County commissioners took a first step this week to trim generous employee medical benefits they say are no longer feasible.
Changes imposed on 262 nonunion employees – including commissioners and other elected officials – will nearly triple some current rates.
Commissioner Mark Richard was told that his current $60-a-month out-of-pocket cost for full-family medical and dental coverage might rise to approximately $170 next year.
Nevertheless, county employee premiums would remain attractive in comparison with those at several other large local employers and national averages.
A Kaiser Family Foundation survey of this year’s rates for private and nonfederal public medical plans nationwide showed workers are paying $74.90 a month on average for personal coverage and $333 for full-family coverage.
That represents 19 percent of the total cost for individual coverage and 30 percent of the cost of family coverage on average.
For Spokane County to achieve its desired savings, commissioners must persuade 1,651 union employees in 20 bargaining units to accept the new package in ongoing negotiations.
“It is a matter of jobs versus benefits,” Commission Chairman Al French said.
Richard said the county government has absorbed rate increases in the past to keep medical benefits the same, but “we just can’t sustain that anymore.”
Rising medical premiums added $1.8 million to this year’s $139.3 million general fund budget.
Budget Director Bob Wrigley said the new plan would roughly offset the projected increase if all 1,913 county employees subscribe.
Commissioner Todd Mielke said eliminating more jobs to balance the budget isn’t practical if the county is to continue providing all its basic services.
“I think all of us have said enough is enough,” he said. “We can’t lay anybody else off.”
Mielke called the benefits reduction a “mid-level approach.”County officials worked with their plan administrators, Premera and Group Health, on structural as well as premium adjustments designed to achieve an average per-employee cost to the county of $1,100 a month.
“It’s more about capping our exposure than it is sharing a percentage of the cost,” French said. “It’s a first step.”
Currently, the county pays the full premiums for employees. Workers pay $45 a month to add their spouses, $35 to add a child, and $60 for full-family coverage.
Under the new Premera and Group Health medical plans, employees will pay 5 percent of their own insurance costs and 10 percent of the costs for adding family members.
The same percentages will apply to the unchanged dental plan, which now is free in all categories.
In addition to shifting costs to employees, the new medical plans reduce premiums by adjusting deductibles, “coinsurance” percentages and caps, and co-payments for prescriptions and office or emergency room visits.
Assuming medical payouts rise 10 percent next year and dental payouts rise 4 percent, county officials estimate the new Premera “preferred provider” plan would cost employees $35.03 for themselves, $125.17 with a spouse, $115.15 for a single parent and children, and $170.26 for a couple with children.
Under the same assumptions, the new Group Health plan would cost $30.71 for employees, $107.76 with a spouse, $99.68 for an employee and children and $146.03 for a full family.
Medical plans vary widely in their details and can’t be judged by premiums alone. Deciding which is better often involves intangible considerations such as choice of providers and personal needs.
A plan that pays more for office calls may be better for some, while others may benefit from an emphasis on hospital costs.
Co-pays, coinsurance percentages and stop-loss caps are just a few of the variables.
Based strictly on premiums, though, an analysis of other large employers’ medical plans shows Spokane County’s current employee premiums are uncommonly generous.
Here is what some other employees pay monthly for personal and full-family coverage:
State agencies and universities in Eastern Washington – Group Health Classic, $71 for individuals, $205 for families; Group Health Value, $30, $93; Uniform Medical Plan, $60, $175.
City of Spokane – Most of the approximately 1,050 members of Local 270, the city’s largest union, pay nothing for themselves and $160.31 to $226.68 for family coverage under four plans. Except for firefighters, other city employees have similar coverage.
Spokane Valley – Group Health, $28.15 for personal coverage, $119.92 for couples with two or more children; Association of Washington Cities plan, $85.78, $275.85.
Gonzaga University – Full-time employees (among about 1,000 covered by the university’s Premera plan) pay $20.19 for personal coverage; $369.12 for full-family coverage. Vision coverage adds $7.64 to $20.11.
Avista – About 1,500 employees pay $63.79 for personal coverage and $162.95 for family coverage under a Premera plan. Dental coverage is included.
The Spokesman-Review – About 300 full-time employees pay $148 to $800 for Group Health individual or family coverage. Rates range from $122 to $706 and from $183 to $874 under two traditional medical plans.