MEA Benefits Trust offers far better health insurance
by Christine Burke
MEA Benefits Trust
The MEA Benefits Trust is a not for profit legal entity separate and apart from the MEA, whose sole purpose is to provide high quality, affordable health insurance to educators. It is run by and for educators.
The Trust provides health insurance to 98% of the schools and 65% of K–12 educators, nearly 70,000 people, because our plans offer better coverage at affordable, stable rates. Participants and taxpayers benefit from our success.
In comparison, insurance plans offered by Maine School Management Association (MSMA) have repeatedly failed, incurred spikes in their rates, or shifted the majority of cost to participants through "high–deductible health plans with a health savings account." Insurance brokers are the only people benefiting from MSMA’s plans.
Trust plans provide the same coverage and benefits at the same costs for every school district and every participant, regardless of age, geographic location, or claims experience.
The new plans sought by the legislature, at MSMA’s behest, could fragment the Trust’s insurance pool into smaller, higher risk pools that will inflate costs for those in rural areas where medical expenses are higher and for those districts with catastrophic claims.
The Trust is able to provide fair rates for everyone because it has a reserve called a Rate Stabilization Fund that is used to avoid rapid premium increases. This kept the premium increases in the single digits for the past five years, when most other plans were delivering double digit increases!
Despite almost 60 years of success, some school boards were not happy because the Trust is an employee–run plan not a management–administered plan. A few districts in southern Maine were even sure they could negotiate better rates and wanted the Trust to share the claims experience for their communities.
The Trust has never collected that data and has none to share. It just doesn’t make sense to separate out data by school district because our group rate is not indicative of their stand–alone small group rate.
Nonetheless, MSMA went to the legislature demanding that districts be given their experience data. Worse yet, Republicans and a handful of Democrats enacted the requirement into law.
No other large group insurance provider is required to give out its experience ratings. Yet, we were singled out and treated differently because we are employee–run. This was very much a power and control issue and not an insurance issue or what is best for educators.
If this new mandate is implemented, the Trust will have to revamp its plans in order to compete with insurance brokers soliciting business from the school districts. We will be forced to use the experience ratings of school districts for any given year in order to arrive at a premium that reflects the risk they represent.
Unfortunately, in this system, some districts will be winners and others will be losers.
A few may see a 5% to 7% short-term decrease in premiums, while many will experience a 13% to 15% permanent increase. Realistically, most increases will hit northern and rural areas of the state where educators are already paid less than their southern and urban counterparts.
This occurred because MSMA and the 125th Maine Legislature were willing to "cannibalize" their northern, rural neighbors just to achieve a 5% to 7% decrease in the insurance costs for urban and southern Maine. And, perhaps most of all, it was a way to diminish employee control over educator health insurance—regardless of the cost.