Mt. Vernon Register-News

November 23, 2013

Health Alliance preferred health provider

BY RICK HAYES rick.hayes@register-news.com
The Register-News

---- — MT. VERNON — A scheduled 30-minute Services Committee meeting on Thursday night turned into a two-hour marathon.

Five proposals for health insurance for Jefferson County were made, which led to a lengthy discussion about which plan which best fit the county's needs.

The county's current health insurance policy with United Health Care ends on Dec. 31.

In the end, a proposal submitted by Dave Spalt of Health Alliance was recommended for approval at Monday's full board meeting. Bruce Hapeman of the Hapeman Group is the serving agent for all proposals given.

Each plan had varying risk factors, although the Health Alliance plan was reportedly one that was described as a "middle of the road" risk factor.

In the end, it was Chairman Robert White — the only county board member with insurance experience — who recommended the Health Alliance plan. Board member Jeremy Hall made a motion to table any recommendation until the full board meeting on Monday night which died for a lack of a second.

The Health Alliance proposal, called a Health Reimbursement Arrangement, is a fully-insured plan, according to Spalt. It has higher deductibles — $1,000 per employee and an out of pocket expense of $1,300 — but the county will pay a maximum of $5,200 per employee annually. The maximum detectible, per employee, is $7,500. The plan includes office visits and emergency room co-pays with an 80/20 format. The total cost estimate provided for each employee is $653 per month.

Spalt said similar plans have been adopted by the City of Carbondale, Ferrell Hospital and Franklin Hospital.

A base Health Alliance proposal was also submitted with a $1,000 deductible for 80/20 coverage and an out of pocket expense of $2,000. The cost per employee proposed was $653 for employee, $1,874 for employee and spouse, and $1,241 for employee with children. The plan did not include dental or vision coverage.

Hapeman spoke on behalf of CIGNA, which did not have a representative at the meeting. Hapeman said it was the lowest quoted plan, although the county may or may not get some reimbursement. The 80/20 plan calls for a $2,000 deductible at a cost of $629 per employee, $1,324 for an employee and spouse, and $1,195 for an employee and two individuals. It is a self-funded plan.

Central Management Services, a PPO, quoted a price of $679 for employee coverage, which included dental and vision options, $1,304 for an employee and spouse and $1,684 for an employee and two individuals. A 90/20 plan, it has a $1,500 deductible and the maximum out of pocket expense per employee is $3,000.

A self-funded plan presented by Illinois Program Insurance Group and its representative Jack Abbott, is vulnerable to the most risk, according to White, in that the county has to fund the account to a reasonable amount. The county's maximum exposure for this fund is $978,068 with the county having to pay no more than $40,000 per member annually. Still, the monthly cost to operate the self-insurance plan came to approximately $81,000 — with $20,000 of it coming out of administrative fees — although the county could have money left over in the account at the end of the year if there is not a high number of claims.

Abbott said similar plans have been adopted in Clinton and Jackson counties.

White asked Hapeman for a recommendation on all plans presented, but he threw the ball back in the court of the committee.

"I have no preferences. You have to be comfortable with it," he responded.