CANTON — St. Lawrence County officials are hopeful that offering buyout payments to county employees who opt out of the county’s health insurance plan will help reduce the county’s expensive health care costs.

Starting April 1, the county started paying buyouts — either $2,000 or $4,000 a year depending on the plan — as an incentive to encourage county employees to opt out of the county health insurance plan. To be eligible, employees had to be enrolled in the county’s health insurance for at least 12 months.

County Administrator Ruth A. Doyle said roughly 20 county employees opted to take the buyout and more are expected to sign on during the open enrollment period, which is going on now. Those who opt out of single coverage are eligible for a $2,000-a-year buyout, while opting out of family coverage provides $4,000 a year.

Rather than receiving a lump sum, employees receive a portion of the buyout throughout the year, divided among each of their 26 paychecks. To be eligible for the buyout, they have to demonstrate proof of alternative health coverage, such as through their spouse’s employer.

By the end of this year, the county expects to spend roughly $60,000 on buyouts.

“Next year, we don’t know the cost, but we’re anticipating there’s going to be an increase only because this is open enrollment for everybody so the buyout might be more attractive to folks,” Mrs. Doyle said.

In the 2018 budget, the county has budgeted $100,000 in the contingency account to cover that expense.

“It’s going to take probably two or three years to really judge where our cost benefit is,” Mrs. Doyle. “With this whole health care transition, we’re creating a partnership with the unions. We invited them in. While it’s still the board’s decision, we gave them an equal voice at the table to talk about whether we should move over to a fully insured plan or whether we stayed self-insured. Everything was on the table.”

The county will continue to be self-insured, but in April switched its third-party administrator from Resolve Healthcare to Excellus Blue Cross Blue Shield.

Potential cost savings associated with the buyout will vary depending on how healthy the people are who take the buyout. People with higher medical expenses who opt out of the county insurance will have a larger impact on reducing costs.

Having fewer people on the health insurance plans reduces the county’s expenses because single coverage costs $9,417.96 a year, single with dependants costs $17,211.31 per year and family coverage costs $23,987.23 annually.

The buyout option was reached through an agreement between the county and its Civil Service Employees Association, the union that represents most of the county’s employees.

Legislature Vice Chairman Joseph R. Lightfoot, R-Ogdensburg, is a member of the county’s Healthcare Committee, which reviewed the buyout option before it was offered. He is also hopeful that county costs will be reduced. The county budgeted $23.5 million in 2017 for health insurance costs and reduced it to $21.5 million in the 2018 budget.

“If people are not using a product, in this case health care provided by the county, the expense to the county goes away,” Mr. Lightfoot said.

Since switching to Excellus, the county has seen fees charged by health providers decrease because Excellus has been able to negotiate better discounts for the county with in-network providers.

“We remain self-insured so that in the end we still control what the plan is,” Mrs. Doyle said. “We’ve seen an increase in the discount percentage from about 20 percent with Resolve to upwards of 40 to 50 percent with Excellus.”

The county remained with ProAct Inc., Gouverneur, for prescription coverage.

The switch to Excellus did not result in changes or reductions in health care benefits for employees, Mrs. Doyle said.

“They saw no changes, in fact they saw an enhancement because now they can Facetime or talk on the phone with a provider and save going to the emergency room. It’s basically a web-based access to health care so you get to choose if you want a phone call back from the doctor or you want face-to-face time with a doctor. That’s an enhancement. We didn’t offer that before,” Mrs. Doyle said.

The county’s health insurance is offered to all full-time employees. Part-time employees who are members of the county’s CSEA union are also eligible. County health insurance is not offered to part-time employees who are members of Council 82, the union that represents corrections officers.

Members of the county Legislature also are eligible for health insurance and pay the same amount towards their premiums as county employees. The options include single coverage, single coverage with dependants and family coverage.

According to Mrs. Doyle, five of the 15 county legislators are enrolled in the county’s health insurance plan.

They are Legislature Chairman Kevin D. Acres, R-Madrid; Chad E. Colbert, R-Potsdam; David W. Forsythe, R-Lisbon; Joel L. LaPierre, R-Fowler, and Rick Perkins, D-Parishville.

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