Changes made two
years ago to the Porter County Government health care insurance plan has
made a web that County Commissioner President Jeff Good, R-Center, finds a
bit too much to unwind.
agitation Tuesday as the Commissioners for more than 90 minutes mulled over
renewing the contracts in place. That included its reference-based pricing
network INETICO, organ transplant insurance firm AIG, stop loss insurance
provider Sun Life Financial, pharmaceutical benefit management provider
Magellan RX and third-party administrator Benefit Administrator Systems
(BAS), all with different renewal dates.
you just heard concerns anywhere from six to nine consultants and has around
$1 million of (administrative) fees associated with it. You just heard
different term dates which makes it almost impossible to manage. I know our
board is an important cog in the wheel to manage this program and it’s very
difficult. It’s extremely difficult,” said Good.
At one point, Good
criticized the consultants involved for not informing the Commissioners of
details such as if contracts are set up to automatically renew.
“I’m just blown
away that we have to back in to a decision like this and I’m not very happy
about it,” he said.
started with Troy Scott of R&R Benefits reporting that the County is seeing
its costs in insurance claims decline to where they were almost a decade
ago, with 2016’s ending figure at less than $8 million, close to what it is
The County’s plan
costs peaked in 2011 with more than $11 million paid out for claims. That
amount stayed at about $10 million before dropping to about $9 million in
2015 when the Commissioners signed with INETICO, Scott said.
throughout the state would have loved to see the turnaround you had from
2014 to 2016. I’m unaware of anything like it, reducing costs by about $3.5
million in three years,” said Scott. “With the medical trend, that is quite
Good asked Scott if
his 2016 figure included administrative and brokers costs. Scott said it
“That’s not a real
number,” Good said. “I want to see an all-in number for (2015 and 2016).”
Biggs, R-North, agreed saying that when the administrative costs are added,
“that changes the whole story.”
servicing agent Mike Anton, of Anton Insurance, and Scott talked about how
INETICO has kept costs down through the reference based pricing model, along
with negotiating claims upfront at a much lower cost, some up to 70 percent
less, versus what other networks in the industry typically do by taking a
“It’s a combination
of risk mitigation, clinical and analytical claim’s repricing. It’s
generated very aggressive contracts and direct negotiations has brought us
success,” said Scott reading a report from INETICO.
Anton and Scott
along with representatives from BAS presented costs for renewing the current
Scott McClure wanted to know what actions would be required from the
Commissioners at the meeting to keep the plan running smoothly as a
combination of agreements would need approval by April and some by May. A
longer discussion was prompted when the Commissioners called up their groups
service consultant hired earlier this year to look at the health plan, Tony
Bontrager of RE Sutton and Associates, to present a comparison plan.
compared the current plan with what it would look like using
UnitedHealthcare (UMR), which has a wider network than the INETICO network.
The rates for the deductible with Sun Life would not reset if the
Commissioners happened to change to UMR.
Getting down to
brass tacks, Bontrager said that the BAS plan would be $8,742,000 in costs
for this year with a maximum cap of $10.6 million. Comparably, UMR’s costs
would be $8,978,000 but with a maximum cap of $10.5 million.
“Your fixed costs
would be the same and claim costs would jump a little bit. Our estimate is 2
to 3 percent but you would gain that national network as well (with UMR),”
McClure said there
are pros and cons to either plan. “The numbers are close but we have the
competing philosophies here with the more traditional united healthcare with
a larger network or we keep going with what we have been working with which
is the INETICO cost plus benefit system,” he said.
The County health
plan could keep its contract with Magellan Rx if it switches to UMR,
Bontrager said. Its choice pharmacy benefits manager however is OptumRx.
The meeting ended
with Commissioner Laura Shurr Blaney, D-South, motioning to renew Sun Life
for the stop loss insurance. The motion passed 3-0.
Commissioners meeting to consider the remaining contracts up for renewal
with INETICO or change over to UMR is set for next Tuesday, March 21 at 10
restated his frustrations, alleging that all of the consultants have failed
to notify the Commissioners about the renewal dates for the contracts.
“This is the
problem that I have with this insurance. There are too many fingers in the
pie and nobody is talking to each other and nobody is addressing and talking
to this board,” he said.
Good mentioned he
voted no two years ago when the Commissioner board contracted with INETICO.
It was approved at that time by Blaney and former North County Commissioner