Ailing Clark County School District teachers trust makes a healthy rebound

The Teachers Health Trust that distributes benefits for 18,000 Clark County School District teachers stood on the brink of collapse about two years ago.

The trust, maintained by the Clark County Education Association and a board of union-appointed teachers, was operating under a multimillion-dollar deficit and had not received an increase in the district’s contributions for seven years.

But in a series of moves that included a change in leadership, a $9.8 million boost in district contributions and various cost increases for teachers, the trust has left its previous financial troubles behind, according to trust and union officials.

That recovery also comes as its provider network manager, WellHealth Quality Care, is acquired by HealthCare Partners Nevada.

The trust’s old issues stemmed, in part, from a benefit-rich plan.

“They had a very liberal, rich plan which, quite frankly, helped create the condition where it was just no longer affordable,” said Gary Earl, the chief executive officer tapped to reform the trust 10 months ago.

Now, the trust has gone from running a deficit for five years, he said, to building financial assets that will grow its reserves.

In 2015, the trust had an average operating deficit of about $8 million, Earl said. He declined to share how much the trust currently has in assets.

TEACHER CONCERNS

But some teachers have taken issue with the changes, which include higher out-of-pocket expenses or co-payments.

Overall, participants have gone from paying very little to about 20 percent for out-of-pocket expenses, Earl said.

Doreen Law, a teacher now on medical leave, saw a change for the worse with the trust’s new health plan.

She said her medications cost much more, and that she has to call the trust continuously because they do not pay its portion of medical bills in a timely manner.

When she went to a rehabilitation hospital because of other medical complications, Law said she was stuck with a $9,000 bill after insurance.

“That’s just ludicrous,” she said. “I have no idea how to pay that.”

Law pays $440 per month to cover both her child and husband, she said. She’ll be leaving the plan soon, switching to health care that will be just under $200 per month.

Mike Collins, whose wife is a teacher, also said teachers were left with huge out-of-pocket costs since the trust’s overhaul.

Under the new changes, he said, his daughter received a surgery that he claimed would have cost about $400 after insurance. But later, he said, his family was informed without notice that they owe $1,300 for it.

When his son had an MRI in the past, it cost his family about $180, he said. After his daughter had an injury that required an MRI, it cost just under $800 under the new plan.

“This of course becomes a surprise when you are at the doctor and need care,” Collins said in an email.

But Robert Hollowood said cost increases for his family — which includes his son, who has Type 1 diabetes — haven’t been dramatic in any way.

Since his wife is also a teacher, the plan covers both of them and the couple doesn’t pay a premium, he said.

“I understand that things are going to be more expensive because the cost of medical care has been climbing by leaps and bounds year over year,” he said.

Hollowood said he felt people were abusing the previous plan and its lack of controls.

He heard of people using more expensive specialists as their primary care doctors, and he received messages from the trust that advised people to stop using the emergency room as primary care.

WELLHEALTH ACQUISITION

Clark County School Board trustees also heard concerns from teachers, said Board President Deanna Wright. She said the trust also did not tell trustees about WellHealth’s acquisition by HealthCare Partners Nevada.

The acquisition was not based on finances, WellHealth CEO K. Warren Volker said in a statement. He said the move also does not have anything to do with issues teachers have had with their healthcare.

“There’s no intent to disrupt what we’re doing or to change paths in any way,” he said. “We continue to work with the trust to improve and refine their health plan. As HealthCare Partners Nevada and WellHealth come together, we will be able to bring an even greater range of services and expertise to the table in support of that mission.”

Earl argued that the trust’s plan is still more favorable and has a higher level of benefits than the average plan.

He also explained that the trust converted to a new claim system last year, an “exceptionally complicated” process that did create small delays in payments. The trust alerted all 3,500 providers in the community to the change, he said, and set up a process to resolve any missing or unpaid claims.

“This trust is certainly not in the business of sending anybody to collections or withholding payments from our partners,” he said. “We’re purely in the business of providing our teachers and their families with the highest level of quality care available.”

John Vellardita, executive director of the education association, said he wished he could tell people they could go back to the plan of two years ago.

The school district’s increased contribution of roughly $583 per person ended in December and has since decreased to the previous amount of $538.

But the union is calling on the district to at least keep the $583 contribution rate, so the trust can remain financially sustainable and build healthy reserves.

“We think that it’s critical to maintain the trust and to allow the trust to complete its recovery, and then to improve its health care delivery system for its members,” Vellardita said. “It’s critical to have that contribution in place.”

Contact Amelia Pak-Harvey at 702-383-4630 or apak-harvey@reviewjournal.com. Follow @AmeliaPakHarvey on Twitter.