BLOOMFIELD, Mo. -- The Stoddard County Commission voted 3-0 Wednesday to purchase county health insurance for 2015 through Mutual Medical Plus in Peoria, Ill. The plan marks the first time that the county has entered into a partially self-funded health insurance plan.
In 2013, the county paid $449,008.68 for health insurance for 56 elected county officials and employees. The premium was set to increase in 2014, so the commission opted to go with the BluePreferred Select insurance plan at a cost of $450,081.44. SoutheastHEALTH in Cape Girardeau and all their facilities including the one in Dexter are included in the Blue Preferred plan.
The plan as presented by Mutual Medical also includes a narrow hospital network with SoutheastHEALTH as the preferred provider. The plan does include the HealthLink network which includes many physicians and specialists in St. Louis and other areas as well as some doctors affiliated with St. Francis Medical Center in Cape Girardeau.
The commission heard presentations from three companies before making their decision. One company out of Springfield, Mo., never got back with the commission with the cost of their plan. First Choice Insurance, now First Midwest Insurance and Financial Services, was another company that presented the cost of a partially self-funded plan. Anthem Blue Cross presented the cost of the current fully funded health insurance plan as well as a partially self-funded plan offered by the company.
Presiding Commissioner Greg Mathis said he was swayed toward Mutual Medical because they were the least expensive while offering the same coverage as the currently county plan. He said the deductible would stay at $5,000 instead of increasing to $6,300, as presented in the Anthem plan.
Mathis said the $25,000 stop loss, which limits the county's liability for each insured official or employee, was lower than Anthem. He also said the cost of the plan presented by Mutual Medical was much lower than the plan submitted by First Choice.
"The county will save roughly $34,000 next year on health insurance," said Commissioner Danny Talkington. "The county will also get 100 percent of the money left over from the pool if not used next year."
Talkington said Anthem would keep 30 percent of any remaining money at the end of the year.
Commissioner Carol Jarrell agreed that she liked the fact the county would get 100 percent of any money paid into the self-insurance pool if there is any money left over.
"It is the taxpayers' money," said Jarrell. "I was elected to be a good steward of the taxpayer's money."
Jeremy Billington, owner of Billington Insurance Services, an agency for Mutual Medical, said Mutual Medical deals with public unions that assure that insurance benefits are not cut, so the option he presented would not continue the trend of rising deductibles or narrowing the field of providers. Within the last week, Cape Girardeau County renewed their partially self-funded plan and the Cape Girardeau School District voted to go with the partially self-funded Mutual Medical plan. The company will also provide health insurance to Camden County officials and employees.
Mathis asked Billington in a conference call whether there was a run-off period for insurance payments. He asked if an incident happened on Dec. 28, would the subsequent claim be paid from the 2015 pool or would the county be liable for the payment.
Billington said the first year contract would be for 12 months, though there would be a three-month runoff, which means there would be a three month period for 2015 claims to be paid from that year's pool. He said if the county renewed the policy, it would go to a 24/12 period.
Under the Mutual Medical plan, the county would put $450,310 into a special account. All health insurance claims would be paid by the county from this pool. Mutual Medical estimated the real annual cost to be $405,513, but said the county should set aside the maximum estimated cost.
Mutual Medical submitted the following breakdown for health insurance: Fixed Cost (Administration fees, RX rebates, individual excess losses and aggregate losses) of $226,327 and Liability Claims of $223,983 for a total cost of $405,513.
He proposed that the county purchase a fully insured product with a deductible of $25,000 for each employee. In the event an employee's claims went above the $25,000 mark, then traditional coverage would come into play.
Talkington asked a question about the prescription drug coverage. Billington said the company looks at ways to save on prescription medications, and often pharmaceutical companies offer plans for free or reduced medications.
"No one else is doing that," stated Billington. "It is better than United Healthcare, Coventry or Anthem."
Talkington then asked how long it would take for a insured employee to find out if they qualify for free medications.
Billington said the process usually takes about two weeks, but often doctors can provide samples until the process is completed.
There was some further discussion about the health network. Billington said St. Louis hospitals were included in HealthLink network. He said the only in-network hospital in Cape Girardeau County was SoutheastHEALTH. He said that hospital had an agreement with Mutual Medical that would lead to bigger savings on hospital stays or procedures. The savings are substantial and will lead to savings for the county, Billington said. He did clarify that since St. Francis Medical Center is the only Level 1 Trauma Center in southeast Missouri, that it would be included in the network in the case of an emergency.
After the discussion with Billington, the commission went over the merits of each of the three that submitted costs to the county.
Talkington made the motion to go with Mutual Medical, and it was seconded by Jarrell. All three commissioners voted in favor.