Logan County Board to vote insurance plans on Tuesday

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[March 17, 2017]  LINCOLN - On Thursday, March 16, the Logan County Board held their monthly Workshop to discuss motions and set the agenda for Tuesday's Regular Board meeting. One focus of discussion was the upcoming dental and health insurance renewal.

On Tuesday, Nathan Whiteman, the county's new insurance consultant, met with the board's finance committee and discussed insurance proposals from Blue Cross/Blue Shield and Health Alliance, explaining some of the details of each one.

At Thursday's meeting, Whiteman shared more details on costs of health insurance through Blue Cross/Blue Shield, Health Alliance, and United Healthcare.

Sara Walker-hite, a Health Alliance representative also came to tell what her company offers and explain more about their Point of Service plan. Walker-hite said the problem with most HMO plans is that there is no out-of-network plan. She said Health Alliance developed their Point of Service plan is a hybrid of HMOs and PPOs.

Walker-Hite said the Point of Service plan provides "an HMO platform product, but still gives you some sort of plan B in case you decide for whatever reason to go out of network." She said the Point of Service out of network coverage is usually not going to be as good of coverage as it would on a PPO. Their focus is to utilize your primary network.

Walker-hite said the Point of Service plan helps "get everyone involved in the conversation and make sure you are getting the best care possible. It helps with utilization and knowing prescription drug conflicts."
Walker-hite said their provider network is statewide and includes hospitals and medical centers in Peoria and Springfield.

Walker-hite gave board members handouts showing some of the service offered by Health Alliance. She said they have strong customer service with "99.6 percent of issues resolved on first call."

Walker-hite said many can get their questions answered by looking at the website YourHealthAlliance.org. The website allows members to access plan materials, print or order ID cards, see the status of claims, search their provider network, use the treatment cost calculator to compare costs, and view deductibles and out-of-pocket spending.

On the website, members can find out which services require preauthorization. Walker-hite said "in-network specialists may require provider-to-provider referrals" and "a referral to a provider in the tertiary network requires preauthorization."

Walker-hite said there are many covered benefits such as an annual wellness exam, well-child care, and various screenings. Rally, their digital health tool, helps members improve health with personalized plans, rewards, and a mobile app.

Walker-hite said they have a 24-Hour Anytime nurse line to help people decide if they need to see a doctor right away or set up a visit, deal with their diabetes, asthma, high blood pressure, or high cholesterol; or find healthcare resources.

Walker-hite said they have various programs. The Disease management program helps people manage asthma, diabetes, or high blood pressure as it provides newsletters and other resources and connects people with care and support. Quit for Life helps people stop smoking. Fitness and pharmacy discounts helps members save money at fitness centers, on weight loss programs, and on prescriptions. Walker-hite said members get discounts when filling prescriptions at Walmart pharmacies.

Whiteman asked, with claims, whether groups using the Point of Service networks were seeing softer renewals.

Walker-hite said "Yes, utilization management helps control costs." She said adding in a second component like a "medicare group" helps "get the best bang for your buck."

Schmidt said he would like to have Walker-hite present more information in upcoming months.

After Walker-hite's presentation, Whiteman shared some numbers and what people would be getting for renewals. He gave board members and other county employees present at the meeting handouts showing rates for Blue Cross/Blue Shield, Health Alliance, and United Healthcare. Whiteman said United Healthcare's costs were much higher, so "they priced themselves out."

Whiteman said the rates were for a $3,500 PPO plan, and $1,500 PPO plan, and a $3,500 Health Savings Account plan. His spreadsheet compared costs for all plans. He said some bring dependent plan costs down.

With all three plans added together, the totals in premiums per year are $738,834 for Blue Cross/Blue Shield; $730,908 for Health Alliance, and $962,991 for United Healthcare.

Ruben reminded everyone that Blue Cross/Blue Shield prices include the $30,000 consultant fee, but Health Alliance does not.

Hepler said differences in out-of-pocket costs among plans could encourage more spousal participation. He said "raising deductibles only keeps the healthy people from going to the doctor" and "utilization management" can reverse trends.

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Whiteman said, "I think what I've heard so far, is if you can provide me with a lower cost plan that still allows me to see doctors in Lincoln, I would be interested in that." He said, "An HMO would accomplish that, but it does not come with a safety net."

Whiteman said he will look at the difference in costs. He said "the question is, and what I still have to look at is, how much difference in costs. How much are we actually going to save giving up that Point of Service safety net versus just the straight HMO plan?"

County employee Lisa Bobb said "I would appreciate you looking at the 105 people on the plans now and what's the best."

Whiteman said we are "trying to look at the plans in place now versus what we can do for those that are trying to continue participating." He said some people said they were not sure if they were going to participate in the plans, but would try to find insurance elsewhere. Whiteman said, "they are probably not going to find anything cheaper on the market or anywhere else."

Schmidt said on Tuesday he would motion to approve a health insurance carrier. Schmidt would also motion to continue life insurance coverage for board members.

Whiteman also gave the board handouts showing the dental plan proposals. Whiteman said he got bids from Blue Cross, Delta Dental, MetLife, and Principal Financial.

Whiteman said Blue Cross has a slight rate increase that is 1.9 percent more than last year. The $2,000 plan is better.

Whiteman said the plans in place are a $2,000 plan and a $1,000 plan. These are the annual maximum benefits an employee can use on the plan.

Whiteman said "most of the employees who have the plan on their own are enrolled in the $2,000 plan." He said "there is currently a $1,000 maximum plan offered" and "I think the thought behind that in years past is that it offered a lower cost plan so that those who wanted to put a dependent on the plan were able to buy into a plan with a lower payroll deduction cost. The members are paying 100 percent of the additional costs on their own."

Whiteman said Delta Dental saves $5,700 on the plan, MetLife shows a $9,700 savings, and Principal shows a $1,300 savings. All of these are part of the $2,000 plan.

Whiteman said, "I was very strict with them to see that they were matching benefits. . . in terms of deductibles, co-pays, preventative, and restorative."

Whiteman said on the $1,000 plans, Blue Cross and Delta Dental had the same rates. Blue Cross is set to go up $1,700 from last year. MetLife had a $3,100 savings, and Principal had a $5,500 savings.

Whiteman said MetLife has good network but only a couple local dentists in network. He said, "Low prices make them competitive even out of network." Whiteman said in network vs out of network is not big deal with dental.

Board member Bob Sanders asked if Whiteman's past clients have used MetLife.

Whiteman said he has several clients who have MetLife. Whiteman said we have used all the companies represented here today and all are great.

Schmidt said he would motion to move for vote Tuesday on MetLife.

Board members present were Board Chairman Chuck Ruben, Vice Chairman Emily Davenport, Janet Dahmm, Bob Farmer, Dave Blankenship, Kevin Bateman, David Hepler, Gene Rohlfs, Bob Sanders, Scott Schaffenacker, Adam Schmidt and Annette Welch. Guests at the meeting included several county employees.

The board will vote on all the motions at Tuesday's Regular Board meeting.

[Angela Reiners]

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