The county is facing a large increase in its self-funded health insurance program, County Mayor Jim Coppinger told members of the County Commission at a budget workshop on Monday.
Without some steps the county is considering to cut the expense, employee health care expenses are projected to rise to almost $35 million for fiscal year 2017. In fiscal year 2012, they were at $22.5 million.
County Mayor Coppinger said "uncontrollable large claims are driving the cost increase."
There were 204 claims in fiscal year 2015 over $25,000 and a projected 280 claims over $25,000 this budget year. There were just two claims over $175,000 in fiscal year 2015, but there are 10 this year. They involve such factors as cancers, transplants and accidents.
The county mayor said plans are to hire a medical doctor at the clinic for county employees. Employees now see a nurse practitioner. That is expected to save money by having employees use the clinic more often and cut down on visits to other physicians that cost the county more.
The county also plans to make more use of Cigna specialists on management of such chronic diseases as diabetes and asthma.
As another incentive to using the clinic, employees are set to pay more for visits to medical personnel other than the clinic. Office visits would go from $30 to $40 and for specialist visits rise from $50 to $65.
Prescriptions costs when the county pharmacy is not used will go from $40 to $45 for a preferred brand and from $60 to $75 for a non-preferred brand.
Out-of-pocket maximums for employees are set to go from $2,500 to $3,000 for individual and from $5,000 to $6,000 for family.
The higher charges take effect Jan. 1, 2017.
The changes together are expected to save the county $2 million.
However, the county administration is also looking at a 2.5 percent salary increase for county employees.
A 2.5 percent increase across the board would cost the county $2,121,000. A 2.5 percent with a floor of $1,000 would cost $2,380,000. A 2.5 percent with a floor of $1,250 would cost $2,750,000.
County employees got a three percent raise in 2013, 2.5 percent in 2015 and 1.5 percent with a floor of $750 in 2016.
There are 1,786 full-time county employees.
The average salary of a county full-time employee is $42,913. The median salary of a full-time county employee is $38,146.
Employee salaries amount to 33.6 percent of the current county budget.
Employee pension benefits cost $11.2 million in the current budget. Officials noted the county may increase its contribution rate to pay the unfunded portion of the pension liability ($17.3 million) off sooner.
The county is set to save $399,000 in the upcoming budget due to newer employees moving to a less-rich pension program.