St. Croix County Board transfers $1.5 million from general fund to health insurance fund
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By LeAnn R. Ralph
HUDSON — The St. Croix County Board has approved transferring $1.5 million from the unassigned general fund balance to the health insurance fund to help stabilize health insurance premiums and to include a plan for an on-site clinic.
St. Croix County took a “big hit” last year in health insurance claims, and the transfer of funds will help reduce the increase in premiums, said Paul Berning, county board supervisor and chair of the Committee on Administration.
Out of the $1.5 million, $500,000 would go toward the on-site clinic, he said.
Tim Ramberg, county board supervisor, asked for clarification on the on-site clinic.
The on-site clinic is part of the planned government center expansion, said Ken Witt, county administrator.
St. Croix County would contract with a private-party medical provider for the on-site clinic that would be located in the government center and would have its own outside access for employees and their families, he said, adding that space has been included between the jail and sheriff’s office for the on-site clinic.
St. Croix County is self-insured, so the on-site clinic would provide a fixed cost for all of the employees and their families going there for medical care, he said.
Rick Ottino, county board supervisor, said he “had a problem” with $500,000 being moved without more detail on the on-site clinic.
The county can have an on-site clinic, but how would the county convince employees who live in Baldwin to use the clinic? he asked.
Long-term projections
The long-term projections for the on-site clinic is that it would stabilize the health insurance premiums, Witt said.
The premiums will cost an additional 23 percent, or another $2.3 million for next year, he said.
Case studies from the Chippewa Falls school district and Dunn County show that using private clinics stabilized health insurance costs, he said.
Dunn County’s director of Human Resources reported to the county’s committee on administration at the May meeting that using ReforMedicine had saved the county $750,000 on health insurance costs over the last two years.
All together, in the first year, the cost for healthcare with Mayo Clinic would have cost Dunn County $716,550, but with ReforMedicine, the cost was $354,625.
For St. Croix County, a loss of $500,000 for the on-site clinic is expected in the first year, Witt said.
During the second year, the clinic is expected to break even, and in the third year, the clinic is expected to save $500,000, he said.
With the use of the on-site clinic, the county will not see double digit increases in health insurance premiums, Witt said.
Send it back
The resolution does not mention the on-site clinic, only the loss for the health insurance fund, said Daniel Hansen, county board supervisor.
The money to make up the deficit and the money for the clinic should be separate expenditures, he said.
Hansen said he wanted to remove the $500,000 from the resolution and send the issue back to the Committee on Administration.
The St. Croix County Board usually approves fund balance transfers in September or October after the audit has been released to the board, but the transfer has been brought to the county earlier than usual because the committee will be setting health insurance premiums at the July meeting, Witt said.
The clinic is a line item in the health insurance fund, he said.
The fund balance in the health insurance fund will affect the premiums set by the Committee on Administration in July, Witt said.
The health insurance fund has a deficit right now of $1 million. With the $1 million transferred from the general fund, the increase in health insurance premiums will be 23 percent, but without the transfer of funds, the increase for health insurance premiums will be 33 percent, he said.
With any luck at all, the claims on the health insurance fund last year were an anomaly, but that is why the transfer from the general fund is requested now so the Committee on Administration can set the health insurance premiums in July, Witt said.
Separately
The $1 million can be used for the health insurance fund, and the $500,000 can be sent back to the Committee on Administration to use later for the on-site clinic, said Shawn Anderson, county board supervisor.
The plan design includes the clinic, but if the county board is asking to develop the clinic without the funds, that can be done and will increase the deficit for the health insurance fund, Witt said.
The $500,000 for the first year of the clinic can come back later for approval by the county board, or it could be added into the language for the resolution currently before the county board, he said.
The clinic approval would come in two pieces, Witt said.
The first piece is the health plan design, which the Committee on Administration will have on the agenda at the July meeting, he said.
The second part of the on-site clinic approval would be the county board approving the capital improvement plan in September, Witt said.
The $500,000 is for the plan design, and there will not be another St. Croix County Board meeting before the money is needed, he said.
If the $500,000 is sent back to the committee, the committee will not have the money available in July to do the plan design for an on-site clinic, and the county would start the clinic with a deficit, Berning said.
If the money is separated now, then the Committee on Administration is not going to know if the county board is willing to move forward with the plan design, he said.
Berning said he would support changing the language in the resolution so that the Committee on Administration could move forward with the on-site clinic.
Amendment
Cathy Leaf, county board supervisor, said the language should be included in the resolution for the on-site clinic.
County board supervisor Ryan Sherley said he agreed that the language should be in the resolution.
Berning noted that Witt had only received information recently on the large increase in the health insurance premiums.
The projection in May was that health insurance would increase by 5 percent to 10 percent., Witt said.
Six weeks ago, he had learned that the increase would be 23 percent at around 4:30 p.m. on a Friday, Witt said.
The county needed to “pivot fast.” The on-site clinic is “the saving grace” behind all of it because it will provide a low-cost or no-cost option for the employees, he said.
Hansen said he objected to the language not being included in the resolution but that he did not object to the on-site clinic itself.
A motion to amend the resolution to remove the $500,000 from consideration and only transfer $1 million from the unassigned general fund failed on a vote of 15 “no” to four “yes.”
Including $500,000
Leaf offered an amendment to the resolution to include the $500,000 for the on-site clinic, with county board supervisor Scott Counter providing a second for the motion.
Heather Amos, St. Croix County Corporation Counsel, suggested that the amendment should read, “Whereas an onsite clinic may have an initial loss of $500,000 and $500,000 of the $1,500,000 transfer will allow the clinic to be financially stable in the future.”
Greg Tellijohn, county board supervisor, said that he must have missed something because he did not recall the St. Croix County Board talking about the on-site clinic as a board.
The on-site clinic has been discussed as part of the government center expansion project. The on-site clinic has been in the planning for a number of years to help stabilize the health insurance premiums for St. Croix County, Witt said.
The Capital Improvement Plan will allow the build-out of the space, he said.
The on-site clinic is “not a done deal” and has two hurdles to clear, Witt said.
The first hurdle is for the Committee on Administration to approve it as part of the offer of health insurance for the employees, and the second hurdle would be the St. Croix County Board’s approval of the build-out for the Capital Improvement Plan in September, he said.
A motion to approve the amendment suggested by Amos passed on a vote of 18 “yes” to one “no,” with Ottino voting “no” on the motion.
The amended resolution was approved on a vote of 18 “yes” to one “no,” with Ottino again voting “no” on the motion.
