University Times

Faculty Assembly on Nov. 5 unanimously approved a resolution "strongly urging" the administration to maintain at least two employee health insurance plans after Pitt's current contract with Blue Cross expires at the end of June 1998.

The resolution specifies that one of the two plans should be an indemnity-type option like the current Blue Cross Comprehensive Deductible plan.

Assembly members passed the resolution in response to a report by leaders of the University Senate benefits and welfare committee, who said that:

* After 1996, Blue Cross will no longer offer its University Health Network (UHN) plan except at Pitt. Current Pitt UHN subscribers may remain in the plan until July 1998, although Blue Cross stopped accepting new Pitt subscribers into UHN as of last July. After July 1998, Blue Cross will cease offering UHN entirely.

* Despite data indicating that Comprehensive Deductible is costing Blue Cross less than the three other plans that Blue Cross offers at Pitt, Blue Cross probably will hike the plan's cost to Pitt by 15 percent in July 1997, the maximum increase allowed under Blue Cross's contract with the University. Under that contract, the maximum increases for Pitt's other Blue Cross plans would be 8 percent for UHN and 7 percent for both the SelectBlue preferred provider plan and the Keystone Health Plan West health maintenance organization.

* Beginning July 1, 1997, University of Pittsburgh Medical Center (UPMC) employees will have a single health care option — Tri-State SelectBlue. The UHN and Traditional Blue Cross plans currently offered to UPMC employees will be eliminated at the end of 1996. For the first half of 1997, UPMC employees may choose between Tri-State SelectBlue (which will be offered to medical center employees at no cost during that period) and a new UHN plan.

The new Tri-State SelectBlue plan is based on Blue Cross's current SelectBlue option but with cost savings for subscribers who choose a primary care physician from the newly formed Tri-State Health System. The system includes UPMC and six affiliated hospitals: Children's Hospital of Pittsburgh, Magee-Womens, Passavant, St. Margaret Memorial, South Hills Health System and The Washington Hospital.

Senate benefits and welfare committee chairperson James Holland said his committee is worried that Blue Cross plans to eliminate its Comprehensive Deductible plan. "It looks to the more paranoid among us, of which I am a leader, that from the beginning [of Blue Cross's current three-year contract with Pitt], Blue Cross planned to get rid of Comprehensive because they planned these high increases in the caps [by which Blue Cross could raise its rates]." Ron Frisch, interim associate vice chancellor for Human Resources, said he is unaware of any plan by Blue Cross to eliminate its Comprehensive Deductible option. "That's a perception that's being touted, but there's been no indication of that to me from Jerry Cochran [Pitt's assistant chancellor, to whom Frisch reports] or from Blue Cross." According to Human Resources, 1,299 Pitt faculty and staff members are enrolled in the Comprehensive Deductible plan, 1,531 in SelectBlue, 1,407 in UHN and 2,545 in Keystone Health Plan West.

Benefits and welfare committee member Gordon MacLeod said the committee fears that Pitt's administration eventually will impose Tri-State SelectBlue as the sole health plan for Pitt faculty and staff.

MacLeod cited last year's decision by Pitt administrators to drop the HealthAmerica plan, and the administration's declared preference for health plans that benefit UPMC and Pitt faculty who work there.

Frisch said it's possible that the University would add Tri-State as an option for University employees after Pitt's current Blue Cross contract expires at the end of June 1998.

"At that point, when we put our contract out for bids, we're going to go for the most competitive price," Frisch said. "But we're going to be extremely sensitive to those plans that are going to support the entire University community, and that would include UPMC." Frisch said he knows of no plan to extend Tri-State's UPMC monopoly to University employees.

Joyce Davis, a Johnstown campus faculty librarian, said elimination of Comprehensive Deductible "could be a real problem for us at the regional campuses." Under Pitt's other Blue Cross plans, many Johnstown campus faculty and staff would have to drop their current primary care physicians, Davis said.

Frisch agreed — although he noted that, according to health insurance regulations, there are sufficient SelectBlue network physicians in the Johnstown area to serve campus employees. "Practically speaking, though, we're not going to do that [limit Johnstown campus employees to SelectBlue]," Frisch said. "It would cause hardships for too many people, forcing them to change their physicians." At UPMC, though, staff who live outside "reasonable access" to Tri-State SelectBlue providers will be offered regular SelectBlue, according to the medical center newsletter Extra.

— Bruce Steele