Health insurance change for county employees to take effect Jan. 1, 2020


The Archuleta County Board of County Commissioners voted unanimously at its Oct. 15 meeting to change providers for county employees’ health benefits.
The change will affect county employees’ “medical, prescription, dental, vision, group life and AD&D [accidental death and dismemberment] along with voluntary benefits,” Archuleta County Human Resources Administrator Robert Smith wrote in an email.
The changes will take effect on Jan. 1, 2020.
Smith explained to The SUN last week that the county’s previous health provider, County Technical Services Inc. (CTSI), was hitting the county with a 6 percent increase for its health insurance premiums, and the county commissioners asked Smith to put the health plan out to bid.
“So, I did,” explained Smith, adding, “Had we stayed with CTSI, the county would have been forced into taking the 6 percent rate increase and either absorbing that total cost upon the county or sharing part of that cost with the employees.”
The county will save about $104,000 with the new plan, explained Smith.
Smith reported the plan coverages are generally the same, with some coverages being a little better than under the previous plan and some of the coverages being a little bit worse.
“All in all, in my opinion, it’s going to come out a real good deal for the county and the employees,” Smith said.
Smith explained the new plan offers freedoms the previous CTSI plan did not. For example, Smith can now take out the county’s insurance plan out to bid each year to find better rates — something that was prohibited with CTSI.
The new plan is also a “level funded plan,” which makes the county eligible for money back at the end of the year.
“The plan design is called a level funded plan, and what that means is that every insurance company when they rate a provider, or employer, they estimate what their total cost of claims is going to be … they price the premiums accordingly,” Smith said.
Smith explained that if Archuleta County comes in below the “maximum expected loss,” the insurance company will split the money 50/50 with the county.
“[The county] can put it into future premiums, future employee benefit costs, things of that nature, to help offset potential increases,” Smith said.
At the commissioners’ work session on Oct. 15, Smith stressed that county employees need to submit any services with health professionals prior to the end of the year.
“[County employees must] understand that they absolutely have to make sure that any services that they are having now with doctors, providers of any kind, that those get submitted before the end of the year in order to be paid. ‘Cause if they don’t, CTSI won’t pay them out.”
County Administrator Scott Wall noted at the meeting that all the local health providers are included in the county’s new health plan.
The county’s previous provider was Anthem BlueCross BlueShield. The county’s new plan will include coverage under Cigna, set to begin on Jan. 1, 2020.