Loading...
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.