Noble County switches to self insurance health plan

Noble County commissioners recently changed health insurance coverage for county employees in order to save money and allow for future projects including infrastructure improvements in the county.

According to commissioners, an increase of 44% with the Health Plan — the county's insurance provider for two full years — was proposed late in 2019 with an effective date in 2020.

The increase would have cost the county an additional $700,000 annually.

Instead, the county worked with Keystone Insurance and is in a position to become a self-funded insurance provider.

"We have had some tough decisions to make over the last couple years regarding the county health insurance policy," said Commissioner Brad Peoples. "With health insurance being our biggest expense next to payroll, any increase or decrease in the cost of the policy has a tremendous impact on the future of our staffing and the funds available to support growth and services in the county.

"Many of our future projects literally hung in the balance because we know infrastructure projects, such as waterlines, sewer lines, broadband, etc., take a lot of initial investment dollars, and local match money. Therefore, a 44% increase to insurance costs would have been crippling to our plans for progress."

Because Noble County is a group of less than 100, the commissioners were limited to the amount of information shared regarding use of the county's insurance policy.

"We felt that we were being asked to pay the bill without understanding the reason for the charges including the way the insurance broker was being paid," said Peoples. "This whole process seemed like a bad idea."

The result was a committee being formed in Noble County to find better coverage.

The committee led by the commissioners, included the heads of department, agency and county offices. A different process was created and competitively bid, according to Peoples.

"The knowledge and savings this decision created is invaluable," he said. "This means we will control the policy and reap the benefits of savings in good claim years. With the expertise of Keystone Insurance, the committee and commissioners have built our own policy from the ground up."

The policy is designed to offer more benefit to the health and wealth of Noble County including its employees. A third party administrator will also help with some of the administrative burden.

"We compensate based on a per-employee/per-month basis resulting in an immediate $30,000 savings each year," said Peoples. "The biggest advantage in year one will be that we now have access to our own data and can use this to our advantage."

Commissioners will be able to study the county's costs and improve the plan design with hopes of driving costs down.

Additional features including MD-Live have been added, along with mental health and behavioral counseling, a program specifically for diabetic patients and a program to monitor chronic health conditions.

"All of these new features are aimed at making our employees happier, healthier and wealthier through the reduced cost of insurance," said Peoples. "Our self-funded plan is a huge step in the right direction for the quality of employment that Noble County can offer employees that also has benefits for the community."

The plan encourages community minded activity.

For example, the plan doesn't require mail order prescriptions so insured members can fill prescriptions at local pharmacies and still experience low co-pays.

"The decisions to make these changes was not easy or simple," said Peoples. "This has been a long process of educating ourselves, debating and studying the habits and needs of our employees and their families.

"We are starting to see the hard work pay off. When citizens require solutions for a lack of public water, internet at a reasonable speed or other development opportunities, it is our job as commissioners to find solutions," concluded Peoples.

Commissioners offered the following answers to some of the most asked questions regarding the self-funded plan.

Q. Should we give up being part of a consortium only to stand alone and become self-funded?

A. Noble County's health insurance policy wasn't part of a consortium to begin with.

Q. What happens if there's a tremendously high claim? Does that potentially bankrupt the County?

A. Within our new Self- Funded plan we have built in a Stop-Loss Policy. This insures the County against a catastrophic loss or very large claims. This allows projections of worst case and best case for the year. In 2022, that is a savings of 1% or up to 13%. At 13% it is about $180,000.00 of savings in 2022.

Q. Will the premium deduction from county employee paychecks be less?

A. No. The premium contribution by employees stays the same, however as savings builds in the fund, a "premium holiday" can be offered. That means no insurance premiums would be paid for the month.