County Health Care Cost Down Due To ACA

Anita Weston, Reporter

Rich Civic Times

RANDOLPH, Utah.  November 6, 2013.  This is the time for county health insurance renewal.  Hoffman Insurance representatives presented to the Commissioners their best offer for the coming year.  They indicated that they had drawn the best policy they could provide for the County this year and still meet all of Obamacare requirements.

The national insurance bill is actually called the Affordable Care Act or ACA for short.  There are ten benefits that all insurance policies must include in order to be in compliance with the ACA laws.

“From www.healthcare.gov/blog:  What’s covered in the Health Insurance Marketplace

These essential health benefits include at least the following items and services:

1. Outpatient care—the kind you get without being admitted to a hospital
2. Trips to the emergency room
3. Treatment in the hospital for inpatient care
4. Care before and after your baby is born
5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
6. Your prescription drugs
7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
8. Your lab tests
9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
10. Pediatric services: This includes dental care and vision care for kids

Specific health care benefits may vary by state. Even within the same state, there can be small differences between health insurance plans. When you fill out your application and compare plans, you’ll see the specific health care benefits each plan offers.”

Mr. Hoffman went down through the list of requirements, explaining the changes that resulted to the suggested policy from what the County has had in the past.  ACA dictates coverage and cost on almost everything an insurance policy would contain unless expensive add-ons were desired. 

There is a decrease in cost to the County this year as a result of the ACA law. Age in the past has made quite a difference in insurance rates.  Usually the older you are, the more the insurance will cost.  The County has quite a few older employees.  ACA, however, won’t allow a 21 year-old person to pay three times less than a 54-year old.  The age of County employees accounts for the lower cost this year.  However, over time, Mr. Hoffman predicted that the costs will go up as it has in the past.

Mr. Hoffman apologized for not coming earlier in the year.  They have always presented information to the Commissioner’s in November, let the Commissioners discuss the possibilities, and then made the desired changes for the December meeting.  This year, however, ACA requires that information must be in the hands of the employees prior to December 1.  Thus, Mr. Hoffman asked if they could make a decision that day.  Since there were no changes that the law would actually allow them to make, the Commissioners accepted the proposal. 

Mr. Hoffman gave the Commissioners a copy of the eight pages of the SBC (Summary Benefits of Coverage) that must be given to each person under the policy.  He had also written an explanation of the required papers hoping it would explain to the employees what the SBC document was saying since it is rather obtuse.  Mr. Hoffman also noted that he and his father will be coming earlier next year so that the individuals taking care of the insurance would not have the pressure of getting the documents out with such short notice.

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