04/22/14 — Council talks health care

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Council talks health care

By Matt Caulder
Published in News on April 22, 2014 1:46 PM

A light agenda at the City Council meeting Monday night left the Goldsboro City Council free to discuss, at length, a possible change to the city's health insurance coverage.

The city benefits committee recommended that the city move over to a fully-insured policy from its self-insured policy, which is expected to go $700,000 over budget this year.

A fully-insured plan through Cigna would allow the city to accurately budget its health care costs instead of estimating claims.

Currently, Cigna handles the city's administrative services and the city operates in its network.

The committee suggested maintaining spouse and retiree coverage, but held off on whether to recommend a $1,300 or a $2,600 deductible.

The $1,300 deductible plan would cost the city $4.4 million, with the $2,600 deductible plan costing $3.9 million.

The current plan is expected to cost $4.7 million in the 2013-14 fiscal year.

The Council expanded on the city benefits committee's recommendation to impose a $25 a month charge on beneficiaries if they do not participate in free-to-the-patient health risk assessments and the city's diabetes management program.

The program offers free testing supplies and currently serves 38 of the city's 70 identified diabetics.

The Council also discussed the merits of charging a fee to beneficiaries if they do not have a primary physician or use tobacco products.

The benefits committee suggested waiting on the other two charges because of the amount of change coming into the plan at once.

City Finance Director Kaye Scott said she expects to begin mandatory health screening in July to begin to identify top risk factors among the city's insured.

"We were going to wait to see what areas we need to be focused on," Mrs. Scott said.

The Council was supportive of adding in all four health risk charges.

"Take hypertension, some people can't control that," Councilman Gene Aycock said. "Tobacco is something they did of their own free will."

City Manager Scott Stevens reiterated that it was a lot to change at one time.

"We are saying, 'If you don't participate in the diabetes plan it'll cost you $25 a month but you can smoke, and there is no penalty,' and that's not fair," Aycock said.

Aycock also supported having the beneficiaries having a primary doctor so that they would be more likely to go to the doctor.

Councilman Michael Headen agreed with Aycock, saying, "It is a true human behavior that people participate in by choice. No one has a gun to your head."

Headen said he also recognizes the difficulty of quitting using tobacco.

The general decision was to look at implementing more behavior charges in October.

Councilman Chuck Allen was also concerned with the way the city measured need to visit the emergency rooms of hospitals.

Currently the city charges an automatic $250 deductible for beneficiaries that visit the ER and are not admitted.

"If they need to go to the ER, it's not fair to charge them if they have a legitimate reason," Allen said. "I don't want someone to wait till tomorrow to get stitched up because they don't want us to charge them a $250 deductible."

The benefits committee will meet next week and is expected to have a recommendation on the deductible for the Council to vote on May 5.