MARIES COUNTY — A health insurance contact made by County Clerk Rhonda Brewer and Clerk’s Deputy Renee Kottwitz at the recent county clerk’s association meeting and training conference made the trip to Maries County last Thursday to pitch their employee health insurance product to the Maries County Commission.

Rodgers said when she and Kottwitz saw the prices, co-pays, deductibles and maximum out of pocket expenses, they thought it was too good to be true. The commissioners are always looking for ways to improve the county, the county government, and certainly to save money. 

David Stuckey of Macon and Brock Kenaga of West Plains, insurance brokers for Trusted Insurance Solutions, were at the commission meeting to talk about their insurance product. They are both school teachers and have seen the prices of health insurance drastically increase every year. They are working with school districts and counties. 

The price listing they presented to the commissioners was one page that quoted an employee only at $395 a month, an employee and spouse at $785 a month, employee plus children at $815 a month, and employee and family at $1,145 a month. There were zero copays on virtual primary care visits 24/7/365, primary and urgent care visits, chiropractic office visits, labs, and X-rays. There are tiered copays on Rx and immunizations. Specialist consults and care and MRI, CT Scans, Ultrasound and other imaging all have $50 copays. For hospital inpatient care and outpatient services the individual deductible is $2,000 with 10 percent coinsurance with $4,000 out-of-pocket max. For a family plan the deductible is $4,000 with 20 percent copay and $6,000 out-of-pocket max. Emergency room is $500 copay plus 20 percent coinsurance. 

There are limitations and exclusions that aren’t covered. These include organ transplant, dialysis, skilled nursing, specialty, and non-formulary medications. These non-formulary medications are new medicines that are in the profit stage and are very costly. 

Stuckey said the excluded services make it possible to offer the lower premiums. 

Stuckey explained they won’t have a consortium this year but hope to have one next year. This will enable them to work with another company that will cover the exclusions for about an addition $9 a month. Some of the people who need the services that are excluded will me moved to Medicaid. 

Savings also are recognized as the company is owned by a group of doctors. There is no corporate board, no shareholders and overhead expenses are nine percent. They have been self funded for 20 years. They are underwritten by New Path Mutual of Utah. 

Maries County pays quite a bit more for employee health insurance. It pays 80 percent of monthly employee premiums, which is $543.40 per employee. The employee pays the remaining 20 percent. The total premium per employee is $679.25 with an annual deductible of $7,500. Some employees do a buy-up to bring down the deductible to $5,000. The monthly buy-up premium is $795.66. 

Stuckey explained how it works with Trusted Insurance Solutions.  The company negotiates a cash price with local doctors. They will reach out to local doctors and establish cash programs. He said most doctors and medical providers like getting cash the day they see a patient. They don’t have to bill that way. 

If Maries County uses this company for its employee health insurance program, it will need to train its employees to contact the company and then the company makes the appointment for the employee. 

There is a tele heath app people can use for virtual primary care. For prescriptions, the doctor calls in the RX and the patient picks it up at the pharmacy. The company is licensed in all 50 states so it is a huge network of doctors across the nation. Break you foot in Florida and there’s a doctor there that is part of this health insurance program. 

If 50 percent of the county’s eligible for health insurance employees participate, there is not health census. 

The company is a believer in preventative care as problems caught early keep bills low. 

The two brokers are working with several Missouri counties and hope to have at least five counties with them starting Jan. 2023. Stuckey said if the commissioners’ answer is, “Not yet,” they understand and hope they will consider them for the next year. “We believe in this product,” Stuckey said. The program is built for organizations with 20-plus employees, but they can do individual plans as well. 

Presiding Commissioner Victor Stratman said they are offering the county a huge savings. “We could pay for all of it,” meaning the county could pay 100 percent of employee health insurance premiums. He wondered how employees will feel about calling an insurance company instead of their doctor’s office to make an appointment. 

Clerk Rodgers said when you are sick, “You have to call someone anyway.”

Western District Commissioner Ed Fagre said it does sound good but he would like to talk to some of the references Stuckey said he will send them. Stratman said it is $148 per employee per month cheaper than the current coverage with Anthem. Some 24 county employees take advantage of the county’s health insurance program. 

Belle Police Contract

There had been a bit of conversation in Maries County about the City of Belle wanting to terminate its association with the Maries County Sheriff’s Office for providing law enforcement protection for Belle citizens. 

Sheriff Chris Heitman came to Thursday’s commission meeting to talk to the commissioners about it. He said he was not given any notice of it and Belle officials were secretive. The sheriff said the Maries County Sheriff’s Office has “made a big investment over there. It’s our phones, our copier. They want to send me a bill for using internet. We have our own internet, router and server and our own phones. Shane did a ton of stuff over there,” he said. He added that new MOSWIN radios are $5,000 each. He said Belle has one of them and they don’t realize how much these cost. Heitman said he thought Daryl White, Jr. liked him.

He told the commissioners this move by Belle “will be rough on us financially,” and the sheriff’s office “has so much invested in it.” Now Belle is trying to recruit Maries County deputies. 

“They needed us and we helped them.” The court fine money the county was supposed to receive was not near as much as what was anticipated. Heitman said Belle’s court system is messed up and there was not much money in fines because of a “poor prosecutor.” Covid-19 also had an impact on the low fine revenue. Now Heitman has decisions to make about the sheriff’s office staffing. He may have to lay off a deputy or two when they pull out of Belle. 

Belle was paying $176,000 and three deputies served the Belle community. This is about $50,000 per deputy with salary, benefits and FICA expenses. He said the fine revenue went to pay for gasoline and other staff, extra deputies, equipment and radios.

Belle also is staying it will use Osage County for dispatching at a cost of $4,000 annually. Heitman said, “Go for it.” He told the commissioners Belle is “heavy traffic” for dispatching and Maries County quoted them $10,000 a year for dispatching because of so many warrants to clear. The majority of the county’s 911 calls are from Belle, he said.

Belle spent less than $177,000, Heitman told the commissioners, because they got $13,000 back in fine revenue. Before the Maries County Sheriff’s Office took over law enforcement for the people of Belle, the city was spending $250,000 for its own police department. Before this recent blow up, the sheriff said he had no complaints from the city council. He said now Belle has two officers who can’t take calls and they don’t have the equipment to do it. Heitman said he told them he’d let them out of the contact at 60 days and cut off at 90 days according to the contract between them. The city council voted to end the association as soon as possible. Heitman’s concern is Belle doesn’t have what it needs to protect the citizens. “That’s why I said no because they would have no protection and we’d be there doing it anyway.”

He said Mayor Daryl White invited Advocate staff writer, Roxie Murphy, to the meeting, and then uninvited her. Heitman brought Murphy into the meeting because “the public needs to know.” 

He’s not sure why the Belle City Council has changed its mind so abruptly. Maries County Treasurer Rhonda Slone said Maries County will get one more turnover/payment from Belle and then that fund will be gone. According to the contract, Belle paid Maries County $43,779 for law enforcement services in February, May, August and November. 

Heitman said they had plans to gradually pull out of Belle when the city had built back up its police department, but the city “just pulled the trigger and said you’re done.” They hired Joe Turnbough at a salary of $52,000 a year and are paying the deputies $20 an hour. 

Three Maries County deputies will be coming back to work out of the sheriff’s office. 

Should be close

County IT Manager Shane Sweno has been working on the problem Maries County is having getting the second payment of $800,000 of the county’s American Rescue Plan Act (ARPA) money from the federal government. 

Sweno was at the county commission meeting last Thursday. He said he’s made progress and explained the county’s Data Universal Numbering System (DUNS) number. Wikipedia defines it as a proprietary system developed and managed by Dun & Bradstreet that assigns a unique numeric identifier, referred to as a DUNS number, to a single business entity. It was introduced in 1963 to support D&B’s credit reporting practice.

Sweno said the feds also had an incorrect email address for the county and he got that fixed and got Treasurer Rhonda Slone verified. There were hoops to jump through using an online ticket system. The day before he called the treasury department and got a number and called and talked to a person. This was a first in this process. He said they discovered the problem was something on their end and the county “was kicked up to another level of tech support. We should be close,” he said.

Checks

Two sizable checks were reported at Thursday’s meeting. The Industrial Development Authority of the County of Maries, Missouri was dissolved on Sept. 27, 2022 in the Circuit Court of Maries County. After legal and publishing fees, “It is further ordered, adjudged and decreed that all remaining funds be paid over to Maries County, Missouri, Petitioner in this cause.” The county received a check for $24,889.82. It was to be put in the general revenue fund. 

Rodgers reported receiving a rebate check from Anthem for $11,910, a rebate for the medical loss ratio. Health insurance companies, according to the Affordable Care Act, must rebate money to those they insure if they spent less than 80 percent of premiums on health care. The county employees who are insured will get a portion of this rebate.

Building and grounds

The county received a bill from MFA Oil, Rolla, which put 1,312 gallons of propane in the courthouse tanks and billed the county $768.91 for it at $2.10 a gallon. Maries County in the past used MFA as its propane provider, but currently does not have a contract with the company. Maries County has a contract with Lock’s Mill at $1.89 per gallon. 

Stratman contacted MFA and informed the company Maries County has no contract with MFA for propane and hasn’t had one for nearly two years. The company acknowledged its mistake, saying they thought the county was on a keep-full basis and they had checked the tanks but they were always full, except for the time when they did put in those 1,300 gallons. It was agreed the county would pay MFA for the propane, but at a cost of $1.89 per gallon.

Rodgers said the elevator doors last week would not close. A technician of Schindler Elevator came the next day and said there was something in the door track that caused it to not close. The elevator in the courthouse is 24 years old and they’ve never had a problem with it. To upgrade it would cost about $12,000.

Stratman said to wait and see how it goes. Eastern District Commissioner Doug Drewel said it doesn’t take much to stop the elevator doors. Fagre said all you have to do is put your hand out and it stops.