University Times

Blue Cross's proposal to become Pitt's sole provider of employee health insurance is raising the blood pressure of some faculty and staff members in Oakland (see story on page 1 and letters on page 2). But it's a non-issue at the University's four regional campuses.

That's because the HealthAmerica health maintenance organization (HMO), which Pitt would have to drop if it accepts the Blue Cross deal, has never been an option for the great majority of faculty and staff at the Bradford, Greensburg, Johnstown and Titusville campuses.

A small number of regional campus employees do belong to HealthAmerica. (The exact number is uncertain, but most are at the Greensburg campus). Other regional staff and faculty, though, live too far outside HealthAmerica's Pittsburgh-based service area to use the plan.

Pittsburgh campus employees currently have five health insurance options — HealthAmerica and four Blue Cross plans, including:

* Traditional Blue Cross, which Pitt will drop effective Jan. 1, at Blue Cross's request, replacing it with the new SelectBlue plan.

* Comprehensive (deductible) Blue Cross.

* The Keystone West HMO.

* The University Health Network, a plan involving Pitt-affiliated physicians.

In contrast, the Greensburg and Johnstown campuses will have three options as of Jan. 1 — SelectBlue, Comprehensive Blue Cross, and Keystone West.

The Bradford and Titusville campuses will have just two options — SelectBlue and Comprehensive. UPB and UPT are outside the service areas of both the HealthAmerica and Keystone West HMOs, as well as the Oakland-based University Health Network.

According to Human Resources managers at the regionals, the major health insurance concern at the four campuses is Pitt's replacement of Traditional Blue Cross with SelectBlue.

The Traditional plan allowed employees to choose their physicians and it covered eligible medical services in full. SelectBlue, however, covers those services in full only after they have been approved by a member's primary care physician, who must belong to the SelectBlue physicians network. If an employee does not go through the primary care physician, a co-payment is required.

For the regional campuses, Blue Cross has agreed to treat out-of-network physicians as in-network physicians until Blue Cross develops its regional networks for SelectBlue.

Susan McGarvie, personnel officer at the Titusville campus, said "no one is happy up here" about the replacement of Traditional Blue Cross with SelectBlue. Of the three Titusville area physicians named so far by Blue Cross to its SelectBlue network in the area, one doctor plans to retire soon and another reportedly is not accepting new patients, according to McGarvie.

"Our Blue Cross representative told us, 'You can't expect a (physicians) network in a rural area like Titusville to be as good as one in Pittsburgh.' Okay, fine. But they (Blue Cross) should still offer us something that's going to be suitable for our area, and we have no guarantee that that's going to happen," McGarvie said.

Bradford campus human resources manager Laurel Butler said that no physicians have signed up yet for the Bradford SelectBlue network. Speaking as president of the campus's new Staff Association, Butler said that most UPB staff and faculty members she has talked with are "displeased" with the loss of Traditional Blue Cross. "We don't have a lot of doctors to choose from to begin with around here. Now, we're going to be limited to those in a network," she said.

Jeffrey Lavine, director of budget and operations at the Johnstown campus, said: "The sense I get in speaking with people on this campus is that they see a little bit of forward progress with the changes in their (health insurance) options for 1995." While UPJ employees will trade Traditional Blue Cross for SelectBlue, they also will gain the Keystone West plan beginning Jan. 1. "Our faculty have been pushing for years to get an HMO option, and now we're getting one," Lavine said.

Joyce Bucchi and Karen Antoniak, the Human Resources officers for Greensburg campus staff and faculty, respectively, said UPG employees currently enrolled in Traditional Blue Cross are generally displeased with the SelectBlue substitution.

But even more displeased are the dozen or so UPG faculty and staff who belong to HealthAmerica, Bucchi and Antoniak said. "The people who are in HealthAmerica are very pleased with it," Bucchi said. "They're not happy that Pitt is considering dropping it."

— Bruce Steele