Board seeks health care plan guidance
by Mike Eldred
Sep 19, 2013 | 1874 views | 0 0 comments | 39 39 recommendations | email to a friend | print
DOVER- Employee health care took center stage again at Tuesday evening’s selectboard meeting, as board members and town employees grappled with the change from traditional health insurance to the “health care exchanges” under Vermont Health Connect.

At a previous meeting, Larry Smith, a representative from the Vermont League of Cities and Towns, met with the board to explain their role in providing employee insurance. He advised the board to decide how much money it will provide for each employee as soon as possible, before the October 1 deadline. After that, it’s up to each employee to choose a plan that meets their needs by December 31. Smith suggested employees choose their plan as soon as possible after the board makes their funding decision.

Dover currently pays all health insurance costs for their employees, funding their deductibles through individual health savings accounts. Under the new system, Smith told board members, they could fund any amount, including health accounts that would cover the deductibles.

On Tuesday, board members asked employees for their input on which plan the board might base their funding decision. “We pay, you choose,” said selectboard chair Randy Terk. “We decide how much we’re spending, so we want your input.”

Dover Police sergeant and soon-to-be chief Randy Johnson urged the board to keep the town competitive with other municipalities. “Health insurance is a big benefit and people care about it. We have to remain competitive to get people to come here.”

The top level of insurance under Vermont Health Connect’s exchange is the “platinum” plan, a low-deductible, high-benefit plan that’s also the most expensive. If the town were to fund the platinum plan for each employee and contribute to a health savings or health reimbursement account, the increase in cost over the current system would be about $90,000 per year. Currently, the town pays about $246,749 for a high-deductible plan, and pays a total of $76,000 in contributions to employees’ health savings accounts – a total of $322,749.

A similar setup to fund the platinum plan and a health reimbursement account would cost $411,734 the first year. But Terk pointed out that the calculations are based on current employees, which includes at least four single-person plans. With the projected hire of at least two replacement employees who may have families, he suggested the board should plan for an even higher number. The town could save money in subsequent years, however, by funding “health reimbursement accounts” rather than the “health savings accounts” that they currently fund. Any unused money in a health savings account at the end of the plan year is retained by the account holder – the employee. With a health reimbursement account, the money belongs to the town and it would only need to be “topped off” every year.

Terk said the board planned to fund 100% of the cost, although other board members appeared apprehensive about making the same commitment. “It’s not about paying 100% of insurance,” said board member Joe Mahon, “For us, it’s about coming up with a dollar figure.”

“We’ll pay 100% of an amount,” added board member Tom Baltrus.

Terk clarified that the board planned to fund an amount that would allow employees to purchase one of the plans. Employees would still be able to purchase any plan – if the plan they choose costs more than the town provides, the employee must pay the difference. “We might say we’re going to fund an amount equivalent to (one of the plans). If everyone picked the plan on which we based our calculation, then that’s 100% going to cover the cost for everyone.

“What’s not certain,” Terk continued, “is which plan we’re basing our funding on. We could choose the bronze plan, we could choose MVP or Blue Cross and Blue Shield (providers). We want some guidance. It might be easiest to say ‘We want the platinum plan,’ but it may not be what you need. A lot of you are stakeholders because you’re property owners and you want to keep your taxes low, as we all do.” Treasurer Patty Westlake objected, apparently under the impression that the board was asking employees to sign up for a plan before the board decides what it will fund. “That’s not fair,” she said. “If I’m a single person and you’re going to allow me $500 per month for a premium, I know what I have to spend. You can’t expect us to pick a plan without knowing what dollar amount you’re going to give us.”

If the board decides to fund 100% of insurance costs, including any health account for deductibles, the platinum plan might be the least expensive. Other plans, with higher deductibles, could cost the town as much as $479,142. The least expensive plan, the “bronze” plan, for example, would cost about $196,925 per year in premiums based on the current number of employees. But funding a health reimbursement account for employee deductibles could cost as much as $241,300 per year – a total of $438,225 the first year and any year the account is depleted. But the town could gamble and hope the fund would not be emptied over the year.

Police department employee Michelle Mann said she was less concerned about which plan the board chooses, and more concerned about minimizing her out-of-pocket expenses for medical care. Unless the board decides to fund employees deductibles, she said she’d prefer the platinum plan.

“So say we chose the bronze plan, but we had an HRA (health reimbursement account) that covered the out-of-pocket?” asked Terk.

“If you cover it, then I’m fine with it,” she said.

“That’s the whole point of this conversation,” Terk said. “We don’t necessarily need to come up with an amount that funds the platinum plan, we might come up with a lesser plan amount and fund and HRA, and everyone’s happy.”

In other matters, economic development director Ken Black said there was “confusion” regarding the portion of the Valley Trail that will connect Wilmington and Dover. Black said the proposed route has changed at least twice over the last week. Black said he walked the “Sherwood Forest” trail, which terminates on Handle Road near the town line. “From what I understood, the trail would continue down Handle Road to the Haystack gate house and continue on another route that would go over Haystack East and eventually come out in the center of Wilmington.”

But Black said he heard from Jim Barnes, who Black said has agreed to “sure pack” the trail, that a portion of the trail had shifted from the Sherwood Forest trail to another trail following an existing power line. Later in the week, he heard from another source that the portion near the town line was back to Sherwood Forest.

The good news, Black said, is that Wilmington has obtained permission from all of the landowners along the proposed route. “But I’m still confused as to what the real deal is,” he said.

Black proposed putting two informational kiosks on the Dover portion of the trail, one at the town line between the Sherwood Forest and Crosstown trails, and one at another trail junction. “But I don’t want to order anything until I know where the real trail is.”
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