEIN explains the cost shifting pretty well.
   Everyone who thinks the B&H plan will be worse than what we already have
   should read it. All you struggling taxpayers are already paying for everyone
   else.

Vicki Meagher

>>   Everyone who thinks the B&H plan will be worse than what we already 
>>   have should read it. All you struggling taxpayers are already paying for 
>>   everyone else.

>>Yes, perhaps that's why the President and her husband made it 1300+ pages, 
so that the average person wouldn't read it!  I believe that if the average 
person really did understand the B&H socialist health care plan they would 
vote it down.  It is full of big government bureaucracy.  It does not allow 
for choices in health care and it forces business to foot 80% of the bill - 
where do you think that 80% will come from - duhhhh, your paycheck and even 
possibly your job!  Get real America - there's no such thing as a free lunch!

There are problems with the current health care system for about 15% of the 
population, but those things can be worked out with other solutions than 
overhauling the entire system to socialist control.

.72 has some very good information it as do many other notes (I'm trying
to understand all the angles on this issue).

But I have to take exception to the following paragraph from CARAFE::GOLDSTEIN -

>  Needless to say, I get rather nauseated by drivel like that in .57,
>    which reflects the rantings of fearmongering politicians and vested
>    interests (overpaid specialists, insurance parasites, drug peddlers,
>    etc.) who fear anything that will control the costs that they are now
>    profiteering from. :-(

 I can assure you that my opinions on the B&H plan are my own and not influenced
 by the above mentioned interests. My opinions are based on the continuing growth
 in this countries deficit and debt as the government tries to combat the biggest
 influence on the budget increases: Medicare and Medicade. Currently, the 
 uninsured are carried by private business when they get medical care. Shifting
 responsibility of payment of those costs, along with the expense of supplying 
 healthcare to all US citizens, over to the US government (an agency not known
 for it's fiscal agility), without a clear understanding of the costs (beyond a
 $.75 ciggarett tax) and how they will be handled, without destroying 
 an already lackluster economy, it a recipe for disaster.

 The problems are easily defined and clearly understood. The solutions are
 not so easy to come by. A solution involving the governmen because all the
 other governments do it (much like the VAT or many other bad ideas), or because
 the B&H plan is the only plan in town, is no reason to support it.

 Now, if we had a plan which promoted preventive medicine for all children
 (up to age 21 if attending college) and provided a limited base level of 
 care for everyone while allowing insurance companies to supply coverage
 for the rest, we could reduce the impact of insurance cost on the private 
 sector, Limit the cost on the US taxpayer, supply the preventative medicine 
 which might offset the cost of
 emergency care and still keep market forces in place to govern health care
 expense.
 
 Doug.

    
    Re: .82
    
   > 3. Note 2739.72 by CARAFE::GOLDSTEIN explains the cost shifting pretty well.
   > Everyone who thinks the B&H plan will be worse than what we already have
   > should read it. All you struggling taxpayers are already paying for everyone
   > else.
    
    What you say is true, but the concern is over whether B+H's plan
    will be an *improvement*.  Yes we are already paying lots for the
    health care of everyone else, and the fear is that B+H's plan will
    have us paying even *more* and all of us, including those not 
    currently insured, ending up with *less*.  No one wins if those
    fears prove true.
    
    What I am really unhappy about is Clinton's attitude that anyone
    who questions the plan is obstructing improvement.
    
    Steve
    
    
    

    
    "Cost shifting" is a given in the B&H plan. But lets look at another
    program to prove that point. Take Social Security. Today we have
    45 million who receive social security. Is this not a distribution
    shift from one group ( younger, working ) to another (older, retired).
    And if you look at Medicare and Medicaid ( Plus Medigap for additional
    coverage), you can see those costs are already shifted away from the
    receiving group. My guess is that as soon as the B&H plan roll
    Medicare, etc. into the new plan, costs will increase dramatically.
    
    To those who believe that costs can be contained with the new plan -
    Look in the B&H plan and see what the gov't does when it reaches
    the cap ? I don't think the answer will surprise you...
    
    
    Bruce
    

    Ever wonder how many of the Massachusetts residents that are
    complaining here about local health care increases voted against
    the mandatory seat belt law?  ;-)

    ever wonder why the Mass. legislature ignores the residents?

    
    Re: .86
    
    Heard on NPR this morning that one reason Clinton has backed off
    quite a way from the cost containment part of his hard sell is
    that he has finally realized that will not happen.  Because of 
    the aging of the US population spending on health care will
    go up *even* if we all get serious about taking better care of
    ourselves and doing more to practice sickness prevention.  Just
    the sheer numbers of us that will be in our 50s and older will
    put a burden on the system no matter how cost conscious and
    efficient it is nor whether we make the shift to taking better
    preventive measures.
    
    Steve
    

    I currently have CoMED HMO and am paying 16.06 weekly for family
    coverage.  It goes up to 34.61 for 1994.  Ummm, I appreciate that costs
    rise year after year, but could there really be justification for more
    then doubling in a year.  This is not JH after all!
    
    What a trend!

    from the Craig Shergold story in another topic.
    
>As part of this whole story, his plight caught the attention of John
>Kluge, the US billionaire, who paid for Craig to come to the US and
>receive specialized treatment.  As a result, Craig has recovered
>completely from his tumor.  He is also no longer seven, but well into

	Notice that he was doomed under the single payer system of
	the U.K.   
    
    	Gary

re Note 2739.91 by SNELL::ROBERTS:

>     from the Craig Shergold story in another topic.
>     
> >As part of this whole story, his plight caught the attention of John
> >Kluge, the US billionaire, who paid for Craig to come to the US and
> >receive specialized treatment.  As a result, Craig has recovered
> >completely from his tumor.  He is also no longer seven, but well into
> 
> 	Notice that he was doomed under the single payer system of
> 	the U.K.   
  
        Notice also that he would have been doomed in the US had he
        not had the assistance of a billionaire.

        Bob

    Re: several
    
    Uh, the UK's current system is not quite single-payer, and is nobody's
    model for a good one!  While the old postwar NHS was said to be pretty
    good, Maggie Thatcher opposed it on philosophical grounds, so she
    gutted it.  Now many upper-income people, including I believe most
    Digital employees, belong to private insurance plans (still much
    cheaper than here), while NHS provides in effect charity care to the
    low-income population.  Perhaps it will be revived by Mr. Smith, should
    he get the chance.
    
    The B&H plan is far from ideal, and is not what I personally favor
    (which would be Canadian-style single payer).  The quality of care
    rendered under any plan would depend upon what level of benefits are
    provided, and how good the providers are.  This Topic has plenty of
    examples of good and bad care in the US; no national system is likely
    to be as good as the best plan, but also unlikely to be nearly as bad
    as the worst.  We at Digital can no longer afford the best, so it's
    catch-as-catch can; if your local HMO happens to be good and get you a
    good doctor (i.e., a few back in Acton, though HCHP in my area is
    horrible), then you luck out.  There is plenty of excess money in
    today's non-system:  Many medical specialists NET over half a million a
    year!  I know of a fellow of around 30 who finished his surgical training
    and was offered a salary of a hundred grand --  a month!  He turned it
    down for about $400k/year in a more temperate environment.  Surgery is
    a high-profit item for hospitals.  To me this is obscene; doctors
    should make a good living, but frankly too many make more than Bob
    Palmer does even with his raise, and I think BP's worth more.
    
    Under B&H, of course, the government doesn't actually administer the
    plan.  It sets standards for private plans, and passes some of the work
    to the states (who can set up plans).  Germany's national plan is also
    administered privately under federal rules, and works well.  The drivel
    I cite is this stupid fear of anything that smacks of "socialism". 
    Maybe you should privatize the army, Route 495, and the courts?
    If you diss me I can then pay to get you busted!  Government is as
    efficient or inefficient as we let it be.

    okay, okay, okay.
    
    I've read what your premiums are going up to in locations that
    have HMO's available, But what is my DMP2 premium going
    to go up to if no HMO's are available in my city.
    
    Thanks and waiting for someone to answer
    Thomas Hart
    Birmingham, Al.

    A few notes back folks mentioned the difference in DMP
    premiums between their zip-code and one nearby.

    Once, when I was relo'd, my permanent address was a
    post-office box for over six months.  Digital was happy to
    accept that, and even changed my state of residence to the
    post office box for state tax withholding.

    Now, I would never recommend fraud, but October is 
    MAILBOXES, ETC.'s customer appreciation month.  If I were in
    the above situation, I'd certainly want to visit the post
    office or a MAILBOXES, ETC. kind of place in a nearby
    zip-code, just to ------ er ------ check out the promotional
    fax rate.   You just never know how much more 'convienient'
    it might be for you to receive your mail somewhere other than
    your home.

    And, as an added bonus -- a place like MAILBOXES, ETC. has
    an attendant to sign for the pesky service award deliveries.

    New Weekly Rates for Leominster, MA  01453
    
                                      Individual      Family
                                      ----------      -------
    Harvard Community Health Plan      $  4.17        $ 18.24
    Fallon Community Health Plan       $  2.71        $ 13.13
    Central Mass. Health Plan          $ 10.92        $ 35.00 (was $26.98)
    HMO Blue Health Plan               $  9.99        $ 32.53
    Tufts Associated Health Plan       $  7.30        $ 26.58
    Healthsource New Hampshire         $  9.74        $ 32.31
    Digital Medical Plan 1             $ 35.63        $ 90.14
    Digital Medical Plan 2             $ 43.01        $107.77
    
    I'll be searching reasons for CMHC being so much more expensive than
    the competition for equal or poorer coverage.
    
    Mark
    

    Last night I had to take my daughter to the ER for attempted
    suicide.  The doctor wanted to admit her and therefore contacted Choice
    Care's agent Bethesda React to get approval.  Bethesda said admit, and
    that six days ofinpatient treatment remain.  This morning, Bethesda
    called and said thatonly one day remained, and that Choice Care
    coverage would be denied.  When ask why they did not tell me that last
    night in the ER, their response was that Choice Care will not make all
    the information available to them to actually confirm benefits.
    
    I tlaked with Choice Care this morning, they did not seem to care but
    did make it quite clear that they would not pay for the treatment. 
    They did sugget that I send a letter to them for their Quality
    Assurance review so that they could consider changes to their plan.
    
    Sooo, I guess I take my daughter home, and wait to collect on her life
    insurance.  Sick, but what else can I do.  Choice Care did not do their
    job, and doesn't care  about their patients.

re .94:

If you haven't received your package in interoffice mail, try VTX HCCZ_US.

	Why does Atlanta - in a bigger metro area than Boston have only
	*one* HMO selection?  Who in management selects these HMOs and
	what is the criteria?  I don't know for sure but I'll be that
	the hospitals used by Kaiser are about 25 miles from my house -
	yet I'm in the zip code that can't use the 'cheap' JH plan.  Dollars
	to donuts that whoever made this decision has *never* been
	to Atlanta.

	Yeah, I wanna write a letter and I want to know to who...

	Rick Beldin
	Atlanta CSC

    
    
    
    
    
    
    Regarding Craig (the kid with the tumor): 
    
    At any level (personal, medical group, or for national health
    insurance) there are only three choices of how to manage health care:
    
    1)  Limit the people who get health care
    2)  Limit the health care procedures that are used
    3)  Spend an ever increasing percentage of income on health care
    
    As individuals and as a nation, we've got to make our choice and
    live with the consequences.  
    
    		Enjoy,
    		Larry
    
    PS:  I've never figured out why Fallon is so much less expensive than
    the other HMOs available in my area -- I've never had a problem getting 
    the medical care I need from them.  Unless one has a longstanding
    family doctor, I think it's crazy not to join an HMO.  Bottom line:
    they make money when you are healthy, not when you are sick.  And
    they also only make money when their customers are satisfied enough
    with their health care to stay with them.  Private industry is 
    efficient, provided that the incentives are set up properly.  LS

    
    
    	I received a package that deals with health insurance.  Is there an
    	additional package coming that deals with life insurance???
    

    I just got my life insurance package in the mail yesterday or the day
    before...
    
    I've been informed that I'm getting a $1485 refund from the old life
    insurance plan...and the rates for continuing term coverage for 1x my
    salary have gone.  I pleased, to say the least.  Anyone else get their
    package yet and find that they're getting a refund?
    

    
    RE: Note 2739.102
    
    I got mine yesterday - I didn't read it that way... but I confess I did
    not "study" it. I took it to say that if one "opts" out of the plan, one 
    may get the $$$. Looks like there is some sort of Cash Value to what
    we've been buying for years... I WILL examine the package VERY closely
    tonight. CIGNA will be having informational meetings at my site (WFO) on
    Monday, I will do my homework so that I may ask meaningful questions.
    
    I'll share my learnings on Monday...
    
    Carl

    Carl,
    
    This is not a cash for opt out sort of thing.  A couple weeks ago we
    got the glossy benefits bulletins delivered at work.  From the
    bulletin (pg. 7)
    
    "Return of Claim Stabilization Reserve Premium"
    
    Those employees participating in the current optional life insurance
    program as of August 17, 1993, will be eligible for a premium refund
    from John Hancock.  Because of our positive experience in the optional
    life policy, an excess premium has built up over several years.
    
    If you are eligible, the amouont you receive will be a percentage of
    the total premium you paid under the current program.  Factors
    affecting your refund include the number of years of your participation
    in the program, the option chosen, and your salary..... the refund will
    not be taxable.
    
    FYI, I was in the insurance plan for about 3 years at 5x my salary and
    only within the last 2 years or so dropped back to 1x my
    salary...mainly because I purchased a whole life insurance/retirement
    plan from an external insurance vendor.
    

    
    
    	Is this package coming to your home or to the work place?  I'm
    	still waiting for the package that allows me to make the changes
    	I want.  After reading the past two and realizing I've had 3X taken
    	out for about 10 years does this imply I should be getting a
    	refund????  I guess I missed this point before now.  Please
    	respond!
        			

The Life Insurance Package came to my house, the Health Insurance Package came
to my office

    BUSY::RIPLEY...as long as you are in the plan as of Aug. 17, 1993 and
    you have been at 3x, it would seem that you would get a refund.  The
    life insurance package gets sent to your home, btw.

    
    
    Anyone have a # to call if you didn't recieve your life insurance
    package?  Thanks.

    
    
    	I haven't received mine either.  I think they are just in the mail.
    	Others just received theirs yesterday.  I did call the people
    	support network and sked them.  They are checking on it.  I guess
    	I'd suggest waiting a couple more days and if you don't have it by
    	Monday night then start checking it out.

	I received mine today  (and I get my mail at the post office)
	/Robin

    
    
    	My life insurance premium refund was $2K, and I had carried 5X for 
    	only 6 years.
    
    	I estimate that I paid $3K for the premiums over that time.  Had I 
    	gone with a private carrier, they would have been  about $2.2K (I
    	had researched it, gotten better individual rates, but never got
    	around to changing it).
    
    	Now I am glad I didn't change.  
    
    	For once, such a deal!
    
    	Bob

    I have a couple questions for the people receiving the life insurance
    premuium refund.
    
    1) what the package looks like?, I received my digital life insurance
    program package, but no dollars amount were included.
    
    2) Does everyone get the refund?, I have 5X my salary since 1984.
    
    3) DO you have a phone number or a contact person for the people who
    did not received the package at home?, I appreciate your responses 
    
    regards,
    
    Carlos
    

    
    It was a white page-sized envelope. Inside was a cute package of
    booklets and single sheets, all the same width but with different
    heights, so that if you align them at the bottom the headers all appear
    one behind the other at the top (endless hours of fun for young
    children). Hidden at the very back of the package was a single white sheet
    that was laid out as a checklist, to be used when you phone in to make your
    insurance selections. At about the center of the first side of this
    sheet was an item, labeled something like "balance" and with a cash
    amount; under that were two options, "send to you as a check" and "deposit
    to accumulation account", or words to that effect.
    

    thanks for the info. I do remember the form, I hope I did not trash it.
    
    
    Carlos
    

    >>today's non-system:  Many medical specialists NET over half a million a
    >>year!  I know of a fellow of around 30 who finished his surgical    
    >>training
    >>and was offered a salary of a hundred grand --  a month!  He turned it
    >>down for about $400k/year in a more temperate environment.  Surgery is
    >>a high-profit item for hospitals.  To me this is obscene; doctors
    >>should make a good living, but frankly too many make more than Bob
    >>Palmer does even with his raise, and I think BP's worth more.

Supply and demand - that surgeon is a specialist and if there are more 
doctors with that same specialty, the price will go down.  You can't compare 
what that surgeon does, to a paper-pusher like a CEO, the surgeon has the 
ability to directly save lives, CEO's don't.  Why should you decide what kind 
of "a good living" the doctor should make, he doesn't try to regulate your 
profession, saying for example "engineers or marketing people shouldn't make 
as much as they do".

Is there a problem with health care - of course - nothing is perfect - but I 
think that B&H's plan is a frenzy to massively restructure the entire health 
care system for the 15% that it's not working for those that are uninsured 
for example.  The number's that are uninsured include people who CHOOSE not 
to have insurance, some who are financially secure and don't want or need 
health insurance.  Cost's are rising, but they are rising all over the world. 
As people become more wealthy, they have higher expectations for their 
health.  But that doesn't mean you dissemble the entire system of health care 
for every American.  And besides, the B&H plan is going to be more expensive, 
not less expensive.

B&H are selling the plan in response to tales of skyrocketing costs, in a 
fear-mongering way, that future generations will be bankrupt if we don't 
control cost.  Then they smother us with lots of compassion, and lots of very 
sad stories.  They are not dealing with facts or reality, and more 
importantly they are not dealing with a true fix for the problems that exist. 
 But they USE the problems that exist to sell a very different bill of goods 
- their goal is for government to step in and nationalize one of the most 
important aspects of everyone's life. 

If the government can step in and take control of this large industry, they 
can probably take control of anything in your life!  Think about it... 

I called CIGNA's 800 # for questions (828-3485) this AM to verify this
stuff about the refund (nothing that good _EVER_ happens to me) and I'll
be darned if it isn't all true!!!

This is a _SIGNIFICANT_ chunk of change we're talking about here after
16 years at 4X! And it's not subject to taxes! And it'll be mailed in
January! FREE MONEY, FOLKS!

-Jack

    Wonder if employees who have been TFSO'd over the past few years will
    get the insurance refund, or if they are SOL.

re: .-1

.104>    Those employees participating in the current optional life insurance
.104>    program as of August 17, 1993, will be eligible for a premium refund
.104>    from John Hancock.

Looks like only the most recent, perhaps.

Gosh - I feel so good about this, I think I'll take my windfall and go out and
invest it in DIGITAL stock . . . 

not!
:^)
-Jack

    Why aren't ex-Digital employees (those who were not in the program as
    of August 17, 1993) eligible for premium refunds?  Seems to me that
    ex-Digital employees were paying into the slush fund for a number of
    years and should have something coming.

re:.115   take a look at what you wrote, then look in the mirror. 
The one who's fear-mongering will be looking back at you. B&H's approach
to this problem has been anything but. 

There may be some uninsured who CHOOSE to be exposed to the enourmous risks
posed by todays skyrocketing medical costs, but if its any more than a
extremely tiny number, I'd be very surprised. The people I know who are 
uninsured, I can assure you, are not trying to drain YOUR pocketbook,
and are not choosing that situation,
 just people less fortunate than yourself. 

Any rational solution to this problem has to address it as a larger
community concern. Framing this problem as an individual rights or freedom 
issue is irrelavent to solving the problem, IMO.

    Sorry, I have to agree with .115. Have you seen any government program
    that operated with any degree of efficiency ? Has the government ever
    approached the kind of efficiencies achieved in the private sector ?
    Everyone uderstands that there is a problem at the lower economic
    levels with coverage. Let's fix that problem. Let's not trash the rest
    of the system which does work for the majority of us. What's need to
    fix the problem is a scalpel, not a chain-saw.
    
    Specifics, how about REAL tax credits for all businesses which offer
    health care to their employees. What about a tax credit similiar to the
    present EIC credit for low income people that could only be used for
    health care. What about real mal-practice reform that would lower costs
    for all of us. These are just a few ideas. I think the only poor idea
    is more government control. 

    
    	This evening I finally opened my package of info on Open
    Enrollment. My wife may be able to cover our family for far *less*
    than I would have to pay while working for Digital.  So I find out
    that I'm currently paying $27.36/week, which will increase to $32.53
    per week. If I choose to Opt-Out, I will receive an additional $25.41
    per week in my paycheck, according to text on page 7.
    
    Excuse me...I'm paying $27.36/week, but they'll only give me back
    $25.41/week? So who gets the extra $1.95/week? We're not talking big
    bucks here folks, but $1.95 times lots of employees adds up. And
    besides, it's MY two bucks they're talking about here! So where does
    it go?
    
    This may have been covered earlier but I don't have time to go thru
    all the replies...
    
    John
    

    re .121
    
    >Sorry, I have to agree with .115. Have you seen any government program
    >that operated with any degree of efficiency ? Has the government ever
    >approached the kind of efficiencies achieved in the private sector ?
    
    Yes to both.  I've seen quite a few government agencies at state and
    federal level operating more efficiently than some Digital
    organizations.
    
    /Butch

    
    RE: .122  Actually your paycheck will increase by $52.77.

    
    
    	Just a reminder to read th efine print on the cash accumulation
    	selection.  If you roll your money into this fund they indicate
    	that they will pay 7% garanteed the first year.  fine print says
    	they will take out 2% when you deposit the money.  This says to me
    	that we actually only realize 5% the first year.  Likewise, with a
    	minimum of 4% if it gets that low they would really be paying only
    	2%!  Is this how others have interpreted this?  sounds just like a
    	"load" like on mutual funds.  I relize that the load is only paid
    	once, when it's deposited.  Can't remember if there is a yearly
    	fee to manage this account or not.  Just a reminder that folks need
    	to really look behind the bold print.  8^)

    My feeling is to take the money and run.  Granted I won't be able to
    run very far but I'm beginning to feel like the old hermit who'll keep
    his money under the mattress rather than in a bank.  I have little
    confidence in *anything* going on around here these daze!
    
    Marv
    

    re. 122
    
    	The money you'd receive from opt-out is the amount digital pays
    for your insurance, the remaining $27 you pay is the amount above that
    you pay to cover the full cost of the premium. As previously mentioned
    your paychek will now be ~$53 greater...  At least this is the way I've
    always understood it.

    
    
    	Oh...never mind. ;)
    

>> I can assure you, are not trying to drain YOUR pocketbook,
>>and are not choosing that situation,
>> just people less fortunate than yourself. 

Then, why should I pay for someone else's health insurance?  I'm already 
paying into Medicare for those "less fortunate"- why should I pay more?  
There are people who don't eat properly and don't have proper shelter, so I 
suppose I should pay more $$ so we can have National Food and Housing 
Programs that EVERYONE must participate in - the government will give 
everyone "free" food and housing - can't wait!!! They should seize everyone's 
homes and turn them into community housing projects for everyone to live in! 
No Thanks!

>>Any rational solution to this problem has to address it as a larger
>>community concern. Framing this problem as an individual rights or freedom 
>>issue is irrelavent to solving the problem, IMO.

Lack of individual rights and freedom is at the core of B&H's plan, I want to 
choose my health care the same way I choose where I live, what I eat, and who 
I associate with - my health is important and I don't want the government 
telling me what care I can have and who will give it to me.

    re: .99  It is amazing that there are no choices for an area with as
    many employees as ALF (approx. 1200).  Most locations in New England
    have 3 - 6 HMOs to select from and 6 - 8 different plans.  Even St.
    Louis, MO with only around 300 - 400 employees has at least 3 different
    HMOs to select from.
    
    ALF has one HMO (Kaiser) and the closest office to my house is 45 min -
    1 hour drive.  They have no OB/GYN doctors listed at that facility, so
    I guess my wife would have to drive even further away.  The only
    hospitals that are supported by KP are 35 - 40 miles from home in some of
    the worst traffic in the South. 
    
    So much for CHOICES......I would love to discuss this with the genius
    that made this decision.....  I doubt that anyone took the time to find
    out where the people that work at this facility live with respect to
    travel time to KP....Choice means having more than one of something to
    select from....Where is the choice here ????  $107 per week is not an
    real option and they know it.

Re: last few on Opt-Out



	If you Opt-Out, the $25.41 per week additional that you get paid is 
	the portion of what Digital pays for your (the employee's) health 
	insurance.

	The $27.23 is what you pay for your family's coverage.

    Re: .121
    >> Sorry, I have to agree with .115. Have you seen any government program
    >> that operated with any degree of efficiency ? Has the government ever
    >> approached the kind of efficiencies achieved in the private sector ?
    
    Yes.  The social security system is *incredibly* efficient, in fact.
    Administration costs are something like 5 cents on the dollar.
    
    The national park service works extremely well, as far as I can tell.
    
    "Government bashing" is popular - and occasionally justified - but
    most of the time government works pretty well.  People tend to 
    emphasize the occasional horrible example and project those cases onto
    government as a whole, but it's comic-book-level simplistic analysis.
    

re .130:

>    re: .99  It is amazing that there are no choices for an area with as
>    many employees as ALF (approx. 1200).  Most locations in New England
>    have 3 - 6 HMOs to select from and 6 - 8 different plans.  Even St.
>    Louis, MO with only around 300 - 400 employees has at least 3 different
>    HMOs to select from.

There's a lot of variation in the availability of HMOs.  Massachusetts has
the highest rate of HMO subscribers.  Some states have no HMOs at all.
How many HMOs are there in the Atlanta area?  Is there a particular HMO
you'd like to join?  If so, why not ask the authorities why it's not a choice?

    re:.several
    There is obviously a philosophical, not factual, issue that separates
    some of us from, say, ::MURRY.  There are those who simply insist that
    government is by definition bad, so it cannot by definition do anything
    well.  Some of them, when given jobs in the Reagan administration,
    intentionally screwed things up just because they couldn't tolerate a
    government job well done!  But as was just noted, the SSA and NPS are
    quite efficient, as are various other agencies.
    
    In any case, the B&H plan gives CHOICE to the consumer.  They can pick
    their doctor and for that matter their HMO.  What it does is set
    STANDARDS for plans so they're more comparable and cheaper to run (same
    forms, for example), and set up UNIVERSAL coverage so that costs aren't
    shifted from the insured to the uninsured (who are covered today by
    very costly, unreimbursed emergency room care).  Both of these are by
    themselves major cost-containment matters.  The plan does not require
    the government to run the plans, just to oversee it.  (I prefer a
    simpler single-payer plan, in which the govt. designates or runs one
    insurance system, who compensates any qualified provider at an
    acceptable fee.  But that puts too many insurance droids out of
    business, I guess.)
    
    Since this is based on philosophy, we can only agree to disagree.  In
    the meantime, we DEC employees get screwed; the ones in Atlanta
    apparently much worse than we in Massachusetts.  (We can get pretty
    decent coverage from Bay State for $40/wk, or less if Tufts or Pilgrim
    PPOs pick up our area/providers, or mediocre-to-poor local  HMO
    coverage for less.)
       fred

I've asked once before, please keep the national health care debate out of this
topic or it will be write-locked.

Thanks,

Bob - Co-moderator DIGITAL

    >>some of us from, say, ::MURRY. There are those who simply insist that
    >>government is by definition bad, so it cannot by definition do anything
    >>well.  Some of them, when given jobs in the Reagan administration,

Please don't assume I think all gov't is bad, it is necessary for the 
security of the nation.  But government control of health care, in my 
opinion, is not good.  

On the subject of this note...
I do not prefer HMO's, but that is my choice, and I can appreciate the fact 
that others do prefer HMO's, that is their choice.  But at least we have a 
choice of what health care we choose to participate in or not participate in. 
I would prefer to have the money that Digital puts into my health care, so 
that I can self-insure and shop around for the care that I need and want, and 
at least I can Opt-out and purchase health insurance through my husband's 
plan.  With a UNIVERSAL (read soon-to-be-socialist) health plan - EVERYONE 
must participate in the government's plan.

>>        <<< Note 2739.137 by CSOA1::LENNIG "Dave (N8JCX), MIG, @CYO" >>>

>>    Am I missing something??

Yes.
    
>>    Going through my Life Ins packet, I see I'm getting a tax-free refund.
>>    I see I can roll it into the tax deferred 'Cash Accumulation Fund'.
>>    I see that contributions are subject to a 2% 'state premium tax'. Huh?

One has nothing to do with the other.

The money is being refunded "tax-free" because you already pay taxes on it
before the original premiums were paid.  The 2% 'state premium tax' is
required of ANY money going into the cash accumulation account.
    
>>    1) I can deposit tax-free money and pay deferred taxes on it later?

There are no deferred taxes on the principle amounts since again,  you
paid taxes on the monies BEFORE they were put into the accounts.

>>    2) I can deposit tax-free money and pay a 2% state premium tax (in 
>>    	a tax deferred account?)

For every $1.00 put into the Cash Accummulation account,  $0.98 gets 
credited to your account and $0.02 goes to the state primium tax fund.

>>    BTW, what exactly _is_ the 2% state premium tax?

Each state taxes *ALL* life insurance premiums to varying degrees.  CIGNA
has averaged them out and decided that can pay the taxes by assessing 
it at 2% for everybody.  Your state may be more or less. 
The optional life insurance premiums already has the 2% figured in to the
rates.  It's only explicitly called out on the cash accummulation fund
deposits.

Garry

    thanks - I deleted .137 (apparently while you were answering it)
    because I found the clause about only interest earnings being
    taxed at withdrawal, not the contribution.
    
    However, I'm still puzzled at the state premium tax; given that they
    say that the fund can be used for other purposes, how can they justify
    taxing a contribution that may/may not go towards ins premiums?
    
    Dave

    
    One thing that hasn't been emphasized about the life insurance
    is the guarantee that you can take it with you if you leave
    DEC.  CIGNA will simply bill you directly and your amount of
    insurance available will be based on the salary you were earning
    when you left Digital.  The rates for this insurance may be
    different -- higher or lower.  CIGNA puts all former employees
    of group company plans into the same pool and establishes the
    rate based on the "experience" (this is just a term that means 
    how many people in that pool die and collect) of that pool. 
    Currently the pool has 90,000 people in it and the rate is
    comparable to the rates the companies are getting.
    
    This is a significant improvement over the John Hancock plan
    because it guarantees you group life insurance whether or not
    you remain employed.  With JH when you left you had to convert
    to an individual plan to remain insured.  Individual rates are
    MUCH higher.
    
    fwiw,
    Steve
     

    re: .136
    If you would prefer to have the money that Digital pays for your
    insurance so that you can self-insure, you are *extremely* naive
    about the realities of the insurance marketplace.  My husband
    is self-employed and I am grateful to be paying the fairly modest
    (yes modest) premium that I pay rather than the truly fbudget
    busting prices the self-employed must pay - usually for benefits
    with huge deductibles (several thousand per year) and  caps 
    on total benefits.  The self-insured with catastrophic illnesses
    are practically guaranteed to run out of benefits within a few years
    (or less) unless of course they die - not a great choice in my mind...
    
    The blessings might be diminishing, but I'm still counting mine.
    
    

    As have others, I see the cost for DMPn skyrocketing to the $100 / WK
    area, which appears to be too much for my wife and I.  This means that
    we need to consider the alternatives, which are (for us) Healthsource,
    Matthew Thornton and Harvard Community Health Plan.  (Central NH area).
    
    So how do we choose which one?  If this is not the right string to ask,
    could someone point out WHERE I can ask for recommendations?  Thanks,
    
      John

Re: .141

Too bad you didn't realize this earlier this week, as you could have spoken
with reps of the various HMOs and gotten literature from them.  You can call
them and hope the info arrives before the 19th.

In this area, there are two types of HMOs offered, the clinic-based plans
such as Matthew Thornton and HCHP, and the "Individual Practicioner
Associations" (IPA) such as Healthsource and HMO Blue.  In the latter, you
select a "primary care provider" physician from a list of those who have
signed up with the HMO.  Healthsource is by far the larger of the two
organizations in NH.  However, the clinic-based programs are much cheaper -
half the cost or less.

You can find some discussions in the MORTAL::NEW_HAMPSHIRE conference.  I've
been very happy with Healthsource for three years, though I don't like the
price hikes.  The HS rep told me that THEIR rates only went up 6%, though
why they went up at all in face of record profits is beyond me.  Digital
seems to price the plans to steer you towards clinic-based programs, though
I would have thought it's all the same to Digital.

				Steve

re -.2
 >>  If you would prefer to have the money that Digital pays for your
 >>   insurance so that you can self-insure, you are *extremely* naive
 >>   about the realities of the insurance marketplace.  My husband

True, being able to take advantage of corporate rates is usually beneficial 
compared to those rates available to the self-employed.

However, I am not so "naive" as you say about the realities of the insurance 
marketplace, since I found that it was much more cost effective for me to 
OPT-OUT (to some extent taking the money to insure elsewhere - through my 
husband's insurance which is NOT an HMO - thank God!) than to pay for even 
the cheapest HMO at Digital.  And Digital has a much larger employee base 
than the company my husband works for.

Re: .141

It's very difficult to evaluate HMO's in a general
sense - particularly Harvard Com.

If you live in Boston and select Harvard Comm, you must
go to their "clinic" for treatment. I  understand that 
this is a "production line" facility. You see whoever is
on duty.

On the other hand, I live in Acton, MA and use
Acton Medical Associates  which is a member
of Harvard Community. We can request a particular doctor
and actually get that person.  Many Acton Medical doctors
give out their HOME telephone numbers.  Doctors have
called at night and asked how our kids are progressing
when they were sick.

The business arrangement between Acton Med and HCHP is ver
interesting - but that's a topic for a different notes conference.

Your best bet is to talk to colleagues who have used 
services of HCHP facility in your area.

Gim

    i've expressed more than my share of crticism of company policies,
    rules, and regulations in the past. however, this time i am pleased to
    compliment those that have worked out the health care and especially
    the life insurance programs. i am not terribly happy about a 45%
    increase in my medical insurance. but at 12$ a week i am not going to
    complain. 
    
    in the life insurance area i added my wife (at 100K), added both my
    children (at 20K each) and increased my coverage and my weekly premium
    went DOWN! many thanks to those who have worked so hard to make a
    difference in these difficult times.

    re. 141
    	John,
    
    	If you live in NH in one of the border communities, ie Salem as I
    do, you may be able to elect a plan that is not listed in your brochure
    that might save you money. Three years ago I joined Bay State Health
    Care when the JH medical plan costs skyrocketed. BSHC was not listed as
    available but I happened to find out from other people who worked in
    NIO and lived in Salem that BSHC was available to them. It seems that
    many of the Mass based plans are available to NH border town folks but
    it isn't made clear... I'm now a member of Tufts as it's cheaper than
    BCHC with the same doctors as I've always had.

>    Why aren't ex-Digital employees (those who were not in the program as
>    of August 17, 1993) eligible for premium refunds?  Seems to me that
>    ex-Digital employees were paying into the slush fund for a number of
>    years and should have something coming.


Did this ever get answered?  Say you paid in for years and dropped it 
in the summer.

-Jay

    
    
    See 2760.43 and a few previous
    
    You're welcome
    
    
    /Bob

re .160 et al.

I know these notes are about CIGNA customer service and not cash, but 
here goes:


If you have some special circumstances w.r.t. your insurance, I strongly 
urge you to get written confirmation that CIGNA is doing what you think.

I am on temporary relo to France.    I also established, some 4 years 
ago, an insurance trust that provides tax benefits only after it has 
been in effect for 3 years.  Ignoring the part where I got the paperwork 
from CIGNA one day before the Nov. 19 deadline (partially DEC's fault), 
I have had a serious problem getting the right thing to happen.

To cut a long story short, I faxed all of my papers to my trustee, who 
had to sign as owner of my life insurance policy; then he faxed the 
paperwork to CIGNA.  I called them a few days later; they told me they 
had not received the fax.  I had my trustee fax the papers again.  I 
followed up, and they claimed they had the paperwork.  [In the meantime, 
one of their reps, who had been specially assigned to weird cases like 
mine, told me that she had *seen* the papers come off the fax the first 
time, so she didn't understand why no one could find them.]

I am on an unexpected business trip to greater Maynard, so I visited my 
house.  There, in the mail, was a notice from CIGNA "confirming" that my 
coverage was identical to what I had last year, when in fact I had made 
substantial changes in dependent and spouse coverage.  So, I called them 
up, and they told me they had no record of my application, so they 
defaulted to my existing coverage.

After I came down off the ceiling, I called Mary Burke at CIGNA in 
COnnecticut, the special rep.  She checked and claimed fury equal to 
mine that they had lost the paperwork a second time.  She arranged with 
my trustee to fax the papers again, and she said she would have various 
people acknowledge receipt by phone.  I told her that I wanted a 
specific person  at customer service to mark each page as received and 
to sign and date each page and to send me back the whole thing as an 
acknowledgment.  We'll see if this is what happens.

BTW: the confirmation I got in the mail from CIGNA had my SS#, obviously 
provided to them by DIgital.  See another note in this conference on 
that topic.

    Has anyone received their refund yet?
    
    If not..then when should we expect to see money coming back?
    
    ..and yes, I am getting a refund..and yes, I did go through the process
    stated on the announcement we received at home.
    
    								Thanks
    								-mike-

    re .149
    
    Well...no sooner did I place the previous note, when I hear from the
    Insurance Company that we will receive our refunds sometime before mid-Feb.
    
    								-mike-

    re .150
    
	I noticed the rdb in your note.  I just talked with CIGNA this morning.
	Their database isn't in 3rd normal form.  They said I didn't have PAI
	(and I wasn't charged for it), but found that I did have PAI on a 
	different screen.  The person said he couldn't understand that.  So
	much for denormalizing databases.

I called Cigna the other day and the young lady I spoke to said the cheques
would be mailed "next week."  I asked if that meant the week of January 17th
and she said that she supposed so. She said that we should have the cheques by
the end of the month.

BobW

    Has anyone looked at their paychecks today ?
    
    The new deductions are there, along with the old ded.
    
    It's a mite confusing.
    
    	It was (and is zero this week)
    
    		Life:		0
    		Dep Life:	0
    
    		With Life Ins Option saying how many multiples am carrying.
    
    The added/changed data:
    
    		Life Ins:	xxx
    
    	Life ins option nows say Yes
    	and Dep Life Plan has XXX through it
    
    	I had signed up for
    		Life
    		ADD
    		Dep Life
    		Spouse Life
    
    Anyone have a clue or should I call Cigna ?
    

    Re: .152
    	What is the number you used ?  (It's been a loooong day)
    

    Look further down. You'll see another entry for Life. Different
    entries for different companies?
    
    Jim C.
    

I called CIGNA today and, quite honestly, I am just a little concerned.  

I had called to verify my family's coverage after the new year, primarily
because there were some subtle changes to the information on this week's
pay stub though I will admit to wanting to make certain everything was
correct from the transition.  Well, I'm glad I did -- my coverage, and my
children's, was correct.  However, they showed my wife's coverage as 
"Canceled".  The person I was speaking with seemed just a bit concerned 
and checked into it.  She called me back shortly thereafter and said she 
erased the cancellation (and made a note that it should not be cancelled) 
but I cannot help but be a little skeptical about where they are at 
currently in terms of their database.

One last thing:  My wife is presently shown as having 30k coverage even
though we applied for more.  The paper work was signed and sent, but 
has not yet been entered.  The person I spoke with said there is a big
push going on there to enter all the info in the next two weeks.  I 
hope they are checking things twice...

-Andy

    Re.55
    I showed the "third" life slot.  What concerns me is the different use
    of the bottom of the check and lack of clarity as to what is going
    where for what.
    
    Bill
    

    My guess:
    
    They had to continue to show the old LIFE deduction because you made one
    payment this year.  So, it was necessary to keep that data for the 
    YTD columns to add up.  The new LIFE INS deduction is where the Cigna
    amount will be shown.
    
    Sound right?
    Chet

    One phone call did it for me.  I too showed strange changes in my pay
    stubb.  Called the PSN (People Support Network) at 1-800-544-9944 and
    they not only cleared up my questions about the deductions but also
    said that the "refund" checks would be out and should be received no
    later than the end of the month....
    
    Toodles.....JP

    re: .156
    
    You're not the only one with concerns.  My pay stub list an
    amount for the new life insurance, and I think it should
    be higher (I used their worksheet to figure out my deductions
    and I'm quite sure it should have been higher).  I tried calling
    Cigna, but couldn't get any information because I can't remember
    my four digit PIN number (hopefully, I still have documentation
    around after my maniacal home office cleaning of last weekend).  
    Without that, they won't give out any information. I signed my 
    wife up for quite a bit more than the 30K, and I'm guessing they 
    don't have her in the database.
    
    I don't have the warm fuzzies that they got this right.
    
    Glenn
                                                            

    When I signed up with Cigna, I asked for no optional coverage for
    myself but $5000 coverage on my daughter. 
    (I couldn't get their electronic signup to work for that, and ending
     up talking to their representative, who stated she would enter my
     requests for me. I got NO confirmation letter at all.)
    
    Well, in checking my pay stub for last week, I noticed that there was
    no deduction for coverage on my daughter. So, I called CIGNA and
    inquired. The lady told me that since I selected no optional coverage
    for myself or a spouse(I don't have one), I was not allowed to buy
    optional coverage for children.  
    
    My reaction is "Why the *&#@ didn't they SAY so?".  I saw nothing in
    the literature I got from Digital that indicated this prohibition,
    and the woman who signed my up gave no indication it wasn't allowed.
    She even said she didn't understand why the electronic method wasn't
    ever letting me get to the menu for dependent coverage.
    
    I'm really hacked off about this!
    
    Marie
    

Re: .162

Perhaps they did you a favor.  Why does your daughter need life insurance?
Does she have dependents of her own who would need the money to live?

				Steve

> Why does your daughter need life insurance?

The usual reason for getting a policy like this is to cover the cost of
a funeral and other related expenses if the dependant should happen to die.
It's kind of morbid, I admit, but that's why I have a policy for each of my
children - if something terrible should happen, the last thing I want to
worry about is trying to come up with money for a funeral in addition to
trying to cope with the loss of a loved one.

--Scott

    
    re: 164
    		Exactly!
    re: 163
    Steve, surely you don't think $5000 would have done much for any
    dependents she might have had.
    
    As it happens, she is 21, and half-way thru college. Which is why *I*
    don't feel the need for optional insurance on myself any longer. I
    missed the enrollment period for adding dependent life a few years
    back, under the old plan, and thought I'd take out the minimium $5K
    on her this time for the reasons mentioned in .164. But whatever MY
    reasons were, *IF* it was not allowed, CIGNA should have said so in
    November! And I still don't think that this 'explanation' agrees
    with the promotional literature Digital sent all of us about the new
    program!  At least, thank God, I wasn't calling to file a claim, just
    following up on the mail message from "A1::USBENFITS" which mentioned
    the new deductions should show up on the paycheck distributed the 13th.
    

    
    There was (somewhere in this or another string, I have been unable to
    locate it) a reply that gave an address for people who were not covered
    under the policy on August 17 but felt that they should have received a
    refund.  
    
    Does anyone have that handy?  I printed it out and promptly lost it!
    
    John

Just checked out VTX HCCZ_US and found I'll be hit with a 28.8% increase in
my HMO rates for 1995.

Bob

Fascinating - for me, the rate has actually gone down about 5%!  (I should hope
so - Healthsource recorded record profits last year!)  Still doesn't make
up for the 21% leap last year, but it's better than an increase!

					Steve

    Looks like Digital Plan 2 has leaped 41%.
    
    

    I'd still like to know why couples with no children are forced to
    subsidize those that have children. If someone decides to have several
    kids, then THEY should be responsilble for their healthcare!!! I
    decided NOT to have kids, yet I'm forced to pay for someone elses kids
    healthcare. $^&*@(*&^#
    
    Harry
    

    For the same reason that we are forced to subsidize you if you have a
    heart attack and require a week of care in a cardiac intensive care
    unit.

>>> If someone decides to have several
>>> kids, then THEY should be responsilble for their healthcare!!!
    
    
    That's the way it works, oh, right, at my next employer.  :-)
    
    ed
    (Oracle bound)              

re: .168

Steve, must be nice.  My HMO plan went up 20+% last year too:-(

Bob

    >              <<< Note 2739.171 by TNPUBS::JONG "Steve" >>>
    >                      -< It's called a risk pool >-
    >
    >For the same reason that we are forced to subsidize you if you have a
    >heart attack and require a week of care in a cardiac intensive care
    >unit.
    
    But I'm just *one* person with *one* spouse. Yet I have to pay for
    myself and a "family". The rate I have to pay is the same for just
    me and my wife as it is for someone with a wife and 8 kids. Odds are
    that those kids will need a lot more medical care than my wife and I.
    
    Sure, it's a risk pool, but most risk pools charge for *everyone*. Ours
    doesn't. Well, it does, but not fairly. Serious medical problems can't
    be avoided. A house full of kids is a decision that is made by the
    parents. The parents should be responsible for their kids. Period. They
    had 'em, they should pay for 'em. Ooops, I forgot! This IS America,
    home of the non-responsible. :-(
    
    Harry
    

    
    reference -1
    
        Why don't you say what you really mean..................
    
    
    bc
    

>    But I'm just *one* person with *one* spouse. Yet I have to pay for
>    myself and a "family". The rate I have to pay is the same for just
>    me and my wife as it is for someone with a wife and 8 kids. Odds are
>    that those kids will need a lot more medical care than my wife and I.

    I find that kid's medical care is relatively cheap...an occasional
    check that on an earache, vaccinations, annual physical.  Adult
    medical care is where the expense lies, not kids.  One heart attack
    or breast cancer treatment will pay for a LOT of kids expenses.

    MOST of the money you spend on medical care in your whole life is
    spent in about the last year or so of your life.

    I suspect you're arguing about the inclusion of the CHEAP medical
    care, not the expensive sort.  Would you rephrase your complaint
    that all the elderly are included along with you and your wife?
    Do you plan on not getting old as well as not having kids?
    bob

    re: Note 2739.174 by DPDMAI::HARDMAN 
    
    Why don't you drop the family plan and save money. Let your wife
    get her own insurance, if you have no children that shouldn't be
    hard to do.

    I've got two kids, 5 and 8, and I have yet to meet my deductible for
    Plan 1 any year (except the year they were born).  Myself, (I waited to
    have kids and consider myself almost middle-age) I've met my deductible
    and paid out of pocket each year since their birth.
    
    How you figure kids are what makes the family plan a "family plan" is
    beyond me.  It's the adults that cost the money....
    
    re -.1  Right on, see how much individual insurance costs for your
    spouse if she's not employed.... you'll be glad to have the family
    plan..
    
    Toodles.....JP
    

    I think it's obvious the company is "encouraging" you and your spouse
    to carry two individual policies. Assuming your spouse is employed
    elsewhere, someone else picks up the tab. 
    
    We chose my husbands plan for the past 2 years, upfront cost are higher 
    than Digital's, but the coverage is better (covers my chiropractor) and 
    after subtracting my opt out $$, the net cost was lower. He works for 
    a very small company and takes a "couples" plan, it's cheaper than 
    a family plan but more than two individuals. The pricing encourages you 
    to carry to individual plans. 
    
    Now if only our enrollment periods overlaped...
    
    Gail

 Because the HMO I was in offered a "couple" rate. Was told the company chose
not to offer it so that the cost was reduced for those with famlies.  They
said they might look into the couple rate for the following year. This eas
several years ago.

						Trace

    Where/how do you find out what the rates for health and life insurance
    will be for next year?  I must have missed something.
    
    Thanks.
    
    rww

As was mentioned - VTX HCCZ_US.

			Steve

One thing that I found disturbing is that, even though they could
have included the information, there was no definition of what
is/isn't covered by my HMO next year...

Maybe I'm just being jumpy, but I'd like to know exactly what, if any, 
coverage changes are going to take place.

Kevin

    
    	kind of on a side note...Did you all know that the dental plan
    	rates are based on 1986 assessment?  in other words, what gets 
    	paid is based on what the costs were in 1986.  It is Digital 
    	that does the assessment and so is not the health plan provider
    	who is dtermining the payments but rather Digital as it was
    	explained to me...Just another exmaple of keeping the costs down
    	I guess.
    

    My HMO has a phone number for "member services" that you can call and
    ask questions about what's covered, and the limits.  They change
    frequently, it's not an annual thing.
    
    Mark

Ref:  - many (bashing kid's health costs)

I raised seven children and had VERY low health care costs.  One year's
expenses totaled $78 (seventy eight dollars), and that included asprins,
cough medecine, bad-aides, doctor/dental bills, etc.

Fortunately, my "little" ones (youngest is now 29) were and still are as
healthy as can be.

Ws

re .184 (dental coverage)

 so that's why the coverage is so awful.  It's been very
puzzling to me that my dentists consistently have charged
prices that were up to 100% more than the allowed price.
(Actually not just "puzzling" - more like "aggaravating")

DO you know of any plans to update this idiosynchracy?


- Lars

    Why should they - it's saving them gobs of money!

    re: .182
    
    Steve,
    
    Sorry, I got the VTX HCCZ_US reference.  I meant to ask for a pointer
    to life insurance rates for 95.
    
    rww

From:	PENUTS::PBAXTER      "PHIL BAXTER - DTN: 275-3412 (USDSL I.S.)" 19-OCT-1994 07:23:49.83
To:	GRIMLY::BEN_IP
CC:	PBAXTER
Subj:	1995 Health Care Benefits

        To: Digital Health Care Benefits Dept.
        -------------------------------------------------------
        I am very upset to see what digital is doing to us 
        employees in the area of health care costs...

        The cost of my Harvard Community Health Plan for family
        coverage is changing from $18.24/week to $21.04/week
        That is a +13% increase in this rate, which is absurd
        concidering that in today's Globe in states that ...
              "Many in state will get no HMO hike in 1995". 

        In PARTICULAR today's Globe reports that ...
        -------------------------------------------------------
                "Harvard Community Health Plan is telling 
                 subscribers how much their rates will go
                 up in January: 'Zero, zip, nada, nothing.'"
        -------------------------------------------------------
        So if Harvard's rates are not going up... why is digital
        increasing the rate that the company charges against my
        income by 13 percent ?

        I am sincerely concerned.
        Phil Baxter 
                                      

    I wonder what's gonna happen to MY rates... I am forced to be on the
    SELECT plan... which has HCMP (the ONLY participating HMO in my area...
    so I have no choice) as my primary care provider, and ALSO has reduced
    coverage JH (PLAN 2) for my family... since my kids live in another
    state where they cannot be covered by HCMP.
    
    Tony

    
    ...why do I suddenly feel like I'm being recruited into a cult?

    
    Re .193:
    
    Thomas,
    
    You took Bad Drugs, man. Someone needs to Talk you Down. In the mean
    time, stay away from Windows.
     

    re:-1 glad to see that I'm not the only one that thought this!
    
    Yeah, Thom, cool it.

Considering your Views on Health, why Are you acting Like a Virus all 
over this Conference?

    I can't tell if the postings from SCHOOL::NEWTON are incredibly
    brillinat, or if they are a Dave Barry column gone horribly astray..
    
    ...tom
    

    
    
    Nah,  incredibly boring.

    This Guy Obviously Suffers From "Winnie The Pooh Syndrome."
    
    Perhaps He Is Related To A.A. Milne?
    
    Just Wondering...
    
    -Ross

>             <<< Note 2739.197 by SCHOOL::NEWTON "Thomas Newton" >>>
>
>    I have never taken illegal drugs or gotten drunk in my life - and
>    never intend to.  The loss of clear thinking is not worthwhile.
                       ^^^ ^^^^ ^^ ^^^^^ ^^^^^^^^

    Yeah, so What's your Excuse?   

	:-)
    

    
        Re  .193
    
        >>  I have been running for Days without Much Sleep ....
    
    
        There's the clue.  Hey, get some sleep, fellow.
    

Are we under attack from a LISP macro?

>Per

Anyway, here's one way you can pay more, even though HCHP does not increase
their rates to Digital:  What Digital charges is based on the minimum cost plan.
If the cost of the minimum plan goes down next year, then what Digital pays
towards everyone's health coverage goes down, and what the employees pay goes up.

The clue that this payment by Digital is going down is the opt-out, which has
gone down for 1995 for the first time since it started.

This may not be the whole answer, but I think it's part of the equation.

Elaine

    re: .204
    
    Made My Day.
    
    Rww

    I live in an area that until 1995 did not have an HMO available under
    the DEC plan. Digital Med 1 Out of HMO and Med 2 were the only
    offerings. With 1995 there are 2 HMOs with a total of 3 plans. Med 1
    goes from $17.50/week to $131.44/week Family. 
    
    I'll have to check with the HMOs on the 20 year old out of state
    college student that needs to be covered.........
    
    Howard
    

re: .207

DMP-1 and DMP-2 rates always skyrocket when an HMO is first made available
in an area.  It's a deliberate attempt by Digital to get you into the HMO.

Bob

    re: .207
    
    DMP-1 and DMP-2 only skyrocket when an HMO becomes a "Point of Service"
    provider.  Yep... you're right.. It's deliberate.  It doesn't cost
    Digital near as much, nor the insured (so I'm told).
    
    Just mine.....
    
    Toodles.....JP
    

    
    No kiddin.  I'm going from $8.xx to $60.xx per week and because I'm on
    disability I can't change!
    
    Bob

    Look at it the other way -- the folks in areas that are just getting
    HMOs have had a bargain for years.  Digital only pays health care costs 
    equal to the lowest cost available program.  Folks in regions with
    HMOs have been paying the higher cost -- or using HMOs -- for years!
    I do think that it should be possible to change, though, even if one
    is out on disability.  I'm surprized that one cannot -- I thought
    "open enrollment" meant precisely that.
    
    	Larry

    uh, I know I'm opening myself up to be jumped on here (it wouldn't
    be a DEC notesfile if someone didn't jump all over someone else about
    something)
    
    but why are so many people pointing the finger at DEC?  Saying DEC is
    doing this to us, raising health insurance rates...
    
    The problem is a lot more convoluted than DEC...
    
    let's see, sue-happy people out there have sued so many doctors over so
    much that the doctors' malpractice insurance has soared and doctors who
    can still afford it (my doctor has quit delivering babies because he
    can no longer afford the insurance) increase the rates they charge
    their patients in order to cover the expense.
    
    Then there are all the expenses hospitals have when they have to treat
    people who don't have the money to pay for the treatment they are
    getting and aren't even on welfare...
    
    And there is the cost of having to treat people who have severe health
    problems like smokers who are still smoking, have emphysema (sp?) and
    lung cancer, or have heart attacks...overweight people who suffer
    health care problems with expensive treatments.
    
    I'm not talking about average healthy people who develop leukemia or
    breast cancer, I'm talking about people who live lives with unhealthy
    habits and then suffer health problems with outrageous treatment costs
    and our health insurance companies spread the financial pain by putting
    us all int he same pool and making us pay to help cover the expenses...
    
    This is a nasty pain in the pocketbook being suffered by thousands all
    across the country, regardless of what company they work for.  DIGITAL
    or DEC or whatever you want to call us these days is not the only ones
    at fault and I don't feel DEC is out to stick the employees this
    time...
    
    this time, mind you...
    
    but it isn't DEC doing this to us...
    
    this is a national problem
    
    imho
    
    okay...scream, tell me I'm wrong...
    
    
    

    RE: -1

    	I do believe the current conversation is about an increase that DEC
    has instituted.  The stated HMO has denied increasing their prices but
    DEC has increased the deduction they take from their employee, that
    makes it 100% Dec, no outside factors are involved.  Sounds to me like 
    one more benefit is being lessened.

    Joe

    I've heard of companies that are doing away with HMO coverage
    in order to get the low health risk employees back into the
    self-insured pool and lower the non-HMO premium.  Not much chance
    that DEC'll do that.  (and less that I'll ever see it)
    
    ed

    Regarding the fact that Digital bases it's benefit on the lowest cost
    available program ...
    
    	I'm pretty sure that HCHP is one of if not the Lowest cost plans
    	HCHP is not changing it's rates .. So again why is Digital?
    	Don't get me wrong... I may be able to afford the +$145/year
    	increase but others may not.  The principle of this matter is
    	is receiving the +$145 a year increase in my deduction?
    
    PS: I have not yet received a reply from my memo that I sent to
        the health insurance benefits group.
    
    Phil 

    RE: .170
    >I'd still like to know why couples with no children are forced to
    >subsidize those that have children. If someone decides to have several
    >kids, then THEY should be responsilble for their healthcare!!! I
    >decided NOT to have kids, yet I'm forced to pay for someone elses kids
    >healthcare.
    
    "Forced", "subsidize", really?
    The argument follows then - Since I don't smoke, don't drink excessively, 
    don't engage in "unsafe sex", exercise regularly, take vitamins, eat well, 
    avoid MickyD's Double Cheeseburgers, drive at a reasonable speed, etc. 
    Why should I be FORCED to SUBSIDIZE the health problems of those who 
    have DECIDED to live a less-than-healthful lifestyle?
    
    The reason is risk-pools.  Under current health insurance options, 
    YOU CAN CHOOSE your health care provider and pay accordingly.
    There are insurance companies out it the market place that have 
    reduced premiums for customers willing to give up smoking, etc. 
    Why Digital does not offer a broader choice of such options is
    certainly open for discussion.  I would like to see it.  
    You raise a valid point.
    
    As another reply stated - why don't YOU take the single coverage
    (which Digital gives you free) and let your wife pick up her own insurance.
    If she does not have a pre-existing condition, then you might realize
    some $$$ savings.  If she does have a pre-existing condition, 
    then am I being "forced" to "subsidize" her?  :)
    
    It sounds to me like you have never had to deal with a really expensive 
    and totally unavoidable disease in your family.  Be Thankful!
    
    Wait until (if) Hill-Bill-y Clinton muck up the system.  
    THEN you will definitely be FORCED to SUBSIDIZE the rest of the world.
    
    <SOAPBOX=ON>
    Re-elect NO ONE this fall.  Send a message to Congress.
    Stockholders disapprove all BOD members.  Send a message to Bob Palmer.
    <SOAPBOX=OFF>
    
    There, now I feel much better.

    I just called my area Benefits Specialist and was told that the reason
    HCHP went up is because Digital has, in fact, lowered its contribution
    from 78% to 75%. I asked if that was going to be published, and she
    said she thought it would be mentioned in the enrollment kit,  but
    since neither she nor I have seen it yet, we don't know.
    
    I also asked if I could complain about that, and she suggested that I
    write her a note and she would forward it through the appropriate
    channels, so you might want to contact your own Benefits Specialist if
    you want to make your opinion known.
    
    

    So _that's_ why I haven't seen any 'zeros' in a while.
    
    For some reason I thought that the base Digital paid was based upon 
    the least expensive employee-only coverage in an area, and we paid the
    differance between that and our specific coverage choice.
    
    Didn't it used to be that employee-only coverage was completely paid
    for by the company (dependant coverage was an adder)?
    
    All you folk who are checking out HCCZ_US; does anybody have a 'zero'?
    
    So if .217 is correct, at the same time they reshuffle plans every year, 
    they keep notching down their portion of the mythical base contribution?

When there was only one medical plan, employee-only coverage was no-charge.
My understanding is that if you are in an area not covered by an eligible
HMO. DMP-1 is supposed to still be free.  But once another plan is available,
the DMPs become very expensive.

					Steve

    As of last year in my area (a short ways NE of Worcester MA) there was
    in fact a $0 option for individual employee coverage -- as there has
    been every year.  It's been Fallon since I moved to this area.  I'll
    check this year to see if there's still a $0 option.  
    
    	Larry

    I sent a copy of .217 to Fran Bastien in Corporate Benefits.
    
    His reply was that 
    
    1) life insurance - payroll contribs are same as last year, though a
    typo exists in the enrollment kit regarding the personal accident ins.
    
    2) health care - over the last few years Digital contributed 88%
    individual and 78% family of the lowest cost HMO that met their 
    quality requirements. These numbers were 'competitivly positioned 
    in the marketplace' based upon some evaluation process. This year 
    the evaluation led to lower number, 85% individual and 75% family.
    
    He also said that this 'cost sharing approach' was documented in 
    the October 1993 Benefit Bulletin, and the change in percentages 
    is documented in the enrollment kits we'll be receiving.
    
    	Dave

Also, for looking at VTX HCCZ_US, the lowest cost HMO in Central Mass is Fallon.
But even that went up this year.  Knowing that DEC's percentage of subsidy went
down explains that.  That also explains why opt-out went down this year.

For my zip code, there are no $0.00 options.  The cheapest seems to be Fallon
employee only for $3.67 per week.

Elaine

>These numbers were 'competitivly positioned 
>    in the marketplace' based upon some evaluation process.

How do you competitivly position a reduction in benefits?

Well, at least we know how they got the money for the VP raises.

Read that as "we think other companies are reducing benefits, so we can too".

					Steve

Re: .225

>   But, it follows digital's benefit strategy:   "It's better than nothing."
>
>   Employee:	"Gee, these dental reimbursments are really out of date."
>   Digital:	"It's better than nothing."
>
>   Employee:	"This 80% reimbursement really sucks."
>   Digital:	"It's better than nothing."

    Until this latest round, I might have agreed.  But with DuMP 2 hovering
    around $152/wk in my area, nothing really is better.  For less than $600/mo
    I've found more comprehensive plans, higher percentages paid, up-to-date
    service evaluations, and lower deductables.  And that is before any opt-out
    reimbursement.

    If I needed (knock on wood) the coverage provided by these sorts of plans,
    I certainly wouldn't sign up for either of the DuMPs.

    Bob

>    If I needed (knock on wood) the coverage provided by these sorts of plans,
>    I certainly wouldn't sign up for either of the DuMPs.

    Bob,

    Exactly the place in the planet Digital that they want you to be!
    THEY DON'T WANT YOU TAKING JHI OR JHII!!!

    

    
>>   I've found more comprehensive plans, higher percentages paid, up-to-date
>>   service evaluations, and lower deductables.  And that is before any opt-out
>>   reimbursement.

    Please, tell us where. I'm not being cynical -- I'm genuinely
    interested.
    

    me too!
    

Re: .227

>   Exactly the place in the planet Digital that they want you to be!
>   THEY DON'T WANT YOU TAKING JHI OR JHII!!!

    Completely understood.  My only point is that this is the first time I've
    actually been able to purchase comparable family health insurance at
    *individual* rates [slightly] cheaper than those avaible from Digital.

    If they really don't want to be in the health insurance business, why don't
    they just get out of it and stop offering those plans?


Re: .228 & .229

>   Please, tell us where. I'm not being cynical -- I'm genuinely
>   interested.

    Blue Cross of Washington & Alaska and King County Medical Blue Shield.
    They serve the greater western Washington state area.

    Bob

    Digital isn't "in the health insurance business".  The DMPs are
    self-insured plans.  As others have mentioned, Digital doesn't want
    you to be in the DMPs, but they have to offer them if there's no other
    choice.
    
    					Steve

    Re: .230-
    
    	Bob, tell us please- is there no lifetime maximum for this plan?
    
    	Blue Cross/ Blue Shield offers a major medical plan here at an
    attractive rate, but it has a $1M limit. The DMP is unlimited last I 
    looked. 
    
    Phil

    RE: .190
    The VTX HCCZ_US states that inquiries will be responded to in 24 hours.
    It has been 144+ hours since I sent my inquiry to GRIMLY::BEN_IP and
    still no response!

Well, I've sent 2 questions to ics::ushr, and have gotten RESPONSES in about 48
hours- but I'm still waiting for ANSWERS (over a week).
In fact, the reply I got to the second question was to call the PSN.

The PSN person answered it - but I really wanted an answer in writing (I realize
email isn't really writing, but at least I'd have a record if I was given the
wrong answer.)

For the record, the question is whether the coverage under the elect portion of
an HMO elect plan is the same as DMP, except for the different numbers
(deductable, copayment, etc.), or whether treatments currently covered by DMP
might not be covered under HMO elect. The answer I was given is that the
treatments covered are the same, just the amounts are different.

Re: .232
    
>    	Bob, tell us please- is there no lifetime maximum for this plan?
>   
>    	Blue Cross/ Blue Shield offers a major medical plan here at an
>   attractive rate, but it has a $1M limit. The DMP is unlimited last I 
>   looked. 
    
    Hmmm ... I don't know the answer to that one offhand.  I'd be surprised if
    there wasn't some sort of limit.  I do remember the out-of-pocket limits
    being lower than DMP.

    Personally, I'm much more concerned about deductables and out-of-pocket
    maximums than I am about lifetime maximums (within reason).  But it's
    all a gamble anyway ...

    Bob

    RE: .190
    After 148 hours.. I finally received an electronic response to my
    19-Oct Inquiry which stated (as per another reply under this note)
    that Digital will contribute less money (via lower %) than it did 
    last year for the same coverage.
                             Individual  Family
    		Last Year       88%        78%
    		This Year       85%        75%
    		Next Year       ??         ??   <- any guesses ???
    
    I have requested permission to post the official response here
    but have not obtained it as of yet.
     
      

    I was denied permission to post the official response to my inquiry
    so I will just leave you with the summation in .236

    I personally think you should post the name of the official who won't
    post an official response.  One would suppose that information about
    one's services should be dessiminated widely within the
    organization.
    
    								Tex

    re: .-1, .-2, .-3
    
    see .221

Information for US employees only:

I recently called Digital's COBRA hotline number: 800-332-2060. (I believe that
John Hancock administers the COBRA program for DEC.)

COBRA basically allows you to continue buying your health and dental insurance
under an employer's group rate for up to 18 months after you leave employment.
You pay the costs (your former employer pays nothing).

I was told that the Harvard Community Health Plan rate for 1994 is $180.05 per
month for a single employee. On January 1, 1995, the rate goes down to $176.81
per month.

The dental plan for this year and for 1995 is $18 per month.

These rates include a 2% administrative fee, which the company is legally
allowed to charge.

Vicki Meagher

Date:	26-OCT-1994 09:58:17.18
From:	PENUTS::PBAXTER      "PHIL BAXTER - DTN: 275-3412 (USDSL I.S.)"
Subj:	Health Care Costs Inquiry
To:	MTS$::"MSO::AGNES BUCHANAN"
CC:	PBAXTER

To: Agnes Buchanan,

	I was disappointed to find out that although my HMO (HCHP), which is one
	of the lowest cost HMO's in our area, is not raising it's rates for 1995,
	Digital will be passing on more of their unchanged rates to it's employees.

	Digital will charge me $145 more next year even though HCHP is not
	changing the rates that it charges Digital.	

	I read on page 3 of our open enrollment package that Digital will be passing
	more of the cost to the employees this year.  With many of our other benefits
	being reduced and pay raises being suspended this is just another ding in
	our ability to support families.

	The fact that Digital is reducing individual cost sharing from 88% to 85%
	and family cost sharing from 78% to 75% may seem minimal but in principle
	is another reduction in pay for us.  I am really stunned that Digital's small
	cost savings from this change is signicant enough to hit every employee's
	pocket.
	
	Can you explain the justification for this change?

	Sincerely,
	Phil Baxter

         <<< HUMANE::DISK$CONFERENCES:[NOTES$LIBRARY]DIGITAL.NOTE;1 >>>
                        -< The Digital way of working >-
================================================================================
Note 2739.241     Health Care/Life Insurance Premiums Go Up!!!        241 of 241
DASPHB::PBAXTER                                      31 lines  26-OCT-1994 10:00
                    -< Justification for reduced benefits? >-
--------------------------------------------------------------------------------
Date:	26-OCT-1994 09:58:17.18
From:	PENUTS::PBAXTER      "PHIL BAXTER - DTN: 275-3412 (USDSL I.S.)"
Subj:	Health Care Costs Inquiry
To:	MTS$::"MSO::AGNES BUCHANAN"
CC:	PBAXTER

To: Agnes Buchanan,

	I was disappointed to find out that although my HMO (HCHP), which is one
	of the lowest cost HMO's in our area, is not raising it's rates for 	
	1995, Digital will be passing on more of their unchanged rates to it's 	
	employees.

	Digital will charge me $145 more next year even though HCHP is not
	changing the rates that it charges Digital.	

	I read on page 3 of our open enrollment package that Digital will be 	
	passing more of the cost to the employees this year.  With many of our 	
	other benefits being reduced and pay raises being suspended this is just
		another ding in our ability to support families.

	The fact that Digital is reducing individual cost sharing from 88% to 	
	85% and family cost sharing from 78% to 75% may seem minimal but in 	
	principle is another reduction in pay for us.  I am really stunned that 
	Digital's small cost savings from this change is signicant enough to hit
		every employee's pocket.
	
	Can you explain the justification for this change?

	Sincerely,
	Phil Baxter

    Two interesting note threads currently going on:
    
    This string, about employee benefits getting reduced and more
    and more costs being passed to employees during the VP-and-under
    salary freeze...
    
    And the string about increasing employee thefts, mostly involving
    Digital-owned property.
    
    kb

    My wife's employer (a hospital) dropped it's contribution to healthcare
    by nearly 25% this year.  Even though their HMO is $800 cheaper than
    last year, we would pay more.

The response that I got stated that Digital is entitled to
change the contribution rate to anything (I guess that includes zero)
and I was wondering what the justification was for the reduction.

I guess "Just because they can" seems to be an unjustified justification.

Oh Well

    I can think of 143 million reasons why.  Can't you?

    re: .-2
>The response that I got stated that Digital is entitled to
>change the contribution rate to anything (I guess that includes zero)
>and I was wondering what the justification was for the reduction.
>
>I guess "Just because they can" seems to be an unjustified justification.
    
    They can because (a) there is no collective bargaining agreement in
    place (ie contract) and (b) there is no state/federal legislation in 
    place to constrain their actions, and (c) we haven't all started leaving 
    due to it and Digital is still able to hire the people it wants. 
    
    All three options are "ours" 
    
    a) form a union and negotiate for benefits
    b) support legislation that requires the benefits
    c) switch to an employer that supplies the benefits
    
    I see this as similar to the trend towards 'temporary workers';
    when the outcry gets loud enough, when the 'resource pool' starts
    drying up, the trends will shift again.
    
    	Dave

    RE: last few

    	If the increase was only 3% I wouldn't complain.  According to vtx
    my cost is going to increase 175%.  I work in Hudson MA and still have 
    the HMO I had when I worked in Westfield MA (it's convenient for me and 
    I've been there for about 17 years).  With Westfield closing early next 
    year I guess they don't want to do business in that part of the state 
    any more.  I'm beginning to think Digital is trying to get me to switch 
    to a different HMO.

    Joe

    re .248: Here in Germany, the employer is required to pay 50% of the
    medical insurance.

    re: .249
    
    I suspect your math is misleading...
    
    Assume the cost of the insurance was $100 (per week) in 1994.
    Digital paid 88% (ie $88) of that in 1994, you paid $12.
    
    Assume the cost of the plan went up 10% for 1995; ie $110/week
    
    If Digital had maintained the same 88% ($96.80), your contribution
    would be $110-$96.80=$13.20 for a ($13.20-$12.00)/$12.00 = 10% increase.
    
    Since Digital's contribution drops to 85% ($89.25), your contribution 
    would be $110-$89.25=$15.75 for a ($15.75-$12.00)/$12.00 = 31.25% increase.
    
    If we further assume that the "your" plan is _not_ the 'base plan' then
    the percentage increase _you_ would see is further magnified. For example
    
    Let's assume the 'base plan' started out at exactly the same 1994 costs
    as your plan (ie $100, $88 from Digital, $12 from you). Let's also
    assume that the cost of the 'base plan' didn't change for 1995; ie it
    stayed at $100. Since Digitals contribution drops to 85% ($85.00) the
    change _you_ will see is (($110-$85)-$12.00)/$12.00 = 108.33% increase
    
    So whereas your 175% may seem huge in comparison to a hypothetical 10% 
    cost increase for "your" plan and Digital's 3% decrease in contribution, 
    it is quite possible even for 'small' changes in the _total_ costs.
    
    BTW, as has been suggested in here before, one way to find out actual
    total costs is to ask for the COBRA prices, which are actual plus 2%. 
    
    Dave

    re: .251
>    I suspect your math is misleading...

>    ...
>
>    Let's assume the 'base plan' started out at exactly the same 1994 costs
>    as your plan (ie $100, $88 from Digital, $12 from you). Let's also
>    assume that the cost of the 'base plan' didn't change for 1995; ie it
>    stayed at $100. Since Digitals contribution drops to 85% ($85.00) the
>    change _you_ will see is (($110-$85)-$12.00)/$12.00 = 108.33% increase

    Why did you use $110 when you just said that the rate stayed at $100?
    Maybe you meant: (($100-$85)-$12.00)/$12.00 = $3/$12 = 25% increase

    The point is the same, an employee is seeing the effect of a percentage
    decrease on the overall cost (a big number) and comparing it to the
    current employee share cost (a relatively small number).

     ---Phil

    re: .252
    
    see the sentance immediately preceding the paragraph you quoted.
    
    ie total cost of "your" plan increased for 95, the "base plan" didn't
    
    ((cost_of_your_plan_in_95 - 85%_of_base_plan_in_95) - your_94_cost) 
    ------------------------------------------------------------------- * 100
    			your_94_cost
    
    Dave

    RE:.251

    Dave,

    	When I said my coverage had gone up 175% it was just a quick guess. 
    After checking a little closer and not going to the extent you did it
    seems my increase is only 168.1%.  The way I look at it is presently
    their deducting $17.70 a week for my medical coverage as of Jan. 1,
    1995 they will be deducting $47.45.  You can rationalize it any way
    you want but 168.1% more money is going to be deducted from my check
    every week come Jan..

    Joe

    
    re: -1
    
      You now pay $17.70 with it going up over 2.5 times to $47.45 a week.
      Looks more like a 268% increase to me.

>>      You now pay $17.70 with it going up over 2.5 times to $47.45 a week.
>>      Looks more like a 268% increase to me.

47.75 - 17.70 = increase of 30.05, or an increase of about 268%.

(Something that has gone up 100% has doubled in price.  You don't say that
something that hasn't gone up, i.e. is at 100% of its original price, has had a
100% price increase.)

        <<< Note 2739.256 by MSBCS::WIBECAN "Going on an Alphaquest" >>>

>>      You now pay $17.70 with it going up over 2.5 times to $47.45 a week.
>>      Looks more like a 268% increase to me.

47.75 - 17.70 = increase of 30.05, or an increase of about 268%.

Hey are you complaining?
  The top management's pay increases MUST come from somewhere and
      so why not your paycheck??  8^)  ;^)  *^)

   db
 

>>         <<< Note 2739.256 by MSBCS::WIBECAN "Going on an Alphaquest" >>>
>> 
>> >>      You now pay $17.70 with it going up over 2.5 times to $47.45 a week.
>> >>      Looks more like a 268% increase to me.
>> 
>> 47.75 - 17.70 = increase of 30.05, or an increase of about 268%.
     ^                            ^                            ^
     |                            |                            |
     +--- Should say 47.45        |                            |
Should say 29.75 -----------------+                            |
Should say 168% -----------------------------------------------+

(It would help, when I correct someone's math, if I'd get the numbers written
down correctly.  Too bad Notes doesn't have an arithmetic checker along with
the spelling checker.  :-)

So, let's try that one more time.  If I screw this one up, I'll go crawl back
under my rock:

From .255

>>      You now pay $17.70 with it going up over 2.5 times to $47.45 a week.
>>      Looks more like a 268% increase to me.

47.45 - 17.70 = increase of 29.75, or an increase of about 168%, not 268%.

(Something that has gone up 100% has doubled in price.  You don't say that
something that hasn't gone up, i.e. is at 100% of its original price, has had a
100% price increase.)

Make sense now?

						Brian

re:-1
    <  Too bad Notes doesn't have an arithmetic checker along with
<	the spelling checker.  :-)
    
    
    do you mean to tell me that there IS a spell checker in NOTES ???
    
    ;)

    
    I stand corrected..

I asked it last year, and I'll ask it again:

  <<< Note 2739.27 by NOTIME::SACKS "Gerald Sacks ZKO2-3/N30 DTN:381-2085" >>>

Are there any HMO Elect HMOs that aren't the clinic type?

re: 261

Yep, but I doubt you want to come to Dallas to use it.

Another reason my rates are going up so much is that the cheapest HMO (clinic
model - blech) in Dallas lowered their rates for '95.  Of course, I don't know
anyone who has actually signed up for that HMO...

Bob

    Pilgrim Health here in the N.E. allows you to see your own doctor in
    his office.
    
    Cal

In looking over my open enrollment package, I can think of only a couple of
circumstances in which the Digital Medical Plans would cost less than enrolling
in HMO Elect and always going out-of-plan.  The way I figure, the difference
in weekly cost is so great that it far outweighs the difference in deductable,
copay, and out-of-pocket max.  For my zip code, DMP1 costs $5172 more
annually than HMO Elect for family coverage (this is in pre-tax dollars).

One exception would be truly massive amounts of outpatient psychiatric care.
After the first $2000, the copay doesn't go toward the out-of-pocket max with
either plan.  With the 10% difference in copay, you might end up paying more
with HMO Elect if you had around $50000 in outpatient psychiatric expenses.

The other possible exception would be prescriptions.  With DMP, the copay
is a flat $8.  With HMO Elect, it's 30%, but it goes toward the out-of-pocket
max.  Since the difference in payroll deductions is over $5000 for family
coverage, you'd need $17000 of prescriptions to make the DMP cost less than
HMO Elect.  This $17000 would have to be split among the members of the
family for the copay to be greater than the $5000 premium difference
without hitting the out-of-pocket max.

Can anyone think of any other circumstances under which DMP costs less
than HMO Elect when you always go out-of-plan?  Are there flaws in my
analysis?

re .263:

Pilgrim's in HMO Elect?

My premium is actually (allegedly?) going down.  I have Healthsource in New 
Hampshire.  For 1994, I paid $32.31/wk for family coverage.  For 1995, it's 
listed as $30.77/wk for family coverage.

I wonder if it was a typo in the enrollment package...

Brian

    	My coverage is also going down, only $0.33 per week but that's
    better than an increase.  I have Tufts which will be $26.25/week for
    family coverage. 
    	A special note of interest for some New Hampshirites. I live in
    Salem and am able to take Tufts as my plan since I live in a border
    community to Mass. It wasn't listed as a choice to me two years ago
    but I happened to find it was available somehow and saved myself a 
    few bucks. I believe Bay State and other Mass plans were also available 
    but weren't listed  in VTX HCCZ_US or in the benefits brochure sent out.
    Check around...
    
    Keith

    Cigna Elect (go to the clinic, see your doctor for a second 
    opinion) just went up from 41 per pay week to 53.
    
    Where is the controls that Managed care was supposed to bring 
    to costs (as well as our foolish abuses of private insurance)
    
    someone at Digital is responsible for this and I am sadly disappointed
    that Human Services will not provide a private insurance alternatives
    to HMOs.  (No the John Hancock plan isn't private medical insurance
    its Digital footing the bill and adminstered by JH)
    
    For 400+ dollars per month I can find private insurance through
    several business and professional organizations.. and they don't 
    have to clout that a workforce like Digital has.
    
    $12.00 per week doesn't sound like much to folks in the GMA but 
    last year we were sold a bill of goods down in Texas that joining 
    the HMO (for the good of the company and to control costs) would keep 
    costs from escalating uncontrolled...  We're well over the rate
    of inflation and climbing...
    
    And they didn't put the change in rates this year in the benefits 
    book like they did last year... I had to look it up myself..
    
    When I'm out of town in the emergency room bleeding to death I hope 
    they ask me my 800 authorization number before wheeling my
    gurney out to the ambulance to take me to the PUBLIC hospital
    downtown..
    
    "I have insurance, no really I do and I work for Digital..."
    
    And I'm paying throught the nose for it...
    
    This is the last year for me and my family... We'll go to the open
    market to buy private health insurance next year..... 
    
    

    >   For 400+ dollars per month I can find private insurance through
    >   several business and professional organizations.. and they don't
    >   have to clout that a workforce like Digital has.
    
    Someone has to ask the question, and it might as well be me... Might
    Digital be losing clout in the insurance marketplace as a result of
    workforce downsizing?
    
    >   When I'm out of town in the emergency room bleeding to death I hope
    >   they ask me my 800 authorization number before wheeling my
    >   gurney out to the ambulance to take me to the PUBLIC hospital
    >   downtown..
    
    No need to concern yourself with this one... The job doesn't start
    until the paperwork's done.
    

Re -.1
From what I've been able to calculate for a family plan in 1995 ...

	HCHP charges Digital $4400 / year    or  $367 / month
	I will be paying     $1100 (25%)         $ 92 / month
	Digital will pay     $3300 (75%)         $275 / month

An individual can buy a family plan from HCHP for $430 / month
but this plan does NOT include any prescription drug coverage 
and it has high co-pays ... 	Office visit  $10
				Emergency     $35
				Hospital      $50/day  ($250 Max)

So I thinks that Digital group coverage rates are significantly better
than individual plans (no surprise). How in compares with other group
rate plans would be interesting to find out.

    I have belonged to an HMO since I've been working (not just at
    Digital).  I have required emergency medical care out of town, and I
    didn't have any problems whatsoever.  You just have to carry your
    healthcare card with you.  Everything the emergency room needs is on my
    card.  Forget American Express Traveler's Checks - don't leave home
    without your HMO (or other insurance) card.  I always have it in my
    wallet.  And emergency procedures were started as *they* filled out the
    paperwork from my card info.  (And I wasn't even bleeding to death!)

Recently the following article was printed in the WSJ and since I thought 
others might have a similar interest, I've included it here.  An attempt to 
get access to the data through Digital failed but I discovered you can 
order it through John Hancock.  The ordering info follows the article.

"New England Health Plans Compared as Bid to Set National Standard Grows"
by Ron Winslow

	A coalition of employers and healthcare plans in New England published 
the first comprehensive report comparing the performance of health plans 
competing for patients in the same markets.
	The report, which rates 15 difference health plans on more than 100 
performance indicators, is a milestone in a nationwide effort to develop 
standards that employers and consumers can use to select and evaluate health 
plans.
	Leaders of the effort said the results amount to a base-line picture of 
how health maintenance organizations in New England are performing in such 
areas as preventive services, patient satisfaction, use of resources and 
financial stability.  Similar efforts to develop such information are under 
way in Texas and California, among other markets.
	While employers in New England aren't expected to make immediate 
decisions based on the study, future reports are expected to play an important 
role in deciding which HMOs win contracts and which ones attract new members.

Seeking'the Best Value'
	Digital Equipment Corp. which is leading the coalition effort, 
currently determines its contribution toward employee health premiums based 
on the most efficient HMO in a market.  Until now, the only indicator of 
efficiency is cost.  With the new data, said Amy Dines, health-benefits 
manager at Digital, Maynard, Mass., "we're going to be able to put our 
financial support behind the HMO that's giving us the best value."
	The report is based on a set of performance standards known as Hedis 
2.0, that was published a year ago by the National Committee for Quality 
Assurance, a health plan-accrediting organization based in Washington.  A 
growing number of employers are requiring their health plans to report on 
performance measure contained in the document as a condition for doing business.
	Still, determining which HMOs provide the best value from all the data 
could prove daunting.  For one thing, the report provided no overall rating 
system for the 15 plans.  And a plan that rates well on, say, making sure 
children under two years old are properly immunized may also turn out to have a 
relatively high use of invasive heart procedures.  "Not one plan excelled 
across the board," Ms. Dines said, though all were strong in some areas.

Setting the Benchmarks
	Health plans expect to use the report to help set benchmarks for 
improving their performance, and in  marketing efforts as well.  "We need to 
have this information to manage the quality of care delivered to our 
patients", said Kathleen Jennison Goonan, director of medical evaluation and 
improvement at Massachusetts Blue Cross and Blue Shield, whose plans were 
covered in the evaluation.  She heads a staff of 40 analysts, programmers and 
doctoral level researchers who collect and analyze Hedis data as part of a 
quality monitoring and improvement effort, she said.
	Christy W. Bell, executive director, Fallon Community Health Plan, 
Worcester, Mass., said his organization will use the report to commend those 
responsible for good results and to help doctors and other providers improve 
their performance.
	Health plans participating in the report provide care to more about 
three million people in New England and account for $4.5 billion in health care 
premiums.  Abt Associates Inc. a Cambridge, Mass., research firm, collected and 
analyzed the data in the report.

-----------------------

For ordering information contact
	Kelly M. Vacca 
	John Hancock Mutual Life Insurance
	c/o New England HEDIS Coalition
	200 Berkeley Street, B-12
	Boston, MA  02117
	Phone:  617-572-7208
	FAX:    617-572-7016
	Cost $100 + 4.50 shipping

I'm interested to know if others in my situation feel the same about an aspect
of our HMO plans.

I am married, don't have any kids and never will, having had a "V" a couple of
years ago.

I use the Mathew Thornton Health Plan (MTHP) and I cover my wife as well as
myself. I am forced to take the family coverage, even though there's just the
two of us because Digital only offers single and family coverage options. MTHP
does offer a coverage option for couples without kids, but Digital has decided
not to make this offering available to its employees. I think this is unfair
and discriminatory.

I first raised this issue to personnel last year, when the premium differential
widened slightly to be three times the single person's rate. The response I got
from the person handling the MTHP liason at the time didn't change Digital's
stance and didn't give me any confidence that it would even be seriously
considered in the future. This year's open enrollment came and now the premium
differential is up to about 4 times the single person's rate.

If this widening differential continues, I think I'll find a family with a
bunch of kids and high health insurance premiums who would be willing to pay me
a relatively small monthly rate to adopt their kids and then lease them back.
At least that way, I'd feel I was receiving value for the payments I'm making,
and I could get tax releief. Actually, this sounds better the more I think
about it :-)

Anyway, I'm sure there are lots of no-kid couples who are in the same
situation; I'd encourage you all to let personnel know how you feel about
paying for four people's health coverage when there's only two of you. The
Digital MTHP liason person is now Lee McKeown (WECARE::MCKEOWN).

Thoughts ?

Jon

I asked personnel a couple of years ago. Got an answer along the lines
that they thought it was more equitable to spread the cost of family
coverage amongst all of us. Heck, 65% or so of my state property taxes
go for schools, so at least it's to be expected. Anyway, I got a
"We'll consider making changes for next year."

						Trace

While you're at it, ask for lower rates for non-smokers...

				Steve

    
    I have been reading this note for a while and just finally  had to
    add my .02 about the couples with NO children and paying a family
    plan.  If you are both working would individual single coverage end
    up cheaper in the long run, if not then you have no b*tch.  I am a
    single mother with one child carrying a family plan for yes count them
    2 people.  We are both relatively healthy , so the cost of our health
    care has far outweighed the expenses we have incurred over the years
    but it's there if I need it.  At least if you are both employed and
    can get insurances seperately you have a choice/ or have her carry 
    you on her plan and OPT OUT and Digital will actually pay you.  
    
    As I said this particular complaint, couples with no children 
    just gets to me  a little because there are some of us who also
    pay a family rate for two people under other circumstances and have
    NO other options available.
    
    Patty

    Well if you raise my rates (I have 4 kids), don't forget to eliminate
    the tax credit you get for day care which I don't get...
    
    You people are pathetic...

    Only if you use day care.  If someone stays home to take care of the 
    kids, no tax credit. 

Regarding paying Town Taxes for Schools...
I once shared this belief for 5-6 years ... 
until I had children ... then EVERYTHING changed. HHHEELLLOOO !!
If only the people with children paid the burden of the Town's school
system ... There would be some pretty hefty tax bills for those people
who could least afford it !!!  

Regarding paying for Family Health Care ...
If you don't have any children feel fortunate about all the money
that you are saving ... this will more than offset the $ you are
paying for your spouse.  If you wanted to compare the two plans...
HCHP costs $5.25 (your 15%) and a plan for your spouse would be
$8.75(your 25%) for a total of $14.00 versus $21.00 for family plan.
So it costs you $7.00 more per week for the family plan which you may
need anyway because you never known when the stork is going to come 
knocking on your front or back door (that can happen when your married
I am told). It may not happen to you because of the big "V" but it 
could still happen to your spouse (in another kind of many ways !) 

And ... If we stop at one spouse .. why not charge for each child...

	ie. $5.25 for you
	    $8.75 for your spouse
	    $x.xx for each subsequent child ??

	Kinda Silly Don't you think


 

    The theory on local taxes for schools is that the education of the
    community's citizens (i.e., public education) benefits the community as
    a whole, not just the persons receiving the education.
    
    For example, an educated youth population implies higher/better
    employment of the town's populace, a better pool to draw from for
    public/private employees, more industry, less crime,... so even if
    you aren't a parent, you do benefit from the taxes you pay.  Not paying
    the taxes results in only a short-term gain and a long term loss. 
    
    Having the tax dollars spent more efficiently to accomplish the same
    result, without shifting the load to those less able to bear it, on the
    other hand, is a win for all.
    
    One could make the same argument for health care premiums, at least up
    to a point - it makes the employment of parents possible, and the      
    company as a whole more successful in the long term.
    
    And yes, I have two children and a wife who works part time to help us
    make ends meet (with no health plan available), so I'm a beneficiary. 
    But I bought into this concept long before I became married or a
    parent, while I was still paying "more than my share" (but not really).
    

    
        .281 alludes to the benefit for the community, and maybe that's 
        we should concentrate on, being a member of a community, whether 
        it's Digital, town, county, state, country, world ....
    
        Seems every time there's a discussion of fees, premiums, taxes, 
        most everyone feels cheated unless they get more out than they 
        put in.  That just doesn't compute.  Try being a contributing 
        member of whatever community you're a part; I for one hope we 
        don't get to quantifying and measuring everything with money. 
    
        Otherwise, you can always try to put yourself on the side which 
        benefits more:  have children as tax breaks, have accidents without 
        seat belts and use more medical coverage, etc. ...
    
        Cheers,
        Peter
    

Gee, mine's going down. Am I reading it wrong, comparing weekly
deduction to my paycheck?

re: .280

>So it costs you $7.00 more per week for the family plan which you may
>need anyway because you never known when the stork is going to come 
>knocking on your front or back door (that can happen when your married
>I am told). It may not happen to you because of the big "V" but it 
>could still happen to your spouse (in another kind of many ways !) 

Please explain how this benefits a single parent who is no longer fertile.

>And ... If we stop at one spouse .. why not charge for each child...
>
>	ie. $5.25 for you
>	    $8.75 for your spouse
>	    $x.xx for each subsequent child ??

I once worked at a company that did exactly that.

>	Kinda Silly Don't you think

Nope.  Makes perfect sense to me.

Bob

I was skimming through my benefits package and saw several references to
bring able to enrol through VTX rather than by the paperwork route.  But
i couldn't find a reference to what VTX keyword to use in order to do this.
Anybody else out there with sharper eyes than me?

- paul

    Keyword for enrollment in some benefits is HCCZ_US
    
    Linda

    I ended up calling the PSN hotline, since I thought the same thing.  
    They told me that you can only enroll/re-enroll for the Dependant
    Care and Health Care reumbursement deductions.  Enrollment/change
    in benefits must be done on the paper form only.  The nice person 
    on the hotline did say that they were working on getting all 
    enrollments to be done by VTX, but that wouldn't happen for this 
    session.
    

    
    
    	re: -1
    
    	I thought that I was the only one who couldn't find the VTX
    keyword.  Well, there isn't one.  You got to use the form enclosed for 
    medical and dental.  It was on page 15, I think, of the explanatory
    book, but someone had to point it out to me!
    
    Diane

    while computing the difference to the 12th decimal place I
    reminded myself "Ah yes, my rate has gone up by 22.28796844%
    but the net increase is 15.71133465% because it's pretax
    money and lowers my income tax bill by a buck or so.  :-)
    
    ed

What happens if I elect to opt out and go on my husband's medical
plan and then he switches his job? Would that, then, be considered a
change in family status whereby I could re-enroll in a Digital plan
and obtain family coverage?

Thanks,
Laura

>> What happens if I elect to opt out and go on my husband's medical
>> plan and then he switches his job? Would that, then, be considered a
>> change in family status whereby I could re-enroll in a Digital plan
>> and obtain family coverage?

As I understand it, yes.  I opt out myself, and had a similar question when I
was deciding to do so.

						Brian

    
    Yes.  When I opted out last year, I made sure I saw that in writing. 
    Of course, now I can't remember "where" I saw it, but it might actually
    be on the medical form itself.  Mine is at home so I can't check right
    now.
    
    Susan S.

    I was looking over the coverages for next years HMO Elect when
    going out-of-plan.  I see that for outpatient psychiatric care
    the rates are 70/30 for the first $2000 and 40/60 after that.
    
    I've misplaced my coverages from last year, but I seem to remember
    that the transistion point was $3000 rather than $2000.  Is this
    a change or am I just imagining it?
    
    I tried to look in VTX for the current coverage for HMO Elect, but
    I couldn't find where to look.
    
    				-John

re .293:

I looked at all the open enrollment packages since HMO Elect was introduced
(it was called HealthNet the first year).  The transition for outpatient
psychiatric care from 70% coverage to 40% coverage has always been $2000.

	There is an obscure difference in the way this benifit is supposed
to be administered for employees in who both live and work in the State of
Nwe Hampshire. I discovered it quite by accident a couple of years ago. The
text of the benifit describes the $2,000.00 dollar point to occur when the
JHC has processed claims that total $2,000.00. In New Hampshire there is
apparenntly a law that states that an insurer must calculate this based not
not upon claimed dollars but upon dollars payed out. So for New Hampshire
residents who work at Digital facilites also in New Hampshire the benifit is
increased by $1,157.00.  JHC must process $3,157.00 in claims, including the
300.00 yearly decuctable, before the benifit reduces to 40%. 

	\Bob Lail

    Did anyone else get an incorrect group life insurance Annual
    Certificate Report recently?
    
    1) they dropped my teenage kids
    2) they reduced my coverage by 40k
    3) they expected me to reapply.
    
    I asked them to research my file and correct their own errors.
    
    Hope this didn't happen to you, too.
    
    JW

    re: -1
    
    <<Did anyone else get an incorrect group life insurance Annual
        Certificate Report recently?
        
        1) they dropped my teenage kids
        2) they reduced my coverage by 40k
        3) they expected me to reapply.>>
    
    I received my corrected copies in the mail yesterday following a call
    to CIGNA asking them to review my file and make the appropriate
    corrections if it was their error.  They found the errors and sent me
    accurate certificates this time.
    
    If you haven't checked your certificate yet, I suggest you do it.
    
    JW 8}