WARNER ROBINS -- With health care costs continuing to creep up, Warner Robins is looking at an overhaul of its health insurance plan that would steer city employees toward options less costly to the city.
“We want to keep providing the best benefits we can, but we’re trying to offset the increases,” said Councilman Mike Daley, a member of the Insurance Committee.
The committee, made up of two councilmen and city department directors, voted Thursday to recommend employees pay more for emergency room visits, brand name prescriptions, doctor’s visits and gap insurance through COBRA. Still, savings from those measures won’t recoup all of the expected $450,000 increase in health care costs for fiscal 2014.
The city, which is self-insured, has battled a rising insurance budget for about a decade.
In 2003, the budget was $3.4 million. Health insurance costs totaling $6.8 million accounted for almost 19 percent of the city’s $35.8 million general fund for the current fiscal year. For fiscal 2014, health insurance costs are expected to be $7.25 million. To soften the blow this time around, City Council will need to approve changes before the new fiscal year begins July 1.
In 2011, City Council voted to charge employees a premium after years of free coverage. Individuals pay $16 per pay period, and families pay $30.
If City Council agrees to Thursday’s recommendations, close to 550 city employees would pay $100 for emergency room visits instead of $50. Doctor’s visits would increase to $20 from $15. Brand-name prescriptions would cost $50 or $75 instead of $20 or $30, the difference depending on whether the drug is bought at a retail pharmacy or through mail-order.
Former employees who have decided to maintain their city insurance through COBRA would see an increase of 25 percent. An individual would pay $330 per month, up from $264. A family plan would cost $847, up from $677.
If the measures are successful in encouraging employees and their families to choose a doctor’s office over the emergency room and generic prescriptions over brand-name ones, the city could save about $243,000, according to Human Resources Director Bryan Fobbus.
But to get closer to the $450,000 needed savings, the committee will need to revisit a topic it has shot down for the past two years -- spousal surcharges.
Employees who have spouses who are employed elsewhere currently pay the family rate of $30 per pay period to latch onto the city’s insurance, the same as an employee with an unemployed spouse with no other coverage options.
But according to the city’s health care manager, Gallagher Benefit Services, Inc., the city could raise about $188,000 if it charged an additional $150 per month to cover spouses who are employed elsewhere.
“If someone has the opportunity to have insurance elsewhere but doesn’t because our plan is so good, then there should be a penalty,” said Councilwoman Carolyn Robbins, who attended Thursday’s meeting.
Paul Shealy, who is the other councilman on the committee with Daley, and Councilman Mike Brashear also attended Thursday’s meeting. Daley and Brashear agreed the committee will need to revisit the surcharge issue.
The council members agreed the city wants to maintain its reputation for providing the best health insurance coverage but must also realistically fund it.
Fire Chief Robert Singletary, an Insurance Committee member, staved off conversation of the surcharge and reminded the room the $450,000 increase is a projection.
“We came in under budget last year,” he said. “I don’t like people being blanketed” with across-the-board increases.
Daley, especially in response to Shealy’s concern some may have no option other than brand-name medicines, said the city can review cases when necessary.
“We can deal with exceptions, but we have got to have a monetary penalty for going to the brand” medicines,” he said.
To contact writer Christina M. Wright, call 256-9685.
