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January 30, 2015

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Health insurance cuts causing uproar among UNLV faculty, staff

Bryan Spangelo knows a thing or two about figuring out things. After all, he has taught biochemistry at UNLV for 16 years and is a senior professor.

But even he is baffled — actually, outraged — by all-but-certain changes for him and other faculty, administrators and staff at UNLV who have health insurance.

Changes in benefits for state workers threaten to upend his budget and his family, Spangelo said.

His teenage son had abdominal surgery that cost $20,000 last summer. It cost him about $3,500 out of pocket. If his son had had the surgery next year, when the changes are in effect, Spangelo would have had to pay nearly $12,000.

“It’s out of the ballpark,” Spangelo, 55, said.

Spangelo and other UNLV employees are not alone. Almost all the state’s 25,000 workers — health and human services employees, prison guards, Department of Motor Vehicles clerks — are part of the same benefits program, which is in deep trouble.

The Public Employees’ Benefits Program, the state’s self-funded insurance plan, needs $611 million for the 2012-13 budget to maintain its level of services, but officials say the state can only afford to kick in what it did this past year, $500 million.

So program administrators are scrambling to cut $111 million — 18 percent — from the medical plan, even before factoring in rising annual medical costs that might reach 12 percent. Combined, inflation and the deficit means that what $1 buys in medical coverage this year will buy only 70 cents next year.

Meeting over the summer, the program’s board of directors found one way to save money: increase the deductible paid by the insured before the insurance kicks in. The board also eliminated most dental coverage.

The board is scheduled to meet Dec. 2 to make the changes final in July.

“As far as I’m concerned these changes are already in effect,” said program executive Jim Wells, chief architect of the changes.

“The state has a large hole,” he said of the looming $3 billion budget deficit. “This is our portion of the state’s overall cut. It’s not being done in a vacuum.”

Wells acknowledges that the changes may hurt the retention of professors, but he says their fears are overblown. Other changes, such as new health savings accounts that use pretax dollars, would ease some of the effect of the high deductibles, he said.

The American Federation of State, County and Municipal Employees union is angry.

Vishnu Subramaniam, a spokesman for Local 4041, said in an e-mail that the state’s new insurance coverage “would be an insurance plan that no insurance agent would be able to sell. It guts the benefits available to employees and drastically increases costs to them and their families.”

A special panel appointed by university system Chancellor Daniel Klaich is set to issue a report on the changes this month.

“We’re talking about the possibility that a family, kids basically, won’t be able to afford basic health care,” said Gerry Bomotti, UNLV’s senior vice president of finance and business, who heads the 12-member panel.

The immediate fear: University employees will leave the system, driving up costs for those who remain enrolled. Another fear: The employees who dropped out will have to be taken back under new federal rules in 2014, wiping out any short-term savings.

Are there any solutions? Not many, Bomotti said, but the Nevada System of Higher Education is considering an emergency supplemental insurance plan that could be funded without the state’s assistance.

The 2009 Legislature avoided such drastic cuts to the state’s employee insurance plan, but not this year.

The board proposed “fairly radical” changes, Bomotti said.

Insurance won’t cover routine medication, procedures or dental care, but will become a “catastrophic health care program” that only covers care costing many thousands of dollars.

For example, Bomotti said, the current $1,600 a year deductible for a family would increase to $4,000. The maximum that a family might pay would rise from $7,400 to $11,800. Moreover, expensive prescription drugs, such as Lipitor that lowers cholesterol, would become part of the high deductibles. Out-of-pocket expenses would rise because most visits to the pharmacy won’t be covered until the deductible is met.

For some healthy families, substantial insurance coverage may not kick in until the last month of the coverage year.

For UNLV, there are few, if any alternatives. Only 1.8 percent of the employees do not participate in the program.

Bomotti said he is braced for many more to leave the insurance plan.

Premiums range from $44 a month for an individual to $195 a month for a family and are likely to rise sharply next year. The board hasn’t set the new premiums yet.

Don Heilman is a senior benefits consultant at Gallagher Benefits Services in Greenwood Village, Colo. The university system has hired Gallagher to study the state health care plan and compare it with those of other universities.

Nevada is unusual in bunching together a variety of state employees in one program, from prison guards to professors. All states struggling through the recession are facing difficulties funding pensions and benefits, Heilman said.

But university programs face special challenges, because it is more likely a prison guard will be hired locally and a professor is recruited from elsewhere, he said.

For that reason, most universities have their own, relatively favorable, benefit plans.

Heilman said cutbacks in other states are “not as dramatic” as in Nevada and changes are far more gradual.

Spangelo, who teaches chemistry required for doctors and other health professionals, is sure he would never have come to UNLV if these benefits changes had been in place.

At $113,000 a year, Spangelo makes a good living (his wife is also a chemistry professor). But the steep rise in health care costs next year means he has to rethink how to pay for college for his son, especially if his son needs other medical procedures.

Colleagues feel the same way and a growing number are circulating their resumes.

“If UNLV and the state of Nevada can’t offer reasonable benefit packages, they’re not going to be able to recruit faculty or retain the ones that we have,” Spangelo said.

With the furloughs, staff cuts and salary freezes, he said, “this is one more thing that gets people out the door.”

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  1. "WAY TO GO By nednougat" That $100.00 hurts like hell when you only get $1124.98 after the $100.oo try to eat pay your taxes lights gas... and any thing else... so go cry some place else, and I still do not want Obamacare-it will break the bank for my grandkids.

  2. $3500 out of pocket on a $20,000 procedure is TOO MUCH.
    $12,000 out of pocket on that $20,000 procedure is ASTRONOMICAL.

    You goofy "welcome to the real world" nutballs I am SURE could come up with that $12,000 "deductible", right???
    Not even to save your own life.

    Nevada will remain a backwater nowhere that cannot attract anything but marginal talent.
    Because "We can't see the forest for the trees"!!!

    "Come work for UNLV! Your Health Care Policy is quite low! Of course, you'll never be able to afford to use the darn thing, but THAT'S OKAY!!! We got the STRIP! You DO like to GAMBLE, right???"

    Um, not with my family's lives, thank you very much.

  3. Maybe, Health Care Reform will not be such a bad thing after all!!!!

  4. @ nednougat: Medicare is much better insurance than the state's health care plan, and less expensive to the insured, too. For one thing, your deductibles are much lower. Your prescriptions cost less, too. Given the choice, pretty much every state employee would gladly opt to enroll in Medicare.

    So here's my question: Why can't they?

  5. Enough with the Republicrat lie that public employees have it so much better than private employees. When things get tough, the public employees get gutted. Oh, unless you believe the lies spouted by Patrick R. Gibbons in these forums on behalf of his employer, the Right-wing NPRI.

  6. The State of Nevada is in financial distress because our legislators have failed to address the problem years ago, now it is TOUGH LUCK. Now their failures will cost everyone in the State in one form or the other.

    The one thing that is certain is medical cost will skyrocket in the future unless something is done right now. Medical cost have been proven to be the means to financial bankrupt for a majority of our citizens. The right wing calls Health Care Reform socialism, socialism is a form of government. Socialized medicine is just Socialized medicine. Health Care Reform offers a means of controlling cost without breaking the the average citizen.

    Everybody cries that they will have to carry insurance. If you do not have insurance right now you are playing with the brink-man every time you go to work in the morning. How many accidents to you see in a week driving our freeways? How many of the people injured have adequate insurance to cover the cost of hospitalization? A friend of mine was hit by a drunk illegal and hospitalized for 4 days, guess what the illegal had no insurance and my friend could only afford PL/PD on his older vehicle which translates into he is stuck with 56,000.00+ in hospital bills.

    On a recent Dr visit, I was charged 460.00 to remove 3 warts on my hand. Total time in the office 32 minutes. I regret to say that I no longer have medical coverage for that treatment. My point is that something has to be done about skyrocketing medical cost.

    The Republicants just want to repeal the whole bill and we will be stuck holding the bill. I can assure you that all of the State and National politicians have medical furnished to them at no cost. For the people that they tax the hell out of, it is just TOUGH LUCK.

    I can not wait until I reach medicare age and can get coverage that I can afford. If I survive driving these freeways that long.

  7. insurance is supposed to cover catastrophic problems. If it covers routine or mundane treatments it leads to hyperinflation. The only way we will reign in the cost of health care is through HSA and cash accounts and ObamaCare is trying to destroy both.

    Still, there are 9,000 state employees on the old HMO plan that gives 2 free checkups a year and 4 dental cleanings a year. There are savings to be had there.

    Also, why not

    1) open up Nevada's health insurance market to competition. We can reduce costs by increasing the size of the risk pool and that can only happen if we can buy policies issued in more populated states
    2) reduce health insurance mandates - Nevada has over 50 mandates on what health insurance covers, each one adds more and more to the cost
    3) force the PEBP to compete on the open market - maybe they can find some savings when they're forced to compete to stay in business.

  8. As a public employee, my concern is whether I am paid fairly for my work. I would defy any of the right-wingers screaming about "overpaid, lazy public employees" and trotting out lies and skewed surveys (hello, R-J pollsters and NPRI) to "prove" their point to come do my job as well as I do it (or as badly, for that matter) for my pay and benefits. Of course, if they did, they would have to admit they are wrong, which they never do, and I can't let them do it because, however frustrated I may sometimes get about the work my students do, my students don't deserve to be exposed to their stupidity.

  9. Mr. Hilton,

    1) Show me your proof.
    2) Welcome to reality. The exact opposite of what you claim is happening.

    Compared with the private sector, government jobs actually grew in the first year of the recession and lost, only slightly in the last year. Compared with the start of the recession the net job less in the public sector is 0-1 percent. The private sector, by comparison has shed several MILLION jobs.

    Its the private sector that is having to fork out billions of dollars to keep the government spending boondoggle going. Forcing the productive part of your economy to prop up the least productive part of your economy means, at best, you slow your economic growth.

  10. Dr. Green,

    I have no doubt that our government employs excellent, dedicated, productive and intelligent people. But this doesn't describe everyone who works for government.

    When you look at the incentives:

    1) pay raise without merit
    2) COLA increases yearly
    3) tenure and seniority protection
    4) very little fear of job loss due to lost revenue
    5) revenue stream tied to threat of force (coercion) rather than satisfying the needs of customers (voluntary)

    With many government jobs, there are simply too few incentives to ensure government is as productive as it possible. In fact, guaranteed pay raises and seniority or tenure protections are negative incentives that protect the least competent government worker.

  11. The day will come when more and more people will drop there insurance and that will cause the insurance companies to increase yet again and so on and so on until there is a exodus of members that leave then the insurance companies will go bankrupt or ask for a bail out.

    I do not hold any animosity against anyone who makes a good living but please understand that you have benefited from a social program and when people who make less can't afford it drops out on the last increase, Adjustments have to be made,
    Now if it were me I would see if i could acquire some sort of policy even if it were not a major medical policy for a short time to carry me over until I found some other group policy to participate in.
    This thing that the state employee's are experiencing will continue to others and so forth so don't turn your back on them because you may need help for your cause and they won't be there for you,
    What would happen if everyone left the plan who would lose the most money? I mean would that cause some company to fold think about it you have the power to cut $500 million off the bottom line of some company and carry it to another company instead who would be looking to make that deal? Shop around ask other companies if they need $500 million added to there income.
    These insurance companies have for years had the power to reevaluate if they want to continue to insure you, You have the same option as a group reconsider if you want them.
    Every year there is a enrollment period this not the time to negotiate, you should start to negotiate 6 months prior to this enrollment period. These companies start 6 months ahead of the enrollment period to make increases and you should do the same tell them you are looking at other companies.

  12. Patrick R Gibbons
    The measures (1-5) that you speak against were put into place to protect the state employees from the whim of elected politicians. The same people that got us into this mess. It took those incentives to get those employees to take those jobs. What will happen in the next two years will greatly effect education, public safety and all the services that our local government provide. When these incentives disappear I can guarantee that the level of service will diminish and you will get what you wanted. Good luck. My advice is move to Texas.

  13. Mr. Gladd,

    Those were progressive era reactions to political machines and patronage. They do more harm than good and, including creating well-oiled voting blocks of people who vote in their own self interest - ie its morphed into its own machine.

    Those things have to be eliminated if we are going to refocus government on providing essential services to the people ... instead of luxury services, benefits and amenities for the well-connected.

    Btw, Texas is doing pretty hot right now.

  14. Mr. Gladd,

    The same problems that face private health insurance also face government run insurance. Government run insurance also cherry picks the young over the elderly. There is a reason why American elderly live as long or longer than the Brits:

    Government run health care dumps you, if the cost of keeping you alive is greater than the productive value you offer to the collective.

    Brits also kill premature babies by not providing them any service. In America, doctors will work to save them and the private run health insurance still pays the bills.

  15. *Note, I believe in England babies born before 24, 25, or 26 weeks (can't remember which) are not covered by NHS. Doctors are required by law to refuse treatment because these babies don't stand even a 50 percent chance of survival. Mothers just watch their babies die right in front of them.

    Anyone who thinks government run health care is more humane just isn't paying attention.

  16. It's past time to join the rest of the First World.
    Allow anyone to buy into Medicare - at cost. Tax work insurance benefits as income. While this will eventually lead to single payer; the current Wall-Street For Profit system is no longer working.

  17. It seems to me that the only real solution is going to be one the divorces health insurance from the job market.

    That said, there is a fundamental tension that will always be present as long as different risk pools are involved. Cherry-picking the risk pool is what allows insurance companies to offer different plans at different levels of affordability. That's the nature of the beast.

    According to an AP story ( ) the new pre-existing condition pool that just went into effect is already in trouble. Instead of seeing over 350k people join as expected, there have been only about 8k, mainly because no one can afford the $800/mo premium. The government is talking about lowering that by about $200/mo next year to encourage participation. Where will the money come from to subsidize that? (Three guesses.)

    The provisions for pre-existing conditions was supposed to be one of the greatest things about the reform package, and it is already a major cost center, as was predicted.

    The only way to level out the playing field is to have a universal pool, but even then, costs *must* go up for those who are in good groups now to allow costs to go down for "bad" groups.

    As I started this comment out, health insurance must be divorced from job benefits and looked at in the same light as other forms of insurance.

  18. "insurance is supposed to cover catastrophic problems. If it covers routine or mundane treatments it leads to hyperinflation."

    Hey, Pat...
    95% of the USA would disagree with you.
    What planet are you from again???

  19. "ObamaCare"...

    How about you folks that have NO IDEA what the Health Care Reform Act is about ACTUALLY EDUCATE YOURSELVES as to what is involved with it, instead of PARROTING the IMBICILES that you listen to on FOX and AM Radio...

    Lar, let's start with you, big fella...

  20. The privatized Social Security plan by the libertarian loonies in Chile was a disaster, it went broke.

    Some medical conditions may require many small trips to the doctor, others major surgeries with follow-ups visits, some conditions would require both.

    So saying "mundane trips to the doctor shouldn't be covered" doesn't work (like what kidney dialysis?), nor does it produce savings.

    The best way to save money is to eliminate the middlemen, namely the insurance companies, they provide no value.

  21. There is one glaring problem with sites that provide nothing but talking points, good or bad: few if any of them cite specific sections of the bill that establish the talking point (and the link posted by gmag does not give the basis for its cliams.)

  22. The electorate spoke - but did you vote for Gridlock? see this petition ;

  23. Patrick, I didn't say that everybody who worked for the government is intelligent. Nor would I say that everyone who works for right-wing think tanks twists facts and evidence in hopes of supporting unsupportable conclusions ... just almost everyone.

  24. Patrick Gibbons: why don't you run for public office, get elected and solve these problems?
    Or would the voting public chuck you into the medical waste bin for your opinions?

    By the way: WHERE IS JOHN ENSIGN? On the Golf Course mapping out Republican strategy to have the medical system take every dime we have and then pitch us into the dirt when that is gone?

    WHERE IS JOHN ENSIGN, On the Golf Course?

  25. GOVERNMENT and MILITARY RETIREES refuse to privatize their Federally guaranteed retirement plans....guess why? Remember the crash of 2008 or was that too far back? They do remember and they don't want Wall Street, the banks and insurance companies in charge of their 'no guarantee' financial future.

    As far as memory goes in Conservative circles, the time period "B.C." means "Before Carter".

  26. Mr. Van_Guard

    That's the reason you and I need this healthcare reform bill in a sense in your case the insurance company has done the ole privatize the profits and socialize the expenses (forcing you to wait on medicare).
    My parents had private health care for several years after they retired but after my dad hit 65 there premium went from $220. a month to $780. a month forcing them to get on medicare, Had they paid a premium into medicare for the last 30 years along with the rest of the population medicare would be solvent for a 100 years or more because they would have been able to get money when the person paying was healthy.

  27. Dr. Green,

    First, the burden of proof is actually on you. Its your side that claims that we've cut to the bone and you have to prove it.

    Here is how we prove whether or not that is true. Lets use competitive sourcing. We'll require the public sector to bid against the private sector to provide state services. The state legislature determines what must be done and the quality of service that must be achieved.

    If the public sector wins the bid then you're probably right, the government was doing the job about as efficiently as possible. If the private sector wins the bid, then you're wrong.

    Finally theories need to contain explanatory power. The points I made aren't twisted, the twisted assumption is that you seem to believe that government workers are some how immune from self interest - that after being protected from job loss to incompetence or inefficiency, that they will somehow magically maximize their productivity. Whether we look at the private sector here in America or abroad we can clearly see that seniority protections discourage productive behavior. Why are you magically immune from that?

  28. PS, don't be lazy Dr. Green, actually address my points next time.

  29. Gmag,

    Its pretty obvious that health care expenses are rising rapidly because we have a third party payer system. We have a combo private-public system where 1) your employer buys your coverage 2) government mandates what you buy 3) you don't care how much the doctor charges and 4) the doctor doesn't care how much he charges you.

    You may think its just "greed" but it doesn't stack up to the empirical evidence. Greed is all over the place. Why haven't cars, computers or gasoline increased in price as fast as health care? In fact, the only thing that has increased as fast (or faster actually) than health care, is PUBLIC EDUCATION...

    The fact is, and this is a very simple economic concept, when you make the price $0 (or near free) people want more of it If someone else is paying the bill, people want more of it. And when supply can't meet demand - what happens? Prices rise.

    The fact is, our health insurance (whether it is private or public) causes hyper inflation in health care.

    If we went to a catastrophic only plan and cash for the rest, prices would drop - most likely they would drop considerably.

  30. GMAG,

    Also, please explain why veterinary medicine, lasik and plastic surgery prices are not rising as rapidly (and in some cases flat or declining in prices) as other forms of medicine?

  31. Patrick R. Gibbons, as usual, you are not telling the truth.

    First, once again, you refuse to identify who you really are: an employee of the right-wing NPRI who is paid to express these opinions. That omission of the truth is the same as a lie.

    Second, you keep mentioning that public employees in NEvada get yearly pay increases through both merit and COLA. This is ALSO a LIE! These benefits, along with heath benefits that cover family members, have been discontinued. You need to keep up with what out state government is doing instead of spreading lies.

    Finally, you ask for proof. My proof, sir, is the truth, as I wrote above. Your arguments are full of lies. just like the NPRI you work for, which is why everyone looks at your numbers and the conclusions you draw from them with great skepticism and doubt.

  32. Health benefit packages are used as incentives to get the best or better-than-average people to work for both private companies and public universities.

    The fact that the Right-Wingers are so quick to make sure that those benefits are reduced to the point that they become a dis-incentive to get the best of the best to our state universities says that they don't care about our state's future.

    Mush! Mush! Race to the Bottom, Right-Wingers!

  33. I worked for a private company for 11 years, until the housing market crash and a layoff in 2008. Since then, I've become an independent contractor (1099 work for several companies, when they have work). We have sold assets and left the A/C off over the entire summer to make ends meet in slow months. I took the cobra and bought my wife HMO insurance and now get the priveledge of paying $600 a month out of pocket. For that we get a high deductible, high co-pay policy. A recent dr. visit cost nearly $1000. I now go without dental coverage, we pay as we go. I find it hard to feel sorry for someone making $113,000 having to pay a little more. It's still a lot less than I pay. I make half that in a good year and pay $7200 out of pocket just for insurance, and 2 or 3 thousand more on Doctor/Dental visits, copays, prescriptions, etc. We cannot afford to subsidize public employees healthcare when we've seen our costs skyrocket and our coverage decline. Join the club guys, The free party is ending. Layoffs are next.

  34. Keep electing Liberals.

  35. Mr. Hilton,

    1) Who you work for doesn't change the fact. Focusing on someone's employer is for the intellectually weak minded - it means you have no counterpoints. Have I ever bothered to ask who employs you? Have you ever bothered to disclose who you work for? I actually don't care.
    2) I don't work with NPRI anymore. I work for myself now and my opinions haven't changed because they are fact based.
    3)Step increases, longevity bonuses, and COLAs are not gone, just frozen or replaced with furloughs

  36. @ BobbyG; I'm no fan of yours for anything that you comment on or write about, but that image opening Regional Extension is awesome. Looks like sound waves. Maybe nature is trying to tell us something. You can't write any better than DipStick, but you've got an eye. I hope you pursue photography. (I deleted, "maybe if you kept your mouth shut but your eyes open you'd do better," lol.)

  37. It's going to get to the point that the faculty employees had better learn to like it because there will be no other state to go to that does not have the same problems managing their budgets. It is just the tip of the iceberg of what is to come for cash strapped states attempting to finance pensions and benefits for the public sector.

  38. Joe Stormont I'm with you.... I Don't have alot of sympathy for someone earning $113,000 who has to pay more for healthcare. Everyone is paying more these days.