TIFTON The Tifton City Council heard from Skip Hill with Partners Benefit Group at last weeks workshop concerning changes in health care.

City Manager Larry Riner said Hill has been handling their health care benefits for quite some time now. He said he finds the best bang for their buck. Hill discussed changes in health care due to Health Care Reform and the Affordable Care Act.

Based on the recommendation from Partners Benefit Group, it is in the best interest of the city to stay with Cigna insurance company at this time. Due to Health Care Reform and the claims history, staff will incur an increase to be shared between employee and the city. However, exact numbers will not be known until open enrollment is completed due to different plans that employees may choose.

Hill explained the waiting period for an employee to be eligible for benefits is no more than 90 days. The city will now be required to offer insurance to employees once they have completed 60 days of employment on the first of the month following that date.

He said whether covered under the city or another plan, all copays or any out-of-pocket that an employee pays going forward must be included in that out-of-pocket maximum. The only exception in 2014 will be prescription copays, which will count toward that out-of-pocket maximum in 2015.

He said for this past year, the city had a 130 percent loss ratio. Additionally, with that loss ratio, there are some taxes and fees that the insurance carriers are having to pay due to the Affordable Care Act, one which is called a transitional reinsurance fee. This fee is paid to the government and will be dispersed to insurance companies that are covering high risk individuals.

That tax will be $63 per year per covered person on your plan, which means that if Ive got a family of four, then the city of Tifton through premiums will pay a tax of $63 for each person in my family for that 12-month period, Hill told the council.

He said the increase that was handed down from Cigna, which includes these additional taxes, equates to a 20.79 percent increase for this coming year.

A mandate is coming in 2015 that if you employ more than 100 employees, you must offer health insurance to anyone who works 30 plus hours a week. Thats considered full time and youre not going to be allowed to charge them more than 9.5 percent of their W-2 income, whatever on a per pay period basis that theyre paying, Hill said.

He added, We made a recommendation to Mr. Riner and Ms. (Carla) Cooper (human resources director) that we go ahead and offer a plan, a third option. He said currently, employees have two options as far as health insurance one is a copay plan and the other is a higher deductible plan.

Read more:

City looks at health care options for employees, chooses to stay put