Supervisors make final decision on insurance coverage for employees

After several weeks of discussion and planning, the Montgomery County Board of Supervisors has finalized insurance coverage for its county employees.
The supervisors had been examining options for coverage after it was determined the county’s current provider was expecting a premium increase of 19% for the upcoming renewal, prompting the supervisors to approve a merger with their current insurance trust and the Iowa Governmental Health Care Plan Trust, which uses Wellmark Blue Cross/Blue Shield.
At the regular meeting March 21, the supervisors once again met with Alera Group representative Tom Schuetz, who highlighted some differences the county could expect as it prepared to enter into insurance through the IGHCP Trust.
“Obviously, when you change from one carrier to another, it’s never completely identical, so I wanted to highlight where the county’s employees might experience some differences, as well as what will remain the same, and some of the things that will be improving as well,” said Schuetz.
Under the new insurance plan through IGHCP, the county budgeted for a 6% increase in its insurance premiums, as opposed to the predicted 19% from United Health Care.
Schuetz said under the new plan, the deductible and out-of-pocket maximums for the employees would remain the same. Also, insurance usage between now and the new insurance taking effect would transfer over.  
“Any deductible and out-of-pocket maximums that employees meet from January 1 through June 30 with United Health Care will transfer over, and they will get credit for that through the IGHCP plan. They won’t be losing anything they’ve met so far,” stated Schuetz.
Schuetz did say that administratively, it may take some time for the update to occur following the transfer.
“Typically, what happens is claims will be incurred right up until June 30. Those will have to go through the system and be processed. Normally, what happens is that Wellmark will look at claims around the end of June, and it may take 30 to 45 days after the transfer for all of the credits to be given, and there may be a period of time where members will need to be guided on where they’re at, and whether they’re getting the right credit. But the good news is, they’ll get the credit and not lose anything,” Schuetz commented.
One of the improvements, Schuetz said, had to do with an employee who had to make a trip to urgent care.
“If someone needs treatment at an urgent care clinic, today, under the current plan, they’ll have to pay a $75 copay. With the new plan, it’s $10. I’m not advocating urgent care over a primary care provider, because that can be more expensive. We do like to see people have a primary care physician,” stated Schuetz.
Also, if an employee goes to the emergency room, the employee will pay $100 and the plan pays the rest, which will go to deductible and coinsurance. Cost for prescriptions will also reduce.
“With the current plan, it’s $15 for generic prescriptions; that will drop to $10. For a brand prescription with no generic alternative, currently they are $30 and that will drop to $25. If the brand does have a generic alternative, the current plan charges $50 and under the new plan the payment is $40. There is also a separate category for specialty drugs, and that cost is $85,” Schuetz said. “All those costs go to an out-of-pocket maximum, which for your group is $1,000. Once that is met, all covered expenses are paid at 100% for the balance of the year.”
Outside of the health insurance premiums, Schuetz said he did not have the new rates for the dental insurance coverage, but expected it to be a low dollar amount. The renewal for vision coverage was not until October, so Schuetz expected the numbers in July, and also expected the renewal costs to be low.
Schuetz said he would be able to provide the differences in a written form that could be sent to the supervisors. Supervisor Donna Robinson urged Schuetz to provide the information in a written form.
“In that format, the information can be shared with department heads who can then give it to their employees and communicate the differences,” said Robinson.
Schuetz confirmed that he would work with County Auditor Jill Ozuna to get the information in a shareable format.  
Schuetz also said he had reached out to the The Iowa Communities Assurance Pool for numbers, as had been requested by the supervisors, and had never received them. Schuetz felt that was because they felt that they didn’t believe they would be competitive.
The final action for the supervisors was to approve the IGHCP health insurance rates. The rates were approved as presented.