County health plan reflects changes
By ELISA SAND, Staff Reporter
New fees attached to each person enrolled in a healthcare plan are set to go into effect in 2014, and the county's employee health insurance plan is no exception.|
As Lake County Commissioners approve the 2013-14 healthcare plans for employees, however, the amount for that monthly fee is still unknown.
Brad Petersen, a representative for Blue Cross & Blue Shield, visited with county officials this month about the present health insurance plan for county employees. At his first meeting with commissioners two weeks ago, Petersen explained that health insurance plans will be subject to a new fee in 2014, the money from which will be used to implement a health insurance exchange.
The monthly fee, he said, is assessed per person enrolled and, according to Blue Cross & Blue Shield calculations, the fee could range from $12 to $15 per person per month.
The exchange, Petersen said, is a web site the general public can use to obtain insurance if they do not have that benefit available through their employer or if the insurance offered by their employer doesn't meet requirements set forth by the Patient Protection and Affordable Care Act.
The fee in question will be assessed to all insurance carriers to pay for the establishment of the exchange.
Petersen said the rates for those insurance policies are income-based, and according to federal law, the exchange is supposed to be set up by July or August 2013.
Commissioners approved two options for employees, both of which meet the new federal provisions. Petersen said according to those requirements, a policy must include specific benefits; meet a specific affordability threshold and maximum out-of-pocket expenses; and the cost for single coverage must not exceed 9 percent of an employee's income.
The new regulations also stipulate that no grandfathered plans can be in place. Employees presently have their choice of three plans, one of which is a grandfathered plan. The plans range in cost based on the deductible, co-insurance and co-pays for various services.
Petersen said the two plans presented for county employees meet all the federal requirements, but this is just the beginning of changes that are taking effect because of the new federal guidelines.
Another change will take place with policies presented in 2014. Those policies will take into account the federal provision that requires the out-of-pocket maximum to include co-pays paid toward office visits. Petersen said presently policies are set up so office visit co-pays are not applied to a patient's out-of-pocket maximum.
In the motion to approve the employee policies, commissioners agreed to cover the lowest single policy amount and the monthly fee connected to the single policy. Employees continue to maintain responsibility for the additional coverage cost for spouses and children who may be covered through a county plan and the fees associated with that coverage.