Wednesday, November 4, 2009
By Jeanne Starmack
STRUTHERS — A council member’s refusal to provide updated health-insurance information or sign a waiver for coverage has hampered the city’s search for the best health-insurance deal, said city Auditor Tina Morell.
Without council member Dan Yemma’s application for updated information for the plan or a waiver, the city isn’t in the best position to negotiate with Anthem Blue Cross and Blue Shield, its carrier now, she said. The city’s contract with Anthem expires Dec. 31.
Anthem is proposing a 13 percent rate increase, she said. She said she had been told by the city’s insurance broker that other health-insurance companies will provide only an estimated rate, not a binding one, without updated information or waivers from each of the 69 employees and elected officials on the city’s plan.
Without binding rates, Anthem won’t be motivated to negotiate down from the increase, she said.
Morell provided The Vindicator with e-mails between the city’s broker and carriers Anthem and United Health Care that indicate they need Yemma’s application or a waiver from him.
Michael Caparso, co-owner of National Health Care Access of Poland, the city’s broker, said two of four companies the broker has shopped did provide binding rates. The two that did not included United Health Care.
“They’re the main one we like to get,” he said. “But we do have some leverage.”
If the city’s health-insurance rates go up 13 percent, each person on the plan would have to pay more — 7 percent each month instead of 6 percent, toward health insurance, she said. The increase also would cost the city $106,000.
Morell provided a letter dated Sept. 14 that was sent to everyone on the plan. The letter asked that everyone fill out their applications and return them by Sept. 21.
On Oct. 1, the clerk of council notified Morell that Yemma told her he wouldn’t be completing the application.
Yemma indicated “there is no reason to fill one out.”
Yemma was referring to legislation he’d proposed to eliminate health coverage for elected officials. That legislation eventually died in the finance and legislation committee two weeks ago, he told The Vindicator on Monday.
Morell wrote him back Oct. 6 that the legislation was only proposed, and the insurance companies wanted the applications based on current enrollment in the plan.
Yemma wrote back in a letter dated Oct. 14 that Morell’s “allegations and purported ‘facts’ ... are inaccurate and/or blatant lies. ... Similarly, if our broker has advised you in the manner you state, which I doubt, they are lying also,” said Yemma, who indicated he is himself a licensed group health broker in Ohio.
Morell had wanted the matter settled before a meeting today of the city’s cost-containment committee, which is supposed to give the broker some direction on how to proceed with negotiations.
Yemma told the newspaper Monday that since his proposed legislation died, he now plans to give the broker the information it needs. “I’ll be happy to do whatever they need me to do at this point,” he said.
As of late Tuesday afternoon, however, he had not contacted the broker with an application or a waiver, Caparso said. If Yemma does turn in an application or waive coverage, the broker can still shop the plan at any time. He and Morell said, though, that it should be done before it gets too late into December.