Evansville official says self-funded insurance still the way to go

Dec. 10--City officials said the Courier & Press was comparing apples and oranges when it printed a story that compared the Vanderburgh County and Evansville governments health insurance plans.

The story published Nov. 22 titled "Cost for city employee insurance rises, county remains flat."

There's not much disputing county premiums are staying the same while the city's climb between 2016 and 2017, said George Fithian, the city's personnel director who oversees the health insurance plan.

Rates for all city employees will rise next year, some paying about $100 more a month in premiums and higher deductibles.

While most of the employees work under the same roof at the Civic Center, their plans, and how the plans impact their employers, are different.

The difference between the county's fully insured plan through Anthem and the city's self-funded plan, which it manages itself, is risk, and the benefits or costs to that risk.

That risk is the self-funded takes the chance of having a year with a high-dollar claims that can bring high costs, like the city is seeing now with millions in unpaid medical debt mounting as 2016 ends.

Fithian said the city is having a bad year, but the benefits to having a self-funded plan is lower costs in normal claims years and lower premiums for recipients.

Fithian said the city's self-funded plan is a benefit to employees and to the city as an employer.

But with more than $5.6 million owed in medical claims still this year, could a fully-insured plan be cheaper or more economical when using public funds?

"My experience has been that's not the case," he said.

But at the beginning of the year, the city will shop the plan, including getting quotes on fully-insured plans, like the county.

"The goal, obviously, is to do whatever gives the taxpayer the best deal, too. They've got a lot of skin in this game," he said.

While the county finds benefits to using a fully-insured plan, Fithian said the city's self-insured plan gives more flexibility to respond to trends.

When claims are low, much like when the county received a $440,000 refund check for its low claims, the city benefits by not having to spend as much. Money put into the hospitalization fund is locked into that account, so any money leftover can't be used for other purposes.

The city's self-insured plan is mostly managed by the city alone, however, it's not totally alone, as the Courier & Press reported in November.

The city has insurance that covers claims over $500,000 and transplant insurance that will cover the cost of a transplant for the patient and city.

City health plan manager Debbie Knoll said there were three transplants this year and two last year.

One of the key differences between the plans is the city's medical coverage includes dental and vision in its premiums, while the county's dental and vision plans are separate. An employee who's married with children who leaves a job from the city's Department of Metropolitan Development for the Vanderburgh County Auditor's Office would end up paying $100 more a month.

City of Evansville Plan I (includes health, dental, vision)

Premiums: Single, $80.25; single and child; $152.48; single and spouse $168.53; family, $224.71

Evansville High Deductible Health Plan (includes health, dental, vision)

Premiums: Single, $56.14; Single and one other, $73.57; Single and two or more others, $83.04

Vanderburgh County health plan (health with dental and vision added):

Premium: Single, $100.80; Single and spouse, $209.74; Single and child/children, $245.77; Family, $327.45

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