Finney County employees on Monday expressed dissatisfaction with communication efforts on the part of county administration after a new insurance policy was passed two weeks prior for implementation in January 2018.
During a routine public comment session at the county commission meeting on Monday, Jennifer Rogers, an investigator with the Finney County Sheriff’s Office, criticized the way in which information was relayed to her and other county employees, noting that the “subtle” changes claimed by the county administration would have a not-so-subtle effect on her family, specifically her son, a diabetic who benefits from a type of insulin covered under the current plan, but not the new plan.
According to Rogers, she and a handful of other county employees only learned of impending changes to their health plan through an email sent by human resources that was “extremely vague” and “difficult to follow” due to its use of jargon.
“This was all presented in a little package of good news,” Rogers said. “No increase to premiums.”
She explained that upon reviewing the list of drugs excluded from coverage on the Blue Cross/Blue Shield of Kansas website, she found that her son’s preferred insulin option was no longer covered, and was instead replaced by a series of other options afforded through a newer card system. She said one of those options had previously given her son and other diabetic patients she knows an “adverse” reaction.
“We, as Finney County employees, are more than just a number,” Rogers said. “It is important to know ultimately how many people are going to be affected by these changes. Not all medications are the same, replaceable or interchangeable.”
Rogers requested that the county commission sustain the existing insurance plan, which effectively affords county employees free visits to the emergency room regardless of circumstance with single-plan deductibles of $300 and group-plan deductibles of $600. Under the new plan, those deductibles are maintained, but emergency room visits would now require a $200 copay.
Commissioners said they intended the new provision to both reduce the costs while incentivizing county employees to make better use of the Finney County Health Department and avoiding unnecessary emergency room visits. Now, employees like Rogers will be forced to adjust as small changes in prescription coverage go into effect.
A consulting report by IMA, Inc. was reviewed by commissioners at the last meeting in September. The report quantified the degree to which county employees have abused emergency room services. That abuse was a big incentive in the commission’s decision to change over to a new policy.
According to the report, in 2016 county employees made 251 visits to the emergency room. Of those, 159 were not considered emergencies, incurred costs of $209,880 and could have been addressed elsewhere, and 18 individuals visited the emergency room three or more times that year.
The county took measures to inform employees of alternatives to the emergency room in non-emergency situations. As of the September report, county employees visited the emergency room 148 times in 2017, incurred costs of $107,088 and only nine visited three times or more. However, of those 148 visits, none were considered emergencies.
At the last meeting in September, commissioners were given three options for how to proceed with a health insurance plan in 2018. The first option would continue the current plan with an additional cost of $585,182 and grandfather all of the previous rates and exemptions.
The second plan — which was adopted — eliminated the grandfathered benefits of the existing plan and reduced costs to the county by $430,277 over 2017. That plan also added a $200 copay for ER visits that would put the remaining service costs toward the member’s deductible and coinsurance. If the member is admitted to the hospital following the ER visit, the ER copay is waived. The deductible will also remain the same at $300 for a single-member plan and $600 for a group plan, and there is no increase to premiums.
The third option would also have eliminated the grandfathered benefits for a reduction in county costs of $654,328 over 2017. That plan would have resulted in more out-of-pocket expenses for members at $500 for a single member and $1,000 for a group plan.
Assistant County Attorney Kathleen Abell echoed Rogers’ sentiments that there was a lack of communication with employees “about these drastic changes.”
Abell requested an appeal process for members using life-sustaining drugs that would no longer be covered by the plan and who would not want to risk their health by taking up a new generic or brand-name drug.
County Administrator Randy Partington said the three options deliberated at the commission meeting in September were not available to personnel until just before the meeting. He noted that county administration didn’t even have access to the full plan options until a week prior to that.
Katrina Pollet, executive director of the Finney County Department of Corrections, took to the defense of the commissioners’ decision.
Under the existing plan slated to change over next year, Pollet noted that $5 million has been set aside for county employee health insurance with a consequence of 10 mills added to the tax levy in Finney County.
Pollet said she has been diligent in her efforts to coordinate with HR in an effort to keep her employees informed on the conversation pertaining to coming health insurance changes.
“I’m sorry that other directors aren’t proactive in doing that, but why should the rest of us have to pay for that?” Pollet said. “To have taxpayers have to do 10 mills just for our health insurance alone is a lot, and as a Finney County taxpayer, I’m concerned where we’re going with that.”
Pollet said you won’t find a deductible ratio of $300/$600 “anywhere else.” She added that she is thankful for the decision by commissioners and urged them to continue to look for ways to reduce the mill levy.
“As a small business owner, I can guarantee you that a $300 and $600 deductible I haven’t seen in 20 years,” said Commissioner Larry Jones. “Most businesses don’t even offer health insurance under $1,000. $1,000 is just barebones. I know it’s going to affect certain people a hard way, but it appears to me that we’ve had a little problem with communication and people finding out the exact facts.”
Kelly Bliemeister, a group consulant with BCBS, confirmed that the insulin used by Rogers’ son is not covered under the plan because the plan defers to a specific manufacturer for that type of insulin. She encouraged Rogers and others like her to contact BCBS customer service to review alternative options for subsequent consultation with a doctor.
County Commission Chair Lon Pishny said he doesn’t feel that the new plan involved any “drastic changes,” adding that the alterations were made “in the spirit of trying to watch out for the taxpayers.”
“Public servants have had pretty darn good health benefits throughout compared to the private sector when you consider out-of-pocket and premium payments, so I just want to stress that point,” Pishny said. “It doesn’t make somebody’s individual situation any better. I understand that. But keep in mind, the five up here have to think globally about taxpayers and then how are we taking care of the employees with benefits and salaries.”