Next year, with the self-insurance plan, Davis said he is expecting the total premium to be about $15.5 million — a $500,000 savings over this year. The county is paying 82 percent of the cost and the employees the rest.
“Basically, we took this health care program apart and constructed something that’s out of the box, out of the norm, but should save millions of dollars in the long haul for the taxpayers,” Commissioner Don Dixon said. “And guarantee our employees great benefits for a reasonable cost.”
Davis said under the new self-insured plan the county pays an administrative fee and the claims themselves. There is a stop-gap feature so if claims top the $175,000 mark the insurance carrier picks up the costs for anything over that amount. In years past they would get between five to 10 “stop-gap” claims. There has been only one so far this year.
Davis said he is excited to work with the county’s new provider, Meritain, a subsidiary of Aetna, because of the savings opportunities.
“Meritain has some programs to encourage wellness, to encourage conscientious selection of providers. That put real incentives in front of employees,” he said.
Davis said he can tell employees are starting to take real ownership of their health care plan because he has seen evidence of people doing their own investigating and choosing the less expensive medical choices, which saves everyone money.
As the commissioners watched insurance rates continue to grow, they stepped up their wellness program which has been a big help, according to Commissioner T.C. Rogers. The national participation rate for wellness programs is around 15 percent, but Rogers said the employees active in the county’s program is 40 percent or better. He and Dixon praised Commissioner Cindy Carpenter for pushing for the program.
“Commissioner Carpenter was relentless I would say is the term, for the wellness program and the success is due in large part by that determination,” Dixon said.
Last year the quoted premium for 2016 was estimated at $16.78 million, and county employees who are on the health and dental plan as well as the county both shouldered the increase. The county didn’t increase the percentage of the total premium their people pay as they did two years ago.
Two years ago, when the first double digit premium was quoted, the commissioners made a deliberate decision to try to get spouses off their health plan, to try and reduce the rates. In 2014 the county saw spouses rack up $958,122 in 247 claims; employees submitted $873,997 in 471 claims and bills paid for 56 children amounted to $101,669. The commissioners shifted payment responsibility from 78/22 percent to 75/25 percent, with the county paying the larger portion and added a $60 per month tobacco premium.
Davis said there are 227 smokers on the plan — up from 162 when the premium was imposed — 1,330 employees are on the health care plan and 254 waived insurance.
Commissioners approved the final year contract with its health insurance consortium, the County Employee Benefits Consortium of Ohio (CEBCO), one year ago, including a 12.6 percent premium hike and kept the $60 per month surcharge for tobacco users — which is still a provision in the health plan.
From June 2013 through May 31, 2014 the county paid $14 million in premiums but CEBCO paid out $16.7 million for claims, so last fall, for the second year in a row, it imposed a double-digit rate hike.
Davis says the prime mover behind the rate hikes has been just some really large, once-in-a-lifetime claims in the past few years. They had a single $5 million claim in 2013 and a $3 million month in November 2015.
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