County shapes up insurance [Ocala Star-Banner, Fla.]

May 31--Wellness programs help premiums

Health insurance companies make easy villains for many people these days.

But despite a recent jump in big-dollar claims, a titan of the health-insurance industry recently cut Marion County -- and its taxpayers -- an $833,000 break.

Florida Blue, previously known as Blue Cross/Blue Shield of Florida, conceded to a reduction of more than 80 percent from its original bid to be the county's insurer -- mostly because the county is working to stem the rising tide of big-dollar claims.

Employers have taken a beating over the past decade in trying to provide health coverage to their workers.

Across the country, according to the Kaiser Family Foundation, the employers' portion of health insurance premiums have on average jumped 12 percent a year between 1999 and 2011.

In light of that Marion County's proposed increase of about 3 percent for next year seemed like a deal.

Yet the rise in premiums for 2013 was held to less than 1 percent.

In dollars, that translates to an extra $167,244 in next year's budget -- a small fraction of the $1 million jump Florida Blue initially wanted, despite being the lowest bidder among four competitors.

Jimmy Kelly, strategic account executive with Florida Blue, said two factors led the company to agree to the reduction.

First, Marion County was credited for holding its claims steady during the two months it took to negotiate the final contract, Kelly said.

In addition, county officials also consented to implement a thorough wellness program in order to curtail new claims.

Had that not occurred, Kelly added, Florida Blue would have stood by its original price -- which the company had an incentive to stick to.

According to Drew Adams, the county human resources director, Marion County had filed 41 claims of $50,000 or more for the year that ended April 30.

That was up 21 percent from the 34 claims for the period from May 2010 through April 2011. Thirty-four such claims were also submitted for the 12 months prior to May 2010.

At a recent County Commission meeting, County Administrator Lee Niblock said the jump was attributable to a workforce that was "aging" and stricken by an "obesity problem."

Adams explained that several types of health issues drove the rise in high-cost claims, including heart disease and cancer, to which obesity and aging are known contributing factors.

He noted that over the past two years, the cost of Marion County's total claims has continued to increase.

That led to cost-control measures such as increasing employees' deductibles and out-of-pocket expenses.

But now part of the new health package for county workers includes Florida Blue contributing $150,000 toward a wellness campaign designed to teach employees how to live healthier lifestyles and to encourage them to submit to assessments to catch potential health issues earlier.

A county report indicates that most benefits will remain the same under the new contract, if not become more favorable to the employees.

Where the cost to workers increases, meanwhile, the new rates go up between $3 a month and $8 a month, depending on the plan.

Clerk of the Circuit Court David Ellspermann, who was on the negotiating committee, said the county's position was that Florida Blue needed to "sharpen their pencils" in order to reach an agreement.

When the bartering concluded, Ellspermann acknowledged that he was "pleasantly surprised" by the "gracious offer" that Florida Blue returned.

"I think they recognized the wellness program is making a difference," said Ellspermann, whose staffers receive regular screenings from a wellness program jointly administered by Florida Blue and Munroe Regional Medical Center.

"I think they recognized what we're doing and what we're trying to do. It was a great response to our expectations."

Florida Blue actually contributed money to the county to launch the wellness initiative in 2010, providing $100,000.

Next year, the amount will go to $205,000.

That includes an upping of the wellness ante by Florida Blue to $150,000 as well as a $55,000 rebate of Florida Blue's "profits" from Marion County that could be recouped under the existing contract, according to Kelly, the company's account executive.

To further its end of the bargain, the county has hired a health and wellness coordinator to implement its programs.

And the administration has also emphasized to workers the need for annual physical exams, completing personal health assessments and participating in classes about preventative measures.

Marion County has also instituted a special initiative to combat diabetes and began smoking cessation classes, one iteration of which featured 25 participants, 18 of whom now consider themselves nonsmokers.

One hundred eighty county workers also participated in the recent "Biggest Loser" weight loss challenge, dropping a combined total of 1,351 pounds.

"Improving employee health not only increases productivity, boosts morale and vitality, reduces stress and reduces absenteeism, but also should help to reduce preventable healthcare costs over the long term," Adams, the human resources director, said in an email.

Kelly said Marion County's program was drawn from similar programs started by the city of Ocala and Marion County Public Schools.

The history of their efforts convinced Florida Blue executives that Marion County could achieve similar advances in the health of the staff, he added.

Marion County's health insurance covers all employees under the constitutional officers -- the County Commission, elections supervisor, property appraiser, sheriff and tax collector -- but not those working for the school district.

Kelly cited the county's embrace of the anti-diabetes and anti-smoking components as critical to Florida Blue's decision to slash its premiums.

He noted that the seed money for the wellness campaign pushed for elementary annual physicals and health assessments. The next round in the coming year will target particular health areas across the workforce.

"We didn't know where the problems were," he said. "But now we've identified them and we can begin attacking them."

"It is significant putting a wellness program in," Kelly added. "Marion County is one of the model programs around the state. They should be commended."

"We have some groups that don't care. They say they don't want to tell their employees how to live their lives. They throw their hands up, and they suffer for it."

Contact Bill Thompson at 867-4117 or at [email protected]

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