The commissioners approved a fully insured plan through the County Employee Benefits Consortium of Ohio (CEBCO) with Anthem in October and then two weeks later rescinded that contract and approved staying with United Healthcare for another year at a cost of $21.2 million. United Healthcare threatened to sue because Horan didn’t put out a request for proposals so the process was flawed.
Commissioner Don Dixon told the Journal-News HORAN wasn’t the only one to blame some of their own staff over the years have been an issue.
“I’m not saying it was all HORAN’s fault because it wasn’t,” Dixon said. “Partly it was their fault, I’ll give them 50% of the credit. But we had people or didn’t have people where they should have been, or we thought they knew what they were doing and didn’t know what they were doing, some of the timing was wrong, so it’s just been very cumbersome.”
Dixon declined to name who on the county’s side has contributed to the long-standing health insurance issues, which is one of the county’s biggest expenses. He said as they consider switching away from self-insurance “let’s just take a new look, let’s put a fresh set of eyes on this, let’s go out in the marketplace and see who is there.”
County Administrator Judi Boyko agreed they are not seeking proposals just because of the incident last year.
“There was an issue that created a little bit of challenge with the county, but that incident wasn’t the sole purpose in going back out,” Boyko said, adding Horan is free to submit a proposal. “It’s an open process they are invited to submit if they would like. We will evaluate their proposal with the criteria we’ve established.”
Commissioner T.C. Rogers said he isn’t certain Horan took a wrong turn when they didn’t shop the policy last year, “there was a judgement made whether there had to be an RFP, and that’s still questionable in my mind.”
Commissioner Cindy Carpenter wanted to issue the RFP for another reason.
“Horan has made inaccurate projections during my entire tenure as a commissioner,” she said. “So we’ve made decisions relying on those and it didn’t allow us to plan for what was really happening. Obviously we’ve kept that health insurance account healthy but it would be nice to have accurate projections to plan our year.”
Karen Mueller, HORAN executive vice president, told the Journal-News they defend the service they have provided the county.
“We are confident that HORAN has provided very accurate reporting, guidance and insights to Butler County throughout our 15 year partnership,” Mueller said. “We not only expect, but encourage, our public entity clients to regularly go to market. We respect their due diligence and look forward to participating in the RFP process.”
Several times in the past couple years double-digit increases were projected but numbers were revised after more claims data was available. Last year the hike was estimated at 14% but ended up being 8%. The same was true for this year, early projections were 8% but the budget reflects 2.2%.
Health insurance has been problematic for the county for years so the county went to a self-insurance model in 2017 after several years of double-digit percentage increases. Some large, unusual claims over several years drove those increases, including a single $5 million claim in 2013 and a $3 million claims month in November 2014.
About the Author