Phelps County Commissioners last week gave unanimous preliminary approval to accept a health insurance bid from Group Benefit Services (GBS), of Springfield, Missouri, as a step toward the county being self-insured.

Phelps County Commissioners last week gave unanimous preliminary approval to accept a health insurance bid from Group Benefit Services (GBS), of Springfield, Missouri, as a step toward the county being self-insured.
However, the motion by District One Commissioner Larry Stratman, was only made so that negotiations between GBS and Phelps County Regional Medical Center (PCRMC) representatives could continue.
The negotiations are taking place so that county employees could possibly get more discounts if they choose the local hospital for their health care needs. The discounts may “steer” employees toward using PCRMC, according to Stratman.
The commission’s action doesn’t necessarily mean that the county will switch health insurance providers at this point.
Commissioners accepted the preliminary bid at their July 29 meeting during a visit by Jim Miller and Mike Deren, both of GBS. The two made a presentation about what their company could offer the county as a third party administrator if the county becomes self-insured. Several county officeholders and department heads attended the presentation.
By being self-insured, the county would basically become its own insurance company and process and pay claims instead of contracting with an outside health insurance carrier. If the GBS bid receives final approval, claims would be submitted to GBS, which would then send bills to the county to be paid.
Stratman said by becoming self-insured, the county could have better control of its health care costs, but that’s it’s a balancing act of offering rich benefits to employees while also remembering that the county is paying for those benefits.
Stratman said many private health insurance providers are in that business to make money. “We’re in it to save money,” he said.
According to the initial bid provided by GBS opened July 8, the total annual premium that the county would pay based on its current enrollment would be approximately $814,169 if all covered buy the basic plan. If all covered buy the buy-up plan, the total annual premium would be approximately $861,309, but those amounts could change as negotiations continue.
With the county’s current health insurance carrier, UnitedHealthCare, the county is paying approximately $884,402 plus a $12,000 agent commission. UnitedHealthCare did not submit a bid when the county sought them earlier this summer.
Stratman said he feels satisfied that if the county becomes self-insured the county employees’ contribution toward health insurance could go down. Currently, employees contribute about 15 percent.
During Deren’s presentation, he said GBS designs plans “that lead to good clinical outcomes.” He highlighted several benefits of their plans, which offers 100 percent coverage with Quest with a LabCard, 100 percent covered diabetic testing program, 100 percent coverage for flu and shingles vaccines at any pharmacy that provides the shots, $5 allergy shots, 90-day retail pharmacy program and the LifeTrac transplant program among other features.
A $500 reimburseable deductible allowance also is being offered with the GBS plans if an employee goes through the HealthLink network. This reimburseable deductible allowance would not apply to county employees who use PCRMC as they will possibly have other discounts available to them there.
A wellness program is also included, but Deren said that program can be changed depending on how much the employees want out of such a program.
Deren said by the county being self-insured and building a reserve that would normally go toward a health insurance carrier’s profits, county employees could start to see more stable rates.
When asked by County Assessor Bill Wiggins if it is the commission’s goal to cover employees’ dependents, Stratman said once the county can begin offering lower premiums, then possibly in two or three years, enough reserve funds can be built up so it’s “more palatable to bring family on.”
Stratman, who checked the references provided by GBS in its bid, asked Deren about the chances of higher individual stop losses. Deren said that may occur in specific instances, but it wouldn’t count toward the aggregate stop loss.
Wiggins also asked about caps on the number of days for rehabilitation offered in the GBS plans. Deren said there are caps, but that most likely a majority of employees would not reach those caps.
County Clerk Carol Bennett reminded employees that if final approval is given to the GBS bid, employees may be encouraged to use PCRMC to be eligible for possible discounts. However, if they go to a doctor outside of PCRMC but in the HealthLink network, they still would be considered in-network.
Stratman said the deductibles and copays would change from seeing a physician at PCRMC versus seeing a doctor in the HealthLink network but reminded employees that rates are not set in stone yet.
Stratman also noted that currently, county employees who are eligible for Medicare stay on the county’s medical plan. With self-insurance, those employees would go on Medicare and could have a Medicare supplement plan but could also stay on the county’s prescription card plan.
Stratman hopes the commission will make a final decision this month and become self-insured as of Sept. 1, a goal he still believes to be possible.
“It’ll be a big switch for Phelps County,” said Presiding Commissioner Randy Verkamp.
During a bid opening July 8, in addition to GBS, the county received health insurance bids from Employers Committed to Control Health Insurance Costs (ECCHIC) of St. Louis; and Ashby’s Covenant Insurance, of St. James, which offered plans from three different partners — Anthem Blue Cross and Blue Shield, Key Healthy Partners (KHP), and Coventry Health Care.