Council Reviews Health Care Options at Special Meeting

WATERTOWN — The Town Council held a special meeting last Thursday to discuss potential costs and plans for employee health care for the next fiscal year. Chairman Mary Ann Rosa cautioned council members at the end of the meeting that the council does not vote on whether or not to switch health insurance to the state plan.

It is an administrative decision, she said. The session was meant to educate council members on the terms of the state plan and how costs might compare to the current health insurance plan.

Town Manager Mark Raimo said the idea was to apply to the state plan to further explore it as an option. It would still have to go before the unions before a change could be made.

Kate LaVoie of One Digital remotely presented an analysis to the Town Council regarding current health care plans, comparing that to the State Partnership Program 2.0.

She said the current self-funded plan would likely cost an estimated 18.4% more in the coming year. The state program is planning a 9% increase over the current costs for the state plan.

According to the documents provided, the Connecticut (CT) Partnership Plan is a low/no-deductible Point of Service plan offered to non-state public employees who work for municipalities, boards of education, quasi-public agencies, and public libraries.

The CT Partnership Plan is the same plan currently offered to state of Connecticut employees.

Information included in the presentation noted health coverage includes $15 in-network office visits, free preventive care, and $5 or $10 generic drug copays for maintenance drugs.

Covered employees and family members may see any provider but will pay less for in-network providers.

The plan is administered by Anthem Blue Cross and Blue Shield (Anthem) and includes access to Anthem's State Bluecare POS network in Connecticut, and access to doctors and hospitals across the country through the BlueCard® program.

The state's Health Enhancement Program (HEP) is included. HEP encourages insured individuals to get preventive care screenings, routine wellness visits, and chronic disease education and counseling.

The information on HEP states, enrollees must get age-appropriate wellness exams, early diagnosis screenings (such as colorectal cancer screenings, Pap tests, mammograms, and vision exams).

There are additional requirements for those who has 1. diabetes (Type 1 or 2); 2. asthma or COPD; 3. heart disease/heart failure; 4. hyperlipidemia (high cholesterol), or 5. hypertension (high blood pressure).

Enrollees would be required to participate in a disease education and counseling program for that particular condition.

They would receive free office visits and reduced pharmacy copays for treatments related to that condition.

If an individual becomes non-compliant in HEP, that person's premiums will be $100 per month higher and there will be an annual $350 per individual ($1,400 per family) in-network medical deductible.

Ms. LaVoie said the state plan is equal to or better than current plans.