Health Insurance Working Group Strives to Close the Gap

In early November, Marc Lewis had every reason to believe that the town’s Board of Selectmen would pass Chapter 69 of the Municipal Health Care Reform law, thereby taking away any power he had to negotiate for his constituents.

Board of Selectmen chairman Mike Gowing had said, “We have a majority vote” and indicated that the Board was likely to take control of town employees’ health insurance benefits.

As Acton Education Association president, Lewis became nervous.

“You’re either at the table, or on it,” he said.

An about-face by the Selectmen occurred on November 21, 2011, however. The issue was tabled until February 6, 2012, in order to give town employees’ representatives a change to redesign the health insurance plans themselves.

Lewis, along with the other union heads, found himself at the table in Room 204 of .

Also present were facilitator Lauren Rosenzweig-Morton, Town Manager Steve Ledoux, Human Resources directors Marianne Fleckner and Marie Altieri, benefits administrator Ruth Cvitkovich, Board of Selectmen member Janet Adachi, School Committee member Kim McOsker, and retired employees representative Mal MacGregor.

Their goal, a directive from the Board of Selectmen: Find a way to trim $600,000 from the cost of insuring Acton’s workers.

The target number is in the middle of the range of two studies that were commissioned to investigate possible savings.

Gowing and his counterparts have had to transfer $2 million of the town's money to close deficits the past few years, and are poised to do it again. The health insurance savings would lessen the burden for FY'13.

The first few sessions of the task force focused on fact-finding around health insurance benefits currently being provided to Acton’s 670 employees and eligible retirees. There are a dozen unique plans.

Representatives from Acton’s Health Insurance Trust, Blue Cross Blue Shield, and Harvard Pilgrim attended meetings to share information.

Next, the group considered the pros and cons of standard ways to reduce costs: raising co-payments for office visits and testing, adding co-payments for emergency room visits and hospital admissions, raising prescription costs, moving to a single insurance carrier, and implementing deductibles.

Also discussed was moving all town employees to a 75/25 split, meaning that they would pay for one quarter of the cost of their health insurance premiums. Currently, three groups of town employees are subject to an 85/15 split.

At times, committee members proposed so many variations that it became difficult to track them.

“We’re all over the place with co-pays,” said Altieri at one meeting. Her role includes recording all the asked-for changes and formulating logical plan designs.

Much debate centered around whether or not employees should be offered mitigation in order to offset the higher costs they will be facing. A three-year plan, which offers 100% mitigation the first year, was formulated.

In mid-January, seven possible health insurance scenarios were identified. Two were voted the best options and sent to underwriting to confirm the actual associated savings.

A proposal was chosen to present to the Board of Selectmen. The plan’s price is close to the target without mitigation, but the group elected to leave the mitigation intact.

Hoping that the selectmen would agree to a longer timeline to realize the savings goal, three members of the group went before the town governors and pitched a plan design that fell short by over $200,000.

The Board of Selectmen shot it down, holding tight to the original dollar amount.

Having expected that her assertion that “the group has been engaged, and really trying to work on the issues” would appease her colleagues, Adachi was not prepared for their reaction.

“I was surprised, and, frankly, disappointed,” Adachi said. “They said that we hadn’t done enough to explore savings.”

“There has to be the trust that we’ve really done our homework,” said Fleckner.

“I have total confidence that we can get there,” said Altieri of the target number.

The Board of Selectmen has agreed to allow the Health Insurance Working Group to present a revised proposal.

All members intend to attend the meeting as a show of solidarity. The suggestion was made by Chris Prehl, who represents Acton’s patrol officers.

“You’re not going to go to a gunfight without a gun,” Prehl said.

The Board of Selectmen will meet tonight at 7:00 p.m. in Room 204 of Town Hall. The agenda includes a discussion and vote of the town’s FY ’13 budget and the Health Insurance Working Group’s update.