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County employees unhappy with surcharge

Despite no deductible, no office visit co-pay, and no increases in their monthly premium and annual out-of-pocket costs for medical, dental and vision insurance, many Washington County employees feel they are being had.
Members of the Employee Compensation and Benefits Committee took a beating from unhappy employees, the majority of which were from the Sheriff’s Office, during the last two meetings held to discuss the county’s insurance renewal.
The committee’s recommendation for the 2015-16 plan with BlueCross BlueShield of Tennessee was approved by the Budget Committee last week, and will be considered by the full commission during its April meeting.
“Curbing the claim costs are the goals behind the recommendation because next year, if faced with an increase, we may not have options to keep the price from going up,” said Ben Kelly of TIS Insurance Services, the county’s broker.
Faced with a $1.2 million increase from BCBST, Kelly said quotes were requested from United Healthcare, Humana, Cigna and Aetna. “We hoped to get a competitive rate, but we did not,” he said during the April 9 meeting. “This situation is not unique to Washington County.”
Kelly said changes in the plan design reduced the increase from 28 percent to 8 percent. The employee’s $2,500 maximum out-of-pocket expenses won’t change, but he said the county will be required to take on more of the cost.
Rather than a $750 deductible, the county will pay 80 percent of claims up to $5,000, which results in a maximum out-of-pocket to the employee of $1,000. Kelly said 90 percent of the county’s claims fall into the $0-$5,000 range.
“This is a mini self-funded plan, but it’s the best way I know to keep everyone happy,” he said.
The employee will pay 100 percent of the next $1,500, and BCBST will pay 100 percent of the cost going forward after the maximum $2,500 is met.
Pharmacy co-pays will not increase, and employees will have the use of Telemedicine services, which provide unlimited, free access to a physician 24 hours a day for minor injuries and illness.
A flexible spending account will offer tax savings by allowing employees to pay for qualified medical expenses with pre-tax dollars.
Also new to the plan are surcharges for spousal coverage and tobacco use, though these surcharges will not affect everyone.
Employees who cover a spouse who has access to insurance through an employer program will pay $50 more per month. The charge would not be applied for spouses who also work for the county.
Employees who use tobacco or cover a dependent who uses any form of tobacco or e-cigarettes will pay a total of $25 more per month. Employees who successfully complete the free tobacco cessation program offered through BCBST will not incur the surcharge.
Kelly said employees will be asked to sign an affidavit regarding their tobacco use. “We’re not going to test, but lying on an affidavit is pretty serious stuff,” he said.
Employees complained they were being penalized with the spousal surcharge. However, Washington County Benefits Coordinator Michelle Shelton-Stewart said the majority of claims are coming from the employees’ dependents.
“The county’s very top claim is a spouse who has insurance elsewhere,” she said. “One of the top two and three also has insurance.”
Other employees said they weren’t changing their lifestyle choices, and the surcharges were just a way for the county commission and the insurance broker to make money at their expense.