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The Cabell County Commission voted 2-1 on Thursday, June 13, 2019, to switch county employees' health insurance from a county-managed system to the state of West Virginia's Public Employees Insurance Agency.

HUNTINGTON - Cabell County employees will soon be giving up their county-managed health insurance for state-run coverage after two commissioners supported switching providers Thursday.

During a regular meeting, commissioners and the county's insurance agent heard from a chamber full of county employees with questions and concerns.

The three-year commitment to the state of West Virginia's Public Employees Insurance Agency (PEIA) is projected to be a savings of $3.1 million a year, which could free up the county to pursue infrastructure projects, encourage economic development or be passed along as pay raises.

However, many employees are worried that the state-managed insurance will cause headaches with more out-of-pocket expenses and less freedom to see doctors of their choice.

There are also several unanswered questions, including whether specialized medications and treatments would be covered under PEIA or if the county would reimburse those who have already maxed out their deductibles.

Commissioners Jim Morgan and Kelli Sobonya voted in favor of the switch to PEIA, outnumbering Commission President Nancy Cartmill, who voted against it and said the move was "a sad day for our employees."

The county currently manages its own health care through Highmark Blue Cross Blue Shield and picks up the bill every month for employees' health care costs. Several commissioners have long complained of the rising costs, which they said made it difficult to budget for from year to year. This is compounded by increasing costs of the county's jail bill. It was argued that switching to PEIA would come with more stability and a fixed cost, allowing commissioners to budget for it.

Pete Thaxton, the county's insurance agent, said the county currently pays approximately $6.1 million a year for Highmark Blue Cross Blue Shield, and in worst-case scenarios that could reach as high as $7 million.

If each of the county's employees and their dependents took the PEIA's most expensive health plans, that would amount to approximately $3.1 million, he said. Single employees would pay $70 a month, while families would pay $140 a month.

Several employees questioned if it was actually a savings if PEIA brought more out-of-pocket expenses and less freedom to see doctors of their choosing. They were also concerned that employees who live across the border in Kentucky and Ohio would be forced to establish primary care or see specialists in West Virginia.

"There's no question that the PEIA side of this equation is going to be West Virginia-providers driven," Thaxton said. "Are there out-of-state benefits? Yes. Are they the same as being in state? No, they won't be. What it boils down to is, can that service be done in West Virginia?"

Cabell County 911 Director Mike Davis said he submitted confidential letters written by his employees to commissioners, letting them know how a switch to PEIA could affect them. Several of his employees see specialists out of state and would not be willing to change providers.

"I can give pay raises with the savings, I'm sure, but I can't cover some of these expenses that they are going to have with a pay raise. It's not going to happen," Davis said. "I am going to lose employees."

Assistant prosecutor Joe Fincham questioned whether PEIA coverage was fully funded and if the employees' plans could be altered because of it. Thaxton said while the plans are separate from the ones used by teachers and West Virginia State Police, the county employees' plans could be altered. State legislators could lessen the county employees' coverage to help fund the state agency plans, he said.

Sobonya said her decision was a difficult one, but came down to being financially responsible with the county's money. The county is strapped for cash and the two biggest factors are insurance costs and the regional jail bill, she said.

"It's not a luxury anymore. I get called by people wanting water projects or wanting sewer projects, and I have to say, 'But we don't have money for that,'" she said. "We don't have money for anything but to pay the regional jail and pay the health care costs."

Morgan said the $3.1 million in savings would be a windfall for the county. Approximately $1.6 million of that would trickle down to the commission. They could use the money to restore budgets for the county's elected officials, which were cut two years ago because of funding problems. The elected officials could then decide to give pay raises, he said.

However, Cartmill said she's been on the commission for 17 years and remembers when the county had PEIA insurance right before she took her seat. Commissioners at the time got rid of PEIA because they preferred to spend their money giving employees good health insurance.

"I know health insurance is expensive, but it's our decision as to whether we want our employees to have good health insurance or how we want to spend our money," she said. "Quite honestly, I'm not too concerned about jail bills and I don't want to take care of criminals better than I take care of our own employees."

It's unclear when the official switch to PEIA would take place. Cartmill said the county is paid up with Highmark until the end of the year and would need to give them notice of their intentions. Thaxton said he will hold informational sessions with employees to help them choose coverage under PEIA's different plans.

Mountain Health Network, which owns Cabell Huntington Hospital and St. Mary's Medical Center, previously offered to help the county lower its health insurance costs with a strategic plan, but commissioners declined for now because the hospital network needs several months of studies and other data first.

Travis Crum is a reporter for The Herald-Dispatch. He may be reached by phone at 304-526-2801.

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