Macon dodges insurance fund deficit

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Macon dodges insurance fund deficit

More than 400 Macon County employees and their families will see a reduction in health care coverage and an increase in their contributions beginning July 1 after commissioners agreed to change the county’s health insurance plan and provider.

County Manager Derek Roland told commissioners the recommended changes were needed in order to prevent a deficit in the county health insurance fund.

“I knew we would be experiencing an urgent need for changes in our health insurance fund — it’s been the number one issue since I started as county manager,” Roland said. “This will affect 408 employees and their families and children — they rely on this. And as the old saying goes, if you haven’t got your health, you haven’t got anything.”

Roland said he formed a committee of county employees to explore different options to determine how the county could increase revenues and decrease expenditures in the health insurance fund. Over the past three years, the average expenditures — including claims and administrative fees — for the county health fund has been about $4.2 million. Roland said he expects the costs to increase to $4.5 million in 2015-16 because of the new Affordable Care Act requirements.

The current contribution levels generate $3.2 million, which leaves the county with a $1.32 million deficit that has to be made up. Roland said the county has a health insurance reserve account to make up for shortfalls, but even the reserve is down to $520,000 — not even half of the expected shortfall for next year.

In 2009, the health reserve fund had $5.9 million and has been slowly dwindling ever since as costs have gone up and employees continue paying the same contributions.

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Decreased coverage

The county health insurance plan covers 90 percent of employees’ health costs.

“Right now we would have a platinum plan under the ACA,” Roland said.

The committee recommended offering the option of a gold- or silver-level plan. Employees would pay 30 percent of the cost under the silver plan and 20 percent under the gold plan.

However, to get the gold plan, Roland said, employees would have to participate in tobacco screenings and health-risk assessments. If an employee tests positive for tobacco use or a chronic condition like diabetes or heart disease, the employees must participate in a health management program to remain on the gold plan.

Roland said the change would place the county more inline with other public and private entities in the current marketplace.

Employee health clinic

Roland said the committee also recommended piloting an employee health care clinic to cut costs. County health director Jim Bruckner said the health department already had federal grant money to implement a clinic with a nurse practitioner on staff. It would be minimal to no cost for the county, according to Roland. Jackson County also has an employee health clinic. The clinic could offer quick and affordable access to health care for employees — $5 co-pay, $1 over-the-counter medications and $2 for lab services.

“Not only would it create a healthy workforce, it would contribute to the long-range plan to decrease costs,” he said.

Roland said the county could try operating the clinic for a year to see how it is utilized and get feedback from employees.

New administrator

Another recommendation — and probably the toughest transition — will be to change the county’s health insurance network and administrator. After receiving bids from 10 providers, Roland said Blue Cross Blue Shield had the best pricing. Offering the new dual plan through the county’s current network, Crescent/Arch, would cost about $4.2 million. Blue Cross proposed offering the dual plans for about $3.7 million — the lowest of all the proposals.

Commissioner Ronnie Beale said he was concerned county employees wouldn’t have easy access to Blue Cross agents to deal with insurance problems like they do with Crescent.

Mike Decker, county human resources director, said Blue Cross assured the county it would have a team of representatives available to help county employees with insurance questions because they really wanted the county’s business.

Total savings

Roland said the county would have a net savings of $700,000 by making these changes to health care coverage while still providing a great benefit to its employees. The county will still have to budget an additional $529,000 for the 2015-16 fiscal year to fund the $3.8 million healthcare cost.

Commission Chairman Kevin Corbin said he’d rather budget $529,000 this year than budget $1.32 million to make up the health fund deficit next year. Corbin, who is in the insurance business, said the recommended plans would place the county more in line with the current marketplace. He said about 80 percent of his clients were on a silver level plan.

“No one buys a platinum plan — even I’ve got a bronze plan,” he said.

Roland said there would be no lapse of coverage during the transition to Blue Cross Blue Shield and the process would begin as soon as possible.

Commissioner Paul Higdon said he was glad to see employees make concessions on insurance to help the county better manage its health costs.

The board unanimously approved authorizing Roland and staff to move forward with implementing the recommended changes. Open enrollment for employees will begin in May.