Putnam County will cover annual health-insurance increase; plan tweaks raise some drug copays for employees on most-used plan

Putnam County Mayor Randy and the county commission voted to have the county pay the full 6.3% increase to the county's group health-insurance premium while approving a narrow change to prescription tiers on Option 1, the plan used by the majority of employees.

The commission's insurance committee recommended that the county absorb the full increase, and county officials and broker Sean Bennett presented an alternate drug-card structure for Option 1 that reduces the county's additional cost from roughly $400,000 to about $180,000 while raising some prescription copays for employees who use certain nonpreferred generics and brand-name drugs.

County Mayor Randy opened the discussion by describing elevated claims the past year and saying the county had worked with Blue Cross to lower an initial projection. "We started out at about 25%. We've worked it down now to about 6.3%," he said. Sean Bennett, the county's insurance broker, summarized plan enrollment and the proposed change: "Option 1, if you renew as is ... would be around the $400,000 increase if you pick up the full tab." Bennett later explained the alternative: increase some copays on tiers 2— (nonpreferred generics and certain brand tiers) while keeping the $1,000 individual/$2,000 family out-of-pocket maximum unchanged.

Under the change approved by the commission, the county will: - Pay the full 6.3% group premium increase for county-covered employees. - Adopt a modified drug-tier schedule on Option 1: some nonpreferred generics would move from a $10 copay to $20; a preferred brand tier would rise from $35 to $45; and the nonpreferred brand tier would rise from $50 to $90. Specialty tiers (5 and 6) remain covered at 50%.

County staff and the broker said the copay increases are limited to Option 1 (the county's most-used plan). Bennett said 486 county-general employees are enrolled on county plans, and 316 of those are on Option 1. He told commissioners that most prescription use is for generics (roughly 88%), and that employees with very large claims typically meet the out-of-pocket maximum in any case, meaning the change would have little or no net effect for those high-claim cases. "If they're meeting their out of pocket max today, this does literally nothing to them," Bennett said.

Commissioners asked several clarifying questions about who is affected and how the costs are split. County staff provided example monthly amounts: for one of the lower-deductible plans, the individual share would be about $299.91 per month and the county share $1,116.46; on the family plan those numbers were presented as $406.65 employee and $1,535.25 county. Commissioners also discussed recruitment and retention, with several noting the county's historically strong benefits package.

A motion was made to accept the secondary plan as presented (the Option 1 drug-tier change) with the county covering the resulting increase from county general funds. The commission voted by roll call: 20 yes, 1 no, 2 abstain, 1 absent. The commission chair declared the motion passed.

Clarifying details discussed at the meeting: the 6.3% premium increase is the total projection without any drug-tier change; the alternative approved would cut the county's added cost roughly in half (county estimate cited ~ $180,000 versus ~ $400,000). Enrollment figures cited by the broker: 486 employees enrolled in county plans (county general), 316 in Option 1. The out-of-pocket maximum remains $1,000 individual/$2,000 family and was repeatedly emphasized as unchanged by the approved modification.

The commission's approval directs staff to implement the renewal with the modified Option 1 drug card and to fund the county portion from county general revenues. The change does not alter office-visit copays or benefits on Option 2, 3 or 4, which staff said will see no increase.

The commission's insurance committee brought the item forward; commissioners noted the committee's recommendation that the county cover the full premium increase and asked for commission input on whether to accept the alternative drug-card tweak that reduces the county's cost.

Copies of the plan details and the insurance committee's recommendation are included in the meeting packet.