During last Wednesday’s (Dec. 7) Sunbury Village Council meeting, Insurance Committee member Scott Weatherby announced changes ahead for the village’s employee health insurance program.
Weatherby said Sunbury’s insurance broker, Chris Whittkop with Arthur J. Gallagher & Co., has said if the village continued to reimburse employees for health care costs at the current rates, the village would be in non-compliance with the Affordable Health Care Act.
“Basically what we’re faced with is going back to a traditional 80/20 plan,” Weatherby said. “Starting in January employees will make a five-percent contribution to their individual premium cost if they are non-tobacco users, 10-percent of their premium if they use tobacco.”
Weatherby said the employee’s health insurance would still be with United Healthcare, but there would be an additional premium assessment tied to a wellness program.
“Our insurer will offer a free health assessment,” Weatherby said. “If our employees don’t complete the wellness assessment by April 1, nicotine users will pay 15-percent of their premium. It’s not punitive to require taking a free wellness assessment. We’re doing this because this is the reality we live in now. You’re going to see more of this across-the-board.”
If they want to keep insurance costs low, Weatherby said employees must sign an affidavit that they have not used nicotine in the past 90 days. A saliva swab during the wellness assessment would detect nicotine use.
If approved by council, the new health insurance plan would require a $35 co-pay for in-network office visits, and a $70 co-pay for out of network; and the plan includes a 20/40/70 prescription plan.
“The maximum out-of-pocket will be $6,850 for a single employee, $13,000 for a family plan,” Weatherby said.
Weatherby said the Insurance Committee checked with other central Ohio municipalities and discovered that many of them require employees to pay 10-percent, 20-percent, and even 30-percent of individual premium costs.
Council member Tim Gose, who works in the insurance industry, said Sunbury’s employee contribution to health care costs is well below everyone else in the area.
Council member Len Weatherby agreed that the United Healthcare option is, in his words, a good plan.
“It’s a reasonable maximum out-of-pocket,” Weatherby said. “And it allows people to make payments.”
Reporter Lenny C. Lepola can be reached at 614-266-6093.