Clark County School District teachers with multiple families with health insurance are facing rising, and in some cases, out-of-pocket costs.
THT Health’s open enrollment period for the 2022-23 benefit year began Aug. 3 and continues until Aug. 24. These changes will take effect Oct. 1.
Factors that have led to the increase include inflation and teacher shortages — more specifically, more money to spread among fewer people with health insurance.
“Health care costs are definitely going up,” THT Health CEO Tom Zumtobel told the Las Vegas Review-Journal on Friday.
THT Health provides health insurance to approximately 36,000 school district employees and their dependents. The trust, which has struggled for years with financial problems and has been bankrupted several times, is overseen by the Clark County Education Association.
The increase in premiums will have a major impact on families opting for a PPO plan.
Teachers who are self-insured or have one dependent will not see an increase in medical benefits but will see a “nominal change” if they choose a dental PPO over the HMO option, according to the trust’s website.
Zumtobel said at Thursday night’s School Board meeting that the school district does a “very good job” of funding teachers but not funding families, and “our losses are with families.”
He also said that the health workers are not happy with the increase in the amount.
John Vellardita, executive director of the Clark County Education Association, referred the Review-Journal’s request for comment Friday to Zumtobel.
In a statement Friday, the school district said, “Because the insurance program is administered by THT, we can hold them accountable.”
Last year, teachers began to express concerns about being demoted as patients by their medical assistants or being sent to charity because they did not pay.
The school district spent $35 million on health care last year, and it must be repaid by the end of June 2024.
In October, an agreement was reached between the district and the teachers union. It included financial transparency and other needs, such as the return of existing complaints.
Zumtobel told the Review-Journal on Friday that the health trust has done “amazing things” in the past year, including settling backlogs and collections. He said it has “changed the profession.”
He said the trust did not expect a premium increase, but the increase in prices and fewer teachers participated.
The Health Trust said on its website that the “cost reduction” is 8.73 percent, compared to local and national employers who are facing cost increases of 12 to 25 percent in their targets.
It’s hard to recruit teachers, Zumtobel said, noting that they understand that premium increases aren’t helping.
He also said that the increase has affected families.
“I hate it, but it wasn’t fair to give it back to the teachers,” he said.
High school teacher Ryan Fromoltz — who is insured as an individual under the PPO plan — said he has heard concerns from district employees with multiple children about how to pay for the increase.
“Teachers are looking at options to quit because wages have increased significantly for families,” he said.
THT Health offers two plan options: a traditional PPO and a low-cost plan.
New this year: The school district will contribute $500 to an individual and $1,000 to a family in a health savings account for those on a low-cost plan.
That’s a huge benefit, Zumtobel said, noting that he thinks it’s been lost in the negotiations.
Other changes: There are additional family registration categories – registrations including two to four people and registrations including five or more people. For now, it’s just “subscribers and family”.
Employees pay $245 in co-pays twice a week for Signature Plan, a traditional PPO. This will increase to between $368 and $475.50, depending on the size of the family and the dental plan chosen.
There is a small increase for the premium Advantage plan, which is currently $232.50 per family. Now, the price will go from $247.50 to $267.50.
By comparison, licensed workers pay anywhere from $7.50 to $19.50 in fees, depending on the plan and dental benefits they choose.
An employee plus one family member pays between $115 and $134 per paycheck.
Contact Julie Wootton-Greener at firstname.lastname@example.org or 702-387-2921. Follow up @julieswotton on Twitter. Reporter Lorraine Longhi contributed to this story.