County's health plan limits choice to Southeast Hospital

Cape Girardeau County commissioners Tuesday chose a health insurance plan that cuts costs and limits employees to using Southeast Missouri Hospital for services other than traumatic injuries.

Faced with an increase in health insurance coverage estimated at 20 percent, commissioners chose a plan that includes incentives for employees to limit their health spending. In the end, the United Health Care plan chosen for employees will add just 7.6 percent to the county's insurance costs in 2007.

Actual premiums for the new plan will actually cost the county less than their current plan with Anthem Blue Cross-Blue Shield, but the county will also set aside $1,000 for each employee to cover part of annual deductible. Renewing the current coverage with Anthem would cost the county $900,000, Clerk Rodney Miller said, while the combined cost of premiums and the $1,000 for each employee through United Health Care will cost $818,000.

"You can't turn down an $82,000 savings," Presiding Commissioner Gerald Jones said. "But I still don't like a plan that excludes one hospital."

Jones, who is a trustee at Saint Francis Medical Center, abstained from the vote approving the new health plan covering approximately 170 county employees.

United Health Care is able to offer the savings because Southeast Hospital is willing to give steeper discounts for exclusive access to the county's employees, insurance broker Rock Finch, an unsuccessful bidder for the business, said.

Jack Green of Swinford and Associates Inc. submitted the winning bid.

Lowered premiums will make the family medical coverage more affordable for county employees. The county covers the cost of insurance for employees, who may elect to add a spouse, children or both to the plan at their expense. For an employee who chooses family coverage, payroll deductions will decrease by $96 a month, to $556, Miller said.

"They way you look at this is if you only have one hospital" in the plan "and it could not provide the same services or care, it would take it out of the picture," Miller said. "But we have two hospitals providing great services."

Limiting employee choices in health care providers is part of a nationwide trend, said Barbara Thompson, vice president for marketing at Saint Francis. The hospital negotiated with United Health Care to be part of the bid for the county's business but couldn't come to terms, she said.

"We have exclusive relationships with other providers, with other companies, and this is one we do not have," Thompson said.

The $1,000 set aside for each employee will cover half of their annual deductible. The new program, called a consumer-driven plan, has a deductible of $2,000, with employees paying the full plan price for doctor's visits, hospital charges and prescription drugs until the deductible is met. The plan pays all of the costs beyond that point, Miller said.

The county has about 170 employees. In addition, the county is allowing the Cape Special Road District, with 11 employees, to join its insurance pool. Adding those workers will drive the premium up, but the road district will pay the difference, about $23,700 a year, for two years. Even with the extra $180 per employee each month, the total cost of the county's new plan is about $20,000 less than the cost of continuing the district's current coverage, said Rock Wilferth, chairman of the district's board of directors.

One benefit from the new plan, Miller said, is that many preventive care measures such as annual physicals and mammograms are fully covered. And if an employee doesn't use the $1,000 set aside for them during a year, that money is available the following year and can build into an account for the employee.

"It starts out with ownership by the county and moves to the employee," Miller said. "The rates have to work to keep these accounts going."

rkeller@semissourian,com

335-6611, extension 126