Community health plan is helping ease premium costs
Some businesses in the Roaring Fork Valley won’t be hemorrhaging money to pay medical insurance premiums this year thanks to a community health plan created nearly a year ago.Members of the Roaring Fork Valley Community Health Plan are generally facing premium increases of less than 15 percent for the coming year, according to insurance agents, brokers, business operators and representatives of the nonprofit organization that operates the plan. They said that’s below the annual increases typically confronting businesses in the valley and also below what’s expected nationally.The relatively modest increase in prices “makes it the most competitive plan in the valley today,” said Michael Sailor, who owns an insurance company in Aspen. “It gets a thumbs-up from [my] office.”The community health plan was created a year ago by a nonprofit that reached a three-year commitment from PacifiCare of Colorado as well as physicians and hospitals in Aspen and Glenwood Springs to work cooperatively to control costs.Brad O’Neil, a representative of Van Gilder Insurance Corp., a broker helping administer the community health plan, said the handful of businesses that have renewed their annual policies so far have been happy with what they’ve found.”People were used to the 40 percent increases,” he said. In comparison, increases of up to 15 percent are easier to swallow.”When it comes to health insurance, particularly in the Roaring Fork Valley, that’s good,” said O’Neil.The company that manages the North of Nell condominiums was one that was used to double-digit increases in medical insurance premiums.”Most businesses have to put some of the onus back on the employees. We pay 100 percent of the premiums,” said general manager Joe Raczak.But the company’s ability to cover the costs of insurance for 15 employees was threatened by the leaps in price. “It’s been going up between 30 and 40 percent per year,” said Lynn Tanno, the company controller.North of Nell signed on to the community health plan last July. This year, it appears it will face increases of between 5 percent and 12 percent – a level that will allow the company to continue to cover costs for employees, said Raczak and Tanno.Organizers of the health plan claimed the first year was more successful than they hoped.About 5,000 residents of the valley are covered under the plan. There are 444 businesses with 10 or fewer employees who signed up for coverage, according to Bill Hanisch, executive director of the health plan. There are only 10 businesses with more than 10 employees, he said.”We had targeted small businesses,” he said. They were hit hardest by skyrocketing insurance coverage.”The competitive pricing model was not working in our valley when insurers could come in and double premiums,” Hanisch said. “We’re so used to increases in medical care that we’re conditioned – like we are to gasoline.”The community health plan is just starting to offer coverage to individuals. O’Neil and Hanisch see that as a huge area of growth. The plan will also expand its coverage area. Hanisch said negotiations are under way to allow participation of businesses in Carbondale, Rifle and Eagle.O’Neil said he believes the program has been successful because the communication barriers that normally exist between an insurer, a plan administrator and physicians have been stripped.In addition, signing up 5,000 customers essentially allows PacifiCare to spread its risk, said Hanisch. Adding more customers gives the group of valley businesses more clout because they are more appealing to the insurer.Insurance agent Sailor said customers appear satisfied with the type of coverage the community health plan provides. “We are not getting complaints,” he said.North of Nell’s Raczak said he wants better wellness benefits, which cover preventative medicine and not just treatment, as well as more coverage of physical therapy. O’Neil said PacifiCare is responding to both of those widespread demands.Scott Condon’s e-mail address is firstname.lastname@example.org
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Telemedicine is a growing field that provides Roaring Fork Valley residents with access to specialists without driving to Denver or Grand Junction. A new midvalley business called Sentia is providing facilities to make telemedicine more accessible.