Health insurance consultant debated for McLennan County employees

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Posted: Monday, March 31, 2014 12:01 am | Updated: 2:31 am, Wed Apr 9, 2014.

McLennan County commissioners will consider approving a contract to hire a health insurance consultant with hopes the person can aid employees and save the county money.

But commissioners are unable to provide a savings estimate and have not researched how many insurance complaints or appeals employees have filed to date.

Commissioners last week approved the creation of a $48,000 yearlong contract for RM Mayes Inc. to educate county employees on how to select and use their insurance plans. The consultant also will establish relationships with health care providers and possibly start a wellness program.

The contract will be reviewed and voted on at Tuesday’s meeting of the McLennan County Commissioners Court.

RoseMary Mayes, owner of RM Mayes Inc., said she will be able to reduce the county’s number of insurance claim appeals by matching employees’ medical needs to the plan that best serves them.

But Commissioner Will Jones, who supports the contract, said he is unsure how many claim disputes county employees have filed or how many employees are dissatisfied with their plans.

“I don’t know the exact amount. . . . The self-insured plan is relatively new. I’m not really sure percentage-wise if it’s an inordinate amount,” he said.

The county started a self-funded insurance plan in 2011 with the hope it would save money in the long run. The fund is paid for by both contributions from employees and the county. The insurance fund will pay for the consultant and had $1,820,914 in it as of Friday.

Scott & White Healthcare is the third-party administrator of the county’s insurance plans.

Jones said he expects the consultant to save money for the insurance fund by connecting employees with the least expensive doctors for their medical needs and forming wellness programs that keep employees healthier.

The health insurance fund shouldn’t deplete as quickly and eventually will enable commissioners to lower employee premiums, but the amount of estimated savings is unknown, commissioners said.

Jones said the consultant will meet with any employee who requests help in understanding his or her health insurance plan and how to use it.

Mayes said, “The insurance plan uses terminology we don’t really understand fully. (Employees) don’t ask those questions in their open enrollment meetings because people are kind of embarrassed to say, ‘I don’t understand what this is.’ They ask a coworker what plan they’re on, check that box and they haven’t really understood the benefit that they have.”

Commissioner Ben Perry said, “If you don’t understand what you’re being offered, you’re not going to get the best bang for your buck.”

The county already has five human resources employees, but Human Resources Director Butch Kelly said his department doesn’t have insurance experts.

“I think it will complement what we do. I don’t think it will take away from what we do,” Kelly said. “I don’t see it changing what we do, but there’s some expertise there we don’t have.”

Kelly said the human resources department primarily helps county employees fill out benefit forms and funnels paperwork to the correct places.

But commissioners provided little evidence county employees need more education on their insurance plans.

District Clerk Karen Matkin said she is open to anything the county does to provide more services to the employees in her department, but the clerks in her office already have a good understanding of what their plans provide.

“I think my employees understand very well. We always give them the opportunity to attend the meetings. Now occasionally, there are things that go on in the meetings or things that are said, later on we find out weren’t accurate,” Matkin said.

Matkin said she has appealed an insurance claim once and a couple of her employees have done the same, but it’s a simple process.

District clerk employees also have participated in the county’s weight-reduction programs, diabetes management classes and other wellness programs.

“We feel like we did fine with the information we had and the selections we had,” she said.

If you go

What: McLennan County Commissioners Court will vote on insurance consultant contract

When: 9 a.m. Tuesday

Where: McLennan County Courthouse Courtroom, 501 Washington Ave.

 
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