Health-care cost may change in Sunrise

The city of Sunrise is looking to lower the cost of health care for itself and city employees. One of the first steps would be a self-funded model of health care.

City commissioners voted in a new policy effective Jan. 1 that they hope will drastically cut down on the overall cost of health care the city has to pay to insurance companies and reduce the premiums city employees have to pay.

"We are taking steps to move to a self-funded model," City Manager Alan Cohen said. "The difference between where we are right now and where we are going is, we will continue to pay for direct health costs, [and] we'll continue to pay for administrative costs. We will not be paying for profit on our health-care costs, and also we will have the ability to garner significant cost savings over time."

According to Cohen, in the last 10 years, approximately $6.6 million went straight into the pockets of the various health insurance companies the city has had during that time period money that could have gone into reserves instead.

"One of the great frustrations we've all sensed here is that every year the insurance companies come in for a 10-percent raise," Mayor Mike Ryan said. "We seem to accept that the insurance companies get 10 percent year after year. This is an opportunity for all of us to work together to try and keep those premiums down. When they are kept down through wellness or otherwise, that everyone benefits from it and it's not just the insurance companies harvesting that profit for themselves."

The city will be using health insurance group AvMed to the tune of $14,926,000 per year to facilitate the administrative side of the health care.

The money saved from not paying health-insurance profits will now go into city reserves that can only be used for health-care costs as per state law.

The contract with AvMed includes their network of doctors, physicians, and specialists. The good news for city employees, according to Cohen, is that 96 percent of the providers are the same as the old health-care insurance, Humana.

"Some individual employees might have an individual physician not in the network, and there might be some displacement there," Cohen said. "But what is important to note in many of those cases is that if any of our employees are in the middle of receiving ongoing treatment, there is a transition-of-care program, which is applicable to things like pregnancy, substance abuse, cancer treatment, and the like."

Under the new model of self-funding, city employees will still have the same level of benefits, the same deductibles, and the same medical service. There will be no change in the services covered by the insurance or in the ancillary services, like drug counseling or employee-assistance programs. However, a small percentage of employees may see that certain physicians or specialists are no longer in their network, according to Cohen. Still, the network is much larger than the old one and covers more area.

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Health-care cost may change in Sunrise

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