Two days after Marion County commissioners approved United Health Care as its new insurance carrier, a special meeting was called April 12 rescinding that decision in favor of Blue Cross Blue Shield’s counter offer.
County clerk Tina Spencer said after letting BCBS know via email they lost the bid, Bruce Schultz, group enrollment representative, inquired if he was too late for a counter offer.
In the new BCBS proposal, Schultz stated because the county was moving to a “non-grandfathered” option, it was possible for them to get within $16,000 of UHC’s annualized costs.
Based on the county’s current premium of $768,560 before renewal, Spencer said the budgeted amount for 2018 would be $844,420. The revised BCBS bid was about a $3,000 to $5,000 difference from the budgeted amount.
Commission chair Randy Dallke thanked Spencer for working late April 11 in order to bring this new information to them.
Commissioner Dianne Novak asked why a decision was made to forego the previous decision on Monday (April 10) and continue researching the issue.
“As a commission, we studied (these insurance plans) for weeks,” Novak said. “I spent hours and hours looking over graphs, numbers and staying within budget.”
Even though the overall numbers are not far off from each other, Novak said if the county had an administrator this wouldn’t have happened.
“I talked to taxpayers on the street and every one of them said the county should stay within budget,” she said. “It was hands down by taxpayers.”
Following Novak’s statement about an administrator, it was as if the fight bell sounded.
Spencer said: “When overwhelming information from employees, who are the greatest asset to this county, say the BCBS plan is what they would like, and when many employees haven’t had a raise in three years.”
In addition, Spencer said she didn’t want to be disrespectful, but when Novak said there’s no money to give employees a raise, and they have to pay more in insurance premiums, she didn’t think it sent a “good picture.”
“Many county employees aren’t working for a top wage, but they stay for the benefits,” she added.
Spencer said she disagreed that the commission hasn’t discussed raises, because it was brought up at the April 10 meeting for further discussion at budget time.
“With 67 employees saying they would like to stay with BCBS, and we aren’t looking at what people are saying, if you don’t look (at another option), it’s like saying we don’t care what you think,” Spencer said.
Novak said she was trying to be fiscally responsible by providing a good insurance plan and staying within budget.
Commissioner Kent Becker said he respectfully disagreed with Novak.
“(BCBS) came back right away and were being more flexible,” he said. “(Spencer) had to report to us that variance, which had decreased immensely. I realize we need to guard taxpayers’ money, but BCBS narrowed it down to where we are close to budget.”
Becker said the employees who wanted to keep BCBS are talking to him, and county employees are also taxpayers.
“My point is, if we went back to UHC, would they come back down some more, too?” Novak said.
Dallke said he had to respectfully disagree with Becker regarding the piece of paper containing names of employees wanting to remain with BCBS.
“This paper isn’t talking to me, it is yelling at me,” Dallke said. “I have been here 12 years, going on 13 years, and BCBS has been a good company to work with. They also explained why rates went up 31 percent.
“Dianne, I don’t know if you can walk your straight line, but however you want to walk it, employees want to be heard and this is within pennies.”
Dallke added that the new bid was within reason, and if an administrator didn’t bring the BCBS information forward, he said he would probably fire him.
“Don’t talk about an administrator,” he said.
Novak asked Dallke not to yell at her.
“What kind of chairman are you?” she said. “It is about financial responsibility, and where is our integrity (regarding bidding process)?”
Novak said she wasn’t disrespectful to Dallke, and she didn’t deserve being “yelled and screamed at.”
Dallke said: “We are here to take care of insurance, and not administrators or anything else,” he said. “(Novak) opened this door, and I will shut it.”
About 10 employees attended the meeting with the majority saying they were willing to pay more in order to have BCBS.
Mark Isley, president of Hub International and consultant to the commissioners, said there are concerns they need to be aware of.
One concern is BCBS lowered its rate to keep the county this year, but there are no guarantees the same rate will be offered next year, he said.
“It could be the county will have to go to the market again, and if it’s another bad claims year, it could have a huge increase—no matter what carrier,” he said.
Karen Vine, senior account executive with HUB International, stated in an email to Spencer that other issues could arise.
“When a carrier uses its underwriting formula to produce a renewal premium, and subsequently provides a sizeable concession, it’s artificially lowering the needed premium based on the formula,” Vine said. “If claims run better than expected, the impact wouldn’t be as significant as the premium collected.
“It would be better aligned to cover the costs of the claims, but if claims run higher than anticipated the artifically lowered premium is less able to cover the costs, thus creating a higher loss ratio and impact to renewal premiums.”
The challenging part in all this, Vine stated, is not knowing how the plan’s claims will run in this next experience period.
Employees need to also commit to being well, Isley said, and think about what they are doing with health dollars and how they are living, too.