LEE COUNTY – An arduous process for the Lee County Board of Supervisors has resulted in a local insurance provider being outbid by a state insurance trust to carry the county’s health insurance coverage starting July 1.
The county voted 3-2 to accept a coverage proposal from Iowa Governmental Health Care Plan over a plan from Assured Partners that accessed the Iowa State Association of Counties health program.
Supervisors Tom Schulz and Chuck Holmes voted for the ISAC plan, while Ron Fedler and Matt Pflug voted in favor of the governmental group plan leaving chairman Garry Seyb to break the tie.
In a small break from Robert’s Rules of Order, Seyb reopened commentary prior to casting his vote in a move that showed the difficulty he was experiencing in voting for one program over the other. After about another 15 minutes of conversation with the board and other people in attendance, Seyb cast a vote for the IGHCP program.
“I’m not the subject matter expert. I wanted to make sure I had a reason,” Seyb said after the meeting.
“I wanted it to be in some kind of tangible reason, not because who was voting one way or another. I personally do not have county insurance, so I was looking to employees for what they wanted. And that was 50/50, the board is 50/50.”
County employees were surveyed over the past week as to which program they would prefer. Out of the 199 employees who are on county insurance 51 voted for the IGHCP program and 50 voted for the ISAC proposal.
The ISAC proposal was brought to the county by Justin Pieper of Assured Partners, formerly Group Benefit Partners, who has been managing the county’s health care program for the past decade.
Pieper got testimonials from many employees in attendance who said Group Benefit Partners, and Pieper specifically, had been very accessible and helpful with the health care of county employees.
Supervisor Tom Schulz instigated the investigation of other health insurance options with bigger risk pools after the county was facing a 17% increase in premiums starting July 1.
Schulz actually brought the IGHCP program to the board and had representatives in to talk to the board. After that presentation, Assured Partners was given another chance to address the issue and came back with the ISAC plan.
That plan hadn’t been presented to the board in prior years, a subject that Supervisor Matt Pflug addressed with Pieper, asking why it wasn’t until IGHCP reps brought their plan to the county, that the other program was brought forth.
Pieper said the county didn’t invite him to discuss options around larger risk pools.
Schulz said the county has made a bad decision and one that could cost 100s of 1,000s of dollars.
“Our employees are definitely going to pay more now for health care not health insurance,” he said. “Under the ISAC plan with the contributions we were making toward copays, deductibles, and out of pocket we basically had the same costs. Now they’re going to have to satisfy 100% of their copays, deductibles, and out of pocket. The way we were funding it, that would not have been the case.”
Schulz said he spent the weekend reviewing and analyzing the county’s claims history and he said there may have been three or four instances where someone wouldn’t have done as well under the ISAC proposal.
“ Maybe, and I’ll go with maybe here, that would be heavy users who didn’t hit out of pocket. Other than that, it was universally favorable to the employee even if we had cut our county contribution in half.”
The county employees’ premiums, deductibles, and out-of-pocket won’t change under the new plan in the coming year, but the county’s portion of self-insurance could take a hit under the new program.
Seyb said it took him some time to come to a good decision in his mind. He said he tries to peel away the politics from decisions that impact so many.
“I didn’t want this to be a political vote. I have to be able to do what I believe is the right thing, regardless of political factors. In my head, what is my gut telling me. That’s where I went,” Seyb said.
“It took me some time to get there because I’m hearing the commentary back and forth between the board members. Tom Schulz is a smart guy when it comes to the numbers. I get that and it weighs heavily on me.
“But 20% coinsurance vs a copay that’s predictable. And specialists may be considerably more than that (with co-insurance). We were going to put some county money against the coinsurance program to offset costs, but in the future, if we get into trouble we could have to pull back on that and that goes against the employee.”
Seyb said with all things being equal he said ISAC couldn’t guarantee a larger premium hit after a bad claims year, while the IGHCP program spreads out bad years in one market or another over the whole pool and everyone sees the same increases. A dynamic that could work in the county’s favor as that pool continues to grow in terms of membership.
He said had the county seen the ISAC program earlier they may not have even reached out to the IGHCP representative.
“The governmental insurance we went with - their rate is across the board. Everybody shares. You don’t get the fluctuation you would get with the other plan,” he said.
Supervisor Chuck Holmes said there is a rule that inhibits the county’s ability to jump back to a previous insurance program after one year and the county could be on the hook for substantial costs as they migrate back to a different program if they don’t like the one they are choosing now.
Schulz said while it’s accurate the county could see larger increases with the ISAC plan, history doesn’t show that to be the case.
“We could get a larger increase with ISAC but that’s a moving target. From what I’ve seen historically, we’re looking at a 6% increase over next two years with IGHCP, and at 9% at year three historically,” Schulz said.
“At some point in my very short-elected tenure I hope I’m wrong about this, because I think we did a very bad thing for our employees and the people of Lee County today.”
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