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Employers struggling to implement new insurance model

GRAND RAPIDS, Mich. (NEWSCHANNEL 3) - Some public employers are wrestling with how to implement a 2011 Michigan law.

Public Act 152 gave public employers the choice between a hard cap and an 80/20 insurance model.

The hard cap insurance model lays out the maximum amount a public employer can contribute toward a premium depending on single person, couple or family coverage. The question has become how to treat a single person who has one child.

"Local control, local control, local control."

That's what Deborah Drick, state Senator Mark Jansen's chief of staff, tells us was the intent of PA 152. She was the lead on the bill.

"It's less expensive for a school district to categorize a single parent plus one child as a couple than it is as a family because then the hard cap they only have to pay $11,000 versus the $15,000 for a family, but that's totally within the school district's choice," Drick said.

Grand Rapids Public Schools has 45-50 employees in that boat, and for now, they're being treated as couples, not families.

"A family contribution for the entire year is $1,590 dollars. For two persons it's $3,516 dollars. Substantial difference between the two,"
said John Helmholdt, GRPS spokesperson.

Helmholdt says GRPS needs clarification from the Michigan Department of Education. In an email to MDE, the district sought an answer, saying "there seems to be a lot of confusion." MDE's response was it's waiting to hear from the treasury office of tax policy. Several weeks and follow up emails later, the district says MDE still doesn't have an answer.

"We have the state senator's office saying, well, it's up to districts to decide. That's great, that's what we hope because if it is, we are then going to rule they should be treated as a family, not as a couple," he said.

MESSA, the insurance provider, told GRPS in an email an employee plus child is billed under a two-person plan, but that the legislation is not clear. In the meantime single parents with one child are paying for the confusion.

"Under the law it says if you do not comply, you could face upwards of
10 percent loss of your per pupil funding. These are high stakes but these are also the lives and the livelihoods of our employees and their children," said Helmholdt.

The Department of Treasury tells me the Department of Education should not be waiting on any answers from Treasury. According to a FAQ document produced by the treasury to help public employers administer the new law, single employees plus a child should be categorized as couples for purposes of the hard cap.

Two calls to the Michigan Department of Education were not returned today.
 
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