Insurance changes proposed for Lee County government workers

Workers covered by the county insurance would pay more if they use tobacco products

LEESBURG — Lee County commissioners will receive recommendations Tuesday night from its Personnel Committee that include a 3 percent increase in the insurance premiums paid by county workers.

Other highlights of the proposed health insurance package include a surcharge for smokers and a new four-tiered coverage plan that offers more options for employees.

Lee County is self-insured, but the County Commission works with Chad Slaughter, vice president of J. Smith Lanier & Co., to administer the plan and provide stop/loss protection through a third party.

That company in 2014 will be Optum instead of Blue Cross/Blue Shield if the full commission follows the Personnel Committee’s advice.

The possible changes include:

— Charging employees and any dependents covered by county insurance an extra $30 per pay period if they use tobacco products;

— Increasing the deductible from $500 to $750;

— Raising co-pay from $25 to $35 for primary care physicians and $50 for specialists;

— Raising the upfront charge for visiting the hospital emergency room from $100 to $250;

— Going to a four-tier coverage system that includes employee only, employee plus family, employee plus spouse and employee plus child.

Lee County government now pays up to $80,000 of an employee’s or covered dependent’s medical expenses before the stop-loss coverage takes over.

Luke Singletary, a member of the Personnel Committee, encouraged county employees to participate in the wellness program and make decisions that help lower insurance costs.

“Do people understand the county is footing the bill for the first $80,000 they spend?” Singletary asked. “That may hit home for the the employee who did not get a cost-of-living raise. … Anything you save goes back to the general fund.

Commission Chairman Rick Muggridge said 2013 has been an unusual year in terms of employees who have experienced high claims. Some of the changes, he said, are designed to place a larger portion of the costs on the people who are more likely to use the insurance.

The tobacco surcharge, for example, is expected to generate $77,220 for Lee County, based on a report that 73 tobacco users and 26 smokeless tobacco users were among the county’s 216 employees.

The Personnel Committee discussed adding a $100 spouse surcharge for the 143 employees who have spousal coverage. The commission backed off that proposal, however, contending the four-tier coverage plan should make the rates more reflective of the actual costs.

Slaughter pointed out to committee members that provisions of the Affordable Care Act include a reinsurance fee, which is a new tax of $13.85 per employee each month, or about $36,000 a year.

Slaughter said the tax will be used to fund the risk pool of the uninsured population coming into the new exchange policies.

County Manager Ron Rabun said the county will continue to “put teeth into our wellness program this year and find some way to measure things.”

Slaughter, who handles insurance administration for numerous clients, said the Lee County plan is a good one.

“We’re finding huge increases in the market,’ said Slaughter. “I think employees are thankful to have what they have now more than ever. I still think Lee County has a very gracious plan.”

He said there is fear in the insurance market overall because of Obamacare.

The changes in Lee County, if approved by the full commission, will go into effect on Feb. 1.