Rock County pursuing new health care plan

Jun. 26--JANESVILLE -- After months of discussing new health insurance options, Rock County is moving forward on an updated plan for its 1,300 employees.

The Rock County Board's Staff Committee on Tuesday advanced a new dual-choice plan to the full board, which will vote on it July 11.

Beginning Jan. 1, 2020, the health care plan limits employees' networks to two insurance providers: SSM Health and MercyCare Health.

Currently, the county has a broad list of network health care providers. The county is self-insured, meaning it acts as its own insurance company, said Rock County Administrator Josh Smith.

Rising numbers of claims and costs per claim under that plan are depleting the county's health insurance account. At the end of 2015, the county had $6.8 million in the account. That number sank to $3.7 million at the end of 2018.

"It was those losses that contributed to our desire to look our options," Smith said.

In March, the county board formed the Health Insurance Plan Ad Hoc Advisory Committee to stabilize the county's health insurance. Fifteen employees and three board members sat on the committee.

The committee voted 12-2 for the dual-choice option June 12. In an employee survey, 66% of respondents ranked the new plan as their first choice, and 30% ranked it as their second.

Deductibles and copays will be significantly lower for in-network providers under the new plan. Prices for out-of-network providers will be higher.

Deductibles are $500 for a single employee and $1,500 for a family for in-network providers. Currently, deductibles are $750 and $2,250 for a single employee and family, respectively.

Rock County will cover 90% of costs for in-network care and 65% for out-of-network care under the new plan. Copays for primary care fall to $15 for singles and families.

To be considered in-network, an employee's entire family must be enrolled exclusively with either SSM Health or MercyCare Health.

Smith said about 95% of care given to county employees is provided by SSM Health or MercyCare Health. The county will budget about $19 million for the new plan in 2020--less than the $21 million budgeted for health insurance in 2018, he said.

But Smith said the county was paying more than $21 million because of the increase in claims and costs per claim.

The county will renegotiate the plan after three years, Smith said.

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