Township Switches Health Insurer for Savings
At Monday night's special
HIF will become the town's health benefits plans adminis trator beginning
Insurance Design Administrators (IDA) CEO and general counsel Daniel Roslokken, the township's third party claims management and payment administrator since 2015, gave a presentation since neither he nor any other IDA representatives were at the
Roslokken discussed the self-funding plan proposal, which he described as having three main components - the town's retention of unspent claim dollars, stop-loss insurance to protect from larger claims, and flexibility and control. "In a basic sense, this is a pay-as-you-go plan," Roslokken said. "If those on plan are so blessed to not be in need of medical services, there are no claims that come in, and the claims cost is down. But, if there is an incidence of use or severity of the cost of use, that's where reinsurance (stop-loss coverage) comes in," he said.
According to Roslokken's packet, which he provided the governing body and public, stop-loss coverage, for both specific and aggregate situations, pays when claims for any one person or the whole group exceed a set dollar limit during the plan year, enabling the maximum cost to be known and locked in for the year.
In contrast, the HIF is a joint fund, with 52 New Jersey municipalities and municipal utility authorities enrolled, and was created by
Roslokken explained that the only cost changes that would come in for a renewal with IDA would be claims costs, which is based on a trend estimate of a 9.25 percent increase through a report auditing the state health benefit plan, and Roslokken described it as "the component none of us have any control over, how sick or how well anyone on the plan would be".
Mulroy asked if "accepting the risk and hoping for the reward" is an accurate summation of IDA's self-funding proposal, referring to the fact that the town could receive a better deal one year due to the possibility of fewer claims, but would also need to be aware of greater costs if there are more or higher claims than expected in a year, to which Roslokken agreed.
"It's like anything. You hope for the best and you plan for the worst," Linhart added. A proponent of the IDA plan, he pointed out that the community can benefit from it because if the township takes on the risk and plans accordingly, it can "ride out the ebbs and flows". Linhart also noted, "The money that's budgeted is simply saved in our bank accounts, as opposed to just cutting a check for the HIF, in which we would not see a return." Linhart stated that he thinks the risk with leaving the IDA plan and going with HIF is that the township will lose its flexibility to manage costs through savings acquired throughout the years. "I think the issue that I have is telling taxpayers that while right now this HIF is a great proposal, I understand that it's a business model and that this proposal is essentially throttled to be more appealing for us to join the HIF. I don't see it as a sustainable number at the bottom line." Mulroy said, "The question is whether we're both willing and financially able to absorb this risk. In my experience, large corporations and municipalities opt for the self-funding plan because they have the financial resources to cover a bad year. In my opinion, small municipalities like us should not engage in making this type of bet, especially since we saw it happen," Mulroy was referring to the
Teague inquired why there is a
"My concern is that we have a
The HIF plan provider will remain


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