City switches health plans
By Debbie Lowe

Change can be intimidating and daunting for many people. Delphi city employees who attended the special Monday night council meeting expressed those emotions, and more, as they struggled to understand what a new health plan would mean for them and their families.

But sit and listen they did. And then they began to ask questions to explain their confusion about the differences between a health savings account (HSA) and the traditional health plan currently offered to city employees.

After nearly three hours of explanation, discussion and attempts to understand the issue, council members voted unanimously to abandon the current Arnett HMO for a HSA.

The 10 percent monthly employee contribution for the premium will be approximately $41.87 for a single plan and $107.55 for a family. The city will pay $418.69 and $1,075.48 monthly for the same categories.

Each employee will be responsible for a $2,500 deductible, however the city will contribute $1,100 for singles and $2,200 for families, the largest part of the deductible for those groups. Out of the remaining $1,400 owed for deductible, the city will pay 80 percent and the employee will pay 20 percent, either $280 for singles or $560 for families before all medical costs are assumed by the insurer. The plan will take effect April 1.

Glendon Wolfe with the Norris Insurance Agency in Flora, along with Roger Write of Pechin Insurance, presented six scenarios of types of coverage with the HSA to explain the benefits and what the costs would be to employees.

"We're trying to find something that meets in the middle," Wolfe said to explain how he derived the information presented out of the various possibilities an HSA offers.

Water superintendent Gary Hathaway said being able to access coverage with the same medical providers would be important to city employees.

Wolfe responded by stating the same doctors who provided for Arnett would be available to the HSA plan.

According to Wolfe, one difference between an HSA and a traditional HMO is an HSA allows for both employer and employee allocations to the savings account.

Wolfe explained the city's contribution to the plan for each employee would be deposited into a savings account at a local bank.

As the employee visits the doctor and purchases prescriptions, the cost for the services would come out of the savings account. The employee would control the account by writing checks or using a debit card to pay for services.

Another difference between the two is that there is no co-pay for the employee. Therefore, all medical costs are charged against the deductible. With a traditional HMO, a co-pay is not considered part of the deductible and that money is lost to the consumer.

In addition, Wolfe said employees would be able to make additional monetary contributions to their savings plans for future medical needs.

He said if an employee did not use all of the city contribution one year, the remaining amount would roll over to the next year thereby building a balance to be used when it was most needed.

Additionally, the city contribution would be used before the employee contribution, therefore if the city contribution was not expended by the consumer in a calendar year, there would be no out-of-pocket deductible for the employee to meet.

The difficult concept for some employees was that when the deductible is met, there is an out-of-pocket expense for prescriptions. The HSA would reimburse the employee, but the turn-around time for that reimbursement would be between 10 and 14 days, which means employees would have to be able to do without that amount of money out of their budgets for that length of time.

Consensus of council members was to devise a method for the city to cover those prescription costs until the reimbursement was received by the employee.

Wolfe said his office has not received a single complaint about the HSA from anyone who participates.

"No matter how you look at it," Mayor Lee Hoard said, "it will be cheaper for employees in the long run."

"I feel like I understand the program much better (after the presentation)," council member John Hampton said. "It seems like it would be cheaper for the employees and the city."

The next city council meeting will be March 5 at 7 p.m.