DeKalb shifting more insurance costs to workers

By April Hunt

The Atlanta Journal-Constitution

DeKalb County taxpayers will likely pay 3 percent more to provide health care to county workers next year, but employees themselves could pay anywhere from 63 percent less to 33 percent more.

Under a deal worked out Tuesday and up for a County Commission vote next week, the county will pay $1.6 million more for health insurance next year, up to $54.9 million.

What employees pay depends on what plan they pick. They are currently offered two options: They can choose to enroll in a health maintenance organization or a preferred provider organization.

An HMO requires employees to choose a primary care physician within a network of doctors and other health care providers. Care from a specialist requires a referral from the primary care physician. Without a referral or by going outside the network, the employee will likely have to absorb all the costs. A PPO is a more traditional health insurance plan that requires employees to pay only their co-payments and deductibles. It allows employees to choose their doctor from a select list of providers in the network who have agreed to a set fee schedule, or at a higher cost to the employee, a doctor outside the network.

The current HMO and PPO plans will go up 1.2 percent and 10 percent, respectively.

But another HMO that county workers said in public meetings they wanted will cost employees at least a third more than the current highest plan, while a new consumer-driven plan will cost less because of its high deductibles.

“We have pushed as much as we can push this year to listen to everyone and keep a handle on finances,” Commissioner Elaine Boyer said. “I think this is a workable compromise.”

The county was ready to OK the insurance plan last week but delayed the vote after CEO Burrell Ellis called for scrapping the new HMO and using those savings to let the county pay more of the cost than employees.

The goal was to give a perk to workers who have not had a raise in four years. But Finance Director Joel Gottlieb said the administration heard again from workers, who wanted the other HMO over any savings.

The county did snag a new concession from Cigna with the delay, though. The insurance company will not increase its administrative costs, which keeps the overall price down somewhat.

“This is what the employees said they wanted, and we did get more savings,” Gottlieb said. “For most workers, these are small increases when historically we saw anywhere from 12 to 17 percent jumps for their share.”

The County Commission is scheduled to vote on the proposal at its Oct. 11 meeting, but the issue will linger. Once the insurance plan is approved, the commission plans to begin reviewing possible changes to its offerings for workers and retirees starting in 2013.