SEIU Local 503 & PEBB'S Health Engagement Model

SEIU Local 503 President Linda Burgin took a strong stand questioning the Health Engagement Model (HEM) at Friday's PEBB meeting. Here are some of her remarks:

I am here because I have been a state employee for almost 28 years and a statewide officer of this union for 7 years, and I can’t think of an issue that has generated so much member outrage as the latest PEBB proposals and policy changes being put in place to bring health care costs down…Literally thousands of emails and phone calls…verbal abuse at meetings…I know many of you have shared my angst over the past few months!

We have numerous concerns about the changes that PEBB is undertaking. I understand, as do our members, the need to address rising health care costs. For years now, state workers have sacrificed wage increases and even have taken furloughs to maintain health care benefits. We know, first hand the impact of the spiraling cost of health care. I am proud of the work our union has done to help make health care more affordable not only for ourselves, but for everyone. In Oregon, we worked hard to get the Oregon Healthy Kids legislation passed, and won a grant to help sign up kids for health insurance. We have been instrumental in creating the prescription drug bulk purchasing pool, and have been active proponents of the Governor’s health care transformation initiative. Nationally we helped lead the way to the passage of the Affordable Heath Care Act. Our commitment to improving access to affordable, quality health care has not changed. However, I want to make it clear that our members have VERY SERIOUS CONCERNS over the Health Engagement Model, as it is currently being proposed. Over the last few weeks we have surveyed thousands of SEIU PEBB members and I’d like to share some of those results with you today.

The most prevalent non-economic concern we are hearing about relates to confidentiality and civil rights. 78% of respondents indicated they are either very concerned or concerned about who will have access to their health information. Concerns include:

a. That the health information that is provided via HEM not be used to deny them coverage in the future;

b. That they do not have to submit to treatments that they do not wish to pursue;

c. That there are sufficient safeguards to ensure that their employer does not have access to their medical information; and

d. That they are not required to go to the doctor more often than they and their doctor determine is appropriate.

Many members have expressed concern over being discriminated against due to their health conditions and questioned the legality of the Health Engagement Model. These privacy, confidentiality and civil rights concerns could easily be addressed and must be addressed, either here today or through subsequent action.


Overall, our members are most concerned by the amount of money that it takes to opt out of HEM with 85% of respondents expressing concern over the opt-out charge. We recognize that while the PEBB Board was exploring options around implementation, you did not know there would also be a premium share. But, as we now know, members will be paying 5% of their health care premiums. The additional cost to opt out of HEM (or to have your partner or spouse opt out) combined with other surcharges, fees and deductibles will be staggering! The cost savings to PEBB must be balanced with affordability for PEBB members and, given that we now are facing a monthly premium share, the financial impact of any opt-out is much greater and should be revisited. Preferably, this program would be set up as with an incentive if you opt in, rather than a penalty if you opt out. In my experience as a Mom and a Granny, as a lead worker and as a union president, I always get much better results by rewarding good behavior than by punishing or penalizing bad behavior.

Another common concern we are hearing about is the use of waist circumference. Would it be possible to use a body mass index instead? Or maybe a hybrid of the two measurements could be used?

We also would like to learn more about PEBB’s plan to evaluate and assess the effectiveness of HEM and its impact on both costs and member health. We have negotiated a letter of agreement with DAS to provide us input in an evaluation process, however, it seems appropriate that PEBB would also have a plan in place to evaluate the program. Does PEBB have an evaluation plan?

And finally, over the last four or five months the PEBB Board has been exploring and evaluating significant changes to our health care – both the plan design as well as the Health Engagement Model. We are very disappointed in the level of communications from PEBB to members. We have heard very little directly from PEBB about the changes that are being made, and there has been little to no solicitation of direct input from PEBB members into these decisions.

Changes of this magnitude require involvement of ALL stakeholders. We would have expected to hear more directly from PEBB through surveys, newsletters, emails and mailings. While PEBB Board meetings are open to the public and public comment is always an option, hearings or information sessions open to members would have gone a long way in making this a better process. We urge you to take communications with members seriously, and step up the information sharing through the various mediums.

This is not the way PEBB has behaved in the past. A few years ago, I brought a group of parents with autistic children here to testify about the need for PEBB to cover some of the medically approved treatment plans for autism…and the PEBB Board voted to do so!

(For an earlier report go here.)