County considers health insurance changes

July 26--A packed commissioners' court room full of Wichita County employees listened intently during an hours-long meeting about Texas Association of Counties health insurance.

Officials are exploring several cost-saving measures within the county budget and a major cost is employee health insurance. The county has been a part of the TAC health insurance pool for a number of years, so they called in TAC Employee Benefits Consultant Ramesha Brandon to explain the choices and answer questions for employees.

TAC has 241 Texas counties that are part of a pool to distribute health insurance benefits. Being part of the pool, Brandon explained, can offer counties benefits they could not get by themselves.

For instance, she said the county paid about $4.9 million in premiums to the pool last year. The amount TAC paid out for Wichita County health claims was about $5 million. An individual plan could decide to raise prices very high the next year to recoup losses, but TAC has the advantage of other counties that can make up for the loss.

Brandon said like many counties in the TAC pool, Wichita had many claims the past year, leading to a possible 8.1 percent increase in insurance premiums for the next year. TAC is not looking to make a profit, she said, but they have to raise rates enough to cover changing health care costs.

"We're not even getting enough to cover the premium," Brandon said.

At the end of each year, TAC contracts with actuaries who help determine acceptable rates for the next year for each county. Using the trend, or what county's use of services the previous year would cost the upcoming year, TAC determined the trend was about 7 percent, so made their rate 7 plus just one more percentage point.

The TAC pool also benefits from surplus when TAC gathers more than they need. From 2013 through Wednesday, Brandon said TAC has given Wichita County back $325,835. Wichita County Judge Woody Gossom said those dollars go back into the general fund to pay toward increases in health care costs.

Like more than 80 percent of TAC counties, Wichita still has grandfathered plans. This means these plans tend to be a lower rate because they were not required to add the required changes in the 2010 Affordable Care Act.

Brandon said TAC has about 30 plans to choose from, but brought numbers for four plans. She also explained a private exchange where employees could look at up to 10 plans.

She also said the county is free to shop for other insurance possibilities other than TAC, but it may involve going through a request for proposal process or forming an interlocal agreement with that group.

One more benefit of TAC is that they take into consideration demographics of the area as well as cost of care. Brandon said they found the county to be about 8.8 percent younger than average among counties, but has a whopping 18.9 percent higher cost of health services. She said this could be due to a lack of competition. She said in the future, employees might consider shopping around for doctors and services because a better rate may be possible closer to the Metroplex or other more-populated area.

No decisions were finalized Wednesday, but one thing is for certain, change is coming to the county health insurance and it will probably mean more out-of-pocket costs to employees.

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