Diocese of Sioux City will see
By JOANNE FOX, Globe editor
While others may be bemoaning the sad state of United States health care and its costs, employees with the Diocese of Sioux City have reason to revel.
For the next fiscal year, which begins July 1, diocesan employees will see no increase in health insurance premiums.
Human Resources Director Margaret Fuentes attributed a number of factors to that good news.
“The cost of prescription drugs has been a huge factor driving costs over the past 10 years or so,” she said. “Often, we would hear that ‘trend’ or medical inflation was considerably less than the ‘trend’ of prescription drug costs.”
A number of formerly name brands have now become generic and that has helped with costs, Fuentes added.
“We also have a more educated employee group who understands their plan and that generic drugs are offering the greatest value under our health plan,” she said.
There was considerably less usage under certain claim categories, as well, Fuentes pointed out.
“Some categories have traditionally been high for us – cancer treatment and skeletal/muscular, that is, orthopedic surgeries, for example,” she said. “Those have decreased.”
The self-insured nature of the plan, at the diocesan-level, also provides positive results, Fuentes pointed out.
“We act as the ‘insurance company’ for our group,” she said. “We are the plan sponsor and oversee the plan with the input and assistance of a group of school and parish representatives from across the diocese.”
This group consists of business managers from the larger diocesan schools and several priests.
“We then contract with Wellmark as our third-party administrator or TPA to adjudicate claims and make sure our plan is following applicable insurance law,” Fuentes said.
Based on previous claims experience, Wellmark’s underwriters tell the diocese how much money they anticipate will be needed for the coming year to pay claims, rent their network of doctors/hospitals and cover Wellmark’s administrative charges.
“We then determine how much money we need to collect to cover all of these items, plus some new costs brought about by the Affordable Care Act,” Fuentes said. “These new costs are borne by every insurance plan, now and will be bundled into insurance rates for the foreseeable future.”
Lastly, but Fuentes clarified, certainly not least, are the results of two years of the diocesan wellness program for the majority of employees.
“We know we have averted some claims, just by identifying some chronic conditions that needed treatment,” she said. “Maybe someone that didn’t know they had high blood pressure or were experiencing higher than normal blood sugar. We had some folks who had maybe become complacent on their drug regime and stopped taking their cholesterol meds, but needed to again focus on those issues. I do think that we have to give our wellness program credit for some of this good news for the renewal.”
In March, Blue Zones Project Sioux City announced the diocese as a designated Blue Zones Worksite.
The Diocese of Sioux City completed designation criteria in the areas of leadership, purpose, habitat and physical environment, engagement and creation of social networks, policies and benefits, and well-being solutions.
“Our lives are so busy with work and family that often times we ignore important elements of being healthy, such as getting enough rest, exercising and being conscience of what we eat,” said Bishop Walker Nickless.
“As a Catholic bishop, I also want to encourage people to make sure their spiritual health is active as well,” he added. “I am very proud of our diocese for making our health more of a priority. The Blue Zones Project has been a blessing for all of us.”
Brought to Iowa through a sponsorship by Wellmark Blue Cross and Blue Shield, in collaboration with Healthways and Blue Zones, Blue Zones Project is a community-by-community well-being improvement initiative designed to make healthy choices easier through permanent changes to environment, policy and social networks.
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