Commissioners get different perspective

Commissioners have a decision to make regarding health insurance.

They heard a new perspective Friday.

Jay County Commissioners spoke with Jessica Clayton of insurance broker OneDigital and learned about the impact of a potential shift to a partially self-funded plan.

Commissioners heard a case for switching to partially self-funding health insurance from Understand, Service and Innovate (USI) Insurance in August. Representatives of the company told commissioners they gathered data from the county’s current health insurance provider, Physicians Health Plan, between 2020 and now. Their analysis indicated the county has overspent about $780,000 for insurance and told commissioners that clients who switch to their care save on average about $180,000 annually.

The program would have a loss cap of $1.5 million to the county, according to representatives. They asked commissioners to sign an agreement for USI Insurance to become a broker to the county for a partially self-funded program through Physicians Health Plan, with the agreement to become effective within 10 days of approval.

When asked by commissioners why Physicians Health Plan hasn’t offered such a plan to the county, USI Insurance representatives said the health insurance agency has no financial incentive to change to such a plan.

On Friday, Clayton told commissioners Chad Aker and Rex Journay, absent Brian McGalliard, groups such as USI Insurance aren’t looking at a long-term perspective regarding factors for determining a viable plan. She noted the current year’s claims had been at a 72% loss ratio as of earlier this year. As of now, though, that figure has jumped to 106%.

She pointed to the number of claims outweighing the county’s premiums in past years. The county’s 12-year average loss ratio sits at 125%, while the last three years’ average loss ratio is 152%.

“When someone from the outside comes in and says, ‘oh, you guys have got to be crazy, you guys should’ve been self-funded … you’re losing, you know, hundreds of thousands of dollars?’ (That is) inaccurate. Not factual,” she said.

She said her company is not against self-funding plans, but rather focuses on offering those as an option when it makes sense to do so.

“We looked at this (for Jay County), we explored this, and it did not make sense,” she said.

The county is currently fully insured through Physicians Health Plan with broker OneDigital. Its renewal date is set for at earliest the end of October.

Clayton noted she could look into a partially self-funded option for the county and could get preliminary prices for that plan by the end of next week. She suggested holding another special meeting with commissioners to hash out the details.

Commissioners president Chad Aker asked what the county can do to get premium costs down for employees.

“That’s the biggest thing, we hear across the board, we can’t keep employees because our insurance is too high,” said Aker. “Is the answer self-funding? Is it fully insured? I mean, we’re just at a loss here.”

Clayton noted the county’s premiums for employees currently sit in the middle of the national average cost. She pointed to changes in recent years to the county’s plan.

“It’s not a quick fix,” she said.

Aker also expressed frustration with hearing two opposing viewpoints from both insurance brokers and noted his lack of experience in the insurance field.

County auditor Emily Franks said she believes seeing data from the renewal offer in coming months should be helpful in the decision.