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County seems to be for tactics to avoid wasting on medical insurance

MADISON — Health insurance is a big expense for employers, including Madison County.

At its most recent meeting, the county board received a report of Blue Cross/Blue Shield health insurance activities from Judd Allen, a representative of Nebraska Association of County Officials.

Madison County, like many other government and private entities, began a cash-in-lieu program a couple of years ago. Through it, eligible employees who don’t enroll in the county’s health insurance may receive a monthly stipend.

The county had about 30 employees take advantage of it last year, but the number could probably be higher. That would help the county to save money, Allen said.

Allen suggested that he could meet with employees in October to explain it one-on-one if that helps. In addition, Blue Cross/Blue Shield might send a representative. The county also might consider increasing the amount it offers to employees based on what other counties offer.

“It might be time to revisit it,” Allen said, “and talk to those employees who are eligible for it.”

In general, employees who are over 65 or have health insurance coverage elsewhere are eligible for a cash-in-lieu payment.

The county also has a $2,500 deductible and a high-end deductible of $6,000 for employees enrolled in its health insurance. No employees last year chose the high-end deductible.

Commissioner Christian Ohl said the high-end plan likely would be attractive to employees who don’t have a spouse or family and generally have low health insurance expenditures.

Ohl said what might be stopping employees from signing up is a fear that once they sign up for it, they can’t opt back into a lower-deductible plan in a few years.

Allen said he wasn’t sure of the rules on that, telling board members that he would do some research to find out if employees can opt back into a lower-deductible plan.

Employees who opt into the higher-deductible can get $1,000 per year placed into their own health savings account by the county. Those funds may be rolled over year after year if they aren’t spent.


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