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District officials present proposed switch to Meritaine/Aetna medical plan, estimate $1 million in savings
Summary
Administrators and the district broker recommended moving to a Meritaine-administered plan using the Aetna point-of-service network, saying it would expand the provider network, add Cleveland Clinic center-of-excellence benefits and reduce district medical costs by roughly 10% (about $1 million); a town hall is scheduled for March 18.
On March 9 the Mill Creek Township Board's Personnel & Policy committee heard a detailed presentation about a proposed change to the district's self-insured medical plan that administrators said would expand provider access and save the district about $1 million annually.
Dr. Jablonski, who led the presentation, said the district currently uses Highmark as its third-party administrator but has been reviewing alternatives to avoid network disruption tied to regional hospital/insurer politics. "The benefit to the district is roughly a 10% savings on medical costs, which is about $1,000,000," Dr. Jablonski said.
The recommended product would be administered by Meritaine and use Aetna's point-of-service network. Administration said claims processing would remain under the district's control because Mill Creek is self-insured and that plan design elements such as deductibles, co-pays and premium shares would be set by the district and would not change under the proposed switch. "We set the co-pay, the deductibles, the premium share, including the preauthorization rules," one committee member confirmed; Dr. Jablonski replied, "Correct." (The administration presentation included a multi-year disruption analysis showing 99.6% hypothetical in-network access under the Meritaine/Aetna network for recent claim runs.)
Administrators highlighted added benefits tied to Cleveland Clinic partnerships included in the broker's umbrella product: certain non-emergency procedures would carry $0 deductible and $0 co-pay plus paid lodging and travel for members, and the district would be shielded from readmission costs under the Cleveland Clinic guarantee for specified procedures. The broker also described regenerative-medicine coverage examples and said Meritaine had high retention among contracting employers.
John, the district's benefits broker on site, said the Meritaine product serves nearly 40,000 members and has broad local participation among private employers and unions in the region. "Many larger local employers and unions have been in this product for a number of years," he said.
The administration said it has met with all eight labor groups and will hold an employee town hall on March 18 at Westlake at 7 p.m. to answer questions. Committee members raised continuity-of-care concerns and asked for network lookup tools; administrators said those resources have been shared with labor groups and will be available at the town hall.
No final board action was taken at committee; administration said the item will be moved forward to the full board for consideration at the end of the month after further labor-group meetings and the planned town hall.
