Opposition to teachers’ health care plan continues to grow

Opposition continues to grow against the local teachers union's proposal to overhaul health benefits for 18,000 educators and their dependents, even as union officials prepare to open enrollment for a plan the Clark County School District hasn't yet approved.

Many teachers expressed shock and worry after receiving notifications that their family doctors, preferred specialists and other providers would refuse to participate in the new plan. Others voiced frustration as the Clark County Education Association, which represents teachers, provides little information about its proposal to hand control of all member health plans to a small local firm and third-party administrator.

Some teachers even have chosen to resign from the school district, in part blaming the shrinking coverage provided by the crumbling Teachers Health Trust.

Meanwhile, it's unclear whether the union-controlled trust, which manages health benefits for all district teachers, can move forward with the changes and open enrollment on Oct. 17 without approval from the Clark County School Board.

"I just want answers, and I'm not getting any," said Bonny Warby, a fifth-year biology and chemistry teacher at East Career & Technical Academy, on Vegas Valley Drive and Hollywood Boulevard.

She and her husband, who is currently studying to become a teacher, are expecting their third child in January.

However, the young couple might have to find a new OB-GYN after their doctor's medical group balked at a demand from the health trust to hand off its contract to locally based delivery care firm WellHealth Quality Care.

Should the Warbys remain with their preferred OB-GYN, they expect to pay out-of-network costs of at least 40 percent for all hospital and labor service charges.

"If we did that, it'd be like buying a new car when we have the baby," Warby said. "My father is actually a retired district attorney. I want to talk to him about any legal avenues we could pursue. I'm not going to be left with this bill."

Rising costs

At a School Board meeting late last month, the CCEA unveiled scant details about its planned overhaul of the THT.

The proposal would decrease from 5,800 health care providers currently operating with the trust to about 5,200. Deductibles, out-of-pocket maximums and co-pays largely would remain the same, or even get cheaper, provided members only seek services within the WellHealth network.

But representatives with the union and WellHealth struggled to answer basic questions about whether teachers should expect to pay higher premiums and if WellHealth's network included enough doctors and providers to treat THT's more than 50,000 members.

John Vellardita, executive director of the CCEA, said on Saturday that more than 65 percent of providers currently working with the THT have agreed to extend their contract with WellHealth. The rest have until an Oct. 15 deadline to do so.

As for premiums, "there is going to be a spike for some folks," Vellardita said. "But for a large number of people, it will be the same or less than what they currently pay.

"Of course, if the district doesn't increase its own contribution, then it'll be a whole different world."

Vellardita referred to the monthly per employee contribution that the district pays to cover health care premiums.

That amount, about $540, has not changed since 2008. In a surprise move, however, the School Board on Wednesday announced it would offer the union $9.8 million to increase its monthly contribution by $45 per employee, effective Jan. 1, 2016.

The School Board still must negotiate whether to allow the THT to move forward with the transition to WellHealth.

"Keeping in mind the challenges and volatility of the Teachers Health Trust," board President Linda Young said in a statement, "the Board of School Trustees will continue to regularly monitor the state of the trust for consideration in the next negotiation period."

'The final straw'

What both sides seem to agree on is that the current trajectory of the Teachers Health Trust is not sustainable and risks the lives and finances of educators.

Count Wendy Gelbart among them.

For the past five years, she worked as a special education teacher with the district and recently accepted a position at a high school. The chance to help students with special needs and stable health benefits initially attracted her to the job.

"After being self-employed for 10 years and having to either be self-insured or uninsured, I was looking forward to having reliable health insurance," Gelbart said.

That changed in June, when the trust announced it would require teachers to fork over 20 percent of doctor's office visits and all medical expenses to help salvage its balance sheets.

Gelbart eventually submitted her resignation two weeks before school started in August. She now works at the University of Nevada, Las Vegas, where she is a doctoral student.

"The last couple of weeks I was with the district, we started receiving notices from doctors that they would no longer take the health trust coverage," she said.

"The health trust wasn't the only reason I resigned," Gelbart added. "It just added the final straw to make me realize I'd be better off somewhere else."

Contact Neal Morton at nmorton@reviewjournal.com or 702-383-0279. Find him on Twitter: @nealtmorton.