Jackson employee health plan will likely shift to Southeast

Barring a last-minute change of direction, it appears Jackson city employees will be offered a new health insurance plan in 2021 in which SoutheastHEALTH physicians and facilities will be preferred providers and the Saint Francis Health System will be out of network.

During their study session Monday night, members of the Jackson Board of Aldermen reviewed health insurance options to replace the city’s current plan offered through United Healthcare (UHC), which has proposed a 20.9% premium increase starting in January, increasing the city’s annual health insurance cost from almost $1.5 million to just more than $1.8 million.

According to the city’s insurance broker, Swinford & Associates, UHC has offered a revised plan with higher deductible and out-of-pocket maximums, but that plan would still cost about 11% more than the current plan.

Both Saint Francis and Southeast submitted proposals for the city’s health plan, but the aldermen expressed a preference for the Southeast plan after learning some providers they thought would be included in the Saint Francis plan were, in reality, out of network.

“Southeast and Missouri Delta Medical Center caught wind they were, as they saw it, misrepresented as being in network in that (the Saint Francis) plan, and they never agreed to do so,” Todd Obergoenner of Swinford & Associates told the aldermen. “So I would say at this time (the Saint Francis plan) is not a viable option.”

SoutheastHEALTH’s “narrow network” plan, Obergoenner said, offers significant potential savings over the next three years.

“Basically, what they’re offering is primary care services at 150% of Medicare rates and all other services at 200% of Medicare rates,” he said. “To give you context around that, PPO (preferred provider organization) negotiated discounts are usually in the range of 350% to 400% of Medicare. Primary care is usually a little bit lower, but for all other services, we’re talking about 350 to 400% of Medicare.”

Obergoenner said the only difference between the SoutheastHEALTH proposal and the city’s current health insurance plan is that Saint Francis providers and services, while still available to employees and covered dependents, will be out of network.

The city administrative staff is expected to make a formal recommendation on the city’s medical insurance plan at the board’s next meeting.

Additional agenda items

Other study session items discussed by the aldermen Monday night included:

• A review of upcoming maintenance and upgrading needs for the city’s wastewater system.
• An engineering services proposal for a sanitary sewer extension in the Jackson North Industrial Park.
• Replacement of the dugouts at Field No. 5 in Jackson City Park in cooperation with the Jackson School District.
• A proposed $28,600 contract with the Humane Society of Southeast Missouri for 2021, a 10% increase over the city’s $26,000 contract with the Humane Society for 2020.

Earlier in the evening, during the board’s business session, the aldermen:

• Approved a two-year agreement with the Uptown Jackson Revitalization Organization at $25,000 per year through 2022.
• Approved a new rental fee schedule for the Jackson Civic Center effective Jan. 1; the new rates were reported last month in the Southeast Missourian.
• Scheduled two public hearings, one at 6 p.m. Dec. 7 to consider a request to vacate a portion of the Short Street public right of way in the Southwestern Realty and Improvement Company Subdivision and the other at 6 p.m. Dec. 21 to discuss the city’s 2021 budget, including proposed sewer and other utility rate adjustments.
• Approved a pair of ordinances related to utility pole and right of way access within the city.
• Approved a task order authorization in the amount of $108,909 to Cochran Engineering of Farmington, Missouri, related to engineering services for proposed replacement of a low-water crossing bridge along West Mary Street.
• Approved an ordinance amending the city’s crosswalk schedule by adding a designation on Parkview Street.
• Approved an agreement with McQuade Enterprises LLC related to a mural on East Main Street.

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