HUNTINGTON — Cabell County Sheriff Chuck Zerkle is asking county commissioners to switch the county’s self-insured health coverage to PEIA, the state’s public employees health plan.
Switching from Highmark Blue Cross Blue Shield to the PEIA Health Plan would save an estimated $3.7 million a year, Zerkle said, which could be passed on to employees for raises.
However, Zerkle’s request comes amid a proposal made by the CFO of St. Mary’s Medical Center, who is working with a group of health care professionals to negotiate lower costs with Highmark.
Commissioners agreed to hold off on making any decisions until Thursday’s regular meeting at the earliest, when the CFO is expected to give a presentation about how her group would go about negotiating with Highmark.
During a May 23 commission meeting, commissioners were set to vote on switching the county’s health insurance coverage from Highmark Blue Cross Blue Shield to the PEIA Health Plan. Pete Thackston, senior vice president of USI Insurance Services, was set to give a presentation on the cost benefits of switching to the PEIA coverage.
During the public comment portion of the meeting, and before Thackston’s presentation, St. Mary’s Medical Center CFO Angie Swearingen addressed the commissioners and asked them to hold off on making any changes until she could come up with a proposal to give to them.
Thackston’s presentation was then moved to the next meeting to allow Swearingen to prepare her presentation.
Swearingen said she is in charge of managed care for Mountain Health Network’s Cabell Huntington Hospital and St. Mary’s Medical Center. The two hospitals joined Huntington Internal Medicine Group and Marshall Health to form an Accountable Care Organization (ACO). An ACO is a group of health care providers that come together voluntarily to coordinate care for the patients they serve.
She said if the county will agree to work with the ACO, they would work to negotiate lower health care costs between the county and Highmark.
During a May 30 special meeting, Zerkle asked commissioners not to work with the ACO and instead make the switch to PEIA insurance, which he said would ultimately save the county money in the long term. Even though PEIA insurance comes with a slightly higher deductible and more out-of-pocket costs, Zerkle said it’s beneficial because PEIA comes at a fixed cost for the county.
For years the commission has grappled with the rising costs of health care and an overall dwindling of revenue. Commissioners have expressed frustrations with trying to budget for the self-insured health plan and costs that are prone to fluctuate from year to year.
Money saved in switching to PEIA could be passed on to the departments of the county’s elected officials, which have been operating under a 10% budget cut for the past three years, Zerkle said.
“We could give county employees pay raises. They haven’t had one in a long time, but their electric bills, water bills and phone bills have all gone up,” Zerkle said. “I am getting behind further and further with my deputies. The counties around me are paying $2,000 to $3,000 more, so why wouldn’t they just drive to the next county and go there and work?”
Swearingen said the ACO has the ability through Medicare to help manage costs with Highmark. Highmark is a third-party administrator that both St. Mary’s and Cabell Huntington use to manage their cost of care, she said.
If commissioners agree to work with the ACO, the county would be the ACO’s first client.
Commissioner Jim Morgan said he was nervous about becoming the guinea pig for the program. He is in favor of switching to PEIA and voted against a motion to delay Thackston’s presentation. He feared any further delays in moving to PEIA would hinder any potential cost-savings from making the switch.
Commissioner Kelli Sobonya said she is in favor of switching to PEIA because the costs of maintaining the county’s self-insured plan is creating a financial hardship. This is compounded by increasing costs of the county’s jail bill, she said.
She said she understands why some county employees would want to keep their current plans, which cost employees approximately $70 a month.
“My question is, we know we are broke, but what are we going to do about it and what is our plan to do something about it?” she said. “These are going to be hard decisions.”
Commission President Nancy Cartmill said she’s been approached by multiple entities, not just the ACO, with proposals to work on lowering the county’s health insurance costs. She told Zerkle she wanted to hold off on making any decisions until she listened to what members of the ACO have to say.
“All we are doing is giving them the opportunity to speak,” Cartmill said.
According to the cost-saving memo provided by Thackston, the county spends approximately $607,000 a month for employee and family plans with Highmark. The county would spend approximately $263,000 a month if it switched to PEIA’s family and employee plans.
Swearingen did not respond to emailed questions by deadline Friday.
Reporter Fred Pace contributed to this report.
Travis Crum is a reporter for The Herald-Dispatch. He may be reached by phone at 304-526-2801.