Changes proposed to county employees’ health insurance
by Sarah Fay Campbell
Health care costs have risen sharply in recent years, but Coweta employees haven’t experienced a rise in premiums since 2005.
The county’s health insurance pricing is not sustainable, however, and possible changes were presented at the recent County Board of Commissioners work session.
The changes include higher premiums, higher deductibles, and increased co-insurance along with other changes for retirees.
The majority of the proposed modifications will take effect on Jan. 1, though developments for retirees could take place a few months sooner. According to County Administrator Michael Fouts, decisions will likely be made by October, when the county’s new fiscal year begins.
For retirees, the most significant modifications would affect those not yet 65 years of age.
Currently, retirees with 25 years of service under the age of 65 don’t have to pay insurance premiums, while their spouses pay the employee rate.
Under the proposed changes, those retirees would pay the same premiums current employees pay.
Once the retired employee reaches 65, he or she would be expected to enroll in Medicare and pay Part B premiums. The county will pay the total premium for a Medicare supplement for the employee. There will be no supplemental coverage for spouses of retirees with 25 years of service. For retirees with 35 years of service, the county would pay a portion of the Medicare supplement premium for spouses.
The current Medicare supplement premium is $375 a month.
Retiree Dennis Hammond spoke at length during the meeting, representing both himself and fellow retirees.
“The current personnel management system book indicates that retirees receive free coverage,” Hammond said. “I don't think it is right to tell an employee who is already retired that they now have to pay,” he said.
“The PMS book states that the county shall pay employee benefits for the rest of their life,” Hammond said. “I’m still kicking. I’m not 65. So you’re saying now that you’re changing my benefits or proposing to change them?”
According to Hammond, many years ago, the county didn’t pay well. Hammond stuck it out, hoping to eventually be compensated for his efforts.
Current employees will experience premium increases if the proposed changes are made. The individual premium would rise by around $10 biweekly, and family premiums would rise by nearly $20 for the same time period.
Deductibles would double for individuals, with an out -of-pocket max of $2,000. The family deductible would also double, with an out-of-pocket max of $4,000. Co-insurance would rise from 10 to 20 percent, pushing the employee to reach the out-of-pocket max sooner.
“Under the Affordable Care Act, deductibles and prescription co-pays count toward the out-of-pocket maximum,” said Jason Brady with Northwestern Benefits, the county’s health coverage consultant. Previously, they didn’t count toward the maximum.
There is also a proposed “health savings account” plan, which would keep the current premiums but raise the deductible for individuals and families. The county would contribute to the HSA.
Health savings account money can be used for a variety of expenses, including dental and vision as well as medical, and the funds roll over each year.
Regarding prescription drugs, a recommendation for a fourth tier was proposed for speciality drugs. The patient would be responsible for 20 percent of the cost, with a cap of $200 per prescription.
Finally, adult orthodontic services would no longer be covered.
According to Lance Dennis of the recreation department, as a parent of young children, paying a higher premium is preferable in order to have a lower deductible.
“I see no reason why that shouldn’t be a part of the discussion,” said Brady.
Hammond and Brady mentioned the possibility of a survey presented to employees, to see what options they would prefer.
A series of meetings with county employees
before implementing permanent changes was recommended and preferred by the majority of meeting attendees.