WEA Select - FAQ about changes to health care program
We know that many people have lots of questions about the change in health care offerings by WEA Select.
This FAQ is to help set the record straight so that WEA members and school employees understand the distinct benefits and advantages of remaining with WEA Select.
WEA Select is our program. It has been designed by educators for educators and our families. We have a proven track record of meeting and being responsive to educators' insurance and health care needs for over 50 years. In fact, WEA Select began as a means to guarantee that all educators had access to health insurance regardless of where they live.
If the plans WEA Select offers are the same as before, why did you change providers?
WEA Select felt that the time was right to see if our members and plan participants were getting the best quality care at the right price. With so many changes in both technology and health care, we were convinced we could take a strong program and make it better.
We wanted to offer two carriers, so that there would be incentives within WEA Select for the insurance companies to compete for your business by improving care and value for service.
This proved true. Near the end of the eight-month review process, Premera withdrew its bid, telling us they did not want to be part of a two-provider system.
Here are some of the improvements being offered by Aetna and UnitedHealthcare.
- Concierge-style customer service, with real people who answer the phone when you call your insurance company and no more interminable wait times, just friendly customer service provided by people who understand what you need when you call.
- No pre-approval for licensed massage services. True! You no longer will have to jump through hoops to have massage doled out in small doses.
- Free opt-in access to wellness tools and programs
- Free “telemedicine,” with 24-hour access to talk with a doctor.
Stay with WEA Select. We exist for our members and school employees. You retain the same comprehensive benefit program you are accustomed to at the same or lower rates, alongside our-member driven claims appeal process and the strength of the largest insurance pool for educators in state.
How does Premera’s new “school pool” compare to WEA Select?
WEA Select’s purchasing pool is the largest and most stable insurance collective for educators in the state that has been in operation for decades.
There are several caveats to note about Premera’s so-called school pool:
- It isn't nearly as large as WEA Select and won't provide the same level of rate stabilization as our 100,000 member purchasing pool.
- Their own contract language says that the rates being offered aren't final until the pool is closed, meaning rates could be higher.
- Further, those “offered rates”
- Don't include the mandatory Dental and Vision benefits, which are excellent in the WEA Select plan.
- Don't account for part time employees, who will have to be calculated in at either full or pro-rated costs.
- Assume that the school district is contributing to the cost of the plan, which may or may not be true in all cases.
What are the administrative fees for WEA Select?
The overall administrative fees are less than 6 percent. This pays for the benefit administration within WEA and our consultant, AON. It includes the carriers’ administrative expenses, such as customer service, and other things like financial audits.
Neither WEA Select nor WEA makes a profit on the plan.
The State Auditor’s office completed a performance audit on WEA Select, and found that the plan is properly administered and meets accepted operational standards.
Premera says it can offer “customized plans”
This is their way of saying they can provide the same variety of plans that WEA Select already offers. WEA Select offers more coverage and cost options than most plans available to Washington employers today. The offerings within our plans have been adusted over time, to meet the needs and input of our participants.
Will the “two year rule” be enforced and keep districts from returning to WEA Select if they opt out?
We don’t think districts should opt out of WEA Select. It is a better program, created by educators for educators. People who are pushing to make a fast decision are hoping to convince folks on grab-and-go marketing points rather than solid facts. That said, WEA Select hasn’t enforced the two-year rule in many years. We review that decision annually.
I heard Premera is offering different rates to different locals. Why is that?
Premera is cherry-picking districts for sales, offering their plan to districts with recent low claims history. Should any of those districts experience high-cost claims, the school pool wouldn't be large enough to protect against it and rates would go up. We know this because when Premera was contacted by some locals with high claims experience, they responded with double digit cost increases. For example, Premera offered one relatively small group with high claims experience a program with a 21 percent increase. Again, the larger the insurance pool, the more stable rates will be over the long term.
What if we go on strike? Are we covered?
WEA Select offers continuation of benefits in the event of a strike. Coverage can’t be cancelled due to strike, because WEA Select considers walking the picket line to be actively working and thus eligible for coverage.
There are several different scenarios that could play out depending on how long a strike may last. That said, even in Marysville, which was on strike for 49 days, members were not asked to pay for their premiums.
Questions about the carriers, networks and providers
Some questions are specific to the plans or the new provides. We’ve tried to provide a few answers to common questions below. For other specific questions, your best bet is to contact either Aetna (855-878-4101) or UnitedHealthcare (844-219-3630) directly, visit weaselect.com or call the WEA Select hotline, 206-681-6920.
Is Providence included in the new plans?
Will my son or daughter who is going to college out-of-state be covered?
All Preferred Provider Organizations (PPO) and some High Performing Networks provide coverage for dependents living out of state. We strongly encourage people to contact the customer service representatives regarding their best options. And remember, our new “concierge style” customer service means you’ll always talk to a person, experience shorter wait times and get timely, personalized attention and answers.
Am I covered if I travel out of the country?
Both carriers cover emergencies out of country. If you have plans to travel abroad, please consult Aetna and UnitedHealthcare to decide which can best meet your needs.
I understand that UnitedHealthcare updates its pharmacy program throughout the year. How will that affect me?
UHC will provide enhanced customer service for our plan participants to help people if they need to make any changes.
I don’t live in the Seattle area, but I currently access health care in King, Snohomish or Pierce County. Does Aetna’s High Performance Network for people living outside of the metro area allow us access to doctors in the metro area?
People who live outside the metro area, but who currently travel there to see a provider should verify that all of their providers are covered within the network they choose, whether Aetna or UnitedHealthcare.