Insurance claims up for MC employees


MORGAN CITY — Total medical claims for the city have increased by 19.1 percent between May and September, while the total claims have increased by almost $100,000.

That was the news that Shelley LeBlanc of Paul’s Agency, the city’s insurance carrier, delivered to the city’s Health Insurance Committee during its meeting Tuesday.

During the first five months (May 1-Sept. 30) since the renewal of the contract with the city’s insurer, BlueCross BlueShield of Louisiana, claims for city employees totaled $523,437, up from $439,592 during the same period in 2010.

During the 2011 period, city employees have totaled $383,663 in medical claims and $139,774 in prescription claims paid.

During the same period in 2010, the city paid $289,824 and $149,768, respectively, in medical and prescription costs.

The spike in claims, LeBlanc said, can be attributed to surgeries in July and September, which combined increased claims by $116,046 from 2010.

However, she said these two spikes are incidents that do not appear to be ongoing problems.

From May to September of this year, total premiums paid have decreased by 11.2 percent from $683,478 to $585,321, which LeBlanc said is mainly due to a rate decrease the city received in May.

The city currently has a claims vs. premium loss ratio of 89.4 percent, up from 64.3 percent in 2010.

LeBlanc said ideally, the city would like to be at an 80 percent claims/loss ratio where for every dollar Blue Cross takes in, 80 percent would be used for claims and the rest for other expenses.

Average monthly health premiums for this year have totaled $117,064, average monthly medical claims were $76,733 and average monthly prescription claims were $27,955.

During the same period in 2010, the city incurred average monthly health premiums of $136,696, average monthly medical claims of $57,965 and average monthly prescription claims of $29,954.

From 2010 to 2011, average medical claims per employee increased by 37.3 percent and average prescription claims per employee decreased by 3.2 percent.

The average monthly costs per employee, though, have decreased from $491.71 from May to September 2010 to $436.81 for the same period this year.

While the city still has seven months left until it must renew its insurance again, the city’s average monthly costs per employee thus far is down from the average cost for the entire year from May 1, 2010, to April 30 of this year.

The average monthly cost per employee for the 2010-11 year was $490.04.

“It is definitely costing you less this year,” LeBlanc told the committee.

During the past year, participation has slipped slightly from 278 to 268.

During the current year, the city’s inpatient costs have remained about even, while its outpatient costs have increased as well as its professional and drug costs.

LeBlanc said that the top claims for inpatient surgeries were digestive diseases, which she said is normally a matter of maintenance once the initial treatment is rendered.

“Then after that, it’s no longer ongoing,” LeBlanc said. “It’s just maintenance-type medications.”

Circulatory diseases, which is normally in the top 2 on inpatient reports, is down to No. 3.

“It doesn’t look like your claims are ongoing,” LeBlanc said. “You’re still a healthy group.”

Because of the type of diagnoses the city employees have been reporting, LeBlanc said the city’s loss ratio should improve.

LeBlanc also noted that during the past year, the city’s average employee age has increased slightly from 47.9 to 48.2.

As for renewals for the upcoming year, LeBlanc said that changes have been made so that customers can get the projected insurance rates sooner.

Absent from Tuesday’s meeting were committee members Ron Bias, Lou Tamporello, Drue Clement and Huey Landry.

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