Sep 232009

Some parishes, The Catholic Messenger and other entities affiliated with the Diocese of Davenport participate in its group health insurance plan because they might not otherwise be able to afford coverage on their own. Here is a Q&A with Diocesan Chief Financial Officer Char Maaske about how the plan works.

Q. What entities in the Diocese of Davenport participate in its health insurance plan? 

A. We have about 20 participating Catholic entities in the diocesan plan. Most of those only have one to four participants. The schools have enough employees that they can get a group plan on their own and often have better rates than the diocese.  Most of the other entities would not be able to get group insurance on their own because they are too small. It is an important social service for the diocese to be able to provide for the Catholic entities.      

Q. Why does participation fluctuate from year to year? 

A. The total numbers don’t fluctuate much. We require a participating entity to be in the diocesan plan for five years because if they have an employee with a serious health issue, the costs of that care get spread among all our participants. We can’t afford to have an entity join our plan, increase our medical costs and then leave us when our premiums increase. 

Q. How do you go about choosing a health care provider for the diocese and its affiliated entities? 

A. Mercer (a nationwide human resource consulting firm for health and benefit administration)  helps get competitive bids for comparable plans from various companies. Some insurers are not interested in our organization because we have less than 100 participants. 

Q. How often do you switch providers for health care coverage? 

A. Every year we get competitive bids. It is disruptive for the participants when we change insurers but we need to be willing to do that to get a better rate.  Competition is what keeps our rates from increasing more. 

Q. What has been the history of health care costs in the Davenport Diocese over the last five years? 

A. The premium continues to increase annually and sometimes greater than the rate of inflation because medical costs increase greater than inflation. Some years the initial increase proposed by the provider is very high and we have been able to negotiate a reduced increase. The challenge for us is to keep the premiums affordable because the diocese and employee share the cost. But we don’t want the deductibles and co-pays to be unaffordable. It is a difficult balancing act. Some families spend more on medical care and will live with a higher premium in favor of better benefits. But others with less medical expense would like lower premiums. 

Q. In general, what type of health care coverage does the Diocese of Davenport provide? 

A. We have a preferred provider plan which means our participants receive a better benefit if they go to providers who have agreed to accept a predetermined fee for some procedures.  If the participant chooses to go to a provider outside our plan they will pay a higher deductible and co-pay plus the difference in the charge that was not paid by insurance. The diocesan plan has a $1,000 per person and $2,000 per family deductible in the network. 

Q. Approximately how many individuals are covered by the diocesan health insurance plan?

A. About 60 to70.

Q. What trends are you seeing in health care coverage?

A. Our insurer recently enacted a provision that participants would need to have precertification for non-emergency procedures such as CT scans, PET scans, MRIs and nuclear cardiology stress tests.  This is an attempt to avoid unnecessary tests and one way to control costs. 

Q. What suggestions would you offer to the federal government concerning reform of the health care system,  from the perspective of the diocese and its entities? 

A. The health care system and insurance providers need competition. To put this issue in perspective: A full time person making minimum wage makes $15,080 annually. A family health insurance plan through the diocese costs $14,760 annually. Coverage for an individual on the diocesan plan is $425 per month, $670 for an employee’s child, $985 for an employee’s spouse and $1,230 per month for a family plan.

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