ATPE News is the official publication of the Association of Texas Professional Educators, the largest educator association in Texas. The magazine addresses the most important issues affecting public education in the state. Learn more at ATPE.org.
Issue link: https://atpe.epubxp.com/i/649527
atpe.org | 25 spring 2016 forced into high-deductible plans." When it comes to spending per public school employee for benefts, Texas ranks last in the country. "At a minimum, we have to keep pace with the private sector," says Sanderson. "We have to be able to compete with neighboring states for quality educators. But right now, the state is contributing an average of $75 per month—the same level as 2001. Fifteen years have gone by. Had the state made incremental increases like every other employer, it wouldn't be a problem. But now, even if they doubled their contribution, it would cost about $1.2 billion to do. It's massive." Weighing the Risk One of the provisions in the ACA is that people who do not carry minimum essential coverage (MEC) through qualifed insurance plans must pay an individual shared responsibility payment. Those who opt not to carry MEC are required to pay this fee when they fle taxes for the year (unless they qualify for an exemption). Many people are questioning whether it makes fnancial sense for them to pay the annual fee instead of maintaining MEC. For some, the fee may be less expensive than the lowest premium, highest deductible plans. However, people who opt to not carry insurance and instead pay the fee are taking a huge fnancial risk. Fees for people who do not carry MEC are calculated in one of two possible ways: percentage of annual income or per person. For a single person who does not have insurance, the fne is 2.5 percent of annual household income OR $695 per person, whichever is higher. According to healthcare.gov, the annual premium for a Bronze plan, the lowest cost, highest deductible plan available through the exchange, is $2,448. At frst glance, it would appear that a single person without dependents would save a signifcant amount of money by just paying the annual penalty. However, this assumes that the person won't get sick or have medical expenses during the year. If the person needs to see the doctor, have lab work done, or go to the hospital, those costs would be paid out of pocket. This person could quickly end up owing thousands of dollars for expenses that would have been covered by insurance after the deductible was met. For most people, the risk of paying out of pocket expenses isn't worth saving a few hundred dollars in insurance premiums. For more information on penalties and for help estimating your annual fee, visit healthcare.gov/fees/fee-for-not-being-covered. Knowledge is Power The stories from HISD continue, one after the other. One teacher needed physical therapy. Insurance covered $40, but each treatment cost $150, so she stopped going. Another, a counselor, needed urgent dental care, but was forced to wait two weeks before she could get an appointment with a dentist who accepted her plan. In another example, a paraprofessional working for the district needed to see a specialist, but not all plans ofered access to all specializations. Amelia Cano is a retired school nurse who still works with HISD. She quickly gets to the heart of the Here are some things you can do to help stay healthy and avoid unexpected medical expenses. GET HEALTHY. Follow the school nurse's advice and listen to your body. Get enough rest, eat good food, and drink enough water. SEEK PREVENTIVE CARE. Annual check-ups and regular screening can detect problems before they turn into emergencies. DO THE RESEARCH. There are valuable guides available online to explain the ACA. Some are more politically biased than others, so search the web and be sure to visit the ofcial ACA website at healthcare.gov. TIPS FOR STAYING HEALTHY continued on pg. 42