6. LMC City Summary1
2014 Health Insurance Survey
Summary: CITIES 9/2/2014
Response Rate
339 of 830 cities = 41%
(Findings are reported as the number of people giving that answer followed by the percentage)
Q1: Does your city provide a health insurance plan to some or all of its employees?
yes %
236, 70%
no %
103, 30%
ALL CITIES RESPONDING:
If public sector organizations were to collaborate on health care costs, please rank the following on a scale of 1-5 in terms of what would
be the most helpful to your organization (with 1 being the most helpful and 5 being least helpful):
Model wellness program
Bargaining strategies
with union Legislative changes
Bargaining clout with
insurance companies or
health care providers in
the region Other (specify below)
rank 1 most helpful rank 1 most helpful rank 1 most helpful rank 1 most helpful rank 1 most helpful
14,7% 11,5% 36,18% 123,54% 11,23%
rank 2 rank 2 rank 2 rank 2 rank 2
41,20% 35,17% 65,32% 50,22% 2,4%
rank 3 rank 3 rank 3 rank 3 rank 3
69,34% 39,19% 62,31% 17,7% 4,9%
rank 4 rank 4 rank 4 rank 4 rank 4
62,31% 39,19% 34,17% 18,8% 9,15%
rank 5 rank 5 rank 5 rank 5 rank 5
15,7% 79,39% 6,3% 19,8% 23,49%
2
ALL CITIES RESPONDING:
Rank on a scale of 1-8 the following employee health plan subjects in terms of your interest in receiving information on them
in the future (1 being most interest, 8 being least interest):
How to
work
with
health
care
providers
Wellness
programs
How to engage
employees/unions
Affordable
care act
Retiree
health
care
How to use the
MNSure
exchange
How to
self
insure
Other (please
describe below)
rank 1
most
interest
rank 1
most
interest
rank 1 most
interest
rank 1
most
interest
rank 1
most
interest
rank 1 most
interest
rank 1
most
interest
rank 1 most
interest
40,20% 18,9% 28,14% 53,27% 12,6% 13,6% 19,10% 5,11%
rank 2 rank 2 rank 2 rank 2 rank 2 rank 2 rank 2 rank 2
38,19% 31,15% 33,16% 36,18% 20,10% 26,13% 17,9% 2,4%
rank 3 rank 3 rank 3 rank 3 rank 3 rank 3 rank 3 rank 3
40,20% 38,19% 33,16% 27,14% 21,11% 30,15% 16,8% 1,2%
rank 4 rank 4 rank 4 rank 4 rank 4 rank 4 rank 4 rank 4
28,14% 43,21% 24,12% 36,18% 23,12% 20,10% 119,0% 2,4%
rank 5 rank 5 rank 5 rank 5 rank 5 rank 5 rank 5 rank 5
25,12% 28,14% 21,10% 22,11% 32,16% 31,15% 18,9% 4,9%
rank 6 rank 6 rank 6 rank 6 rank 6 rank 6 rank 6 rank 6
13,6% 17,8% 20,10% 14,7% 46,23% 45,22% 22,11% 0%
rank 7 rank 7 rank 7 rank 7 rank 7 rank 7 rank 7 rank 7
9,4% 20,10% 17,8% 5,3% 37,19% 27,13% 54,27% 3,7%
rank 8 rank 8 rank 8 rank 8 rank 8 rank 8 rank 8 rank 8
12,6% 8,4% 26,13% 7,4% 8,4% 10,5% 34,17% 29,63%
3
Cities that provide insurance:
If Yes: Which of the following best
describes your plan:
The plan is self-insured: your
organization funds the claims of your
employees, even if you contract with a
third party to make the payments.
The plan is fully-insured: you contract with an insurance
provider such as Health Partners (and pay a monthly
premium) and they both fund and pay the claims.
The plan is purchased from and administered by a
service co-op.
9, 5% 108, 62% 56, 32%
Cities that provide insurance:
If your plan is self insured, who is your carrier or plan administrator?
blue cross %
48, 67%
medica %
10, 14%
healthpartners %
10, 14%
preferred one %
2, 3%
other
2, 3%
Other: Mayo, MN PEIP
Cities that provide insurance:
Do you provide cash in lieu for employees who decline coverage?
yes %
37, 22%
no %
134, 78%
4
If YES, what is the average monthly amount of cash given to an employee:
less than 200 %
11,30%
201-500 %
18, 49%
501-1000 %
8,22%
over 1000 %
0, 0%
Other (describe):
$2000 single, $4000 family - combined deductible (HSA)
$2500 single - $5000 family HAS
Health Partners $2000 49ers ?
one plan is $3,000 & the other plan is $500 with copays
There is no majority plan - we have 6 diff options
Two plans 2500/5000 and 4000/8000
Varies depending on selection of coverage
we have an HSA, and deductible limits are mid-range of IRS permissible deductibles
Cities that provide insurance:
What is the number of employees (not retirees or dependents or
spouses) who elect coverage?
average
69
Cities that provide insurance:
Please list both the employee and employer monthly premiums for the plan covering the majority of employees:
Employee for single
plan
Employer for single
plan
Employee for family
plan Employer for family plan
average average average average
77 524 375 1050
5
Cities that provide insurance:
For the above plan, what is the individual deductible for the plan covering the majority of employees?
$0-500 %
45, 27%
$501-1000 %
13, 8%
$1001-2000 %
39, 3%
$2001-3000 %
42, 25%
$3001-4000 %
12, 7%
more than 4000 %
6, 4%
dk/not sure %
3, 2%
other %
8, 5%
Cities that provide insurance:
Please rank on a scale of 1-4 what you see as the biggest barrier to sustaining your health plan outside of
costs (1 being the biggest barrier, 4 being the smallest barrier):
Employee knowledge and
engagement in their health
care
Collective
bargaining
agreements
Health care provider issues - e.g.
employee access to network price
competition
State and federal
laws - e.g. aggregate
value
rank 1 biggest %
rank 1 biggest
% rank 1 biggest % rank 1 biggest %
30,20% 28,19% 23,15% 70,45%
rank 2 % rank 2 % rank 2 % rank 2 %
34,23% 31,21% 58,38% 31,20%
rank 3 % rank 3 % rank 3 % rank 3 %
48,32% 27,18% 42,27% 32,21%
rank 4 % rank 4 % rank 4 % rank 4 %
36,24% 65,43% 30,20% 21,14%
6
Cities that provide insurance:
Which one of the following is your most important partner in managing your health plan?
broker/consultant %
70,41%
service coop %
45,26%
health plan %
31,18%
provider %
4,2%
employees %
21,12%
Cities that provide insurance:
Do you have a labor/management or employee committee that studies employee benefit issues?
yes %
52,30%
no %
122,70%
Cities that provide insurance:
How would you describe employees' knowledge of what drives their health care costs?
Very good %
13,9%
good %
68,45%
Fair %
70,46%
poor %
0%
7
Cities that provide insurance:
If public sector organizations were to collaborate on health care costs, please rank the following on a scale of 1 -5 in terms of what would be the most
helpful to your organization (with 1 being the most helpful and 5 being least helpful):
Model wellness program
Bargaining strategies with
union Legislative changes
Bargaining clout with insurance
companies or health care providers in
the region
Other (please
describe below)
rank 1 most helpful % rank 1 most helpful % rank 1 most helpful % rank 1 most helpful %
rank 1 most
helpful %
10,6% 6,4% 30,20% 98,59% 7,23%
rank 2 % rank 2 % rank 2 % rank 2 % rank 2 %
28,18% 31,21% 52,34% 38,23% 1,3%
rank 3 % rank 3 % rank 3 % rank 3 % rank 3 %
53,34% 34,23% 44,29% 11,7% 1,3%
rank 4 % rank 4 % rank 4 % rank 4 % rank 4 %
52,34% 32,22% 25,16% 11,7% 4,13%
rank 5 % rank 5 % rank 5 % rank 5 % rank 5 %
11,7% 45,30% 2,1% 8,5% 17,57%
Other (describe):
Employee education
Employee Education about Healthcare cost drivers
Employee costs
Get rid of aggregate value issue
grouping for larger pool when determining costs
Healthcare costs
Information that would help convince Council that this is a valuable retention tool for employees
Joint educational efforts to employees
Keeping costs down
Making Hospitals and Drug Co. explain and curb not only high costs but the price differences from Hoispital to Hospitals.
8
Cities that provide insurance:
Rank on a scale of 1-8 the following employee health plan subjects in terms of your interest in receiving information on them in the future (1 bei ng most
interest, 8 being least interest):
How to work with health
care providers
Wellness
programs
How to engage
employees/unions
Affordable
care act
Retiree health
care
How to use the
MNSure exchange
How to self
insure
Other (please
describe below)
rank 1 most interest %
rank 1 most
interest %
rank 1 most interest
%
rank 1 most
interest %
rank 1 most
interest %
rank 1 most interest
%
rank 1 most
interest %
rank 1 most
interest %
34,23% 17,11% 22,15% 43,28% 5,3% 10,7% 5,3% 4,13%
rank 2 % rank 2 % rank 2 % rank 2 % rank 2 % rank 2 % rank 2 % rank 2 %
30,20% 26,17% 30,20% 28,19% 15,10% 15,10% 7,5% 2,6%
rank 3 % rank 3 % rank 3 % rank 3 % rank 3 % rank 3 % rank 3 % rank 3 %
36,24% 29,19% 29,19% 19,13% 15,10% 19,13% 10,7% 1,3%
rank 4 % rank 4 % rank 4 % rank 4 % rank 4 % rank 4 % rank 4 % rank 4 %
19,13% 34,22% 20,13% 27,18% 18,12% 14,9% 13,9% 2,6%
rank 5 % rank 5 % rank 5 % rank 5 % rank 5 % rank 5 % rank 5 % rank 5 %
16,11% 20,13% 19,13% 17,11% 25,17% 27,18% 13,9% 1,3%
rank 6 % rank 6 % rank 6 % rank 6 % rank 6 % rank 6 % rank 6 % rank 6 %
10,7% 12,8% 14,9% 11,7% 34,23% 36,24% 18,12% 0,0%
rank 7 % rank 7 % rank 7 % rank 7 % rank 7 % rank 7 % rank 7 % rank 7 %
5,3% 11,7% 7,5% 3,2% 30,20% 21,14% 51,34% 1,3%
rank 8 least %
rank 8 least
% rank 8 least %
rank 8 least
%
rank 8 least
% rank 8 least %
rank 8 least
% rank 8 least %
1,1% 5,3% 9,6% 3,2% 6,4% 7,5% 32,21% 21,66%
Other (describe):
Administering a cafeteria plan and additional benefits
Employee Involvement
Employer Use of Exchanges
How to minimize the costs of medications.
Private Exchanges
Seeking bids/quotes for all providers including MnSure
Understanding Insurance Policies
9
Cities that provide insurance:
Other comments:
Being a small city, with only 5 full time employees, and currently 3 of those employees getting insurance through their spouses employers (IBM & Mayo)
we have very few options.
Expertise on regulations governing HRA/HSA/FSA and interaction with HDHPs.
For question 7: We pay a flat amount toward insurance, so ee contribution to health insurance varies based on the employee's selections. Our employee's
are educated on what they should be doing - eating right, exercising, etc. I'd be interested in how to get them to take the next step - implementing it!
Happy to help in any way I can! I was not on this email; it was forwarded by my HR director. Please remove JoAnn Lempke and/or Ron G uilfoile (both
retired) and replace with me on any active lists. Thanks! NL
Health insurance is confusing and expensive.
Premiums were $577 per quarter before the affordable care act and $977.25 after the affordable care act. Same coverage.
Questions 4 & 5: We don't pay cash, but rather require the money to be put into a retirement account (457 plan or whatever)..
The coop provides the service and education we need; employees are not engaged because they choose not to be. I didn't like that I was u nable to put
more then one item as very low priority.
The insurance program the way it is now is much too complicated and sounds like it is only going to get worse as deadlines are met. I have gone to
workshops and listened to professionals explains the law changes, but still is confusing. Am in fear that I will not comply with something and end up
having the city fined.
The small cities seem to suffer the most when it comes to health care costs. It would be nice if there was a way we could collaborate as one large
insurance group or join a larger group to get the better costs. Although, we do now have the option of going with the MnSure program, the program isnt
the best for the older generation as teh costs are more than what we would currently pay. So it does benefit for the younger group but not the older.
This is our answer to number 7 since it does not fit within your parameters. Cost of Coverage: Single: $791.18/month Employee plus one:
$1,660.94/month Family: $2,219.98/month For 2014, the City pays the first $850/month of all insurance (health, dental, life , disability, long-term care).
A single employee has to pay out of pocket if they want all of those benefits (or they can just take health, dental, and basic life for about the $850). If
someone wants to cover additional family members, they would have to pay out -of-pocket - anything above the $850. As the price is pretty steep, no one
has done that as of yet. Employees that do not take the health benefit, receive money in their deferred compensation account . The amount is equal to
$850 minus any elective insurance (dental, life, disability, long -term care.)
We are a very small city with only 3 full time employees. We all have family coverage and our families range in size and ages. Our most long term
employee has himself, wife and a 25 year old insured, our other employees has himself, wife and 3 older childre n and I have myself, husband and 3 small
children all under the age of 5. It can be difficult trying to figure out our rates each year since we have so little insured . If 2 people have something major
done during the year, our premiums sky rocket. In the last year, we as employees offered to increase our deductibles to try and reduce cost to the city, but
the council declined and decided to stick with our current plan, which went up 13% from the previous year.
We are looking at what a Private Exchange could offer us in terms of meeting a wider variety of needs as well as stabilizing cost. New ideas should be
pushed out for employers to learn about such as real time transparency tools for CDHPs that employees can use to make informe d choices. Tools can
lower claim costs and have a higher employee satisfaction. Informing employees and urging use of telemedicine as a cost co ntrol for some general or
specialty care.
We are quite different in our approach to benefits in that we have a cafeteria plan, and provide a flat dollar amount to all employees regardless of family
status and they must not only purchase their heath insurance with these dollars, but all other benefits too, including dental , life, and LTD, flex accounts,
10
HSA accounts, so it's always hard to compare with other public sector agencies. Even this survey was difficult to answer on the questions regarding
premium cost for the plan with most employees as they have 6 different choices and they are spread out across the plans. The new "concept" that brokers
are promoting now, is what we currently offer, they are just re -branding the name from a cafeteria plan approach to a marketplace or private exchange
whereby you give employees a defined dollar amount and they pick and choose their benefi ts.
We don't have any unions in the city. We use Personnel Policies to dictate the distribution of premium costs between employe r and employee.
we have 2 employees, the city covers $200 per month per employee we went on our own and got HealthPartners 3 for free plan with $4000/year
deductible after 3 single coverage for clerk is 346.17 per month = 146.17 taken out of check maintenance has family plan 639.43 per month 439.43 out
of check
We use Resource Training & Solutions (an insurance co -op for counties, cities and school districts) and have Blue Cross/Blue Shield coverage. What is
frustrating here is that we are very small and avenues to find information seem limited. Due to the fact our employees (2) ar e fully covered by the city, the
employees would like to deduct from their gross pay for spouses premiums. No one seems to know exactly how we can do this or if it is a llowed. Our
state acctg system (CTAS) doesn't have the capability to not remove taxes from what we perceive to be an allowable ded uction from our gross pay to
ensure our spouses are covered. The state is working on a new CTAS program and hopefully that will be addressed.
We would like more information on benefits from city to city and what other types of benefits could we offer.
With medical technology advancements, we wonder why the cost of medical care continues to go up. Not everything is in the "test ing" stages that would
make the cost of medical care so high. As we progress and more is developed, our hope is that the cost of me dical care would truly go down or at least
remain steady enough to handle any increase that might/will come along.
Cities that do NOT provide insurance:
Does your organization provide a stipend for employees to purchase health insurance on their own?
yes %
39%
no %
61%
Average stipend is $451 per month
Cities that do NOT provide insurance:
Do you have a labor/management or employee committee that studies employee benefit issues?
yes %
5,6%
no %
81,94%
11
Cities that do NOT provide insurance:
How would you describe employees' knowledge of what drives their health care costs?
Very good %
7,12%
good %
21,36%
Fair %
30,52%
poor %
0%
Cities that do NOT provide insurance:
If public sector organizations were to collaborate on health care costs, please rank the following on a scale of 1-5 in terms of
what would be the most helpful to your organization (with 1 being the most helpful and 5 being least helpful):
Model wellness
program
Bargaining strategies
with union
Legislative
changes
Bargaining clout with insurance
companies or health care providers in the
region Other (specify below)
rank 1 most
helpful % rank 1 most helpful %
rank 1 most
helpful % rank 1 most helpful % rank 1 most helpful %
4,9% 5,9% 6,12% 25,41% 4,24%
rank 2 % rank 2 % rank 2 % rank 2 % rank 2 %
13,28% 4,7% 13,26% 12,20% 1,6%
rank 3 % rank 3 % rank 3 % rank 3 % rank 3 %
16,34% 5,9% 18,36% 6,10% 3,18%
rank 4 % rank 4 % rank 4 % rank 4 % rank 4 %
10,21% 7,13% 9,18% 7,11% 3,18%
rank 5 most
helpful % rank 5 most helpful %
rank 5 most
helpful % rank 5 most helpful % rank 5 most helpful %
4,9% 34,62% 4,8% 11,18% 6,35%
12
Other (describe):
all ranked 5
all ranked 5
Allowing for HRA or HSA for employees when health insurance isn't provided. Also, providing a database
similar to the salary database which shows city contributions to employees.
cost
cost to City and/or employees
doesn't apply to our city
Funding
health care not provided nor provided for
LOWER COST!
Lower premiums
none
none-all 3 employees are part-time
small town won't offer
UNDERSTANDING THE NEW REQUIREMENTS
Cities that do NOT provide insurance:
Rank on a scale of 1-8 the following employee health plan subjects in terms of your interest in receiving information on them
in the future (1 being most interest, 8 being least interest):
How to work with
health care
providers
Wellness
programs
How to engage
employees/unions
Affordable
care act
Retiree
health care
How to use the
MNSure
exchange
How to
self insure
Other
(please
describe
below)
rank 1 % rank 1 % rank 1 % rank 1 % rank 1 % rank 1 % rank 1 % rank 1 %
6,11% 1,2% 6,12% 10,20% 7,14% 3,6% 14,28% 1,7%
rank 2 % rank 2 % rank 2 % rank 2 % rank 2 % rank 2 % rank 2 % rank 2 %
8,15% 5,10% 3,6% 8,16% 5,10% 11,21% 10,20% 0%
rank 3 % rank 3 % rank 3 % rank 3 % rank 3 % rank 3 % rank 3 % rank 3 %
4,7% 9,18% 4,8% 8,16% 6,12% 11,21% 6,12% 0%
rank 4 % rank 4 % rank 4 % rank 4 % rank 4 % rank 4 % rank 4 % rank 4 %
9,17% 9,18% 4,8% 9,18% 5,10% 6,11% 6,12% 0%
rank 5 % rank 5 % rank 5 % rank 5 % rank 5 % rank 5 % rank 5 % rank 5 %
13
9,17% 8,16% 2,4% 5,10% 7,14% 4,8% 5,10% 3,21%
rank 6 % rank 6 % rank 6 % rank 6 % rank 6 % rank 6 % rank 6 % rank 6 %
3,6% 5,10% 6,12% 3,6% 12,24% 9,17% 4,8% 0%
rank 7 % rank 7 % rank 7 % rank 7 % rank 7 % rank 7 % rank 7 % rank 7 %
4,7% 9,18% 10,19% 2,4% 7,14% 6,11% 3,6% 2,14%
rank 8 least %
rank 8 least
% rank 8 least % rank 8 least %
rank 8 least
% rank 8 least %
rank 8
least %
rank 8
least %
11,20% 3,6% 17,33% 4,8% 2,4% 3,6% 2,4% 8,57%
Other (describe):
all ranked 8
all ranked 8
doesn't apply
How to get group rates for small cities
N/A
no idea
no one full time
none
none
Picking insurances that best fit the individual
Cities that do NOT provide insurance:
Other comments:
All subjects are of least interest
City has no full time employees
I am having trouble with section 7. When I check the response section for one line, a previous check on the line
above disappears.
I am the only full time employee here at the City and I am on my husband's insurance plan as he is union and has
an exceptional health care plan.
I don't think our city cares if we have health insurance or not. We only have 2 employees.
one full-time employee, one part-time employee - no health plan
The City of Dakota does not have any fulltime employees.
The City of Ortonville pays each full time employee $660.00 a month to find their own policy. Regular part time
is prorated according to hours worked per month. This works good for us.
14
There are four of us here that do NOT get a stipend, and need to find our own health care - for a single person
under the new law it would cost me $1300 A MONTH for a deductible of $500 - now if I wanted a $3000
deductible it would cost me $350 - however, I would need to go to the doctor at least 15 times to make up the
deductible! I might as well take the fine for not having insurance, because it's cheaper than the monthly rate, and I
would still need to pay the doctor with my own money. So, how is this helping the middle/lower class peopl e,
when now I have to pay MORE out of pocket than before?
We are a small city and do not have any full time employees
We are a small city with only about 38 households and do not have a full time employee.,
We are a small town and no full time employees. We won't ever offer health insurance.
We are a very small city (160 residents) our city staff consists of a part -time clerk and a "on-call" utility person.
We are a very small, volunteer city. No one even makes enough to pay PERA.
We are too small to have health care for employees.
We do not have any full time employees.
We have 4 employees total and I am the only full time employee.
We have been trying to get a group health insurance plan for our city for two years. The agents can only come up
with unaffordable premiums for us.
We have no employees
we really have no full time employees. elected officials do what they can. contract out police and fire. hire
occasional help.