DeKalb County commission approves creation of two-plan health benefit option; sets key deductibles and co-pays

DeKalb County commissioners voted May 21 to have Apex Benefits produce two employee health plan options — a preferred-provider organization (PPO) and a high-deductible health plan (HDHP) paired with a health savings account (HSA) — while staff and benefits consultants were directed to finalize stop-loss and transplant insurance and to model employee contribution scenarios ahead of the July 1 plan start.

The commission’s action formalizes a plan design the county’s benefits advisers and HR described during a lengthy discussion about premium equivalents, contribution strategies, pharmacy tiers, telehealth and employee education. The choice gives employees a lower-premium HDHP/HSA option and a PPO option with first-dollar co-pay coverage, officials said.

The vote matters because it sets the framework for open-enrollment materials, employee communications and IT configuration needed before the July 1 effective date. Commissioners also asked staff to model multiple contribution splits and potential county contributions to HSAs for final decision by the end of next week.

Apex and PHP representatives and DeKalb County HR staff presented details of the proposed design. The HDHP would use an embedded $3,500 individual deductible and a $7,000 family deductible; the commission was told the individual maximum out-of-pocket would be about $5,000 under the proposed structure. "The plan design that we laid out in the…