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HEALTH INSURANCE Medical Mutual selected for county schools



Published: Thu, June 30, 2005 @ 12:00 a.m.



One school district's superintendent voted against using the company.

By DENISE DICK

VINDICATOR STAFF WRITER

CANFIELD -- After 22 years with the same company, Mahoning County school employees have changed health insurance administrators.

Mahoning County Schools Employee Insurance Consortium voted 13-1 Wednesday to approve Medical Mutual of Ohio as the administrator.

The consortium includes the Mahoning County Educational Service Center, Mahoning County Career and Technical Center and all of the school districts in Mahoning County except Youngstown and Sebring.

Canfield schools cast the sole vote against the company.

For 22 years, the consortium has used Professional Risk Management of Boardman as its administrator.

The vote came after Medical Mutual representatives told member superintendents that the company guarantees the consortium a 48 percent discount for providers within its preferred provider network. For those within the company's traditional plan, the guaranteed discount is 34 percent, representatives said.

If the discount is less, the company would pay the consortium the difference.

Professional Risk Management had said it would provide a 46 percent discount.

Concerns

Canfield Superintendent Dante Zambrini said he voted against going with MMO because many of his questions weren't answered.

One provider, for example, gets an actual average discount of 9 percent. In a Century Business Services comparison, a 53.2 percent discount was calculated for that provider, based on a regional average, he said.

Zambrini also said that in an earlier presentation by MMO, the company had 21/2 pages of services provided in specific school district health insurance plans that the company didn't cover.

On Wednesday, the company had narrowed that to a handful.

University Hospital in Cleveland is not in MMO's preferred provider network, which also concerns Zambrini.

"I've had employees who have had open heart surgery and other serious procedures at University," he said.

Zambrini wants the consultant to perform an audit of the services provided by PRM so that after a year with MMO, the consortium will be able to see the guaranteed savings.

"I want hands-on verification," Zambrini said. "Some of these were projections rather than hands-on verification."

Motion to withdraw

Members also voted against a motion to allow Austintown and Boardman to withdraw from the consortium, effective Oct. 1. The two districts, which comprise about 900 of the consortium's roughly 2,500 employees, made the motion earlier this month after the body turned down Aetna as the administrator.

Austintown, Boardman, Canfield, Jackson-Milton, Mahoning County Career and Technical Center, Mahoning County Educational Service Center and West Branch had voted in favor of the two districts' withdrawal. The remaining districts, Campbell, Lowellville, Poland, South Range, Springfield, Struthers and Western Reserve voted against it.

With a 7-7 vote, the motion failed.

Century Business Services, or CBIZ, a Columbus consultant the consortium hired for $60,000 to review health care administrators' proposals, found that the withdrawal of the two districts would decrease the consortium's $7 million fund balance.

In the long term, it also would mean fewer people to share the risk. It may also cause other districts to look elsewhere, CBIZ found.

Michael Creatore, an Austintown board member, believes the effect of the two districts' withdrawal prompted most of the superintendents to approve MMO.

He said his district, which tabled a motion earlier Wednesday to withdraw from the consortium pending the consortium vote, will continue to weigh its options.

James Hall, South Range superintendent, said every superintendent in the group wants to save money. They aren't opposed to change; they just wanted to make sure it was the right change, he said.

"Medical Mutual has a good reputation in the medical community," Hall said. "I was confident that we would be spending public dollars wisely with MMO."

He also liked the guarantees on discounts.

"We wanted quality service and low cost and we were looking for the best deal we could get," Hall said. "I think we got it."




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