The Greeneville Board of Mayor and Aldermen had a busier than normal Monday with a three-hour workshop on health insurance costs.

The informational workshop was held after a brief called meeting in which a new police officer was hired. (Please see related story.)

Topics covered during the workshop included a report on health trends in the Appalachian region, an overview of the city's existing health insurance coverage, and information of how the city could realize savings in their coverage.

The workshop concluded with a presentation on potential cost savings by Chris Poynter and Drew Mann of Trinity Benefit Advisors (TBA) in Knoxville.

TBA is the company that Alderman W.T. Daniels recommended at an Aug. 19 budget workshop because of its potential to cut the city's $2.5 million in health-insurance costs.

At that time, the aldermen asked to hear presentations on health insurance coverage and potential savings.

TBA is a consulting firm that works with companies and governmental entities to help them and their employees realize the most health-insurance savings possible, according to Poynter.

Locally, TBA has worked with Forward Air Inc., Landair, MECO Corp. and So-Pak-Co, Poynter noted. He encouraged the board members to contact these companies for references.

Poynter showed an example of one of its customers that is similar in size to the Town of Greeneville.

TBA had found that the company could save $621,311 to $777,407 a year, he said.

Poynter explained that the savings were realized through higher network discounts on eligible claims.

The discounts were given because the companies paid higher fees per employee, according to Poynter.

For example, doubling the per-employee fee from $19 to $38 resulted in an increase in savings from 23 percent to 47 percent on $3.5 million in claims.

The end result, Poynter said, was $766,271 in savings.

Poynter also shared a press release from the Blount County government, a TBA customer.

The press release stated that Blount County switched health insurance administrators and projected savings of $932,970 in 2008.

Mann noted that Blount County expects to save $2.2 million in 2009.

Poynter and Mann provided copies of a written proposal for the Town of Greeneville that included background information, a partial list of clients, the processes used by TBA and actual case studies.

Poynter said the town would not have to pay TBA until it sees results from its work.

He also said the savings could be realized without changing the actual medical benefits received by the town's employees.

Alderman Daniels said he knew of several health insurance administrators that are interested in working with the town.

Alderman Sarah Webster said she still would like to see presentations from other health care administrators.

The board discussed the possibility of seeking bids on its health insurance coverage.

Recorder Jim Warner said, "I think we do need to look at any ways that we can save money."

Earlier in the workshop, the board heard a presentation about its current health insurance administrator.

David Grazier of Corporate Systems Administration, said the plan includes $200 deductibles per employee and $400 deductibles per family.

The coverage pays 80 percent of the claim up $1,000 plus the deductible. Then, the coverage pays 100 percent, Grazier said.

The maximum amount an employee can pay out of pocket each year is $1,200, he said.

"You have an excellent, excellent plan," Grazier said.

He noted that all claims are "scrutinized" by a group of eight doctors in Augusta, Ga., to make sure they include the correct treatments and billing and to ensure the most savings possible on each claim.

For prescriptions, employees pay $20 for brand names and $10 for generics, he said.

Danelle Sells, payroll clerk, gave the board copies of the 78-page booklet that explains the town's employee health benefits.

She said every employee is given a copy of the booklet when they go through orientation after being hired.

The workshop began with a PowerPoint presentation from Bruce Behringer, assistant vice president of the Office of Rural and Community Health and Community Partnerships at East Tennessee State University.

Behringer's presentation was titled "Update on Health Issues in the Appalachian Region."

Behringer, who also is the Tennessee representative to the Appalachian Regional Commission's Appalachian Health Policy Advisory Council, said ARC is creating focused partnerships with federal agencies to address diabetes, cancer and substance abuse.

He presented statistics that show high rates of premature death (ages 35-64) caused by heart disease, lung cancer and diabetes.

For heart disease, the premature death rate in Appalachia is 27.4 percent higher among white males and 29.8 percent higher among white females, when compared to the total U.S. rates, he said.

For lung cancer, the premature death rate in Appalachia is 27.7 percent higher among white males, he said.

For diabetes, the premature death rate in Appalachia is 22.4 percent higher among white females and 20.5 percent higher among black females, he said.

Other medical conditions, including stroke, other cancers and chronic obstructive pulmonary disease (COPD), had less than a 20 percent increase compared to the total U.S. rates.

The only areas in which Appalachia had lower percentages than the total U.S. rates were among black females for lung cancer (3.7 percent lower) and other cancers (2.1 percent lower).

Behringer also showed that Greene County exceeds the nation by 29 percent in premature all types of cancer deaths, by 31 percent in colorectal cancer deaths and by 67 percent in lung cancer deaths.

Tennessee, based on 2001 statistics, is the second highest state in the nation for the percentage of adults who report no physical activity (35 percent), Behringer said.

It was the fourth highest state for cigarette smoking in 2002 (27.6 percent), he said.

Tennessee, in 2001, also was the seventh highest state in obesity prevalence among adults (23 percent).

For death rates, Tennessee ranks third in strokes, seventh in cancer, eighth in diabetes and 10th in heart disease, based on 2001 statistics, he said.

The presentation showed that Greene County exceeds the state in the percentages of citizens who:

* have no health insurance (19 percent);

* have no diabetic lipid profile (25.6 percent);

* smoke cigarettes (29.9 percent);

* smoke during pregnancy (35.3 percent); and

* have physical inactivity (35.3 percent).

Behringer also showed maps with clusters of certain types of diseases in different areas of the country.