Sticker shock! | AspenTimes.com

Sticker shock!

John Colson

Hayley Cassatt

Second to housing, perhaps even before wages, one of the chief concerns of many employees in the Roaring Fork Valley is finding affordable health insurance.It’s a concern that employers have, as well.”It’s just a struggle for all of us,” said Community Banks of Colorado regional director Kurt Adam, explaining that he recently lost two employees at a bank in the Eagle Valley because of insurance issues.

In an effort to help, the Roaring Fork Valley Community Health Plan (RFVCHP), a nonprofit organization that serves the central Rocky Mountain region from Eagle to Aspen to Rifle, has been at work for more than decade finding affordable insurance for small businesses.Last week it was announced that RFVCHP would lose its insurance carrier, PacifiCare, which is dropping its Colorado group plan business on Dec. 31. RFVCHP has signed up with Aetna Insurance Co., effective Jan. 1.With 16 plans offered at a 5 percent discount to members of area chambers of commerce, and three plans reserved for chamber members only, the RFVCHP board is hoping to serve an ever-growing local work force that is too often uninsured or underinsured.Plus, officials say these plans bring lower premiums for employers and employees, better coverage and greater ease of management, thanks to increased flexibility within the various plans themselves.”This is truly a chamber of commerce plan,” said Brad O’Neill, a vice president of Van Gilder Insurance Corp., which serves as “development consultant” to the RFVCHP. “It’s unique to the state of Colorado.”

Created in 1993, the valley’s Community Health Plan initially helped arrange group insurance plans for a handful of large employers. It was greatly expanded in June 2003, when the nonprofit signed with PacifiCare to provide competitive coverage for valley businesses that were struggling with the escalating cost of providing insurance for their workers.By early 2005 at least 500 employers in the valley had joined the plan, offering insurance to some 5,000 workers, according to O’Neill. Van Gilder Insurance Corp. helped RFVCHP select PacifiCare as its initial carrier and has been instrumental in the switch to Aetna.

The new array of plans is offered as another benefit to chamber members; benefits historically have included discounts on workers’ compensation costs and ski passes for employees.Some chambers members, of course, have never used the Community Health Plan and do not plan to.The Ben & Jerry’s ice cream outlet in Aspen, for example, is a member of the chamber. But its management will not sign up for the Aetna insurance because employees already have insurance, either from other jobs or through individual insurance plans.”I have my own insurance,” said manager Adam Melchiori, adding that Ben & Jerry’s pays the premiums though a contribution included in his paycheck. Melchiori said a deal with Aetna would be superfluous for the ice-cream shop.In Basalt, Midland Shoes owner Tracy Bennett is the store’s only full-time employee. She currently has her own health savings account plan, but as a member of the Basalt Chamber of Commerce she is eligible for the new Aetna group plans. It’s an option she may pursue.

“I’m really busy right now,” Bennett explained. “Because I don’t have to insure employees, I can just take my time” and look at the new insurance offerings “maybe after the first of the year.”Community Banks’ Adam, whose office is next door to the Aspen Chamber Resort Association, said his employees have been insured through PacifiCare. With the insurer pulling out of Colorado, the bank chain’s home office has contacted the ACRA about having its 18 employees in Aspen and Basalt join the new Aetna plans.The Aspen Historical Society has five employees who were insured through PacifiCare and are now insured by Aetna, though not through RFVCHP. The historical society’s insurance agent, Mark Devlin, said the nonprofit will switch to the chamber plans on Jan. 1.Anna Scott, an archivist with the historical society, has been happy with PacifiCare because it has been “really simple.” Due to deliver here baby in February, she is “a little worried” about the switch to Aetna in the middle of her pregnancy. She added that Aetna doesn’t seem to “cover a lot of lab fees until you meet your deductible,” and lab fees are something she has been dealing with a lot.”In general, [the insurance coverage] has been pretty good, but you really have to pay attention to the bills,” she said. She said PacifiCare lost track of her deductible status when she got married, and only recently rectified the problem.Local insurance agent Michael Sailor, who has been selling PacifiCare policies as part of RFVCHP since 2003, has begun switching his clients over to Aetna and will continue to be an active broker of the chamber deals.Sailor has been a member of the Aspen Chamber Resort Association for some time and plans to join the chambers of Basalt, Carbondale and Glenwood Springs. With Aetna, only insurance brokers who are chamber members can sell the three chamber-only plans.

A benefit of the new Aetna plans, according to information from Aetna and its partner, Ben-E-Lect, is that they can be tailored to individual businesses and to the needs of individual employees. In fact, flexibility is built into the relationships between premiums and deductibles.Keli Childs, of Ben-E-Lect, said that between 50 and 70 percent of all employees either don’t use their employer-sponsored health-care plan or use it so little that they never even meet their deductible.For those who don’t use insurance much, Ben-E-Lect can craft a policy with a high deductible payable by the employer, coupled with a low deductible payable by the employee. That translates into lower premiums, Childs said, which helps with a company’s cash flow.For example, when the employee’s deductible (say, $500 for argument’s sake) is met, the company would kick in the higher deductible (perhaps as high as $2,000). The insurance company would start paying once that higher deductible is met.

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The goal with these policies is “price transparency,” so the insured can always know what is being charged and what is being paid, according to Childs. Plus, the costs used in designing the plans are based on Roaring Fork Valley health-care prices, not those in Denver.Asked if the policies cover alternative health-care techniques and therapy methods, such as chiropractic care or acupuncture, Aetna’s Jeff Miller said the company has begun covering “some chiro, some therapies.” The company also is working on compiling a list of alternative health-care practitioners who agree to provide services to Aetna clients “at a discounted rate” compared to non-Aetna clients.Another aspect of the new plan is a health savings account. Under this plan, money not spent on health care in a given calendar year can be rolled over for use the following year.ACRA President Debbie Braun estimated that an employer with 10 full-time employees, paying close to $70,000 per year in premiums (which she said is average in this area), could save several thousands of dollars a year under the RFVCHP plans. And, by using Ben-E-Lect to create specialized plans, “they could save even more.”Liz Phillips, Basalt chamber’s director, said one critical benefit to the Aetna deal is that local doctors and hospital officials were involved in setting it up. Plus, the plans’ managers will be “constantly monitoring it to be sure it works for people.”John Colson’s e-mail address is jcolson@aspentimes.com