APS and new healthcare provider

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09/30/2023 11:31

Subject: APS and new healthcare provider

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Anonymous wrote:It was handled poorly and employees can’t do anything about it. We got an apology. That’s it.

Or, APS handled it as any employer would and employees are just mad.
Or, something in the middle. Maybe APS made some sort of deliberate or unintended mistake to exclude Kaiser, maybe they didn't. But the teacher's representative group AEA should have been aware contract was expiring and there's always a chance of changes.
I will agree that holding all the sessions about the insurance/whatever it is the teachers need to do during the school day is ludicrous, thoughtless, and serves Syphax employees' schedules rather than teachers.

There are, as I see it, three possibilities:
1) APS excluded Kaiser by accident (i.e. wrote the RFP in such a way that Kaiser can't or wouldn't bid), and upon realizing their mistake, chose to just go forward and force everyone else to live with it with the absolute bare minimum notice.
2) APS excluded Kaiser due to some misplaced sense of priorities (such as fewer providers means processing fewer payments, less back-end paperwork). That would mean APS places a lower value on keeping the health benefits of 50% of its workforce than on an opportunity to reduce its own administrative burden. In this scenario, APS also didn't feel the need to let anyone know it made this choice until the last possible moment.
3) Kaiser chose not to participate despite APS offering ostensibly reasonable terms it had offered in years past (seems pretty unlikely given that Kaiser is generally one of the more affordable and centralized providers, but we can entertain it as a possibility). In this case APS still failed to let people know what was going on, both to get them ready, and to give them a chance to agitate for Kaiser to change its tune.

In all three scenarios waiting until the open season to let people know what happened is just an appalling management failure. In each scenario, letting things play out like they did just suggests a total clock-punching mentality on the part of Syphax, doing the bare minimum and then just shrugging if things go wrong. And now the burden of that incompetence is being borne by the people who are actually responsible for carrying out APS' mission. Considering our tax dollars go to achieving that mission, people have a right to be unhappy.

Provider changes are a part of life, and happen to lots of employers. But the way this provider change was handled is unacceptable. This is a basic function of any medium or large scale organization and they managed to screw it up. Even if they didn't screw it up (as in scenario 3), their lassitude and failure to communicate turned it into a screw up. You can't expect an organization to accomplish its mission well if it turns a basic function (negotiating providers) into a disruptive event for half its employees, and then can't be bothered to do a to help ease the disruption.

Apologies don't fix that kind of failure. People should be fired over it.

I think there's a 4th scenario: APS was looking to streamline for cost effectiveness. Which is an acceptable and prudent business practice, in and of itself.

You're describing scenario #2. If you want to trim costs, why wait until the last moment to tell people? Also Kaiser is not the most expensive option.

Is this true? In every place I have worked that offered a Kaiser option, it WAS the most expensive plan offered. And not by a little, but premiums on the order of 2x or 3x more.

That’s interesting we are other options High deductible plans? Kaiser is the cheapest premium for APS employees but it does come with limitations obviously.

High deductible is always the cheapest, but Kaiser was always the most expensive.

Does Kaiser have deductible and co-pays?

For APS? Yes to copay, no deductible Iirc

So that is probably why the premiums are higher. I wonder if you look at total cost paid by employee (premiums + deductibles + standard fees) how they compare.

To clarify-Kaiser premiums in APS were not higher than the other options. Someone else was saying Kaiser was more expensive on their plan.
Also of note the upcoming BCBS HMO option is less expensive than Kaiser, still no deductible, lower copays. I think the Rx coverage might be slightly worse but I’m not on any regular medication so I’m not sure.