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St. Mary’s County staff proposes 2-tier health premium tied to wellness participation; CareFirst offers 0% premium increase for FY18
Summary
Benefits staff reported a 0% premium increase from CareFirst after FY17 plan changes; county proposed a mid-year two-tier premium with wellness incentives to hold plan costs and offer no plan benefit changes for FY18.
County benefits staff told the Commission of St. Mary’s County on March 7 that a set of FY17 plan changes successfully contained claims costs and that CareFirst presented the county with a 0 percent premium increase for FY18.
Catherine (presented as Catherine in the meeting) explained the county operates a self-insured health plan administered by CareFirst covering county employees and several quasi-governmental entities. The benefit plan’s total premium is roughly $15 million annually; employees pay 15 percent of the premium. Staff said FY17 claim costs for medical services decreased 4.6 percent and pharmacy claims stabilized, and that member out-of-pocket expenses had increased.
To hold costs while preserving benefits, staff recommended a two-tier premium structure tied to wellness participation. Under the proposal, employees who participate in the county wellness program — elect a primary-care physician, have an annual physical, or complete an online health assessment — would receive a wellness credit and avoid a premium increase. Employees who do not participate would see a small premium rise. Staff proposed the two-tier premium go into effect mid-year (January 1, 2018) to give employees time to comply and for education efforts.
Catherine said Bolton Partners (the county’s insurance consultant) and CareFirst had reviewed the approach and indicated carriers bidding on the plan would look favorably on a program that incentivizes wellness. Staff also recommended no plan benefit changes for FY18 and proposed wellness credits rather than outcomes-based penalties.
Other discussion items included a recent formulary change (effective Jan. 1) intended to promote generics and control specialty drug costs; a forthcoming benchmark report on the county’s 457 retirement plan with a possible joint RFP with the Board of Education; and an OPEB analysis Bolton Partners would provide to the OPEB board for further consideration.
