ROBERT PIERCE
• Leader & Times
Recently, Seward County commissioners approved the renewal of the county’s health insurance plan for its employees, and that renewal officially took effect May 1.
Last month, Administrator April Warden reviewed what this means for the county’s employees as she talked more in-depth about the renewal.
Warden started by saying the county’s initial medical self-insured renewal with Blue Cross Blue Shield of Kansas saw an overall starting increase of 4.5 percent.
“The estimated dollar total for that would mean an increase of $206,436,” she said. “We pay Blue Cross Blue Shield for administrative costs to administer our program even though we’re partially self-funded.”
Warden said this is a flat fee, but when looking at benchmarking and what other entities pay, she said the county’s insurance brokerage firm, IMA Financial Group of Wichita, was able to negotiate a decrease to 11.2 percent of $23,659 for that fee. She added this is a fixed dollar cost figured from administrative fees, and she said this was huge for the county. She also felt this could not been done without IMA’s help.
“Due to the projected stop loss hits and the Blue Cross Blue Shield pool, what that means is they look at other self-insured books of business like ours, population size, the number of members we have in our plan, we were seeing an increase of 5.9 percent,” she said.
Warden did say, though, expected claims were expected to increase by 4.6 percent this year, but the overall increase of the final negotiated renewal was only 4 percent, equivalent to $182,776.
“Overall, that was pretty remarkable, especially when you talk to other entities throughout the state or other entities within Seward County, Liberal. Their renewals are coming in a lot higher than that.”
Warden said she felt a large part of this is likewise contributed to IMA working on the county’s behalf, but she also said employees played a part as well.
“We communicate ways to them they can help us cut costs and keep health care costs down and the vision of the leadership throughout the county, the commissioners and what they’re trying to achieve and our other leaders working in that realm,” she said. “The county was able to remain grandfathered, which means we keep the same plan. There was a minimal increase to the employee share of the premium cost.”
Warden explained IMA’s role in helping the county with its insurance plan.
“IMA shops for stop loss providers,” she said. “IMA offered us some options for plan changes. We looked at that. By plan changes, that would be different deductibles, different emergency room costs, different pharmaceutical plans, but overall due to the low renewal percentage change we had this year, it wasn’t their recommendation to make changes because we didn’t see any significant decrease. It wouldn’t save us a lot of money to make a plan change, plus once we make a plan change, we’re no longer grandfathered, and they don’t offer our plan anymore that we have currently.”
With pharmaceutical prices continuing to rise, as they looked at the county’s insurance history, Warden said commissioners chose to implement an IMA pharmacy program with this year’s renewal.
“The IMA pharmacy advocates was developed to help employers and their members to save significant money on the ever-increasing costs on specialty medications,” she said. “That group is called IPA, which stands for IMA Pharmacy Advocates, and they use several alternative funding methods to enable members to have those prescriptions build while mitigating the costs incurred by us as a group health care plan, and they pass the savings on to members.”
Warden said the pharmacy plan is completely voluntary, and employees can choose whether to take part in the plan on their own.
“They can get those medications at zero cost to them,” she said. “Based on the claims that were filed in 2023, we have 49 eligible members and 18 eligible drugs that could result in a substantial savings from incorporating this plan.”
Warden said even with as little as 20 percent participation in the plan, the county could still save an estimated $98,479, and with 100 percent participation, that amount could be as big as just less than $500,000.
Warden too said employee contributions did increase this renewal period.
“Employee only increased by $25 a month, and family contributions increased by $50 a month,” she said. “As a result of all of that, the county’s renewal of our medical, dental and life insurance, the cost to the county’s going to be $92,605.”
As the county’s insurance brokerage firm, Warden said IMA provides many services, including health and welfare benefit plans strategic consulting.
“What that means is they develop multi-year strategies for all of our benefits, and they try to link those to the goals and objectives the commissioners set,” she said. “They do cost containment and funding approaches for us, plan and process change recommendations that could possibly help save us some money. They do design analysis and recommendations. They do a lot of benchmark reporting for us.”
Warden said IMA officials have meetings with herself, the county’s human resources department and commissioners.
“They also do vendor related services,” she said. “They look at the vendors we currently use such as Blue Cross Blue Shield, Advanced Lives, AFLAC for our flexible spending.”
Warden said IMA likewise helps with renewal negotiations to help keep administrative fees low.
“They also evaluate and review our plans and coverages if we go to them with any problems, customer service issues,” she said. “They can help us with that. They do underwriting and financial services for us. They look at loss ratios. They look at trends for us. They review and evaluate stop loss levels and pricing for us. They provide information, including premium equivalent rates, our COBRA rates, as well as IBNR rates. That’s incurred but not yet reported. They’re able to look at that stuff for us. “
Other services provided by IMA include program cost program cost projects and employee contribution development. Warden said when a plan is grandfathered, drastic changes cannot be made to employee contributions, and she said IMA helps county leaders look at reserves and customized monthly financial recap, as well as year-end expense projections and reconciliations.
“They’re also a huge help with our regulatory compliance services,” she said. “There’s always legislative and regulatory issues we need to be aware of. They also provide resources for us for benefit programs and compliance related questions. They do assist us with our annual reports and filing we have to do.”
Another huge service IMA provides, Warden said, is advocacy.
“They will call our carriers and vendors such as billing or if there’s questions with enrollment or claims issues or appeals,” she said. “I’ve had to call them and say this employee was told this service wasn’t going to be covered. Can you look at our contract and tell me why it’s not covered under our contractual services? Oftentimes, they’re able to resolve most of those issues for us.”
Warden said IMA likewise provides support for employee communication efforts, as well as help with surveys and open enrollment.
“They design our employee benefits booklet we pass out to all of our employees and new hires,” she said. “They’ll manage requests for information for our HR technology assessments and resources. They do health risk management. They assist in the development of communication and employee engagement and implementation support when we put in different programs and services. They also help us look at impact information, planned design stop loss, care management, patient compliance, customized recording, and they do our year over year comparisons for us.”
Warden said IMA also has a number of HR resources.
“They have a ThinkHR Hotline where we can call to get assistance with certain questions,” she said. “They also give us access to ThinkHR, which has a ton of training resources for us. They also have a library of information through ThinkHR.”
Warden said she is pleased with the renewal review and having the county’s grandfathered plan stay in place for another year.
“This is a huge recruiting tool for us,” she said. “As public service, we’re not always able to pay competitively to what they can in the private sector, but having a strong benefit package does help us with recruiting. It also helps us in retention of employees. At the end of the day, we know we’re providing a good insurance plan. It gives them peace of mind knowing their health needs are covered, and the health and well being our employees is something that’s very important to us. I feel very good about where things started in our renewal period.”
The county’s insurance renewal period runs May 1 through April 30. Warden said while the county is always one year away from possibly having to make some big changes, she believes this is not the year.
“It’s important we’re transparent in communicating with our employees,” she said. “The insurance market is a difficult one. The costs are always increasing, and that’s very difficult for us to be able to sustain that in our year to year budget process. I always tell the employees we’re only one year away from having to make some changes. We’re very fortunate to have the benefit plan we have, and I always remind them to be grateful for that and to be thankful for what we’ve been provided knowing that could change in any given year.”
Warden said making changes to the plan would mean the county losing its grandfathered status, and this also means the current benefit package could no longer be offered. She added the biggest changes she saw in this year’s renewal were pharmaceutical costs.
“This always shocks me with the amount medication costs and the need for employees and their dependence to be provided the medication they need for their health,” she said.
Warden said county leaders tell employees about changes, and she said employees are always doing their part to keep costs down.
“We’ve communicated to them the cost to utilize the emergency room when it’s not truly an emergency situation,” she said. “Since we’ve communicated that with them and had those discussions, we’ve seen a reduction in the use of the emergency room once we could show them the cost and the impact this had on our benefits.”
Warden said current and past commissioners have implemented programs to help reduce costs as well, including telehealth, TriaHealth and the IMA pharmacy plan.
“Everybody’s trying to do their part,” she said. “I believe in hiring IMA as our brokerage firm, it has been a huge asset.”
Other things Warden likes about the county’s work on the health insurance plan includes having specific goals and vision, communicating those to employees and knowing what an important part of the benefit package medical, dental and life insurance is.
“They’re doing their part, and they don’t want to lose it either,” she said. “I think it takes a whole team approach full circle. We’re only one year away from having to make a change possibly, but hopefully, we can stay on this trend and keep after it the way we’re keeping after it.”
