Description: This article is an explanation of how medical insurance program works at Pflurgervill ISD. It is presented by Kenneth Adix who is the CFO of Pflugervill ISD. He believes that each of individual choices collectively results in how much insurance cost.
My name is Kenneth Adix and I’m the CFO of Pflugervill ISD. I want to share information with you about our medical insurance program.
As you may know, our open enrollment process occurs in October. Employees will make their insurance selections that will take effect on January 1st. What you may not know is that since 2011 we have had a self-insured medical insurance program. Let’s go over what that means.
Simply put self insurance means we collect all of the funds and pay for all medical expenses out of our own insurance account. Our collected funds come from two sources.
One is the district’s monthly contribution of $400 toward an employee’s medical insurance premium. The other source is what we pay for medical insurance premiums and our payments for services such as co-pays for doctor visits and prescriptions. Now our insurance card says Humana because we contract with Humana to administer our insurance plan and process the paperwork associated with our plans.
However, we pay for all the costs associated with our medical insurance every time we go to the doctor and go to the ER have a baby etc. Those claims are processed by Humana, but paid out of our own insurance account.
When what we are paying out is more than what we’re taking in, we have to raise the premiums that are taken out of our paycheck in the same way.
We pay for all cost, and we also realize all of the benefit of finding ways to lower cost.
One way you can ensure that we are not overpaying is by using a company we contract with called compass. Compass is a free service to all our employees. You can e-mail or call compass to have them find a doctor for you, provide you with price quotes from what different providers will charge you for services such as MRIs lab work medical procedures prescriptions.
Compass will also work on your behalf to resolve billing questions or ensure that you’re not being overcharged for a service.
The most important thing to realize is that each of our individual choices collectively results in how much our insurance cost will change year together. We can make a positive difference.