County wants outside-the-box thinking on health insurance

April 27--BUTLER COUNTY -- The Butler County commissioners are taking a hard line with their health insurance carrier, saying they should get concessions as the largest employer in the group.

Human Resources Director Jim Davis said the county paid about $15 million for insurance last year, and with the latest enrollment figures in, it looks like the county and its employees will pay $15.8 million this year. If they hadn't taken an aggressive approach reining in costs, the amount would have been $16.7 million.

Davis said the between what was budgeted and what will actually be paid this year is about $1.1 million. During a work session Monday Commissioner Don Dixon said they could use the savings for any number of things to lower costs such as paying more into employees' health savings accounts.

For people who elect to take the higher deductible plan the commissioners pay $400 into a health savings account and $800 for families, according to Davis. The county could up the contribution, given the estimated $1.1 million savings it will experience this year.

The commissioners are starting to plan for what will inevitably be another rate hike if they don't head it off at the pass. Dixon asked their insurance consultant Angela Wolf to get creative and put pressure on their carrier, the County Employee Benefits Consortium of Ohio (CEBCO). As CEBCO's largest client he said he expects "special treatment."

"It's time we get out in front of it. Last year really set the groundwork for us to be able to go on and make some changes that couldn't have otherwise been done," he said. "We've just been strapped and just trying come up with a six, or eight or ten or twelve percent increases we were getting every year, if we didn't make any changes. This is going to help the taxpayers, it's going to help our employees. We're not going to be followers just like everybody else."

The estimated 11.3 percent premium increase the county received last summer was nearly double the hit the county took in 2013, after someone turned in a single $5 million claim. Officials said claims are the driving force behind rate increases. From June 2013 through May 31, 2014, the county paid $14 million in premiums and the paid out $16.7 million for claims.

The commissioners have made a deliberate decision to try to get spouses off their health plan, to try and reduce the rates. Last year the county saw spouses rack up $958,122 in 247 claims; employees submitted $873,997 in 471 claims and bills paid for 56 children amounted to $101,669. Davis said 20 employees have dropped the county's plan altogether since the county shifted the percentage responsibility and added a $60 per month smoking premium. Davis said 162 people pay extra to smoke.

Wolf said other ways of tackling rising costs is to educate employees on cheaper medical alternatives, for example she said it can cost $4,000 for an MRI at a hospital but only $800 at ProScan Imaging. County Administrator Charlie Young said they need to teach their employees to be better health care consumers.

"None of this is about encouraging anyone to choose a lesser quality of care," he said. "This is about where there is equivalent care available with vastly different costs to us. The drive to consumerism is critical to that, because there isn't a decision anyone makes except the patient or the parent of the patient and the whole point of wellness is to get people involved."

The county has ramped up its health and wellness program and offers incentives for participation. Commissioner Cindy Carpenter asked Wolf to compile a list of services and costs that they can share with their employees.

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