County considers insurance options

The affiliation between Pioneer Medical Center and Billings Clinic will bring several notable changes to the hospital’s structure. 

But it will also bring adjustments to several elements of the Sweet Grass County government —notably, the cost and delivery of heath benefits.

Three members of the county’s five-person health insurance committee and the commissioners met with representatives from the Montana Associations of Counties Health Care Trust May 6 to discuss options moving forward without PMC.

They’ll meet May 16 with representatives from Blue Cross Blue Shield, their current provider, and determine changes to coverage costs.

The commissioners do not have a vote in the insurance provider decision, only in the amount paid toward employee insurance benefits. That contribution is currently $615 per month.

This often presents a stalemate of sorts — the committee is hesitant to make final decision before they know the coverage amount, while the commissioners are interested in the final choice before presenting their payment decision.

Spousal coverage

One major change moving forward is a result of both an interpretation of state law and the elimination of county-paid coverage for PMC employees. 

Previously, the county opted to forgo extending coverage to county employee spouses, primarily due to requests from PMC employees on the lower end of the pay grade. These employees requested coverage not be extended to their spouses because it made them ineligible for subsidies on the government’s health insurance marketplace. 

President Barack Obama signed the Affordable Care Act into law March 23, 2010, which instigated the development of the marketplace and other comprehensive health insurance reforms aimed at making “health care more affordable, accessible and of higher quality for families, seniors, businesses, and taxpayers alike,” according to the U.S. Department of Health and Human Services.

While the spouses could obtain insurance through the marketplace, having access through the county required them to pay full price, rather than cost based on income. 

As insurance rates continued to increase, coverage for both the county employee and spouse caused a strain on the lower-income employees, as the county pays only a set amount for the single employee.

MACO Health Insurance Trust Marketing Coordinator Shelley Murphey said the trust’s legal advisors recently issued an opinion on the state statute that addresses health care coverage for government employees, ruling that the extension is required. Committee member Jami Moody, who works as a paralegal for Sweet Grass County Attorney Pat Dringman, said Dringman also reviewed the statute and was comfortable with the MACO interpretation.

Moody didn’t expect it to be an issue moving forward because the primary opponents were with PMC.

Trust benefits

Murphey outlined coverage options for the committee based on a plan similar to their current benefits. Unlike other health insurance companies, the MACO Health Care Trust is represented by a board of Montana county commissioners elected by the membership during a noticed annual meeting. The trust was established in April 2005 as a member benefit non-profit organization.

With that, Murphey said, rate increases the last four years have been minimal — up and average of 3 percent in both 2013 and 2014 and an average of 0 percent in 2015 and 2016. Increases for individual counties are capped at 5 percent each year based on claims utilization. MACO also offers decreases to counties — up to 10 percent — based on that utilization.

To read the full story, pick up the May 12 edition of the Pioneer or subscribe to our e-edition. Current subscribers are provided complimentary access to the e-edition with registration.

By Lindsey Erin Kroskob / Pioneer Editor

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