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County Legislators Hear Options to Help
Stabilize Employee Health Insurance Plan Costs
By: Nick Altmire (nick@linkinglewiscounty.com)  05/03/17 07:00pm
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    Lowville, NY- Lewis County Legislators received a special presentation prior
    to Tuesday evening's regular meeting, from Noelle Murphy- VP & Manager of
    Employee Benefits with Gilroy, Kiernan & Gilroy, on options available to help
    stabilize the skyrocketing costs to the county's employee health insurance plan.

    Lewis County, along with Lewis County General Hospital, both offer employees
    insurance through a county run self insured plan model. This puts a higher risk
    on the employer if the plan does not meet performance expectations, but allows
    for greater control over the plan. Ms. Murphy said another benefit of a self
    insured plan is that you normally don't see yearly premium increases.

    The county's self insured plan, which covered around 2,021 members in 2016,
    has seen costs exceed premiums each of the past five years. Over this same
    time, overall premiums for individual coverage have increased from an average
    of around $453/month in 2012 to $688/month in 2016. Of the $688/month
    average premium amount for 2016, the county's share for each employee
    averaged $516/month while the employee share was $172/month.
















    Ms. Murphy noted that a number of steps have been recently implemented to
    help control costs, including:
  • Added a 4th tier insurance for speciality medications
  • Added CanaRx option for lower cost medications
  • Renegotiated prices with Excellus for better prescription discounts
  • Conducted a dependent audit to ensure those enrolled in the plan are
    eligible to do so
  • Specialist co-pay for non LCGH doctors increased from $25 to $30
  • A deductible was implemented at facilities other than LCGH
  • Out of pocket maximum increased to $2,000

    Other possible solutions for the board to consider, according to Ms. Murphy,
    include:
  • Continue to increase premiums by 10% every six months to cover plan
    costs and ensure sufficient reserves
  • Cut costs within the plan by changing benefits
  • Offer a second, lower cost plan for employees to choose from
  • A combination of any or all of the above

    Some options to consider for changing the plan would include discouraging
    overuse of the plan by having those who use the plan more pay more as
    opposed to having everyone pay more. The plan could also be changed to
    encourage more use of Lewis County General Hospital services and their
    affiliates.

    A second plan could be added on a voluntary basis to include greater cost
    sharing for covered services, while carrying a lower monthly premium. This
    plan could include three tiers, offering single coverage, coverage for two, or
    family coverage options.

    It will be up to the board to decide what, if any, changes should be made to the
    plan in the future. Ms. Murphy suggested the self insured model is probably still
    the best model for the county to use.
                                                                            linkinglewiscounty.com
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This graph shows plan costs (dark blue) have exceeded premiums (light blue)
since 2012 for the county's self insured employee healthcare plan
This graph shows the breakdown of plan costs, with administrative costs in light
blue, claims in dark blue and prescription costs in green.
This graph shows the premium increase history for individual coverage, with the
county's share in dark blue and the employee share if light blue.
This chart shows where Lewis County's plan stands in reference to other hospitals
and municipalities.