All city of Waupaca employees will pay higher deductibles under the new health plans approved by the Common Council at a special meeting on Nov. 1.
However, Waupaca police officers face the highest deductibles and medical co-pays in 2012.
Under the current health plan, all city employees have deductibles of $250 for individuals and $500 for those on the family plan.
Now, the city will have two separate health plans: one for employees who contribute to their pensions and a separate plan for the police officers who are not contributing to their pension.
Police and firefighters are exempt from the state’s new requirement that all state and local employees contribute 5.9 percent toward their pension. As a result, the city’s health plan requires that they pay higher deductibles than employees who are making that contribution.
City employees who are contributing to their pension will have deductibles of $2,000 if they are on the single plan and $4,000 for the family plan.
For this group of employees, the city will also fund a Health Reimbursement Arrangement of $1,500 for those on the single plan and $3,000 on the family plan.
In 2012, for employees contributing toward their pension, the HRA will cover much of their deductibles.
Those on the single health plan will pay the first $500 of their $2,000 deductible, with the HRA then covering the next $1,500. It will be the same for those on the family plan. In those cases, they will pay the first $1,000, with the HRA then covering the next $3,000 of the $4,000 deductible.
After deductibles are met, there will be 100 percent in-network coinsurance.
The city will only fund an HRA for the employees (and covered spouses) who have a biometric screening and complete a health risk assessment.
The plan approved for the city’s police department also calls for deductibles of $2,000 for employees on the single plan and $4,000 for those on the family plan.
However, the city is not funding an HRA for the police. They will pay the full amount of the deductible. And, after reaching the deductible, police officers will then have an 80/20 in-network co-pay on their medical bills.
The carrier for both plans will be the WEA Trust.
There were questions and comments about that aspect of the health plan during the Nov. 1 council meeting.
“The law was made. We didn’t ask to be made exempt,” Officer Josh Krueger said.
Mayor Brian Smith told him to “have a seat.”
After the council’s votes on the two separate plans, Smith said there was one negotiation with the police officers. “It lasted less than an hour. We brought forward a plan,” he said.
The city proposed that the police contribute the same percentage toward of their pension. The law enforcement association rejected that proposal.
“Your health insurance plan could be the same as the other city employees through negotiations,” Smith said.
Lisa Benitez is the president of the city’s law enforcement association. In an interview with the County Post West that took place prior to the Nov. 1 council meeting, she said police and fire are exempt from being required to contribute toward their pension.
“This is happening in other municipalities. In the city of Eau Claire, a lawsuit has been filed,” she said. “Cops are being given exhorbant deductibles because they are exempt from the retirement payment.”
Details of the plan were covered on Nov. 3 in two separate meetings for employees.
City Administrator Henry Veleker said questions about the wellness aspect of the plan came up extensively during those meetings.
“At this point,” he said, “the expectation is that at a minimum, they will have to do the health assessment questionnaire and the blood work for the employee and spouse to get the city to fund the HRA.”
It is anticipated that a Wellness Committee, made up of city employees, will be formed to look at what things will be done beyond that, Veleker said.
“Moving into it for the first time, there will be some (wellness) activities this coming year,” he said. “How many employees will have to do is yet to be determined. But, the expectation is that they will have to go beyond the health risk assessment and blood test.”
During the Nov. 1 council meeting, Smith said the new plans represent a “radical change” for what employees and the Common Council are used to seeing.
“Any time you have changes,” he said, “employees will be concerned. I think you will find out this plan is a better plan than what we had before.”
Vickie Thoreson of M3, which is the city’s health insurance consultant, told the council the ultimate goal has been to keep the best benefits at the most affordable cost.
For 2012, the plan year begins on Jan. 1 and ends on Sept. 30. The city wants to move the beginning of its plan year to Oct. 1 of each year to coincide with its budget planning.
While next year’s plan year will be for nine months, subsequent ones will be for a full year.
Thoreson said that with the WEA Trust, there is a full statewide network of physicians and hospitals, as well as a national network.
“All the providers in Waupaca are part of the network and also going east and west,” she said.
There are some things there is little or no control over, such as an aging population, new technology and drugs, the overall inflation of medical services and the trend of people using more specialty providers versus primary care providers, she said.
Engaging employees in talks about health risk factors and things they can do to be healthier is something the city can do, Thoreson said.
“Lifestyles add costs to health plans,” she said. “The information will be confidential. It would be illegal for the employer to see any personal data.”
Requiring employees to participate in wellness activities in order to have an HRA funded is an arrangement she sees throughout the state.
“We work with about 150 schools. Many are doing the same thing,” Thoreson said. “All we want to do is get the employees in and let them know what their numbers are.”
Health coaches will be available to help them, and she said employees will not have to “pass a test” in order to receive the HRA funding.
Under the new state law, plan design and choice of carrier are no longer bargainable items, Veleker said.
However, the cost share on the premium can still be bargained, he said. All city employees will pay 10 percent of their monthly premium.
During the Nov. 1 meeting, Officer Bret Rodenz noted that an officer has a baby due the first week of January and there is a feeling he is being penalized with the new plan.
Thoreson said that even if the city had not changed carriers, its plan year would have ended on Dec. 31.
Krueger said, “As we go forward, where does this leave us as far as insurance goes?”
And, Dectective Sergeant Brian Hoelzel, one of the five non-represented law enforcement employees, said that while understands why they have higher deductibles, he questioned why they are responsible for the next 20 percent after that deductible is met.
Rodenz said if a city officer was making the pension contribution, it would be $3,800 to $4,000 per year, he said.
He asked why their health plan includes potential costs above that. The 80/20 in-network coinsurance after the deductible is met could result in some paying as much as $6,500 out of pocket in 2012, he said.
“You’re talking to the wrong people,” the mayor said. “It’s all about negotiations.”
In regard to the pending court case in Eau Claire, Smith said, “Our labor attorney doesn’t feel they’ll win that. We do have the money budgeted to cover the HRA for police (if the police in Eau Claire win).”
On Nov. 4, Veleker said this of the 80/20 plan design for police, “We have the ability to do that. Our goal is to try to instill a little fairness across the (city) organization as far as what employees contribute. This is what we felt is fair. I know the police feel they are being singled out.
“The police are not required to pay toward their pension. I do know of other municipalities in the state where they agreed to pay toward their pension.”
For the five non-represented city law enforcement employees, they have until Dec. 1 to decide to contribute 5.9 percent toward their pension and thus qualify for the plan being offered to the other group of city employees.
“They have to make their judgments. We respect their decision as far as whatever they want to do in their best interest,” Veleker said.
The city will sit down with the police union if it is interested.”