A word of caution: High Deductible Health Plans

Posted Apr. 24, 2019 by

OCSEA members may have recently received a letter from Optum Rx regarding the state’s new voluntary High-Deductible Health Care Plan. As you may remember, management put on the table a high deductible health care plan during the last round of contract negotiations.

The union opposed their plan since high deductible plans often shift more of the burden onto consumers with higher out-of-pocket costs. But the issue went to the Fact Finder and the Fact Finder allowed for management to offer a voluntary high deductible plan, while still keeping our traditional PPO health care plan.

Now, the state will be rolling out the high-deductible health care plan during this year’s open enrollment period from May 20 to May 31.

But a word of caution is in order. OCSEA did not agree to the high deductible plan, therefore, the union is not a party to its implementation. In other words, this health care plan is OUTSIDE of the collective bargaining agreement and the union has no seat at the table when it comes to its design or implementation. The union does, however, still negotiate and oversee the implementation of the traditional PPO health care plan via the Joint Health Care Committee.

Other things you should know about the high deductible health care plan include:

  • A deductible of $2,000 for individuals and $4,000 for families per year must be met before ANY medical insurance kicks in. You must have the ability to pay these costs up front.
  • If you or a dependent have a chronic health condition, such as arthritis or diabetes, you will pay the full cost of all treatment until you reach your deductible. (Unlike the high deductible plan, the traditional health care plan covers the total cost of diabetes treatment as long as the member is compliant with the program.)
  • While there is no co-pay for doctors, you will pay the total cost of the doctor visit until you’ve met your deductible.
  • The Fact Finder did require the state to provide seed money for a Health Savings Account for two years to go toward health care costs.

More specific information will be forthcoming from the Dept. of Administrative Services about the high deductible plan in your MyBenefits guide mailed to your home address. If you have questions about the differences in the two plans, you can contact Kelly Phillips, the union’s health care expert at