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First Posted: 11/1/2013 Luzerne County government&#8217;s health insurance plan has been described as generous, and employees may be willing to accept less coverage or pay more to reduce layoffs in 2014, officials say.
Union leaders Paula Schnelly and Charles Majikes said they told the administration they will consider health care alterations if they receive a written menu of options with the projected savings.
Both emphasized no changes would be accepted unless they are presented to their union members and accepted by majority vote. Schnelly represents more than 400 union workers in the American Federation of State, County and Municipal Employees, or AFSCME, union, and Majikes is among 81 adult and juvenile probation officers and domestic relations support officers.
Schnelly, Majikes and other county union representatives have been meeting with county Manager Robert Lawton about strategies to reduce an estimated 217 layoffs needed without $2.4 million in workforce concessions and $8 million from a proposed 8-percent tax hike next year.
Copayment increases
Increasing copayments is one possible concession being researched, Lawton told council during his 2014 budget presentation last week.
The county&#8217;s copayment is currently $10 for both primary care physicians and specialists and $50 for emergency room visits that don&#8217;t result in hospital admittance. Lawton said he is awaiting analysis on the savings from various copayment increases.
County employees also pay no deductible.
County Councilman Stephen A. Urban said at last week&#8217;s budget session his private-sector employer&#8217;s insurance plan requires him to pay a $3,000 out-of-pocket deductible each year before his insurance covers medical treatment beyond a wellness physical.
Urban also reiterated his call for employees to start contributing more toward health care.
&#8220;We&#8217;re paying almost every cost for every employee in this county, and that&#8217;s got to end,&#8221; he said.
County workers pay flat fees or percentages toward health care, but Lawton said the percentage amounts haven&#8217;t increased in several years to keep pace with rising costs.
The county pays about $9,000 annually for single insurance coverage and $24,000 for family, Lawton said.
Employee contributions
The 10-percent contribution paid by non-union and many unionized employees amounts to $526.50 per year for single coverage and $1,286 for family.
Based on Lawton&#8217;s projections, these 10-percent contributions should be upped to $900 for single and $2,400 for family.
The flat rates paid by some unionized workers are less.
For example, prison employees pay $720 a year, which amounts to 3 percent of the cost of family coverage.
Probation/domestic relations officers pay $480 for single coverage and $1,140 for family. Court-appointed support staff workers hired before March 1, 2006, pay $360 a year for single and $900 for family coverage.
The highest county health care contributions are in the court-related union represented by AFSCME, which has a contract awarded through binding arbitration requiring employees hired after May 1, 2013, to pay 15 percent. The others pay flat fees or 12 percent but will all switch to 12-percent contributions on Jan. 1.
New county detectives also must pay 12 percent, but those hired before 2013 pay $1,200 annually.
County officials can increase the payment amounts at any time for employees contributing percentages because they are supposed to be paying a percentage of the &#8220;true cost of health care,&#8221; Urban said.
The only exception is for assistant public defenders/district attorneys because their contract, which expires at the end of this year, has a cap saying the 10-percent can&#8217;t exceed $598 for single coverage annually or $1,300 for family.
Fiscal problems
Lawton cited rising health care costs as one of the county&#8217;s fiscal problems during his budget presentation.
The county is expected to hit its $15.1 million budget allocation for health care in 2013 and has been advised to allocate $20 million next year based on claims history and inflation, he said.
The budget can&#8217;t absorb an increase that high, said Lawton, who is taking a risk by allocating $17.7 million next year. The earmark includes costs for government branches largely reimbursed by state and federal funding.
The county pays most claims out-of-pocket because it is self-insured. Switching to a private insurance plan would cost about $1 million more, Lawton said.
Special &#8220;stop-loss&#8221; insurance covers the cost of individual claims over $300,000 if employees must undergo expensive treatment. Lawton said that&#8217;s &#8220;great&#8221; if one employee requires $3 million in treatment but said the county must pay $2.5 million if 10 employees have claims totalling $250,000 each.
Councilwoman Elaine Maddon Curry told Lawton $20 million is &#8220;on the high side&#8221; and questioned if the administration is following the lead of many other workplaces that are requiring employees who smoke to pay more toward health insurance.
Lawton said he is exploring wellness programs that could reduce claims and plans to explore all options to reduce county health care expenses.
Council&#8217;s strategic initiative committee, which developed proposed workforce standards, has recommended employees who smoke be forced to pay any smoker-related premium costs.

County eyes health insurance savings