A Texas county believes in magic. Facing ever increasing health care costs the county resorts to status quo strategies to temper increases – it’s called cost shifting……………………Meanwhile back at the ranch some Texas political subdivisions are improving benefits and lowering costs at the same time…………………………Health Care Strategies for Political Subdivisions
Gregg County increases health insurance contribution, demands on workers
Gregg County increased its contribution to employee health insurance premiums again Wednesday ahead of significant changes over the next 13 months.
Commissioners also implemented plan design changes meant to protect the county from catastrophic claims.
“The bottom line of what we started today is the beginning of a change that must happen if we’re going to keep our tax rate low,” County Judge Bill Stoudt said, “which I intend to do.”
More than 25 minutes of terse discussion preceded the vote, as commissioners determined how the changes will impact employees as early as July 1. The county’s outgoing health plan consultant, Ken Wethe, said the steps taken Wednesday are needed for the county to stay grandfathered from the Affordable Care Act while also protecting the plan.
“It’s an industry standard of cities and counties,” Wethe said.
Gregg County’s health plan protects more than 700 employees and their dependents — all at a cost of $6.5 million to county taxpayers this year alone.
Commissioners voted unanimously to increase the county’s contribution to medical and dental insurance premiums by 3.5 percent, an amount County Auditor Laurie Woloszyn says increases next year’s health plan budget by about $200,000.
Commissioners last increased county contributions in 2016 by 7.5 percent, but more direct changes are coming to employees as the county plans to exit grandfathered status next year and become more efficient, the judge said.
“If you don’t think health care is changing in this country and in this state and in this county, you’re just mistaken,” Stoudt said, “or you don’t know what’s going on. If we don’t make a change, if we don’t start doing something, this $6.5 million bill that we’re paying every year — $6.5 million — is going to go to $7 million, and then it’s going to go to $8 million. That’s the point here.”
Starting July 1, employees will be required to get precertified for all outpatient care and surgeries.
The court also increased employees’ stop-loss insurance deductible after July 1 from $230,000 to $250,000, increasing the county’s premiums by $25,377.
Annual wellness physicals and an established primary care physician will be required of all employees in an effort to encourage good health, Human Resources Director Rita Fyffe said of the plan design changes.
“Are you saying that we have a lot of employees that don’t have a primary care physician?” appointed Pct. 4 Commissioner Daryl Williams asked Fyffe, who answered, “Yes.”
After July 1, 2019, any employee who doesn’t agree to a physical or a primary doctor must contribute a monthly monetary amount to the plan, she said. Commissioners will have ultimate say on the penalty.
“We’re just really trying to encourage our employees to be healthy,” Fyffe said, “and to have that relationship with their doctor so that they know exactly what’s going on with them.”
Commissioners also changed the start date for employees’ life insurance plan — from Oct. 1 to July 1 — because commissioners want to know how much benefits will cost the county earlier in the budget-writing season that ends Sept. 30.
Pct. 2 Commissioner Darryl Primo stressed to Fyffe that every individual employee should quickly be notified about the changes and the possible penalties.
“You said ‘plan design changes,’” Primo told Fyffe. “To me, that’s another code word that (employees) are going to have a problem if they’re sick and need help right now. That’s what I want to make sure everyone understands.”
Fyffe promised to email employees and go over the changes during scheduled open enrollment sessions next week. She also said that all employees are strongly encouraged to reach out to the human resources department for any health insurance questions that they might have.
Gregg County’s employee health plan will remain grandfathered from the Affordable Care Act at least through July 1, 2019, Stoudt said. That means that the county will continue paying 100 percent of employees’ medical and dental premiums, but even that might change in 13 months.
“If we don’t make changes, and I’m talking serious changes the way that health care is going, this could be a tough issue going forward,” he said. “It’s going to be painful, because there’s change, but health care is changing all across the country and state.”