Clinton County officials discuss insurance policies
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"We have companies that we work with that strictly no spouses are allowed to be participants on their plan," Hammes said. "We have plans where the employer will charge that spouse an extra premium if they participate on the plan. So if I have coverage through my own work and I can get access to that I would pay some sort of surcharge to have coverage through the plan here."
Hammes said medical claims show 53 percent of the county's expenditure is coming from employees. Thirty percent of the expenditure is coming from spouses. He added dependents are required to be allowed to participate in the plan even if the county implements a spousal carve-out.
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"We're not saying that spouses cannot be on your plan necessarily," Kearns said. "You may want to structure it in such a way that they can. But if they have access to other coverage through an employer arrangement then they take that as their primary coverage rather than taking your coverage as the primary coverage. Again, they can remain on your plan. That's one way to structure it. I think that's probably the kinder, gentler way to actually structure it."
Hammes also suggested for the upcoming fiscal year the county look at moving from a two-tiered structure to a four-tiered structure. The county's health insurance is currently offered at an employee and family rate. The current rates for 2017 and 2018 are
Hammes suggested the county for fiscal year 2020 consider increasing deductibles and coinsurance. He suggested the county consider offering a dual option for employees consisting of a base plan of a
"Everything goes toward deductible and coinsurance under a high deductible health plan," Hammes said. "But the money that is set aside for employees is not taxable. So if you decided to put money in there the county would save obviously on any money you put in there to help employees pay for the deductibles. In addition to employees if they were incentivized to put money into their Health Savings Account as well to pay for those expenses. They wouldn't be taxed on that money as well. The money stays with those employees. If the employee comes, works here and they put money into their Health Savings Account it's not like a flexible spending account where the money is lost at the end of the year. Once that money is in that employee's account the money stays with them."
Hammes said the current plan offered to county employees is a great plan, especially when compared to employers of the county's size. He said government entities such as city, county or school districts typically have more rich benefits and contribution strategies for employees.
"But long term is that sustainable and what does that look like going forward?" Hammes asked.
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"We always tell people you need at least six months on a high deductible health plan in advance of implementation date to educate," Kearns said. "You don't do it through one meeting. You do it through a series of meetings.
"Fiscally, you're still very fiscally sound. You're not in what I would call in a panic mode at this particular point in time. But I do believe based on what we see, what we've been seeing in terms of what's happening with healthcare costs that we need to begin to plan today not just for 2020, really 2020 and beyond. Because this isn't going away. This isn't going to get changed. This isn't going to get better overnight. It's going to be a long-term process."
Hammes said more companies are adding additional options for plans to give employees a choice when selecting the health insurance plan they want for themselves and their family. He did not see having multiple plans as a negative effect, stating it gives employees more options when selecting a plan best for them in their situation.
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"I think that benchmarking would be good," Srp said. "I've always kind of looked at cost of an employee as an employee benefit package as opposed to just salary. So I think it's important that we maintain that mindset when we work through this. Because if we were to make substantial cuts to the benefit package then that is a negative move for all those employees. I don't want to see that be the outcome."
"When we have a spike like this I look at it when we talk about these things that's like a reminder that we can cruise along for eight years like we have been and then all of the sudden we could have one to two people have a difficult year and that affects our bottom line,"
Wolf referenced the spousal carve-out, where the spouses of county employees may be required to pay a premium for the county plan. He suggested the county get input to determine how many spouses of employees would participate in the county plan. He expressed concern the Supervisors will make a decision without knowing how many employees would decide to opt for the county plan instead of the plan offered at their employer.
"We're just really trying to figure out based on the 23 percent rate increase from
Clinton County Supervisors in February voted to set the county contribution at 6 percent for fiscal year 2019. The increase was approved after county officials were made aware the county insurance plan went up 24 percent this year.
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