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CIA Committee recommends health insurance renewel

Following the largest amount of claims in eight years, Washington County was looking at a 33 percent increase in health insurance costs.
Instead, two options designed to keep costs manageable and meet the requirements of the Affordable Care Act have been proposed for 2014-15.
“We had to make a change in the out-of-pocket costs because co-pays going toward the maximum would have them met quickly, which would skyrocket the (renewal) cost next year,” broker Tom Foster told members of the Commercial, Industrial and Agricultural Committee during their May 12 meeting.
Foster and Benefits Coordinator Michelle Stewart presented their recommendation for renewal with BlueCross BlueShield of Tennessee, which offers two choices for county employees.
Plan 1 raises the maximum out-of-pocket per year from $1,750 to $4,000, but part of the increase will be offset by the ACA guideline that directs all co-pays be applied toward out-of-pocket expenses.
In addition, a Health Reimbursement Account would limit the employee cost to $2,500 with the county responsible for the remaining $1,500.
No changes are proposed for the co-pays for physician’s office visit, emergency room and prescription card or the $750 deductible, but there is an increase in employee contributions.
Plan 2 is a deductible plan that provides no benefits until the employee has paid the full $6,350 deductible, which also covers the maximum out-of-pocket expenses.
This plan is not HRA eligible, but includes no co-pays and is considerably less expensive. Costs to receive medical, dental and vision insurance for a family will cost an employee $175 per month under Plan 1, but only $70 per month under Plan 2.
Foster said the lower-cost plan has to be offered to comply with the employer-shared responsibility provision of the ACA, informally known as the “pay or play provision.”
“If an employee goes to the marketplace and gets a subsidy, the county can be fined $3,000,” he said.
Stewart said only 10 percent of employees are meeting the deductible and out-of-pocket maximum, and most are using the co-pays. Her concern for employees choosing the lower-priced Plan 2 is they would be unable to afford doctor visits without the benefit of a co-pay.
“We’re trying to dissuade employees from taking this plan,” Foster said.
Cost to the county for the 2014-15 renewal is approximately $5 million, which Stewart said is close to a 2 percent increase.
Commissioner Sam Phillips made a motion to recommend Plan 1 to the county commission. The motion was seconded by Commissioner Alpha Bridger and passed with unanimous approval. Stewart explained Plan 2 has to be included so the county is in compliance with ACA requirements.
County commissioners were expected to vote on the insurance renewal during their May 27 meeting.