Fayette County changes healthcare providers
The Fayette County Board of Commissioners adopted a set of changes to its health care for county employees in a series of one-year agreements at its Thursday meeting.
Chairman Scott Dunn said the county had been working on the new programs since February.
Healthcare costs for the county have jumped over the past three years, to the point that the county added co-pays this year to offset the expense, Dunn said.
“We recognize that the way we have done it in the past was not sustainable, and that we needed to find an alternative,” he said. “We feel that we’ve done that. We should be able to save money and be able to provide better healthcare for employees.”
Fayette County also reached an agreement with The Health Plan of Wheeling, W.Va., to act as third-party administrator for the county’s medical insurance plan and benefits. Administration costs were estimated at $302,841 a year, according to materials provided by the county.
Cigna will operate as the county’s medical network, replacing Highmark.
“They’ll be able to go to more hospitals and be available in more states than we had before,” said Commissioner Harry “Dutch” Kaufman.
The county brought on Versus RX as the new pharmacy benefit manager, which Dunn said would result in a “substantial” savings. If employees agree to have their medications mailed to them, the county should be able to save enough to eliminate the co-pay, he said.
“There are about 35 medications that really drive up the cost of Fayette County, so we’re going to target those 35 medications,” Dunn said. “If you mail order those, then there is no co-pay.”
A consulting agreement between the county and Samaritan Fund will give employees advice on obtaining financial assistance through charities and foundations for qualifying individuals.
Since the county’s insurance program is self-funded, the balance can be highly variable, Dunn said, with low-usage years helping to build the fund and years with catastrophic claims that deplete the fund.
The county will pay Samaritan Fund $60,000 for each participating employee and $15,000 for each additional family member, up to a maximum of $105,000.
“People who are having catastrophic claims will end up having to pay zero,” Dunn said. “So there is a benefit to not only the county, but it will also be a benefit to any of our employees who have a high-cost plan.”
In another agreement, Health Equity will administer health savings accounts for eligible employees for a monthly fee of $1.50 per account.
Dunn said he hoped the county would be able to save up to $2 million through the changes. The new pharmacy agreement alone would account for about $1.2 million, though total savings would depend on how many employees wind up using it, he said.
“The Samaritan Fund is actually going to cost us money,” he said. “We’re self-insured, so you know if somebody gets really sick, we pay for that. And so what happens is we’re hoping that our employees don’t have to utilize this fund because that means they’re sick. So that’s the hard part to figure out.”
Dunn said the new agreements should mean an end to what he said had been “an inferior product for an escalating cost.”
“That’s why we started this back in February, going through all the meetings, finding out who’s who, getting all these proposals from everybody, and so we’re very pleased to offer this next year,” he said.
The new agreements will take effect Jan. 1.