As some of you might have heard by now, Anthem proposed a fairly substantial rate hike for next year. Even after backing off the initial quote for a 20 percent increase, the best Anthem would offer us was a premium increase of 12.5 percent for next year.

Fortunately, we found a cheaper – and better – option that will actually put more money in your pockets next year. Effective Jan. 1, all guild members who want coverage through the guild health-care trust will be switching to SummaCare. Our insurance agent and a representative from SummaCare will be available at 4 p.m. Tuesday, Nov. 21 in the northeast corner conference room to review the benefit and answer any of your questions. We’ll review the open enrollment procedures at that time as well.

We know change is hard. But the pluses of changing to SummaCare are undeniable. SummaCare came in with a bid that allows everyone to contribute substantially less per pay period next year than you’re paying this year for Anthem. For full-timers, these are how next year’s SummaCare rates compare to your current contribution per pay period with Anthem:

• Employee only: $2.93 per pay period versus $27.25 this year
• Employee plus spouse: $55.80 vs $91.23.
• Employee plus child/children: $36.84 vs. $49.69.
• Family: $101.80 vs. $120.13.

Under SummaCare, you’ll also face less out-of-pocket charges than you’re paying with Anthem. For example, you pay 20 percent of the costs for in-network, outpatient services – things such as lab work and x-rays. Under the SummaCare plan next year, you pay nothing as long as you go to an in-network facility. A few other areas of potential savings include outpatient surgery ($0 instead of $100), ER visits ($75 instead of $100); urgent-care center visits ($35 instead of $50), ambulance services ($25 instead of 20 percent) and allergy testing ($15 instead of 20 percent).

Doctor’s visit co-pays will remain $15. The co-pays for generic drugs and preferred (tier 2) brand-name drugs will remain $10 and $20, respectively. The co-pay for non-preferred (tier 3) brand-name drugs will increase slightly, from $30 to $40. However, keep in mind that your co-pays would be as high as $150 per drug under the company’s “Blue” and “Green” plans with UnitedHealthCare.

You’ll probably find most doctors in the area contract with SummaCare. But some people might be concerned that Akron General Medical Center is not part of the SummaCare network, meaning you’ll have to pay the out-of-network deductible of $500 for individuals then 70 percent of the charges up to a maximum of $3,000 to go there. But Akron General offers a special program that allows people, in some cases, to go there for the same charges as they’d pay at an in-network hospital. And, of course, everyone still has the option of enrolling in the company’s “Blue” or “Green” UnitedHealthCare plan, which does include Akron General. But realize that under the company’s plan, you could be responsible for as much as $3,000 in out-of-pocket charges, even at an in-network hospital.

Full-time rates per pay period for the UHC Blue Plan for 2007 are:

• Employee only: $38.19
• Employee plus spouse: $97.00
• Employee plus child: $97.00
• Employee plus children $139.25
• Family: $139.25

We’re sure you’ll have questions, which hopefully can be answered at Tuesday’s meeting. In the meantime, feel free to contact Bob or Cheryl.

Cheryl Powell and Bob DeMay
Guild healthcare trustees