BATH TOWNSHIP — The Bath Township Board of Trustees are continuing to shop the healthcare marketplace in hopes to provide the best, affordable healthcare coverage for township employees and their families.
“The time is approaching for the board of trustees to make a decision, but I really need to have a hand on this before I make a recommendation,” Township Trustee Steve Ross said during the Oct. 4 township meeting.
Ross said he carefully examined a number of healthcare plans during the last several months and recently talked to Frank Harmon, president of the Ohio Insurance Services Agency and founder of the Ohio Public Entity Consortium Healthcare Cooperative (OPEC-HC), and Bryan Schira, president of the King Agency.
Ross explained that OPEC-HC would continue to offer Affordable Care Act (ACA) fixed rates to the township and other members of the consortium who renew their contracts for 2018. ACA rates are based on their products rather than the health status and other risk factors of the applicants. The ACA requires insurers to accept all applicants and charge consumers within a geographic area the same age-banded premiums.
However, Ross pointed out that the King Agency, which is located Holland, Ohio, is offering to underwrite the township group, which takes into account the health conditions of the township employees and their covering dependents. The agency would opt out of the exchange and shop the marketplace for the best rates.
“They can show our actual usage. We have no transplants, no babies, or significant health risks. We are pretty easy to insure,” said Ross. “The agency is pretty confident that we can get a better rate going the underwriting route than the ACA route.”
According to Ross, the King Agency sent a number of flyers from Aetna, Medical Mutual of Ohio, and other major medical insurance providers to the township trustees. He noted that these plans are being widely marketed to small groups as alternative plans to the ACA plan. The plans are not exclusive to the King Agency and are compliant to the law.
“In a nutshell, these plans are not subject to any of the ACA requirements because they are a self-funded platform. Most small-group ACA laws apply to only fully-insured health plans,” Ross said. “Self-funded plans can underwrite an individual group and take into account the conditions of the employees and their covered dependents in terms of their monthly rates for coverage. This can be a tremendous advantage to groups that do not have significant health risks within their employee population.”
Ross noted that the insurance carriers who are offering self-funded plans would be willing to offer maximum monthly rates that are significantly less than ACA rates that are fixed with high-risk factors routinely built into the rates.
Ross also noted that he did not pursue obtaining a quote from the Burnham & Flower Insurance Group because the agency is offering only ACA rates to public entities, which would be comparable to the rates OPEC-HC would be offering as of Jan. 1.
“I am looking at responsiveness, price, legal issues, business size, experience and employee turnover when evaluating one agency verses another agency. As of tonight, I am leaning towards the King Agency,” said Ross. “Within the next two weeks, we are expecting to receive a new group of insurance rates that will be effective Jan. 1.”
For the last three years, the township has been a member of OPEC-HC. However, in May, the OPEC-HC Board of Directors informed members that the consortium was facing a multi-million dollar deficit. If the township exits the consortium at the end of its contractual commitment, it will be charged a share of the deficit, which would add up to $52,000 for the 13 township employees enrolled in OPEC-HC.
In June, trustees signed and delivered a letter of intent to the OPEC-HC Board of Directors, stating that the township would withdraw from the consortium when its contract expires at the end of this year. However, township trustees have until Oct. 31 to resend the letter and renew its healthcare coverage with the consortium.
The township also joined forces with the Stark County Combined General Health Department and about 29 other Ohio governmental agencies in late August in the ongoing litigations with OPEC-HC, the Ohio Insurance Services Agency, and Frank Harmon. As part of the lawsuit, the governmental entities are pursuing relief from any potential fines and are asking for a full accounting of all money they have paid into OPEC-HC.
“If it will save the township about $20,000, that is what we are going to do,” Ross said in regards to the ongoing litigations.
Linda Collins is a freelance writer for Greene County News.