Changes in county insurance to raise employee costs

Sept. 28--GRAHAM -- Beginning Jan. 1, Alamance County will have a new insurance carrier, resulting in a mixed-bag of increases and decreases for county employees.

"We are moving insurance carriers," county Human Resource Director Sherry Hook said. "We are doing that because we were looking for a carrier that could provide us and our employees increased customer service, but also a carrier that will work with us to put wellness programs in place because we want our employees to be healthy."

Alamance County is self-insured, meaning it covers the full cost of employees' services, but the county does use an insurance carrier. Beginning Jan. 1, it will move from Coventry to Cigna.

"When they go to the doctor, their visit is processed, right now, through Coventry, and their explanation of benefits comes through Coventry, and Coventry cuts the checks to the doctor offices, but they pull all of that money out of the county funds," Hook said.

Under the current insurance carrier, county employees pay 20 percent of the total cost when they go to the doctor's office. This means, Hook said, that they never know how much the trip is going to cost until they go. Under Cigna, the county will move to a co-pay system. It will be $20 to visit a primary care physician and $60 to visit a specialist.

"If they are having to have services to have testing, surgeries or hospital stays, that sort of thing, then they would be meeting their deductible and then meeting 20 percent of the cost after the deductible," Hook said.

THE DEDUCTIBLE for county employees is going to increase. Right now, it's $345, and it's going to jump to $1,500.

As for dependents, the plans will follow the same as employees, but it will cost more for employees to cover a dependent. There are three tiers within the county: a spouse tier, a children tier and a family tier and each of those tiers will go up $75 impacting 245 employees.

Part of the changes of the insurance that will affect the county is the inclusion of an additional $15 per employee that the county will put into its insurance fund. This comes after the county voted to add an additional $50 per employee in that fund at the start of the fiscal year. The county was dinged in its audit after auditors felt it wasn't contributing enough to the health insurance fund.

"The reason that we went up in July is that through our audit, our auditors did not feel our insurance fund balance was healthy enough," Hook said.

Commissioners approved these changes after a presentation from Pierce Group Benefits, which helps the county broker which insurance carrier it should go with.

ALAMANCE COUNTY has been self-insured for a number of years, and this allows the county to reap the benefit when its employees are healthy, Hook said.

"The benefit to being self-funded is that when employees are healthy and do not have a lot of visits or medical issues, then there are potential savings that can be earned," Hook said. "If you are a fully funded plan, you are paying a set amount per employees or dependents to an insurance company. So if you have a really good year claimswise, they retain all the money. If we have a really good year claimswise and we're self-insured, then we retain that money or use it to build the health insurance fund. So that is really the benefit."

The county has stop-loss insurance, which covers any claim that exceeds $350,000, Hook said.

Open enrollment for county employees begins in October.

___

(c)2016 Times-News (Burlington, N.C.)

Visit Times-News (Burlington, N.C.) at www.thetimesnews.com

Distributed by Tribune Content Agency, LLC.