Smith County employees to see health, vision insurance increase in October

June 21--Smith County employees will see a 5.3 percent increase in their health insurance rates next fiscal year, and a 1.98 percent increase for vision coverage.

The dental plan will be unchanged with no price increases.

On Tuesday, the Smith County Commissioners Court received a presentation from Dallas-based Brinson Benefits, a consulting firm brought on to help with the county's healthcare plan. The county is partially self-insured.

Brinson Benefits made a presentation on suggested changes for next fiscal year, which begins on Oct. 1.

The county's health plan will cost an additional 14.6 percent next fiscal year. County employees will pay 5.3 percent of the increased cost, and the county will pay 9.3 percent, based on the verbal presentation and a one-page summary of changes, which was given to the press.

Two slides also were released. Those included a comparison of the current plan costs to those expected next fiscal year and one on Lap-Band-like surgeries, which will now be covered by the county.

This is the first cost increase to county employees in five years, Brown said.

The projected numbers are not final, and the consulting firm has one more insurance company to negotiate a final contract with, which could affect overall rates. That contract relates to stop loss insurance and would provide a protection measure for the county that would kick in if an individual claim reaches a certain threshold.

Dawn Brinson, founder of the firm, said the county isn't seeing a huge rise in the number of claims made, but the claims are coming in higher. She attributed the rise in the use of standalone emergency rooms as a potential factor.

"They look a lot like an urgent care," she said. "It's possible that people have gone there thinking its an urgent care."

Brinson suggested changing the payment structure for the use of standalone emergency rooms to help curb the use of those facilities.

"We want a big enough barrier (so employees can) decide if they need urgent care or emergency care," Ms. Brinson said.

Chiropractic services also will be more expensive next year.

"We recommend chiropractic care to no longer be at a co-pay ($65 per visit)," Ms. Brinson said. "We see high utilization in and out of network. We will still cover it, with the same number of visits per year, but propose making that subjected to co-pay and deductible."

Co-pays are proposed to remain the same, according to the verbal presentation.

The county has three basic plans for insurance, which have different rates if the employee is single, married or has children covered on the plan. They range from

Insurance for a single employee will remain free for the basic plan but will increase for buy-up plans.

In an effort to curb the monthly premium increases, the county increased the out of pocket maximums on the plans -- effectively the worst-case scenario on how much health care would cost a single person or family in a year.

"Worst-case scenarios are built in to protect people..." Ms. Brinson said. "Those limits impact the fewest number of people. Very few people reach those limits. Office co-pays and deductibles are things people use to get affordable care. We wanted to focus on those things that impact the most people."

Those increases vary on whether the deductibles are in or out of network and they also vary based on the plan the employee is on. The county does, however, plan to limit the maximum costs for large families with more than two children.

"Across all three plans the concept is to reduce family deductible limits -- the worst case scenarios- this is great for large families," Ms. Brinson said.

Twitter: @TMTFaith

___

(c)2017 Tyler Morning Telegraph (Tyler, Texas)

Visit Tyler Morning Telegraph (Tyler, Texas) at www.tylerpaper.com

Distributed by Tribune Content Agency, LLC.