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County employees' spouses not off insurance

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news Ellsworth, 54011
Ellsworth Wisconsin 126 S. Chestnut St. 54011

Lots of questions were asked and, while not all were answered, a solution was reached as the Pierce County Board June 24 finalized its health insurance plan changes for 2015. 

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The finance and personnel committee earlier this month approved a set of changes, which included increasing the deductibles to $1,000 (single), $2,000 (family) and out-of-pocket maximums, a three-tier premium program of single, employee plus children and family, along with implementing a wellness initiative which requires a health risk assessment, no tobacco use and an annual physical in order to have lower premiums.

The recommendations were asked to be approved Tuesday on the first reading instead of the traditional two for resolutions so finance and personnel could set the 2015 premiums at its meeting next Monday.

The county board seemed to have no objections about those changes. The one stirring the pot was a recommendation kicking employees’ spouses off the county’s insurance plan if they can get insurance through their work.

Administrative Coordinator JoAnn Miller explained previously the county has been working for the last three years to avoid paying the “Cadillac Tax” in 2018.

A provision of the Affordable Care Act was the new excise tax on high-cost health plans proposed to both slow the rate of growth of health costs and finance the expansion of health coverage. The provision has been called the “Cadillac Tax” because it targets so-called Cadillac health plans providing workers the most generous levels of health benefits. These health plans’ premiums are paid for mostly by employers, and have little cost sharing for employees.

Beginning in 2018, self-funded health plans like Pierce County would be assessed a 40 percent excise tax for health plans exceeding a certain annual limit ($10,200 for individuals, and $27,500 for self and spouse or family coverage). Therefore, the county has been asking employees to pay more for its health benefits.

Miller said the spousal option was recommended due to a couple of factors. One, the Affordable Care Act now requires an open enrollment period, which allows employees to jump on without a qualifying event. The county is concerned employees not currently covered will opt for coverage from the county. And two, their research has shown spouses have higher uses of health services and, with half of the county’s workforce covered by the plan over age 50, older participants tend to use more health care.

For more please read the July 2 print version of the Herald. 

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