Atlantic County hears presentation on adding HRA "Difference Card" to state health plan to lower employee premiums

Marsh McLennan Agency and The Difference Card on Thursday presented an optional health reimbursement account (HRA) product that would sit on top of the New Jersey State Health Benefit Plan and, presenters said, reduce employee payroll deductions while covering copays and deductibles.

The proposal, presented by Tony Mahone, executive vice president of sales at Marsh McLennan Agency, and Chris Calderon, chief sales officer at The Difference Card, would use the 2035 state plan as the county’s base plan to lower premiums and issue a Mastercard “Difference Card” funded as an HRA to pay copays, deductibles and pharmacy costs for participating employees. The offering is voluntary; presenters and union representatives said they have been meeting with union leadership and members to educate employees about the option.

Supporters said the change addresses recent sharp increases in the state health plan. “Forty-four percent combined is just unaffordable,” Chris Calderon said, referring to multi-year premium increases he outlined; he added that family coverage in one expensive option has “breached $50,000 per year.” Mahone and Calderon said the strategy buys a lower-cost plan and uses the HRA to make employee cost-sharing no worse than current coverage.

Presenters described how the card works: the Difference Card functions as a Mastercard and can be used at any merchant terminal that accepts Mastercard; employees and covered dependents age 18 and older receive cards. For most in-network visits the card would pay the plan’s copay or deductible at the point of sale; the card is also programmed for pharmacy tiers and mail-order prescriptions. Employees who forget to use the card can submit receipts or explanation-of-benefits forms through a mobile app or by mail; Calderon said the vendor processes claims in about two business days and can reimburse by direct deposit or check.

The presentation included data from other New Jersey counties that have adopted the same model. Mahone said Hunterdon County adopted the model in 2023, Gloucester County moved to the strategy in January 2024, Ocean County realized nearly $5,000,000 in annual savings, and Essex County implemented the strategy as of Jan. 1, 2025. The presenters said participation rates and exact savings vary by plan mix; they gave example premium-reduction percentages for employees who move from higher-cost plans to the 2035 plan paired with the HRA: about 24% for the Direct 10 population, 21% for Direct 15, and 13% for the Direct 2030 group.

Commissioner John Corsi asked how unions and membership had reacted to the proposal. Tony Mahone and other presenters said they have met with union presidents and representatives and that the three largest unions in the county — AFSCME, CWA and Teamsters — have provided “really positive feedback.” Tammy Robbins, who said she has attended employee education meetings, told commissioners the meetings and follow-up have yielded favorable responses; she said a PBA meeting was scheduled and expected to go well. Megan Prazutti, a senior consultant who worked on Ocean County’s rollout, said uptake increases after coworkers share positive experiences: “Once they understand the process, then they embrace it,” she said.

Presenters described a funding figure the state requires for 2025 enrollment: about 14,720 (presenters did not verbalize currency on the slide but discussed it as the funding amount the state requires for the HRA in the 2025 plan year). Calderon characterized that figure as a maximum per family and said the county would only pay as members actually use services; he and Mahone said the amount functions as an unfunded liability that is drawn down when claims are processed.

On timing and next steps, presenters said they would continue member education through March, provide the county administration with modeled savings for the county budget, notify the state of the county’s intent, and aim for an effective date of May 1 with final enrollment in the two weeks of April. Jared (surname not specified in the transcript) from county staff said no board vote is required for implementation if employees choose the option, and the board would see the financial impacts during the budget process.

Commissioner Parker and other commissioners thanked presenters for outreach to employees. No formal action or vote was taken on the floor during the presentation; staff said the administration and budget committee would review financials and include any changes in the 2025 budget process.

The presentation materials remain with county administration; presenters said they will continue education sessions and return with modeled savings and budget impacts for commissioners to review before any enrollment is finalized.