The Health Care Labor Coalition gathered to discuss proposed benefit changes to the Uniform Medical Plan and updates to the Wellness Program July 1.
There were four changes the Washington State Health Care Authority are planning to make to the Uniform Medical Program that will effect higher education workers.
- Six previously excluded procedures will now be covered. Examples are: circumcision was previously uncovered and is now covered with no limitations, massage therapy will cover more than four units when the medical criteria is met, genetic testing, orthotics, and home health have minor changes.
- Nine U.S. Preventive Services Task Force service recommendations were implemented. These have to do with such things as alcohol misuse, hepatitis C screening, HIV screening, intimate partner violence screening, tobacco use interventions, lung cancer screening, BRCA (breast, ovarian, tubal or peritoneal) screening.
- Pharmacy out of pocket maximum is now limited to $2,000.
- A further benefit in three above is that tier 3 generic drugs that don’t work so the Uniform Medical Program member uses a non-generic can now be considered part of the $2,000 limit, and co-pay as long as there is a clinical exception.
Additionally, there was a SmartHealth Wellness update.
The comprehensive and new wellness program known as SmartHealth will be approved by the Public Employee Benefits Board July 23 and go into effect Jan. 1, 2015. This will be an attempt to encourage all agencies and institutions under PEBB to set up wellness plans.
There will be an online portal that will allow each agency and institution to develop their own wellness plans and ensure that they meet the PEBB standards.
Western Washington University was recognized as a state leader in wellness plans. They are one of only five agencies or institutions leading the way on wellness plans. The others are: attorney general office, health care authority, department of retirement systems, and student achievement council.