photo by: Mackenzie Clark

Douglas County Commissioners Nancy Thellman, Michelle Derusseau and Patrick Kelly listen as Interim County Administrator Sarah Plinsky, not pictured, discusses changes to the county's health insurance plan for the 2019-2020 year during a meeting on Wednesday, April 24, 2019.

None of the three Douglas County commissioners was eager to move to approve the next year’s health plan for county employees on Wednesday.

Interim County Administrator Sarah Plinsky had told commissioners at a March 20 work session that the county’s “extremely low deductible” health plan would not be sustainable. For the 2019-2020 plan year, the county has dodged major changes; however, staff will be looking more closely at other options — including high deductible plans, tiered plans and health savings accounts — to consider for the following year.

Over the past four years, the number of claimants with large claims has trended upward, causing the county’s costs to increase significantly. The stop-loss insurance plan, which provides reimbursement to cushion the county from some of the largest claims, will increase 55% next year based on that trend.

Willis Towers Watson, the county’s insurance broker, estimated that if the county kept its current plan, costs would increase 11.7%, or about $1.18 million. The tweaks to the plan for next year will lessen that a bit for an increase of 8.0%, or roughly $779,000.

Plinsky said in speaking with employees, she didn’t receive much of a consensus. Some said they’d rather see their premiums increase than pay more in copays and deductibles; others said that the cost increases should be on the usage charges, so that those who actually use the health plan are paying more rather than costing the employees at the lower end of the pay scale more for their premiums.

Under the approved plan, employees’ monthly premiums are projected to increase by about $6 for individuals, $22 for plus-one plans and $31 for family plans. The plan leaves primary care physician copays at $25 per visit but raises specialist visit copays from $25 to $50. The plan will add $400 to the maximum out-of-pocket costs, making individuals’ $2,500 and families’ $4,450.

Plinsky said retirees currently pay 55% of their premiums, which is unusual. Most employers that continue to offer retirees insurance coverage require them to pay 100%, she said.

The commission on Wednesday voted to increase that cost share to 60% for retirees. Plinsky said that increase does not offset any of the county’s total costs, but it helps moderate the employer’s risk.

Another change, switching the prescription drug formulary from standard to select, will impact 18 employees taking 14 medications, Plinsky said. According to estimates from the broker, that could potentially save the county about $80,000 compared to what it would be under the current plan. Prescription copays will also increase by $5 to $10, which would mitigate about $42,000 in cost increases.

The insurance plan is available to employees and retirees of Douglas County, the Lawrence-Douglas County Health Department and Bert Nash Community Mental Health Center. Altogether, it’s a pool of about 700 people.

Grant Township requests road repair assistance

Keith Browning, director of public works and county engineer, came to the commission with a request that wasn’t on the agenda.

He said some of the chip seal roads in Grant Township were damaged beyond the ability of the township’s employee and equipment to handle, and a trustee had asked to pay the county to help fill some potholes and make repairs for safety reasons. Browning said the repairs wouldn’t be a permanent solution, but would help to make the roads safer in the short term.

Browning did not have a written agreement for commissioners’ review — rather, he said he’d given the trustee an estimate of about $16,000 for time, materials and equipment, and he’d not yet heard back whether township leaders would accept that verbal agreement.

Commissioner Patrick Kelly asked if there was any other work the county does on a verbal agreement.

“We wouldn’t do that unless it was a township or somebody we work closely with,” Browning said.

Commissioners agreed to allow Browning to proceed.