May 29, 2014

Health Care

Kelly Fox, the health insurance broker for the county, spoke to the BOC during a work session on 5/22/14 to prepare them for the upcoming health insurance rate increases.

Last year the BOC implemented an HRA (health reimbursement account) program. The HRA had a $5000 deductible, but to make it palatable to the employees, the county paid all of the deductibles incurred by the employees over $1000.  This saved $158,000 in premiums, and it is estimated that the county will pay approximately $50,000 in deductibles by June 30. The actual savings appears to be $100,000; however, the loss ratio of 120% made the premiums jump for the coming fiscal year.  

Following are the comments made during this meeting—as we understood them–

  • There is no Humana option for Monticello because there are no providers that will take those plans here.

  • Blue Cross/Blue Shield is not paying claims, so no providers will accept them.

  • Because of ACA (Obamacare) reinsurance fees are now tacked on to all plans–collected on monthly basis. $20,971 of fees will now be added.

  • ACCG, the county’s previous provider, had a 45%-52% rate increase for FY15. Jasper County had a 46.04% increase without additional fees added. One reason, Jasper County had a 120% loss ratio.

  • The monthly rate now is $335 per month per employee. The county pays 100% of the employee’s health insurance premium and 50% of the spouse and/or family’s premium.

  • UHC (United Health Care) will be the lowest cost option. $382/person will be the new rate. This will be an increase of $66,000 over current cost.

  • The BOC will budget $50,000 to pay for deductibles incurred over $1,000.

  • Mr. Fox emphasized repeatedly that the county must be diligent in record keeping. He suggested that his office do all the compliance work and review and pay all bills every month. The BOC agreed to do this.

  • There will be a $66,508 is increase making the Annual premium $580,867.

Comm. Salmon asked what the cost to the county would be if they did not offer coverage, meaning employees would go to the ACA Exchange to get insurance. Kelly Fox replied that with 130 employees, the Obamacare penalty would be $200,000 to $300,000. Comm. Salmon said, “We’d save $300,000 if we just pay the penalty.” He was the only commissioner that seemed interested in exploring all the options and possible savings.

Last year, Kelly Fox told the BOC it was only a matter of time until the county would have to send the employees to the Exchange. He did not mention that this year, but the rules keep changing, so no one really knows what might happen from year to year.

Comm. Trammell said there was no incentive for employees not to use health insurance. Kelly Fox said there are some, but the employees don’t have to pay anything.

The county employees pay nothing for insurance, only $1000 of a $5000 deductible, a $25 co-pay (going up to $30); therefore they have no incentive to manage their health care costs.

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