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Grant County Commissioners hear health insurance proposal

During the regular Grant County Commission meeting Thursday, Oct. 10, commissioners heard two presentations.

The first one addressed insurance for Grant County employees. County Manager Jon Paul Saari said the county is in the state risk management pool. "This year we had notice of a 15 percent increase in premiums, and we have been told we may see more of an increase in January, so we started talking to Robert Rydeski about our pulling out of the state risk management pool. There are others in the pool who have had large risks and we have to pay for them. This is just a proposal from Rydeski."


"We put some effort into this proposal," Rydeski said. "For a broad overview, we are an employee benefits company, with clients in Silver City, Texas and Arizona. We had the county before it took the opportunity to go to the state management risk pool. At that time it made sense.

"The problem is the state is overwhelmed, so the county has to put tasks on its own staff," Rydeski said. "We will help with the claims and help with network physician problems. We are still unclear about what tariffs are coming from the state-supported plans. We compared your current state rates with our current plan. Presbyterian is the one we recommend. It has the Affordable Care Act rates built into it, as of January."

He said his staff sent requests for quotes to Blue Cross, United, Lovelace and Presbyterian.

"You have 150 employees," Rydeski said. "The only way these insurance carriers will do it is if the whole group signs up for the plan. Blue Cross and Lovelace were not competitive and United did not make a quote.

"You have Delta Dental, and I recommend you stay with that plan," Rydeski said. "You are fully insured, and the lifetime orthodontics limit would reset. Two of the dentists you use are not in the plan, but they could sign up as a preferred provider organization (PPO).

"For vision, I couldn't find a plan that would compare to what you're paying now," he continued. "VSP would be double, so I recommend Reliance Standard, because no one would have to change providers.

"You would have $50,000 in life insurance, with the opportunity to buy more," he said. "Short-term disability is an Achilles heel. It's voluntary. I recommend all have it for long-term disability. Short-term is not that big a deal. The caveat in the current plan is that for long-term, it does not pay for 12 months if you have a pre-existing condition, which is the industry standard. Ours will pay the next day."

He said the state plan for disability is to pay the employee 40 percent for up to $2,000 for two years. "What we're proposing is a $2,100 premium to cover every employee, who would then get 60 percent of their pay up to $5,000 until retirement age."

Rydeski said the county now has a high and low option and Presbyterian would offer the same, with the difference in the high option of Presbyterian not having a $1,000 deductible like the state, but having a $750 deductible, and a flat $35 co-pay for medications.  "Presbyterian is ACA-compliant with the out-of-pocket maximum for an employee being $3,200 and co-pays quit. We're not sure if the state will be ACA-compliant."

The network physicians for Presbyterian's PPO are substantially the same doctors in Silver City as Blue Cross. "If you go out of state, you are still in the network with facilities such as the Mayo Clinic and M.D. Anderson. If you are out of network, you will pay the pricing of that physician or facility.

"I guarantee there will be some people who have to change their relationships with their doctors, but we will take it case-by-case if they are already in treatment," Rydeski said. "If it's an emergency, you can go to the emergency room or urgent care and you are in the network throughout the U.S. Your college students out of state are in network. Most colleges have urgent care clinics."

For the low option, it is an HMO (health management organization) plan. "I envision young, healthy people taking that option. They couldn't go to Mayo or any others out of state. Everything is included in the co-pay and there is less out-of-pocket."

In answer to Commission Chairman Brett Kasten's question about why mail order prescription drugs are higher in price, Rydeski said it is because they are for 90 days worth.


Commissioner Ron Hall asked about the air ambulance.

"That is a problem that I would love to talk to them about in an open meeting," Rydeski said, getting a little riled up. "Can you set it up? It is a real problem, and it is a community problem."

Rydeski said the Presbyterian insurance proposal, in his opinion, would offer county employees more benefits for less money.

Saari said the premiums would save the county about $9,000 a month, and that includes if the county picks up the full cost of long-term disability coverage.

Hall said he would like to have Rydeski give the presentation to employees before the Commission votes on the issue.

"Our scope of service is to meet with every one of your employees," Rydeski said.

"We have no face on the state plan, but we know where to meet with you," Kasten said.

Saari said another savings to the county would be in personnel costs. Renee Calloway, the human resources officer, every six months has to go to every employee to re-enroll them into the state plan."

"We would do all that," Rydeski said.

"I worked for a company when Robert was a broker, and he does everything he says he will," Kasten said.

The next presentation will be covered in the next article.

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