Sept. 28, 2003 – The government health insurance plan the Senate is being asked to ratify on Monday still is officially under wraps, and the debate is on as to whether it calls for significant increases in premium rates.
The renewal deadline is Oct. 1 — Wednesday.
Gov. Charles W. Turnbull announced on Friday that he was calling the Legislature into special session on Monday to ratify the health and dental plans that his administration has worked out with Cigna and MetLife, respectively. He did not release any information on the plans, but his statement in a Government House release contained language about health care costs having "skyrocketed" in the last few years and called the process of getting reasonable rates "quite daunting."
As a part of the health benefits package, the governor also is proposing legislation to exempt the companies from paying the 5 percent premium tax that is supposed to go into the Insurance Guaranty Fund as a hedge against company defaults.
Paulette Rabsatt, who chairs the government employees' Health Insurance Board, said on Saturday that she would not discuss the terms of the policy renewals. "You'll find out Monday at the session," she said.
Word of substantial increases has been circulating in the local insurance industry for weeks.
"I heard 20 percent," Steve Baker of Baker, Magras & Associates said.
But another industry expert, Ray Barry, chief operating officer for V.I. Equicare, said on Saturday that premiums are not increasing for medial coverage, although they may be increasing for pharmaceuticals and for dental coverage.
Most Virgin Islands physicians belong to V.I. Equicare, which is the territory's only Preferred Provider Organization. By law, only insurance providers who use a PPO can contract with the government.
Baker is a strong critic of Equicare. Because it is the only PPO in the Virgin Islands, he says, it is a monopoly and has the power to set medical rates — and, indirectly, insurance rates — for the largest chunk of the insured population, some 12,000 government workers and their families. Moreover, because of the size of the government workforce, Equicare also indirectly influences the rates everyone else pays.
Barry counters that Equicare acts as a regulatory force. Before it was established in 1998, individual physicians were free to charge whatever they wanted, and that left the door open to possible gouging by the few.
Equicare's fee schedule has not changed since 1998, Barry said, except that it went down by 5 percent in 2001, when the government's previous carrier, Blue Cross/Blue Shield, requested the decrease. Although that decrease was supposed to be only for a year, it is still in effect.
Some senators have indicated they plan to take a hard look at the plans despite the administration's late submission.
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