Feb 19, 2014 - By Eric Blom, Staff WriterFremont County is hoping a large incentive will encourage its employees to improve their health, leading to lower claims costs to the county's health benefit plan.
Plans would roughly double premiums for employees but allow them to reduce out-of-pocket costs to less than the current level by participating in a newly adopted wellness program for next fiscal year.
Fremont County commissioners approved the wellness program Feb. 4 and heard a report from the executive health committee, an employee group tasked with advising the county board on health insurance.
"My vision of it is the person who's eligible for the incentive pays a little less than they're paying this year, and the person who doesn't receive any incentive pays a lot more, maybe as much as twice as much," deputy county treasurer Jim Massman said. "That's how we would implement this."
The county board liked the idea.
"That would seem to be in accordance with our idea of incentivizing attending to your health, and also people who don't want to avail themselves of that and don't want to practice some health standard, they'll probably pay more," commission chairman Doug Thompson said. "That was our idea."
Costs up 15 percent
The cost of the county's health benefit plan rose 15 percent last year to $6 million. A rise in claims has been driving up the price for several years, and commissioners have been concerned the costs would take over the county's budget.
Claims drive costs for the county's self-insured health benefit plan. Under the system, the county pays a certain amount for each employee who wants coverage into a pot of money. Employees contribute a smaller portion as well.
After deductibles, co-pays and out-of-pocket limits are met, that pot of money pays the medical bills of covered individuals, just like standard health insurance. While insurance companies can raise premiums to cover increased costs, self-insured groups have to put more in the pot themselves when expenses rise.
Under the new wellness plan, employees and their covered spouses would be eligible for a total of $1,200 yearly in rebates per person if they meet several health standards. If they do not meet the benchmarks, they still can receive the discount if they follow a plan to improve their scores on several health criteria.
The current wellness program provides a maximum rebate of $640 per person, and only 20 percent of covered employees are participating. The executive health committee hopes 80 percent will take part in the new program.
Alternatively, if a doctor writes a note saying "a health factor makes it unreasonably difficult" or "medically inadvisable" for an employee to meet the standard, the individual still can receive the rebate.
The first benchmark is a body mass index of less than 30 or a girth of less than 35 inches for women or 40 inches for men, according to a plan document. Second is a blood glucose level of less than 126 mg/dL or a score of 7 percent or less on an A1c glucose test. Third is a total cholesterol level less than 239 mg/dL, and last is a blood pressure lower than 140 over 90.
Each standard has its own rebate, and employees can qualify for all or some of them.
Employees have to submit results from tests measuring blood chemistry, blood pressure, height, weight and girth by May 31 to qualify for a rebate starting July 1, according to a plan document. The screening could take place in the 12 months before the deadline.
Commissioners in January discussed making a screening mandatory to receive the health benefit plan from the county but tabled the issue.
The county's wellness coordinator, Penny Fahey, intends to develop plans for employees to follow it they miss a benchmark but want the rebate. She would develop guidelines so alternative plans are consistent, Massman said, but that piece is not finished yet.
The benchmarks were developed with help from health experts, including the Fremont County Public Health office and the Centers for Disease Control, Massman said.
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