PEB Board approves Medicare rates for 2022

Wed, 07/07/2021

On June 30, 2021, the Public Employees Benefits Board (PEB Board) met virtually. The meeting was open to the public via Zoom.

Meeting recap

Highlights of the meeting are listed below. See the briefing book for all presentation materials.

  • The Board approved the following resolutions:
    • 2021-16: To allow benefit accumulator amounts, such as deductibles, out-of-pocket maximums, and benefit and visit limits, to transfer when a subscriber moves from one Uniform Medical Plan (UMP) option to another
    • 2021-17: Endorsed monthly Medicare explicit subsidy of $183 or 50 percent of premium, whichever is less
    • 2021-18: Endorsed Kaiser Foundation Health Plan of the Northwest Medicare premiums
    • 2021-19: Endorsed Kaiser Foundation Health Plan of Washington Medicare premiums
    • 2021-20: Endorsed UMP Medicare plan premiums
    • 2021-21: Endorsed UnitedHealthcare Medicare Advantage plus Prescription Drug (MA-PD) premiums
    • 2021-22: Endorsed Premera Blue Cross Medicare Supplement premiums
  • Staff proposed the following resolutions for a later PEB Board vote:
    • 2021-23: To allow the UMP consumer-directed health plan (CDHP) to cover an expanded list of preventive care benefits for certain chronic conditions before having to meet the plan deductible.
    • 2021-24: To allow 24 chiropractic, 24 acupuncture, and 24 massage visits per year for UMP plans, with a copay when seeing an in-network provider (instead of the current coinsurance approach). Copays will not apply to the deductible (except in the UMP CDHP as required by IRS rules).
    • 2021-25: To allow dependents to enroll in PEBB dental on a self-pay basis for 36 months if they lost dental coverage when the employee was disenrolled from PEBB dental to remain in SEBB medical.
  • Staff reviewed proposed KPNW benefit changes regarding self-referred naturopathy, acupuncture, and massage, along with a self-referred rehabilitive therapy benefit that combines visits for outpatient physical, speech, and occupational therapies.
  • Staff presented a new KPNW benefit change regarding prescription insulin, lowering the out-of-pocket maximum cost to the member for each insulin prescription fill from $100 to $75.
  • Staff reviewed proposed Kaiser Permanente Washington (KPWA) benefit changes including adding in-home infusion therapy and $0 copay for two urine drug screenings per plan year.
  • Staff reviewed efforts currently under way to potentially align PEBB medical plans with School Employees Benefits Board medical plans for 2023.
  • Staff presented a comparison of PEBB Program and open market Medicare plans.
  • Staff presented an overview on SmartHealth, the voluntary wellness program, including:
    • Requirements to qualify for the wellness incentives.
    • Statistics and trends for 2018 through 2021.
    • PEBB-specific SmartHealth materials.
    • Plans to continue to promote SmartHealth participation.

Next meeting

The next public meeting of the PEB Board is scheduled for noon to 5 p.m. on July 14. Board members and the public may attend virtually via Zoom. The link or call-in number will be noted on the meeting agenda, which will be posted on the PEB Board Meetings and materials webpage.