Over the past several weeks, it's become clear that PeaceHealth's new health insurance plan under Moda Health will increase costs significantly while narrowing the scope of covered care.  Your WSNA bargaining team is doing everything we can to mitigate those cost increases, expand the list of covered providers, and make it easier for you to access care when and where you need it, which is why we met with management's representatives on Tuesday, November 26th. Our goals for this first session were to (1) get reliable answers to nurses' questions about both the decision to change plans and the plans themselves, (2) ensure management knew about and understood the problems with the new plans, and (3) identify realistic solutions to those problems so we could make formal proposals at our next session.

Management admitted that one of the primary goals of this transition was to encourage employees to get healthcare through PeaceHealth, essentially directing them back to the company store. They called the move "good business," but they also noted that premium increases reflected the rising cost of care and market rate deductibles. We know those points conflict: the benefit of a company store is lower costs for employees, but the higher costs of the Moda Health plans only discourage employees from using PeaceHealth providers.

Management also acknowledged that there are regions and specialties where they aren't yet fully staffed with providers, leaving employees and their families waiting months or more to establish care within PeaceHealth. They suggested that employees call the priority scheduling hotline (833.838.6307) to get easier access to providers who are accepting new patients, but noted that patients would have fewer options about their specific provider if they used that route. They also recommended that nurses who need care quickly -- including prescription refills -- use urgent care or walk-in clinics to fill the gap, but we know urgent care's availability is unpredictable and rarely accommodates nurses' work schedules.

At the end of the day, PeaceHealth's recommendations would only further overwork employees and overtax departments our community has outgrown. When we suggested supplementing PeaceHealth's own providers by covering other physicians in the area, management confirmed it did not plan to add care networks — like Family Care Network in Bellingham — to the plan, stranding employees in what could quickly become a healthcare desert.

Here's more detail on what we discussed with management and what we need from you between now and our next session.

Your questions

We asked management your questions about this change, including:

1. Why specific providers and networks weren't covered under the new Moda Health plan;
2. Why the EPO's premium costs increased more for employees than for the employer;
3. Why deductible costs had risen so much across the board;
4. Where nurses could find specific information about how their prescription coverage will change (if at all);
5. Whether PHMG was prepared to treat the many employees who would need to establish care as new patients under the Moda plan;
6. How nurses and their dependents could continue ongoing treatment plans during the transition;
7. Which providers were covered under which plans; and
8. When PeaceHealth would have a complete list of covered care and covered providers.

Problems with the new plans

We also shared a list of problems nurses across the state had identified as they researched and tried to enroll in the Moda Health plans. Those problems include:

1. An unclear scope of coverage and mixed messages from Moda and PeaceHealth. Nurses reported that information they received about the scope of coverage had changed over the course of this month's open enrollment period, and that Moda Health's representatives had admitted the plan was still being finalized. We told management this lack of clarity robbed nurses of a chance to make a meaningful choice about their health coverage for 2025.
2. Much more limited access to care outside the PeaceHealth system. While a comprehensive list of covered providers remains a moving target, one thing was clear: nurses will have fewer options for providers outside of PeaceHealth. This has led to longer wait times for nurses seeking care and will potentially impact PeaceHealth's ability to recruit and retain nurses.
3. Much higher costs. Nurses will pay as much as $110 more per month for plans with higher deductibles, out-of-pocket limits, and prescription costs.

Solutions we proposed

Finally, we shared a list of potential solutions that could help expand health coverage and mitigate the impact of this transition. Our suggestions included:

1. Holding a second open enrollment period so nurses can choose health coverage with the most complete and up-to-date information;
2. Options to mitigate costs to nurses, including reimbursement options and paid leave for nurses traveling to covered providers;
3. Priority access to appointments with PeaceHealth's in-house providers so employees can get care and get back to work as efficiently as possible
4. The opportunity to opt out of coverage and be reimbursed for alternative health insurance if the new plans simply don't work for an employee and their family.

We want to be clear about what we think we can realistically accomplish at the table. PeaceHealth has so far refused to even acknowledge what we're doing as bargaining, insisting the 2025 plan is substantially similar to the 2024 plan, and they've expressly said they do not intend to add FCN as a covered network in the future. With that in mind, we've focused on proposals that will mitigate costs for nurses and their families while expanding access to care wherever possible.

We need you!

We plan to meet with management again over this issue after the Thanksgiving holiday. Between now and then, we need your help illustrating how significant this change will be to PeaceHealth's employees and how important it is to WSNA nurses. Here are two things you can do to participate and support our efforts:

1. Call the priority scheduling line at 833.838.6307 if you need to establish care with a PeaceHealth provider. By calling the line, you're letting management know that an employee and/or their dependent needs care and that you haven't been able to get a timely appointment with an in-network provider.
2. If you've experienced any of the problems above — including mixed messages about coverage, inconsistent answers during open enrollment, trouble finding a provider, or long wait times for vital care — submit a MyHR ticket reporting the issue by clicking on "AskHR" in Crossroads. When you receive a confirmation email, forward it to your WSNA nurse rep, Barbara Friesen (bfriesen@wsna.org)  so we can keep a tally of the tickets nurses have submitted.

We hear your concerns. Please reach out to your local unit officers as well as your nurse rep, Barbara Friesen, bfriesen@wsna.org, with any questions.