BY KRISTEN BUCKLES
The cost of Greene County's maintaining self-insurance may be on the increase, according to reports received by the County Insurance Committee on Wednesday.
Jim Jordan, the county's insurance broker, has reported for the past several months that the county has been seeing an increase on the volume of claims.
"If you look at just our contract year, which began in July, when you look at just the [past] four months, we're averaging $375,000 a month in paid health claims," Jordan said.
"The trend is obviously not good. If we didn't apply any [of this recent] trend to the rest of our fiscal year, we would be tracking at $4.4 million in claims. If you add our fixed costs onto that -- about $600,000 -- that's going to be close to $5 million that we're tracking.
"If you trend it, it could be as much as $5.4 million."
Jordan clarified that it has not been any one or more large claims that have caused the increase, but instead a general increase in the number of claims.
Surprisingly, however, the number of persons under the county's self-insurance plan has actually decreased in the time that the claims themselves have increased.
"We had 840 total members -- that's employees and dependents -- for the preceding 12 months," Jordan said.
"For these four months, since July, we're down to 814. So it's actually dropped a little bit, but our claims have risen."
He noted, however, that claims will typically run in cycles, with three good years and three bad years.
"We just have to keep a watch on this. Hopefully, we'll trend back and have months like we had in 2010-2011."
Not only are claims running at an increase, but also prescription drug costs are showing a 14 percent increase over those same four months (July through October of this year), Jordan said.
"That's even with the clinic in place, so prescription costs are still going up," he said. "That's a little surprising, although our prescription costs overall are not out of line."
He explained that he has researched and compared Greene County's prescription costs to those of businesses of a comparable size and found them to be about the same.
"But our cost per employee is high," he said.
AFFORDABLE CARE ACT
County Attorney Roger Woolsey questioned whether Jordan will begin to formulate recommendations for how the committee could respond to these increasing costs.
Jordan noted that he is currently looking at issues connected with the Affordable Care Act (Obamacare) as the result of the Nov. 6 election.
"Those issues that we're looking at will not directly impact us for 2013, but 2014 -- then it will," he said.
"There's still a degree of uncertainty there. What was decided by the election is that the Affordable Care Act will continue as law. There's still uncertainties there; there's still policies to be determined."
The insurance broker emphasized, however, the importance of the committee's "keeping an eye" on what will come in 2014.
Jordan commented that it is surprising that the number of local members of the county's self-insurance plan has decreased since the benefits are good and costs are low for employees and beneficiaries on the plan.
"You all have been able to keep your premiums level the last two years. Your budget has stayed the same ... your benefits have been practically the same. That's almost unheard of," he said.
"We've done that at the expense of our employees over the last 20-some years in not getting a pay raise because pay raises were not given in lieu of the county giving insurance," Sheriff Steve Burns said.
RUMORS AND ISSUES
County Mayor Alan Broyles said that there is a need to dispel a rumor that the two local hospitals would no longer be accepting the entire county insurance policy.
This is incorrect, he said, and acceptance is only a potential issue with the Medicare portion of the plan.
A county employee also appeared before the committee to complain of what she said is a delayed reimbursement for a $3,000 medical bill that the employee paid out of pocket in June.
She said that she received an approval letter for reimbursement of the expense in early October, but she added that actual reimbursement has continued to be delayed since that time.
The committee spoke with representatives of the insurance company, who confirmed that the issue seems to have been that the information photocopied to the company by the member appeared illegible.
Commissioner John Waddle recommended that the employee make copies of the information to provide to the representatives. He indicated that the issue should be resolved by Monday.
County Budget Director Mary Shelton also discussed with the committee a number of complaints that she has received regarding the county's vision plan.
For those who need bifocals or trifocals, only the most basic lenses are covered, she said. When members covered under the program request the bifocal or trifocal lenses without visible lines, the insurance will not pay "one penny," she said.
This complaint follows a number of issues the county has experienced with the policy because of a limited number of vision care providers that will accept the plan.
Jordan noted that the current vision plan provides similar or better benefits than Blue Cross Blue Shield, the county's previous vision insurer -- but at a $40,000 annual premium rather than the $60,000-$70,000 annual premium the county formerly paid Blue Cross Blue Shield.
The committee formally requested that Jordan and Shelton work together to research the issues and options surrounding the vision plan.
The committee also voted to approve conducting business with a new local branch of the AFLAC insurance company rather than with the branch in Gray.
The local branch provides some of the insurance services for some county employees.
The committee also voted to approve monthly reports.
In addition, Shelton informed the committee that the second installment of the Lose & Win program is complete and that the Wellness Committee is now promoting a walking program through Dec. 28.
While she said the next program has not yet been decided on, the committee is exploring the idea of a stop-tobacco program.