“You can tell how healthy a man is by what he takes two at a time—stairs or pills.”
The health of our employees in Tazewell County is one of our most important priorities. Studies show that a healthier workforce is more efficient, productive and satisfied with their work. Second only to salaries, the Tazewell County health plan is the most important benefit we offer. And it’s also the most difficult to manage.
Like many large employers (Tazewell County has approximately 600 employees), we are a self-insured organization. A combination of employee premiums and county (tax) money funds the Health Internal Services line item. For 2013, Tazewell County has budgeted just over $4 million for claims, administration and re-insurance. The administrative costs are approximately 2.5 percent of the overall budgeted amount, which we consider within an acceptable range.
We pay directly from our health fund for claims up to $125,000. When a single claim reaches that threshold, re-insurance takes over payments. Before the passage of the Affordable Care Act, there was a maximum total payout on any individual claim. With the ACA now in place, there are no longer any caps on single claims. A premature baby, a cancer patient or any serious medical event can quickly consume an insurance pool of resources.
The remainder of these funds is used to reimburse providers for costs incurred, and as I mentioned in the beginning, these costs can be difficult to manage. Tazewell County has many ways in which we try to control costs while providing coverage that works for our people.
One mechanism for controlling costs is our Insurance Review Committee, which is composed of employees from each department in the county, along with several board members. Its charge is to determine what to cover and how much. Since we all have “skin in the game,” the incentive is to find the right coverage for the right price for as many employees as possible. It is important to note that all healthcare coverage issues are outside the collective bargaining process, and are uniform for all employees. Another important caveat is that many things are now mandated by the ACA, which does not give us as much flexibility as we’ve had in the past.
For the last two years, we have partnered with the City of Pekin to conduct a health fair for our employees, which helps to identify potential health issues before they become bigger problems. We also encourage wellness and pay for smoking cessation initiatives. If they use the health fair or are nonsmokers, employees can receive a break in their premium costs. Although not large, we hope to grow these premium differentials to encourage healthy lifestyles for all of our employees.
One other measure we use to hold down costs is requiring employee spouses who can buy health insurance from their employer to do so.
Like so many organizations, Tazewell County strives to provide the maximum benefits for our employees at the most efficient price. We believe the partnership we have established with our people to reach mutually agreeable coverage provides a model for others to follow. Our employees are our best asset, and keeping them healthy is a responsibility we take seriously. iBi