BY KRISTEN BUCKLES
Preliminary quotes on the cost of insurance for Greene County's employees and their beneficiaries indicate that either significant changes will have to take place this year to benefits, premiums and/or deductibles, or the County Commission will need to increase funding for the insurance program.
Members of the Greene County Insurance Committee discussed these options on Wednesday, with the understanding that an increase in funding is unlikely.
As a result, County Insurance Broker Jim Jordan approached the county's current source of reinsurance and administration of their current self-funded plan, UnitedHealthcare, for preliminary estimates. Jordan also contacted BlueCross BlueShield of Tennessee, and Humana, for estimtes.
During the meeting, Jordan only presented the data from United, but he agreed to bring firm quotes from each of the three carriers to a called meeting in April.
He said those quotes would feature the cost of the current benefit plan with some tweaks to copayments, as well as options for more significant revisions.
He presented a preliminary example of such a revised option to the committee as a means of providing an option that would not increase premiums for most county employees.
Staying with the current plan, he explained, would not be feasible without a significant increase in funding or much-increased costs for the employees.
"All carriers' quotes agreed that, based upon current benefits, Greene County will exceed their current budgeted costs by anywhere between a minimum of $560,000 [using expected costs], and a maximum of $2.09 million based on the aggregate factor," Jordan said.
He attributed the higher costs to increased claims over the past 12 months ($4.4 million) and added fees and coverage expectations placed on employers by the federal Affordable Care Act, also known as Obamacare.
Jordan said the county's current total claims and fixed costs for the health insurance is $4,583,412, plus the annual $200,000 cost of the county clinic and $40,000 cost of the vision care plan.
The county has approximately $800,000 in an insurance reserve fund that would, if ever necessary, cover just over two months of claims, he said.
Covering even just the minimum $500,000 cost increase estimate for the current benefit program through an increase in all employees' premiums would result in a $1,500 increase per employee, he said.
CURRENT BENEFIT PLAN
In the county's current benefit plan, Jordan said, employees can choose between two options, the second of which features a higher premium for better benefits.
Only 22 employees participate in the current Option 1, which features a $300 deductible for an individual or maximum $600 deductible for family coverage, and an out-of-pocket maximum of $1,500 per individual or maximum $3,000 for a family.
Employees also pay 20 percent of the approved coverage until reaching their out-of-pocket maximum.
Most employees (344) participate in the second option, which features no deductible, no employee share on approved coverage, and the same out-of-pocket maximums.
However, the second option offers lower copays on prescriptions, hospital stays, emergency room visits and outpatient surgery.
While both options combined cover an average 364 employees, the total number of employees and dependents on the plan totals an average of 828, Jordan reported.
Under these current plans, employees pay only between 5 and 12 percent of their premium costs, with the county covering the large bulk of the expense.
Jordan presented two preliminary health insurance options for the coming year that he said could aid in avoiding a massive premium increase.
The first option would serve as a "baseline" to avoid any premium increases for most employees.
The second option would allow employees to pay out-of-pocket through higher premiums for a better benefit plan.
"This was estimated -- and I stress estimated -- at this point, with just the baseline cost of $4.5 million," Jordan said.
The baseline option would feature a $500 individual deductible, with a $1,000 maximum deductible for family coverage, and a $2,500 out-of-pocket maximum for individuals and $5,000 maximum for families.
Copays would also increase.
The second option for improved benefit coverage would be identical to the county's current Option 1. However, this would significantly increase employee premiums, Jordan said.
He speculated such an increase could take an employee's individual premium for this option from $30.46 per month to about $200 per month. For families the cost difference could be from $177 per month to $700 per month, he said.
"The people that are using your plan, and also affecting your rates, will be paying more out of pocket," said John McInturff, of Tri-State Claims.
McInturff emphasized that the employees' option to use the free county clinic keeps benefits practically the same and said that the new baseline proposal is still better than what 95 percent of employers with clinics currently offer.
Sheriff Steve Burns and Road Superintendent David Weems expressed considerable hesitation with this much change to the benefit plan, emphasizing that the county's current healthcare plan is a major part of how they are able to draw and retain some employees despite lower wages.
Should such changes take place, they urged the committee to increase the county clinic's hours of operation and the number of providers, to help balance this change.