Commissioners hear health insurance proposal during budget discussion

Scotts Bluff County Commissioners were presented with a proposal to consider a change to their health care off erings for employees during budget discussions Monday, March 31.

Discussion began with the consideration of the process for approving the upcoming year's budget.

"I can mention a couple things, because I think I'm the one that instigated this discussion, somewhat," Chairman Mark Harris said.

One of Harris' concerns when it comes to the county budget is that elected officials and department heads prepare their budgets without "any guidance as to what our expectations are when they finish at the end."

Harris said he is suggesting a percentage increase to the overall budget, rather than having to wait till the end and cut millions off .

"That needs to be done by us declaring that percentage upfront," he said.

Harris reference 2.5% numerous times as an example from a Morrill County commissioner, reiterating later that the 2.5% was only a "suggestion with just a number that was used."

The importance of department heads getting proposed budgets to management accountant Lisa Rein in a "timely manner" was also a needed discussed. Harris said he thought the commissioners need to help with that.

"It'd be like, 'Hey, if you don't get your budget turned in, here's what's going to happen,'" he said, an implication that commissioners would set budgets, likely cutting them.

Asked when budget discussions needed to begin, Rein told commissioners it would depend on when the commissioners wanted to have their budget decision. She recommended sooner, rather than later.

Commissioner Charlie Knapper said that he felt that commissioners needed to set budget goals and limits.

"I made that comment two weeks ago with the hopes that we would all think about what those goals might be, voice those goals tonight, and that we provide department heads with some guidance," Knapper said.

According to Knapper, two of his three goals from last year were achieved: Giving a 3.5% raise to all employees and lowering the levy. His third goal was to stay off the pink postcard, which did not happen, given that the property taxes went up by more than 2%.

Rein said the issue last year was a long property protest time in July, long meetings in August and that pushed the budget time to September.

"We should start diving into (budget) stuff in May and June," she said.

Commissioner Ken Meyer agreed with Rein, saying he liked the idea of starting earlier.

Knapper voiced frustrations, saying he didn't think much progress had been made.

"We set this workshop to have a budget discussion, and all we've decided is that we're going to talk about the budget sooner on the calendar than we did last year," he said. "We've said that each of the last six years I've been here. ... it's a little frustrating."

Knapper then invited a guest to speak with suggestions on how the county could lower the budget.

Nick Lease, of Next Gen Benefits Solutions in Scottsbluff , addressed the commissioners about their health plan, recommending them to hire a consultant such as himself "that can access the role of DOGE."

Lease suggested he was able to see that the county spends about $3.7 million a year on health insurance, $2.9 million of that estimated to be claim spending.

"You're looking at about 23% or $876,000 and really what my encouragement is is going back to the DOGE comment," Lease said, "which is encouraging the county to put out an RFP to have a consultant come in and help you guys make well-educated decisions as far as it comes to your health plan." The county is self-insured, with administration done by RCI, a company associated with Regional West Health Services.

Lease reiterated that he was not outright saying changing plans or networks, but to "hire an expert" — himself — to see how the county could reduce cost.

"I believe conservatively, right now, you're spending about 20% to 25% too much on your claims," he said.

Advocating for his own business, Lease said the vendors he was associated with — Colorado health care companies that he said he couldn't release — would provide better care at a lower cost that Regional West. The answer had been given in response to a question about whether county employees would be able to use "preferred centers," most notably Regional Wes, with Lease's off ering.

But, Lease said, "if you guys do an RFP, and you hire a consultant and your employees are willing to work with that consultant, I am 100% confident … we can eliminate their out-of-pocket cost."

The fact that patients would have to travel for care is why the out-of-pocket is waived, he added.

"I would like people to stay and support local health care but the fact is a lot of people are going south for health care anyway," Lease said. "They've got a million different options to go use one of our direct contracts."

Meyer told Lease to contact the county's health insurance committee and "take it from there" with regards to setting up a meeting. However, Meyer did note that if taxpayers are going to pay more in taxes, those in charge need to make sure that all the roads are done, and done correctly.

Mitch Wages, who identified himself as a businessman from Scottsbluff , addressed the board with regard to the budget and Lease, asking if this was the best way to cut expenses.

"There's probably ways to cut a lot of expenses, and I think the first place that that should take place are the people in charge of are the ones that know the best," he said. "That would be the people that were elected or appointed to do that job, right?"

Meyers responding, saying he's not advocating for raising the budget every year either, "but we also have an obligation to the taxpayers" to do things right with the taxpayers' monies.

"But at the end of the day," Wages added, "the people that work there are the ones that do the best decision-making."

In other business, commissioners discussed at the meeting included Sheriff Mark Overman asking for an RFP for nursing services at the jail. This item was tabled from the last meeting, since the commissioners asked Overman to get it reviewed by an attorney. Overman noted he had the contracted reviewed by NIRMA, since they have services with them as part of their contract, and county attorney David Eubanks reviewed it as well.

The commissioners also discussed the foot-traffic app agreement, Placer.ai, which has been discussed at multiple meetings. The app, originally brought up by Knapper, was originally proposed for a three-year contract to split costs between the county and Twin Cities Development. TCD has now asked it to be a one-year agreement. The item was eventually tabled while board members review other options that would potentially save money.

Contact Megan Kelley: Megan. [email protected], 308-6329041