Jackson County Times

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Thursday, March 18, 2010

School Board Is Evaluating Self Insuring Approaches to Health Care

Board hears presentations on advantages of self insuring

By Sid Riley

In an effort to curb the increasingly high cost of providing health insurance coverage to the many employees of the school system, the Jackson County School Board is evaluating the possibility of “self insuring”. At Thursday’s workshop meeting the Board listened to a one hour presentation made by Mr. Lester Morales, a representative of SHIP –Willis, a firm which specializes in assisting qualified employers in creating and administering their own insurance programs. This is an increasing trend among large employers, including many school systems and governments.

Under this approach, the employer designs the features they wish to offer in their plan, and they collect and/or provide the funding for their employees to receive needed health services, and they then pay the providers. A “cap” is set for a single claim and total claims experience. If actual claims exceed that level, those claims are paid by a separate insurer who is paid premiums to function as a “safety net” to the employer’s plan. Under this approach, if claims history is less than the cap, the employer realizes a gain over the cost of conventional insurance, and if the cap is reached, the employer breaks even…realizing no gain or loss over conventional insurance.

Insurance “pools” can be formed which involve combinations of employee groups. At the meeting on Thursday, several superintendents and officials from school systems in neighboring counties were present. Thus, the possibility of combining Jackson with several other North Florida counties into an insurance pool is also being evaluated. Approaches which have been used in other areas include combining the school system employees with the county’s employee pool.

Another interesting aspect of the self insuring approaches is an associated wellness program in which members can elect to be participants. Through this enrollment the members receive discounts on their health care premiums, discounted drug costs, and other related perks. Throughout the process, noted health care problems are discussed and life style changes are counseled and assisted for improvement in chronic or potential health problems.

Some self insurers provide clinic services for members. These clinics are set up to provide basic health needs, some with doctors on staff, others with nurse practitioners. The board also plans to evaluate making agreements with existing facilities in the county to provide clinical services…if they proceed with self insuring.

One of the benefits of self insuring is that the larger pooled group of policy holders provides increased leverage for the school systems when negotiating with traditional providers for involvement. It should be noted that this evaluation is in the very early stages of study, and much work remains before any decisions on the matter are made.

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