County switches to new health insurance company

By Lesley Jenkins
star staff
ljenkins@starhq.com

   Carter County will be shelling out more money this year for health insurance for county employees. This also means employees will pay more for deductibles and co-payments.
   County officials anticipated a 15 percent increase in insurance costs per recent nationwide trends. When new figures came back from Cariten, the county's current provider, the increase was approximately 19 percent. "Our renewal rates were not where we expected them to be," said Jason Cody, finance director.
   Cody said he compared Cariten to four other plans -- Blue Cross/Blue Shield, John Deere, Cigna, and the State Insurance Plan -- to find a new insurance provider. County officials chose John Deere as the new health insurance provider, because "they provide a little better benefit structure advantage over Cariten," Cody said.
   Employees have two options for obtaining the insurance. The first is a fully-funded option that requires no employee contribution. The second option requires the employee pay approximately six percent, or $45 per month.
   Cody said many employees have chosen the first option. Approximately 180 employees are covered by the county, including seven retirees, a number Cody expects will increase when baby boomers begin to retire. Less than 10 employees chose the family coverage plan.
   "Health insurance is the biggest single line-item in the budget," said Cody. Covering each employee for $293 per month will cost the county $586,000 for one year he said.
   Fully funded health insurance through the employer is becoming rare according to Cody. But the county will receive a little help with the additional cost that wasn't budgeted because an audit performed by Cody's office revealed that the county is still owed some tax dollars by the state's Department of Revenue.
   Cody said $13,000 in sales tax and Halls income tax was mistakenly given to the city of Elizabethton instead of to the county. When a business is located in the county but has a city mailing address, tax dollars sometimes are misappropriated. The state has already committed $13,000 to the county, and Cody feels more will be committed soon.
   "Money went to the city or another city but it is rightfully county money. I have reviewed the income tax and we are working on getting it funded back," said Cody.
   The city of Elizabethton will not have to issue a check payable to the county for the misappropriated funds, but will instead have portions taken out of future statements.
   "We eventually get the money, and the city doesn't get a direct one-time hit," said Cody.
   The John Deere plan has a deductible that is $50 higher than Cariten, from $250 to $300. The maximum out-of-pocket cost for John Deere will be $1,300, including the deductible. The Cariten plan did not include the cost of a deductible.
   The new drug card is a 10/30/45 card. Cody said the prescription card is the main difference between John Deere and the state insurance plan, which has a 5/20/40 drug card. Patients will now pay a $10 deductible for generic prescriptions, $30 for in-between brands, and $45 for name brand prescription drugs.
   Cody said because of advertising for name brand drugs, many patients want the name brand instead of the generic that the doctor might suggest.
   He also said since maintenance drugs, like blood pressure medication, is the most prescribed type of drug, the biggest complaint that many patients have is the drug card.
   A person who has two or three prescriptions could pay as much as $30 per month even if they are prescribed the generic drug.
   Cody said he has received questions about why the county did not choose to use the state insurance pool, which the county school system uses. He said the school system does have the option of John Deere and Blue Cross/Blue Shield in the insurance pool and the only difference between the two is the prescription drug card.
   He attributed the demand for name brand prescription drugs to the nationwide increase in insurance costs, as well as the growing number of elderly individuals, and difficulties in the health care system.