City health insurance ready for a checkup

Audit of dependent eligibility could produce savings

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COEUR d'ALENE - The city of Coeur d'Alene spends more than $4 million a year on health insurance coverage for its employees, their spouses and dependents.

That's a lot of money, city officials agree, and a big budget item like that needs to be scrutinized.

So to ensure only those who qualify are on the Group Health insurance plan, the Coeur d'Alene City Council on Tuesday night unanimously approved a third-party analysis of enrolled dependents. The $9,999 Health Decisions Inc. assessment was not budgeted for, but city officials believe they will see savings from the endeavor.

"It's one of our largest cost centers," said Finance Director Troy Tymesen. "The goal here is to make sure that everybody on the city's plan is an eligible participant."

Tymesen added that if three dependents on the city's plan are ineligible, the savings would cover the cost of the survey.

Mayor Steve Widmyer told Tymesen that he knows speculating with the city's budget is "always a dangerous thing to do." He then asked the finance director if he believed the study would find enough ineligible dependents to at least break even.

"Yes sir," Tymesen responded. "According to the industry average for an organization of our size, we should find more than that."

City officials closely monitored a similar study done by the same company for Kootenai Health, Tymesen said, and found that Health Decisions Inc.'s proposal was the best of three.

They also worked with the city's Medical Insurance Committee, comprised of representatives from the Lake City Employees Association, Coeur d'Alene Firefighters IAFF Local 710, the Coeur d'Alene Police Officers Association, and an individual speaking for city employees not represented by a union.

"Did they offer any feedback on this?" council member Dan Gookin asked Tymesen.

"They were very positive to it, councilmember," Tymesen responded. "They are very comfortable with us attempting to keep the cost down, both for the city and for themselves."

After clarifying with Tymesen that the study would not look at spouses on the health care plan, Council President Woody McEvers asked if city employees planned on changing policy to ensure no other ineligible dependents would be added in the future.

"Things will absolutely be different," Tymesen said. "Probably one of the biggest challenges for us is determining what would make someone ineligible. In the event of a divorce, the court can make a decree (on custody of a child), but that doesn't necessarily mean the dependent qualifies. Going forward we will ask for documentation so that we know they're eligible."

Tymesen estimated the study will be completed within the next three months. That timeline would see the city dropping any ineligible dependents prior to its next renewal period with Group Health, he added.

In Post Falls, Human Resources Director Teresa Benner said the city's health insurance provider, Regence Blue Shield of Idaho, does a good job of notifying employees when their dependents "age-out" and no longer qualify.

"But audits are a good idea," Benner said. "It's something we would consider doing in the future."

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