Q and A Update: Health Care Reform--Implications for SMC Faculty

April 4, 2007

During the Faculty Association Representative Assembly, March 29, 2007 , two questions about SB 840 (Kuehl) were unanswered. Senator Kuehl addressed the questions during a Community Forum at the Los Angeles Center for Enriched Studies later that same day. The following is a summary of her answers.

Question: I'm retired with Medicare health care coverage and the Santa Monica Community College District Medicare Supplement coverage. What will happen to my supplemental coverage if SB 840 is enacted?

Answer: Under SB 840, the California Health Insurance System (CHIS) will be created. It will receive payments now going to private insurance carriers and will pay providers for medical treatment. Therefore, money now going to pay a premium for a Medicare Supplement plan, under SB 840, will go to the CHIS and Medicare Supplemental coverage will be provided through the State plan.

Question: Per our collective bargaining agreement, our District contributes to “employer supported” health care insurance reimbursement during retirement for vested faculty. Under SB 840, what will happen to my coverage if I move out of California during my retirement?

Answer: Under SB 840, the Santa Monica Community College District would continue to reimburse you for the contributions made to the CHIS, rather than to the current health plan. For our District, individual retirees will be covered under the CHIS, as long as the District continues to authorize payment into the CHIS. If the covered individual receives services out of state, the services will be reimbursed at the customary, California benefit rate. If the charges for service exceed the California rate, then the individual will be responsible for the excess charge. (Note: This is the same benefit coverage for out of state charges under our existing plans.)