LACERS BOARD UPDATE: 2020 Health Rates Include New Acupuncture Benefit


Michael Wilkinson, LACERS/Legal Representative

By Michael R. Wilkinson
LACERS/Legal Representative

The LACERS Board has approved renewals of the health, vision and dental benefits for the 2020 calendar year, highlighted by a new benefit – acupuncture. An acupuncture benefit had been requested by members, and now we have the program, which will be offered on all of the health plans on the same basis as the chiropractic benefit. While the offering varies slightly by plan, a typical offering is the Kaiser plan of 30 visits per year, with a $15 copay. Some of the uses for acupuncture are: general pain relief, back and neck pain relief, nerve conduction, digestion improvements, anxiety and other stress relief. As always, consult your medical professional.

The overall premiums for 2020 are down by 0.1 percent, and most health plans will not experience a premium increase. However, Anthem HMO premiums will increase by 9.1 percent, and United Healthcare Medicare Advantage HMO will increase by 7.5 percent. There will be no changes to copays for this year.

The Delta Dental PPO will have no change, while the Delta Dental HMO will have a 6 percent increase. Anthem Blue View Vision will have a 5 percent increase with a negotiated rate for the next three years at a 5 percent increase.

Our rate reduction of overall premiums is especially satisfying when we compare it to the assumed actuarial trend rate (based on plans across the United States) of 7 percent for this year and 7.88 percent for the 10-year average, including 2020. When we look at premium rates, our members deserve a lot of credit in living healthier lives by visiting their doctors, taking their medications, exercising, and eating healthy foods. This results in happier, healthier lives and also lower health costs. As if we needed it, these good results are even more incentives for us to continue to support our LACERSWell program that is funded by payments from our health carriers as part of their contracts.

The Board voted to retain the maximum health subsidy of $1,790.80 based on the Kaiser HMO premium for members under age 65, or with Medicare Part B only. The maximum for members with Medicare Part A and B is $550.57. The maximum dental subsidy is $44.60.

Finally, the Board has made a change to our Medicare Part D (drug benefit) that will help a few members who have been hit with high prescription costs. In some of the plans the member must pay 5 percent of a drugs cost once they have hit the plan’s out-of-pocket spending limit and entering the “catastrophic phase.” The difference between the 5 percent payment and the regular copay can be crushing for members who need lifesaving and expensive specialty drugs. LACERS has negotiated agreements with all of the health plans that they will only require the member to pay the copay and not the 5 percent, which would otherwise be required.