BNA - Guild News

Sept. 28 , 2001

Referendum on Proposed AETNA Health Care Changes

Guild Members Only

TUESDAY, OCT. 2
Rockville
12:00 noon to 1:00 p.m. - Guild office D.C.
10:00 a.m. to 11:00 a.m. - BNA 4-4010
11:00 a.m. to 2:00 p.m. - Link Lobby
3:30 p.m. to 5:30 p.m. - Link Lobby

Here are the proposed changes in the Aetna health plan. The changes would increase prescription drug co-pays, and adjust the frequency of physicals allowed under the Aetna plan. It would increase the physical benefit for some and decrease it for others. The proposals were formulated by a committee made up of four Guild members and four BNA management representatives. BNA has endorsed the proposed changes, and has asked for an up or down vote on the package. The changes cannot be implemented without approval of BNA Guild members.

PHYSICALS

- Add annual physicals for children age 6 to 18. Currently only children 5 and under get annual physicals.

- Add annual well-woman exams for routine ob-gyn checkups in addition to physicals. Currently women must choose between getting a "well-woman" gynecological exam or a physical exam.

- Change the frequency of adult physical exams to every two years for everyone. That would increase physicals for those 30 and under from every three years, but decrease physicals for those over 40 from every year. There would be no change for those 31-to-40.

- Add physicals for retirees who currently don't have coverage for physicals.

- Increase the dollar benefit for physical exams from $250 to $300.

- Make all physicals performed by non-network doctors subject to the annual deductible and 25% employee co-payment. Currently out-of-network physicals are treated the same as in network.

PRESCRIPTION DRUG PRICE CHANGES

-Reduce amount to be dispensed at retail from a 34-day supply or 100 units (whichever is greater) to a 30-day supply.

-Increase the retail co-pay from $5 generic/$10 brand to $10 generic/$15 brand.

-Increase the mail order co-pay from $0 generic/$5 brand to $10 generic/$15 brand. Mail orders are for a three-month supply.

COSTS

According to BNA, if the prescription drug changes had been in effect in 2000, the increased cost to Guild-covered employees would have been approximately $124,558. (The estimated cost for all BNA employees, including non-Guild covered, is an estimated $287,000).

BNA estimates the employee share of the prescription drug cost would go from the current 10.5% to 17.8% BNA estimates if the change in physicals -- including the well-woman checkups -- were in effect this year, it would cost BNA an additional $47,257 for Guild-covered employees and dependents as well as formerly Guild-covered retirees and their dependents ($108,888 for all BNA employees, dependents, retirees). The Guild asked for a straight comparison of prescription drug costs versus physicals based on 2000 data, but BNA said it could not provide that.

The estimates on the costs of the physicals are based on all Guild-covered employees, retirees and their dependents taking full advantage of the revised physical benefits and using in-network doctors. It does not include the proposed physical payment increase from $250 to $300. The company says the average cost of an in-network physical ranges from $55 for school-age children to $88 for adults 65 and older.

A BREAKDOWN

BNA says 341 Guild-covered employees have 273 children ages 6-17 who would benefit from the improved child well-care benefit. If all those children had in-network physicals it would cost BNA an estimated $15,015 per year.

BNA says there are 572 Guild-covered female employees and covered spouses of employees who would benefit from the proposed annual well-woman exams. If each covered female had a well-woman exam each year the cost to BNA would be $37,466 (based on BNA's estimated average in-network cost of $65.50).

BNA says 164 formerly Guild-covered retirees and spouses would benefit from the addition of annual physicals at an estimated cost of $14,432.

BNA says the reduction in physicals from annual to biennial for 586 Guild-covered employees and spouses aged 41-to-64 would save the company an estimated $23,147.

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