Teachers throughout Rhode Island pay far more in health insurance premiums than they did 13 years ago, but a survey by The Journal shows vast differences by school district in the amount they pay for coverage.

In the 1994-95 school year, only teachers in Jamestown paid a percentage of their health premium. Last year, after a decade in which health insurance emerged as a critical and contentious contract issue, 33 of the state’s 36 districts required some form of cost sharing. But teacher contribution still trails private sector workers in the state by a wide margin — although in some communities teachers are paying far more than other public employees.

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The escalating cost of health insurance and strained school budgets have lawmakers and government watchdog groups calling for teachers to join the state employee health plan, a move they say could save millions each year.

A Journal survey of the state’s 36 school districts shows great disparity in several areas: how much teachers contribute to their health insurance premiums; the amount districts offer in “buybacks” to teachers who decline coverage; and the cost of health benefits for retired teachers.

In the 2006-2007 school year, three districts — East Providence, New Shoreham and Pawtucket — still did not require teachers to pay a cent toward their health premium, which cost taxpayers an average of $13,500 for a family plan and $5,200 for an individual plan statewide. About half the teachers in Chariho and Woonsocket — those hired before 1996 in Chariho and before 1994 in Woonsocket — also are exempt from contributing to their health benefits. In contrast, teachers in Barrington and Coventry paid 15 percent last year — or about $2,000 a year for a family plan — as did most teachers in Jamestown and the other half of the teachers in Chariho and Woonsocket. New teachers hired in Barrington since 2006 pay 20 percent of their health insurance premium — the highest percentage in the state.

Teacher contributions in some districts are catching up to the state’s private sector, where employees on average pay between 15 percent and 20 percent of their premiums, according to Christopher Koller, the state’s health insurance commissioner. In 2005, the average employee contribution in Rhode Island for a family health plan in private companies with fewer than 1,000 employees was $4,214, and $962 for an individual plan.

Most Rhode Island teachers, who earn on average $54,730 annually, pay far less. Last year, teachers in 17 districts paid less than $1,000 a year toward their family plan. Teachers in 20 districts paid $540 a year or less for individual coverage.

Another benefit offered by 33 of the state’s 36 districts is a “buyback” for teachers who decline insurance, usually because they are covered by a spouse. Cranston, New Shoreham and Scituate do not provide buybacks. Twenty-two districts offer buyouts of up to $3,500. But a handful of districts give teachers half the cost of a family plan — about $7,000.

For retiree health benefits, some districts, such as Burrillville, North Kingstown and Scituate, offer no coverage. Others, such as Providence, offer coverage for life. Until 1995, Providence also offered it to the spouses of retired teachers. Last year, retiree health benefits cost the district $3.7 million.

The variations in teacher contributions and benefits reflect the complex histories of individual teacher locals, particularly the tradeoffs negotiated during sometimes heated contract talks with school committees and municipal leaders.

Teachers feel passionately about maintaining a high level of coverage — in most cases provided by the company perceived as the standard-bearer, Blue Cross & Blue Shield of Rhode Island. Cities and towns are beginning to feel just as strongly about their inability to keep pace with the escalating cost of health insurance. Nationally, health insurance premiums have increased between 8 percent and 14 percent a year since 2000, while inflation and worker earnings have only increased 3 percent to 4 percent over the same period, according to the Kaiser Family Foundation, a nonprofit organization that conducts health policy research.

“I would say that to the people I represent, health insurance is as important — if not more important — than salaries, and that good health-care plans for themselves and their families mean everything to them,” said Marcia Reback, president of the Rhode Island Federation of Teachers, which represents teachers in 11 districts in the state, including the three largest — Providence, Cranston and Warwick. “When there are suggestions that the design of their health plan is tampered with, it goes right to their hearts. It’s extremely emotional, and it’s substantive.”

Cities and towns can simply no longer afford to give teachers health insurance for free or retired teachers health benefits for life, says Lisa Blais, a specialist in union contracts who works for The Education Partnership, a Providence-based, business-backed advocacy group.

“Back in the day when health insurance cost absolute peanuts, it was very easy to give it away at the negotiating table, at very little cost to the employer and at no cost to the employee,” Blais said. “Unfortunately, in today’s environment, health insurance typically represents the second-largest expense to the employer, right behind payroll. Therefore, negotiating health insurance really requires a shift in negotiating strategy that acknowledges the limited resources that districts have.”

REQUIRING TEACHERS to pay for a portion of their health insurance is relatively new in Rhode Island, but the practice has spread in the last few years.

Thirteen years ago, Jamestown teachers paid 5 percent of the cost of their premium, making them the first to contribute to their health-care premium. (Teachers in Rhode Island have long paid “co-pays” — $5 or $10 or more for doctor’s visits or prescriptions.)

By September 2004, most contracts around the state required teachers to contribute to their premium, although in nine districts, teachers still paid nothing, and in 11 others, teachers paid just a few hundred dollars annually in the form of a deductible or flat fee.

Since then, the burden of paying for health care has gradually shifted. In 2005, teachers in Cranston, East Greenwich, Johnston, Little Compton and South Kingstown began contributing to their health insurance. In 2006, teachers in Central Falls, Narragansett and North Providence joined them.

Starting this fall, New Shoreham’s teachers will pay a flat fee yearly — $390 for a family plan and $160 for an individual plan. Pawtucket teachers will pay 5 percent of their premiums, or around $700 for a family plan. For 2007-2008, East Providence remains the lone district not to require teachers to cover a portion of their insurance premium.

In many cases, districts where teachers have agreed to pay a portion of their premium have made concessions in other contract areas — although union officials say the compromises are not necessarily quid pro quo.

In 2005, Johnston teachers agreed to pay $780 toward their health plans. That same year, the district agreed to pay teachers that same amount for attending three mandatory meetings. In Pawtucket, teachers negotiated a 5-percent contribution to premiums starting this fall. In that contract, the district increased the “buyback” for teachers who waived coverage by $1,000, to $3,000. In Narragansett, teachers started paying about $335 toward their health insurance in 2006. That contract also included a reduction in the school year by one day.

However, the growing trend of teachers — and other public employees — contributing to their health premiums is an important step, say watchdog groups.

“Everyone is doing it a little bit differently, but everyone is moving in the same direction, and that is requiring everyone to pay a portion of their health-care costs,” said Gary Sasse, executive director of the Rhode Island Public Expenditure Council. “Obviously, 20 years ago, this was not an issue because health [coverage] was just a nice benefit that people received for working in the public sector. But with the meteoric rise of health-care costs, it’s become more of a financial issue for districts.”

Union leaders say that while they believe in full health care paid for by employers, they acknowledge that the current climate pressures teachers to share the burden.

“I think that given the escalating costs of health care, school committees have decided to shift some of that burden to the employee,” Reback, president of the Rhode Island chapter of the AFT, said. “I’m not sure that ‘fair’ is the right word, but it could be that school committees saw themselves with no choice.”

Robert A. Walsh Jr., executive director of the National Education Association of Rhode Island, said some of the reasons behind teacher benefits are not obvious. For example, about half the teachers in the state do not pay into Social Security because their locals voted not to join the program, which began in the 1930s. So teachers rely more heavily on pensions and lifetime health insurance when they retire, he said.

Previous contract negotiations have also played a significant role in determining how much teachers pay toward their health insurance. Teachers in Cranston, for instance, paid nothing toward their health insurance from 2003 to 2005. But prior to that, they paid one of the highest percentages in the state — 12 percent. Former Mayor John O’Leary struck a three-year deal during a fiscal crunch: if teachers agreed to pay 12 percent in 2002 while receiving no raise, the city would give teachers raises the last two years of the contract and drop the required teacher contribution to health care, said Joseph A. Balducci, Cranston’s business manager. Cranston teachers now pay 5 percent of their premium.

At the same time as the vast majority of teachers are contributing to their health premiums, some municipal workers — such as police officers and firefighters — are getting better deals.

Providence teachers, for example, pay more than 10 percent of their premium, while police officers and firefighters pay nothing, according to Mayor David N. Cicilline’s office. (The city’s Fire Department has been without a contract since 2004, which is when teachers started contributing to their premiums.)

Smithfield’s School Committee this spring analyzed the amount town workers received in various benefits — including health, dental and pensions — and determined that the town’s 160 municipal workers received significantly more than the district’s 339 school employees — $34,235 a year in benefits per town employee compared with $15,861 for each school employee.

“Whenever I ask for more money for the schools, all I hear about is how much we’re paying in teacher benefits,” said Jean Harnois, School Committee chairwoman. “So I wanted to see where our town was on the municipal side of spending. And we found the town employees get twice as much as our teachers.”

IN 2004, THE STATE switched 50,000 active and retired employees and their families to UnitedHealthcare, saving the state $25.3 million in administrative fees over three years. Recently, the state extended the contract through June 30, 2010, and officials say they are happy with the plan and have not received many complaints about service or coverage.

Lawmakers, including Governor Carcieri, would like to move the state’s 13,000 teachers into the plan. RIPEC’s director agrees, saying it would make costs more uniform.

“We need good health insurance for teachers, but at a cost that’s affordable to taxpayers,” Sasse said. “It’s clear that neither the taxpayer nor the teachers are being fairly treated under the current system. Taxpayers are paying more than they need to pay and some teachers in different districts are being treated very differently, which is unfair.”

Under the UnitedHealthcare plan, the state paid about $14,388 for a family plan and $5,136 for an individual in fiscal 2007 — comparable to the costs paid by districts for similar coverage. State employees paid an average of $1,348 toward the premium of the family plan and $514 toward an individual plan. (One exception is the Rhode Island Brotherhood of Correctional Officers, which is in arbitration, partly over the issue of premium-sharing. Its 1,320 members do not contribute to their health insurance plan, said Susan Rodriguez, the state’s deputy personnel administrator.)

Some union leaders say they are not opposed to the concept of a statewide teacher health contract, or having teachers join the state employee plan, but they question the details of how it would work.

“We’ve tried this conversation a million times,” said Walsh of the NEA. The state plan may represent savings compared with some plans, but what about districts that have negotiated lower rates with Blue Cross,Walsh asked. Why should those districts pay more?

“Will the state say, ‘We will subsidize for the greater good?’ ” Walsh said. “We just don’t know.”

Among those pushing for teachers to join the state employee health plan is state Rep. Jan P. Malik, a Democrat from Warren who for the past two years has sponsored legislation that would require school districts and town employees to join the state plan if it is cheaper than the one offered by Blue Cross.

“The bill states that the plans would have to be comparable in quality,” Malik said. “But the savings here is important. And this could open the Rhode Island market up to more competition, which would also be good.”

Although the proposal stalled after hearings for the past two years, Malik said he plans to submit the bill again next year.

The Education Partnership, which worked with Malik to develop the proposal, estimates that $11.5 million a year would be saved statewide if school districts switched to the state plan. The Education Partnership said United’s administrative fee is considerably lower than that of Blue Cross — $24 per employee versus $75 per employee — resulting in the savings.

A spokeswoman for Blue Cross declined to comment on the exact amount of the administrative fee, but said the rates are higher because the company offers more to customers. Blue Cross & Blue Shield of Rhode Island has 686,000 members; UnitedHealthcare in Rhode Island insures 223,000.

Blue Cross currently insures the vast majority of teachers in the state. Last year, just North Kingstown and recent hires in Providence received their health care through the state’s other provider — United. For the coming school year, North Kingstown teachers voted to return to Blue Cross, which means almost all the state’s teachers receive health care from the same company. In many districts, Blue Cross is written into the contract — a fact that has angered state and local lawmakers. In several other contracts, a company is not specified, but teachers have the right to veto any proposed health insurance change.

“I don’t think United is an inferior plan — I actually think it’s very close to the [Blue Cross] plans teachers are on,” said Tim Duffy, executive director of the Rhode Island Association of School Committees. “But I think there is a perception that United is not a quality product, because when it first entered Rhode Island 10 or 15 years ago, there were some problems, and people remember that.”

Blais, of the Education Partnership, wants teachers to put aside their affection for Blue Cross and focus on cost.

According to Blais, the Warwick school district, which was facing a budget crisis last year, could have saved more than $1 million if it had switched to United. “Why should it be legal for local officials to walk away from a million dollars in savings and then cut programs to kids to cover that same million-dollar deficit?” she said. “That’s what happened in Warwick.”

Duffy says the time is right to consider moving teachers toward a statewide plan. An ambitious proposal to establish a statewide school funding formula fell apart in June when key lawmakers began questioning how money is currently being spent — particularly on teacher benefits. Lawmakers voted to “level-fund” schools for the coming year, resulting in a net loss to many districts. At the same time, a new state law lowers the cap on how much municipalities can raise property taxes each year to pay for town services and schools.

Cities and towns are urgently seeking savings wherever they can, Duffy said.

“I think the time is right for some sort of statewide program, but there needs to be a uniformity of plan design so everyone feels it’s appropriate, which will be a challenge,” Duffy said. “But if school districts and unions aren’t quick to seize on the need, I think it might be imposed upon them by the legislature at some point.”

jjordan@projo.com