County employees to pick up greater share of insurance cost

County employees will be paying a larger percentage of their health insurance premiums under plan changes approved by at a joint finance and personnel committee meeting on September 16.

Several years ago, the county approved a plan to gradually increase the percentage paid by county employees from 10% up to the eventual goal of 20%. That plan was put on hold as the county utilized plan design changes through the Wisconsin Counties Association Group Health Trust (WCA) in order to keep premiums lower. In the past few years the county has seen savings with a dual system with narrow insurance network members paying less than those in a broad network.

Under plan administration changes, that dual option is no longer available according to Tim Deaton of the Horton Group. In its place, the county was given the option of renewing with a single broad network plan or shopping for other providers. Deaton said that based on the county’s usage history, WAC’s initial proposal was a 13% premium increase. Deaton said they were able to work with the provider to get the renewal increase down to 9%.

Things didn’t look much better for the county when going to the marketplace with proposals for similar plan designs from Anthem “Blue Priority” at 9.86%, from Security Health Plan at $10.92% and Anthem “Blue Preferred” at 19.86%. Deaton noted that WPS, WEA Humana, Network Health Plan and Aspirus Arise all decided to quote plans for the county as being with uncompetitive based on the county’s plan needs or outside their service area. The county also looked at a cooperative plan through Security Health Plan which includes the city of Medford. This plan would result in a 3.04% increase next year.

While the savings of the plan would be significant when compared to the increases of other plans, committee members raised doubts about coverage. Committee member Scott Mildbrand noted the difference in coverage of tier four drugs. The current county plan maxes out at a $50 copay for expensive medication, the cooperative plan puts a 25% copay on those drugs.

“People take insurance so that it doesn’t break them,” Mildbrand said noting that this could amount to hundreds or thousands of dollars for these medications. Deaton explained that the drug costs would count toward the maximum out of pocket expenses employees would pay.

Other committee members noted the plan only offered family or single plan options which would result in significant increases for the large number of county employees currently on the employee plus one plans.

While the 9% increase is lower than the WCA’s initial price, the increase is nearly double the 5% county finance director Larry Brandl estimated when he prepared the preliminary budget. Deaton said there were options for “buying down” that increase by making changes to the plan design.

Plan design changes include increasing the deductible by $250, increasing the amount of out-of-pocket by $500 and increasing the employee share of co-insurance cost for out-of-network doctor visits. All of these changes combined to bring the increase down to 5%.

With the county budget facing a significant gap that still remains to be filled, committee members looked at setting the employee share of premium expense to 15% across the board. Employees on the narrow network were previously paying 10% of their premiums while those on the broad network were paying 18%.

In return for the increase in premiums, committee members noted the employees would have access to a much broader network of providers.

Committee member Lester Lewis put it in perspective noting that between Medicare and supplemental insurance he was paying more than what county employees would be paying even with the plan changes. “I don’t think it is out of line,” he said.

With the changes and premium shift, the county portion of the health insurance premiums costs for 2021 should be close to flat compared to what was in the 2020 budget.

In other business, personnel committee members:

★ Approved continuing to deduct regular payroll taxes from employees’ paychecks. In August, President Donald Trump issued an executive order to allow businesses to defer payment of the payroll taxes until the end of the year. According to Koerner, when the deferment period ended, employees would face double payments as they made up for the deferred time. Koerner recommended the county continue to collect the taxes.

★ Approved granting public health director Patty Krug the authority to hire grant-funded limited term employees to work as contract-tracers and assist with following up with quarantined individuals as the number of cases in the county continues to increase. Krug said she hopes to tap former public health nurses who will have the knowledge needed for the jobs. The authorization allows Krug to bring people on board as needed without having to call a special personnel committee meeting each time. As with other county LTE positions, they will be limited to 1,199 hours in any 12-month period so as to not qualify for county benefits. Lewis commended the health department workers noting that not only were they putting in long hours dealing with COVID- 19 but they were also doing all their regular public health activities.