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Asante announces changes to benefits for 2021

Premium costs will go up slightly while some coverage is enhanced.

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2021 health plan
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This is the time of year when we announce any upcoming changes to the benefits package following a review of our Asante employee benefits plans, utilization, costs and enhancements.

You’ll recall that effective Jan. 1, 2020, Asante implemented a focused strategy to encourage employees and covered dependents to use Asante Physician Partners and Asante Health Network providers to increase quality and reduce overall costs of the medical plan.

One of the ways to ensure success for this strategy is to encourage our local non-Asante providers to join AHN, a clinically integrated network. By doing this we have increased the number of provider groups by more than 45%, resulting in additional choices for us all within Category 1 (formerly known as Tier 1), where we have the best plan provisions.

For 2021, we will continue to promote that strategy and have made no changes to the overall four-category plan design. We are also still offering the three medical plans — the PPO plan, the Savings Health Plan and the Reimbursement Health Plan — so you may choose the one that best suits your individual circumstances. We also will allow for another “transition year” for primary care and OB/Gyn services, moving those not contracted with AHN to Category 2 instead of Category 3 for calendar year 2021.

Here are the changes being planned for 2021. Watch for complete details as open enrollment approaches this fall.

Health Plan benefit enhancements
  • Increasing physical therapy visits to encourage conservative treatment approaches and avoid surgery when possible
  • Increasing the treatments covered for varicose veins when medically necessary
  • Providing a fertility treatment benefit
  • Including all non-AHN-contracted primary care providers, obstetricians and gynecologists in Category 2 (instead of Category 3) for calendar year 2021.
Wellness Program updates

These provide contributions to your Health Equity health savings or health reimbursement accounts when you complete these three activity categories.

  • Age-appropriate preventive exam
  • Interactive program on physical, mental or financial wellness
  • Engagement in Journi, the new Regence communication platform
Health premium adjustments

Over the past three years, PPO plan premiums have had only a modest 3.5% increase. The premiums for the Savings Health Plan haven’t increased from 2017 rates, and premiums for the Reimbursement Health Plan haven’t risen in more than five years. Based on the current plan use and planned enhancements, premiums will experience a moderate increase in 2021.

  • The PPO plan will increase by 9.8%, and the other two plans will see an increase of 5.3%.
  • For full-time employee-only coverage, employees who take part in the wellness program will see an increase of less than $4 pretax per month.
  • The Reimbursement Health Plan remains free to full-time employees who take part in the wellness plan.
  • Other coverage levels will increase based on the percentages noted.
  • For employees in the PPO plan, increases range from $3.88 to $40.56 per month.
  • For employees in the Savings Health and Reimbursement Health plans, increases range from $0.60 to $16.14 per month.
Dental premium adjustments

Asante will continue to offer three dental plans: the MetLife core and buy-up plans and the Willamette Dental “DMO” plan.

  • The MetLife core plan premium will have a 2.5% increase.
  • The MetLife buy-up plan will have an 8.2% increase, partly to account for increased benefits:
    •  In-network benefit coverage increases from 80% to 100% for basic services.
    • Calendar year maximum increases from $2,000 to $2,250.
  • Willamette Dental plan premiums remain static.
Vision Plan adjustments
  • VSP vision plan, core plan premiums remain static at this year’s rates.
    • Benefits increase: SunCare benefit offers sunglasses in lieu of frames and lenses
  • VSP buy-up plan premiums increase from 8 to 11% ($1 to $2.42 per month, depending on your coverage level), partly to account for increased benefits:
    • Frame allowance benefit will increase from $180 to $200.
    • SunCare benefit offers sunglasses in lieu of frames and lenses.
Tags: 2021, Health benefits, medical, open enrollment, premiums, vision
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9 Comments. Leave new

  • My husband is turning 65 in February of 2021. Currently he is covered under my insurance and I assume that I need to continue him on my insurance as a supplemental. Can someone give me the name of who I should talk with to discuss what I need to do during open enrollment?
    Thank you for your help!

    Reply
  • Tami, you can email my**************@as****.org with your question and contact information and a benefits specialist will reach out to you to assist.

    Reply
  • “The PPO plan will increase by 9.8%, and the other two plans will see an increase of 5.3%.” Yet in negotiations for the nurses the hospital wants to give us less than 2% increase in salary for the first year. What happened to more affordable care for the consumer? Can you explain how these increases in plans will be more affordable to Asante employees?

    Reply
    • Michele,
      From 2017-2020, all employees, including nurses, received increases to pay, either through their contract base increases, or step increases and through merit increases and market adjustments. The majority of employees employed during that time received more than a 12% pay increase over the three year period, yet, as noted in the article, 2 of the 3 medical plans had no premium increase during that time and the PPO plan only increased by 3.5%. The current increases are required so that the plan can remain solvent and continue to serve the needs of our covered employees and dependents.

      Reply
  • I have been an Asante employee X 30+ years. Secondary to the upcoming 2021 Health Plan coverage, It is my understanding that my spouse & I will each need to pay out $4,000 each as co pay / deductible before Asante covers costs. Our established MDs are not in the Asante Net. The are respected MDs of the community. It is a slap in the face to the non Asante Net MDs as well as to the Asante long term employees. In, addition the extreme elevation in the costs of our insurance are too expensive for the average household.

    Reply
    • Karen,
      There are three health plans from which to select. None of them have a $4,000 individual deductible unless you are treating with providers completely outside the Asante Health Network and the Regence Network. If you would like to discuss your particular circumstance with someone from our benefits team, please email my**************@as****.org and they can help to ensure that you understand how our plans work. Individual providers may choose to join the Asante Health Network or not, and you can choose to continue to see them, or change providers to someone who is in the AHN. That is one of the key points to our medical program, you get to choose. Many health systems in Oregon require you to see only in-network providers for care.

      Reply
  • Peggy Lehman RN
    August 28, 2020 3:43 pm

    Why is the increase in PPO so much more than the increase in the other two? I have been considering changing to the PPO this year but am questioning if the benefits outweigh the cost increase?

    Reply
    • Peggy,
      Traditionally, those employees and dependents in the PPO plan have a higher utilization of the medical benefits, so the actuaries that assist us with the premium rates recommend the higher increase to keep up with the utilization as that equates to higher costs to the plan. Everyone has a different set of circumstances to consider, which why we offer three different medical plans from which to choose.

      Reply
  • Melissa McGuire
    September 2, 2020 11:39 am

    You mention that Asante “will allow for another ‘transition year’ for primary care and OB/Gyn services, moving those not contracted with AHN to Category 2 instead of Category 3 for calendar year 2021.” Does that mean that Asante is planning to do away with Category 2 and that all providers not in the AHN will eventually incur the costs associated with Category 3?

    Reply

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