LABELLE — The Hendry County Board of Commissioners voted unanimously in a special meeting last Wednesday evening, June 26, to seek bids on the health care insurance package that’s offered to county employees.
The commission chamber at the historic Hendry County Courthouse was packed with county employees, including the constitutional officers, who were dismayed that the commissioners voted at their last regular meeting, June 18, to stay with United Healthcare and try to negotiate a better deal when the company’s renewal premium came in with a price tag 16% higher than the county is paying for fiscal 2018-19. Fiscal 2020 starts Nov. 1, leaving not much time to find a better deal that the Hendry County Board could go with instead.
County Board Chairman Mitchell Wills started out, “This is a meeting to take a look at our insurance program we talked about last Tuesday night.” On July 18, the board had voted to stay with their carrier United Healthcare despite having been notified just prior that their premiums would rise by around 16%, or roughtly $400,000, for the new fiscal year. The commissioners directed that staff work with United to try to bring those numbers down by looking at other plans, including a long-term wellness strategy that has been shown in many other places to save money on insurance premiums.
But after word got around about the increase, something of a revolt spread through county staff, leading to the special meeting and summoning Hendry County Clerk of Court Barbara Butler back from a convention in Orlando to deal with the issue.
Board votes to seek proposals
Commissioner Darrell Harris immediately made a motion to rescind the previous week’s action. With a quick second from Commissioner Michael Swindle, it passed 5-0. Mr. Harris then made a motion to advertise a Request for Proposals, or RFP, on the Hendry County employees’ health care plan. Commissioner Emma Byrd seconded and it also passed unanimously, to loud applause from the audience, made up mostly of county employees.
County Commissioner Karson Turner wanted to discuss the future and moving to a new approach. “I’d like to ask the constitutional officers: Ms. Butler, regardless of how the bids come back, do you anticipate that you are going to implement a long-term wellness plan? Are we going to engage in a long term approach to try to beat these numbers down?”
Clerk Butler came to the podium and answered: “Karson, I don’t see why not. I don’t see why we couldn’t have a win-win on both sides. I’m all for going out and seeing… what’s it going to cost us, $100 to the county? Let’s see what the bids are, let’s see what they come back with, and let’s see if they have a wellness plan. Let’s look at all the options and then come back and discuss it with the constitutional officers.”
Instead, she complained, “We didn’t know anything. It was a presentation by United Healthcare that was on the agenda. We had no clue of what was going to happen, or we would’ve all been at the last meeting.”
Ms. Butler explained that she was upset that commissioners did not vote to seek proposals. “As comptroller, I don’t think that an increase of that magnitude, without going out, is good for the county.”
“We had two graphs that were presented at the last meeting that showed a long-term approach being taken in two counties,” Commissioner Turner said. “Taylor (is) a little bit smaller than us, Hardee almost matches us like-for-like demographically. They’ve implemented a long-term strategy, they’ve implemented a Health Savings Account and the county, I believe in Hardee County’s case, is actually contributing to that HSA, and that in turn is buying down the cost of insurance on a yearly basis. And I think that Hendry County needs to be moving toward these aggressive kinds of calls. That’s the way medicine is moving,” he said, suggesting that they have a wellness fair for employees.
Ms. Butler said she and many others were not happy with the way the insurer was dictating its choices on coverage to claimants, nor with its formularies that differed greatly from the previous insurer’s, in some cases doubling employees’ costs for prescription medications.
“Well, then,” Mr. Turner replied, “we have to work through this.” He described the tough choices on coverage for his own employees in his business that he’s had to face and admitted to being not very experienced in dealing with an insurer. But, he added, “when a physician sees an insurance plan that is rich, they take advantage of that. And if you go back and look through our historical numbers, I think that has occurred.
“This is going to take everyone. I’m happy to see this many employees of Hendry County in here,” he went on, “because it’s going to take every one of us to work through this process and try to pull these numbers into check.”
Commissioner Harris said, “Everybody is paying more and more per month for prescription drugs. I’d rather pay a little bit more and have better performance.”
Newly elected Property Appraiser Dena Pittmann said she thought a longer-term approach was a “great idea.” But she also said, “On prescriptions, even the generic is double what I’ve been paying. We’re getting unequal services for the cost,” she said. “I’ll pay $50 for a steak, but don’t give me a hotdog and call it a steak. We were pretty much promised a steak for nearly the same cost as we were paying last year, and the steak didn’t come through.”
Commissioner Turner said, “We have to change ourselves actuarially.”
County Administrator Jennifer Davis said, “I think overall we have to take it to the next level. We have to be engaged year-round from a proactive perspective.”
On the timing of the renewal proposal being received, she said, unfortunately, the industry more or less dictates it. The last insurance committee meeting was in March, she added, “and we asked for it then, but we didn’t get it until real late. They kind of play the game,” she said, so that resulted in the renewal premium not being known until literally just hours before the commissioners’ meeting the previous week.
“It’s important that we all buy into a wellness strategy,” she said. “Right now, insurance costs go up an average of 8% per year. We have to get loss ratios down, start using urgent care clinics or doctors on demand instead of the ER when it’s feasible. We can all work together to save money; that’s what we need to do.”