Benefit changes for 2015

Dear Fellow Employee/Union Member:

Recently the Joint Labor and Management Insurance Committee (JLMIC) agreed to modest changes in 2015 benefits that will lower the County’s costs and protect the health of employees and their families.

Last year the County and labor announced a new way of negotiating benefits that allows us to adjust benefits more regularly so we can be more responsive to market conditions. To keep you updated the JLMIC created a website with background on who we are, how we negotiate and what’s happening with health care costs.

The JLMIC has benefitted in its talks from data provided by a third party, Mercer. To help you understand the decisions we make and how they balance the needs of members against the reality of rising health care costs, on our website we are sharing all of the data given to help us in our discussions.

As of January 1, 2015 the following benefit changes will go into effect:

  • The Benefit Access Fee will increase from $50 from $75 per month.
    • As before, Group Health members will not pay a benefit access fee.
    • Employees pay a benefit access fee for covering a spouse/domestic partner who has access to medical coverage through an employer other than King County.
  • In the KingCare plan, step therapy will be expanded to include more classes of drugs.
    • This will apply to new prescriptions. Members who are already taking one of these medications will be able to continue with their current drugs.
    • Step therapy begins medication with the most cost-effective and safest drug and progresses to other more costly or risky therapies only if necessary.
  • Revised coverage of compounded drugs.
    • Compounded drugs are made by combing, mixing, or altering ingredients to create a medication tailored to the needs of an individual patient.
    • Compounded drugs are not FDA-approved. There can be health risks associated with compounded drugs that do not meet federal quality standards.
    • Compounded drugs can be made using poor quality practices may be too weak, too strong, contaminated, or otherwise impure.

How these changes will affect the county’s costs and the number of health plan members can be found on the JLMIC website. There you can also subscribe to get emails on important JLMIC developments.