Email to faculty from Lawrence Hamilton Lawson on 1/31/2025
PFF met with the District Thursday to discuss the ongoing Scripps situation and continue to advocate for faculty.
First, Scripps and Anthem continue to talk. Hopefully, those talks yield positive results, but so far, that has not been the case.
We asked the District for a definitive answer to this question: Are there any options for folks to stay with Scripps and be in-network during this enrollment period? The answer the District received and relayed to us is no. For the plan period, through Sept 2025, and there is no ability to move to or add a plan that includes Scripps in-network--unless the negotiations succeed and Scripps comes back to Anthem.
The next question we asked for an answer to was: Will there be a possibility to have Scripps as an in-network plan for the next enrollment period? The answer here is that the Benefits Committee will be convened to discuss looking at other options for the future and make recommendations. Based on previous research, SISC was the best of the options and it may still be despite this. Also, for those with providers other than Scripps, things are mostly going well. But we've asked the District to look, and, through the Benefits Committee, they will. We'll report back.
In the meantime, we, alongside the District, encourage folks still on Scripps PPO to review all communications from Scripps, Anthem, and the District. (Scripps HMO folks were automatically moved to new doctors, and those HMO folks can select a new in-network doctor of their choosing at the beginning of any month, per the Benefits Office.) There is important information from Anthem, etc. about how to switch doctors so that you can be assured your coverage, and potential and unknown future coverage, is in-network. Faculty have mostly reported smooth transitions so far. We really, really don't want to see folks hit with unexpected medical procedures while they are with an out-of-network provider as the financial impact could be major. In the end, the choice to move to a new doctor now is yours to consider, but please do consult the information you've been given.
I wish I had better news. The possibility of moving away from a doctor you've seen for 20, 30 years is awful and especially so because of why we're in this mess--a breakdown in negotiations between Scripps and Anthem that's no fault of faculty. We wanted to exhaust every question and potential path with the District in support of our faculty and report back. We will continue to explore options for future terms.