[{"_1":2,"_111":-5,"_112":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,99],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},"mediaId",6310622,"mediaKeyId","2398752-20a5fe8676c30857a21e6fb06189a86e","parentId",2398752,"title","Board moves to end sheriff's OJI pay deviation after two current cases close; legal staff flagged equity and tax concerns","audioSeconds",549,"startMs",2756000,"endMs",3305000,"viewUrl","/Search/View?dp=1&key=2398752-20a5fe8676c30857a21e6fb06189a86e&start=2756&end=3305","thumbnailUrl","https://assets.pipeline.soar.com/2398752-20a5fe8676c30857a21e6fb06189a86e/thumbnail_2756000.jpg","articleUrl","/articles/6310622/Sumner-County/Tennessee/Board-moves-to-end-sheriffs-OJI-pay-deviation-after-two-current-cases-close-legal-staff-flagged-equity-and-tax-concerns","mediaUrl","https://secure.pipeline.soar.com/6310622-f189033343b1bb0bafd8530f16e3f0e1/orig.mp4?Expires=1773625266&Signature=fXAvM0NgJRVQAqqUsAUsRGIhaJWMFmA95UuE~7Wa5mL6gsRVQZO-25ltUiOK2tDNBlG0GLxs2AqC~OcgZz0VUzM-~0nKsYC0UCKKn8yPIq1FRI1Cwez6EqJ8VxqHE1V1G~SFQLYPJKU5VPZayfXl52mqt2YBFi9fPfsifFuDgtwvbqp~ZOb3F5oqWxyGCuNfWfbsoG7LroYgKH01ne5a8Fd7pGyPfkXGbWyUQrKW9PPLLR-tfiixzxvFOBw9AO0bdbu3yZEBVsEocD2eTRsjvB7GRukndNpHqWy3gVpdPywboDIDndPjU5g55DPfR~o7AbnuX0HP1cH6e6VDLE1TKg__&Key-Pair-Id=KUT5TJCACFTXG","author","Sumner County, TN","date","2025-02-26T13:24:43Z","article","Sumner County's Self-Insurance Board addressed a multi-year practice in which the sheriff's department has been paying an additional one-third of employees' pay for on-the-job injuries (OJI) above the county plan's standard benefit structure.

County legal and benefits staff told the committee they have questioned the legal authority for the department-level deviation and raised concerns about equity across county employees and tax treatment of the supplemental payments. A legal advisor noted that the county plan language identified the OJI benefit as an exclusive county-provided payment, and expressed concern that the sheriff's practice effectively carved out a subset of employees for enhanced pay and benefits (including retirement/TCRS credit accruals) not provided to other county employees.

Because the practice dates back to 2007–2008, committee members debated next steps and the potential fiscal and legal consequences. After discussion, a motion carried to allow two employees currently receiving the higher payment from the sheriff’s budget to continue receiving those payments through the end of their existing OJI claims, and to enforce the county's OJI policy (the standard two-thirds/66% structure described in the plan) for future cases. Legal staff was directed to provide a formal opinion and staff were asked to compute historic costs associated with the deviation so the committee can quantify fiscal exposure.

The committee asked staff to coordinate outreach to the sheriff's office and to brief the commission about the policy change. Members emphasized the need for a uniform county practice and flagged potential tax and benefit-credit implications if payments were continued for some employees and not others.","mediaType","Video","parentTitle","Self-Insurance Board (Cam2) 2/25/25","oneSentenceSummary","Sumner County's Self-Insurance Board voted to allow two currently affected employees to finish their on-the-job-injury (OJI) claims under existing pay arrangements but directed staff to enforce the county OJI policy thereafter and to quantify the historic fiscal impact of a sheriff department pay deviation.","taxTitle","Sumner County, Tennessee","taxId",19115,"location","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6310627,"Committee approves adding vision coverage; staff directed to finalize contract",266,1312000,1578000,"/Search/View?dp=1&key=2398752-20a5fe8676c30857a21e6fb06189a86e&start=1312&end=1578","https://assets.pipeline.soar.com/2398752-20a5fe8676c30857a21e6fb06189a86e/thumbnail_1312000.jpg","/articles/6310627/Sumner-County/Tennessee/Committee-approves-adding-vision-coverage-staff-directed-to-finalize-contract","https://secure.pipeline.soar.com/6310627-121d617c2e4fc7a01e1e72d3e0e1fd00/orig.mp4?Expires=1773625266&Signature=OwBSc2sLD8mBEK0yjweh7svQZGpUNC5-XdzcPeqpJ01tdGk7RIaPKHbrEOxfmWhGx82AsO7hn3HMOFkMhNqJHms1A4UvzxNDUeFNoc5Uy~XmnqXIOtT1~wB8c37YqOU4HJ3jbBaIPkn3664BThLbrW9O4pgNTt1haP0Yk-Su3CWhriFp~BdnhTMAHQC9LTG8tpL9zaZCNQsx8HBfb4uQvmI12WEGQN6S-gQutBRGTYkT5x5oi~lbiB0oD1X-8kpfryRs1oO9xA4vpI5wsFAZD7qpkm0M7OcvTyP2Lwh2gvisxVumhZdQZ31DdaV1faaETUFEYK~hif~WQSHVv1jcEg__&Key-Pair-Id=KUT5TJCACFTXG","The Sumner County Self-Insurance Board voted to proceed with a contract to add vision coverage to employee benefits and asked staff to finalize contract terms and implementation details.

Staff said the county previously offered a vision benefit but stopped when Affordable Care Act dependent rules made the plan administratively difficult; brokers later proposed returning a vision benefit. A consultant explained that expanding the benefits to include vision and consolidating administration will increase costs and that an updated Explanation of Coverage and contract language are needed. The consultant provided a cost estimate for the contract support: approximately $700–$1,000 per month depending on scope, and a rough annual estimate of about $3,600 for the proposed consulting/update services.

A motion to proceed with a contract amendment to add vision coverage passed by voice vote. Board members asked staff to prepare the final contract and provide the paperwork for signature once the scope and pricing are confirmed.","The Self-Insurance Board approved moving forward with a contract to add vision benefits and to update plan documents; consultants estimated an added consulting/administration cost of about $3,600 annually for the service described in the meeting.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6310633,"Self-Insurance Committee backs 5% health-premium increase; members press clinic use, weigh Rx and wellness measures",7355,109000,7464000,"/Search/View?dp=1&key=2398752-20a5fe8676c30857a21e6fb06189a86e&start=109&end=7464","https://assets.pipeline.soar.com/2398752-20a5fe8676c30857a21e6fb06189a86e/thumbnail_109000.jpg","/articles/6310633/Sumner-County/Tennessee/Self-Insurance-Committee-backs-5-health-premium-increase-members-press-clinic-use-weigh-Rx-and-wellness-measures","https://secure.pipeline.soar.com/6310633-bb41514069e801fcd1c0ad50d8e1f51c/orig.mp4?Expires=1773625266&Signature=OBPiu~gUez55F2D--1EyvShJT5MW2mq5uy2MCZ4YwB~X83sohflHVLkWZY-7QiXVToAqAY9SCbct7Ym~Kkk-GD8fWGoVu-OXSqZUmgl6qvnLI~n3vlid0XTIJMpEUprtM4Lcnd~OapjAYgab3nDALgjsjOiHSTePthDTpCESaL5kotn4PJKdQfpy-HFt~KMJhKKfrgEQbMajUwC0dP5iHr5lolkkkDFqkU0K--NDHMHJvsf70fatx1gb4h0u~jec~sMxrga2vEWImdH48YJ4XrdsV~7V~s2pscwK-TGIITskyJ~3xSpJcNBUD1XL9mk2-15WMS4rTfrhJTTT2xfPOQ__&Key-Pair-Id=KUT5TJCACFTXG","Sumner County's Self-Insurance Board voted to adopt a consultant recommendation for a 5% increase in health-plan premiums and spent much of its meeting reviewing fund balances, rising pharmacy costs and clinic-driven wellness efforts that officials say could reduce claims.

The board's finance director told members the county's pooled health-insurance cash totaled about $20,900,000 as of the December accounting period, with roughly $6,900,000 in revenue and $6,300,000 in expenses over the most recent reporting period. The director said the health fund is “getting tighter” and that the premium discussion later in the agenda should address that trend.

Consultants and staff emphasized that pharmacy spending — in particular specialty and weight-loss medications — is a major driver of recent increases. A consultant told the board “that is the name of the game in pretty much every plan now” when explaining why prescription drugs have grown as a share of total costs. The consultant said the plan’s preferred population had a modest increase while the nonpreferred population rose sharply this year, noting nonpreferred members generally have higher cost-sharing and tend to include employees who do not participate in wellness offerings.

The board discussed strategies intended to shift utilization toward the county clinic, which staff said can deliver care at substantially lower cost. A clinic representative described outreach tactics — text care and virtual visits — and noted a combined increase in behavioral-health visits last year; the representative and benefits staff proposed targeted mailers and cellphone-based messaging to raise clinic use, while cautioning that outbound texts can lead employees to opt out of messages.

Staff also presented a proposed weight-loss program that couples lifestyle requirements (three months of participation, nutrition coaching and exercise) with possible medication after proving nonpharmacologic steps. The consultant said lower-cost medicines would be tried first and that GLP-1s could be an option in some cases; the group discussed prior-authorization rules that some PBMs and carriers are applying to GLP-1 prescriptions. The consultant estimated the club’s negotiated medication costs but emphasized variability by person and duration.

After hearing the financials and wellness proposals, a motion to accept the recommended 5% premium increase carried by voice vote; the minutes record a voice vote but do not show a roll-call tally. Consultants recommended holding dental rates flat (0% change). The board asked staff to return with comparative benchmarks, targeted engagement plans to shift prescriptions to the clinic pharmacy where appropriate, and scenarios showing the fund’s reserve trajectory under alternative rate steps.

Board members repeatedly stressed that the plan is self-insured — meaning employees’ actual claims drive costs — and that the clinic and wellness initiatives exist to encourage lower-cost care and healthier behavior.

Staff said more detailed rate-setting materials and actuarial work will be included in the formal premium-setting packet for the upcoming fiscal year.

Less-critical discussion included administrative line items and monthly plan results; board members requested continuing monthly monitoring and additional outreach metrics from the clinic.","Sumner County Self-Insurance Board reviewed fund balances and rising prescription costs, accepted a consultant recommendation for a 5% health-premium increase, and discussed ways to steer employees toward the county clinic and wellness programs to blunt drug and nonpreferred-plan cost spikes.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6310617,"Committee clarifies lap-band coverage: employee-only, cap and grandfathering for existing cases; forms to be standardized",1378,4488000,5866000,"/Search/View?dp=1&key=2398752-20a5fe8676c30857a21e6fb06189a86e&start=4488&end=5866","https://assets.pipeline.soar.com/2398752-20a5fe8676c30857a21e6fb06189a86e/thumbnail_4488000.jpg","/articles/6310617/Sumner-County/Tennessee/Committee-clarifies-lap-band-coverage-employee-only-cap-and-grandfathering-for-existing-cases-forms-to-be-standardized","https://secure.pipeline.soar.com/6310617-acebd0ef7a817043c44f8e3ccd010f27/orig.mp4?Expires=1773625266&Signature=kW2ZgWQPoc9rEvS-CDtiRdUm3KDMOjXxGM33ljXzQgB93yHxOJH4Xuulj-rWsbD4IGmmYyKP9eOyZlGJXdbnVKep0CuFEJhRyEoNRNn3uMAZ94YdcJQp1ybXlHrTAH0Xn112IENdP282okQCwKASKsKzNpcqgrSio~pB~wGXTzxdWJeXnjSJ9Fv5llo0QZIfTleZ3MbCIHkRWpL6b~96ShCf4WdKd5xXIDMqDywwPNO1ycgYno4ew9UDA9PX1-Yc3pCvPw0A8QBXM4KnfQQOKUBvVQlywQhjhTkRcaZrkAjRL5Iayt-nl5MKacc-SpVJ46BO~HMSY4nfC~ih~GihGg__&Key-Pair-Id=KUT5TJCACFTXG","The Self-Insurance Board reviewed and clarified the county’s bariatric (lap-band) benefit after finding inconsistent forms and minutes that had created confusion over eligibility.

Staff and members recounted that the board originally required five years of employment and five years of plan participation for lap-band coverage, but that a COVID-era, one-time waiver had been applied in at least one case and that some forms in circulation incorrectly show a two-year requirement. Committee members said the plan document and past minutes were ambiguous; legal and benefits staff reviewed the minutes and concluded the COVID waiver had been intended to apply to an individual case rather than to permanently reduce the eligibility threshold.

After discussion the committee directed that:
- The plan remains an employee-only benefit (dependents/spouses are not covered under the lap-band benefit as written in the plan).
- The committee will revert to a 5-year employment / 5-year coverage standard going forward, with existing individuals who relied on a 2-year waiver to be grandfathered (staff to identify current cases and confirm eligibility).
- The benefits office must adopt a single controlled form with a revision/control number and an explicit legal statement that the board-approved form supersedes prior drafts; the committee asked that legal review and sign-off be obtained on the consolidated form.

Board members also clarified benefit limits: the plan limit discussed in the packet is the lesser of 90% of the procedure cost or $18,000, and committee members asked staff to explicitly include “procedure only” language so that post-operative cosmetic or unrelated procedures are not treated as covered costs. Staff were directed to solicit clinical guidance, consider direct contracting options (Vanderbilt discussed as an example) and return with recommended clarifications to the plan document and the controlled form.","The board resolved longstanding confusion about the county's lap-band (bariatric) benefit: the policy applies to employees only, the committee will return to a 5-years-on-plan/5-years-of-employment standard going forward, current enrollees who relied on a 2-year COVID waiver will be grandfathered, and the committee directed staff to adopt a single,","actionData","errors"]

Article not found

Board moves to end sheriff's OJI pay deviation after two current cases close; legal staff flagged equity and tax concerns

Committee approves adding vision coverage; staff directed to finalize contract

Self-Insurance Committee backs 5% health-premium increase; members press clinic use, weigh Rx and wellness measures

Committee clarifies lap-band coverage: employee-only, cap and grandfathering for existing cases; forms to be standardized