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A small government employer is trying to solve its health benefits problems by putting its 265 employees in an individual coverage health reimbursement arrangement plan.
The members of the Monongalia County, West Virginia, county commission approved the shift at a meeting last week.
The county hired Take Command to be the ICHRA plan administrator.
The county appears to be one of the first local government employers to trying using the relatively new type of health benefits arrangement.
Some communities questioned whether the county or employees would end up paying more, but Sean Sikora, one of the commissioners, said the critics have been spreading misinformation about the shift.
The Affordable Care Act prohibits health insurers from considering preexisting conditions when individuals buy health coverage, but not when a large group buys coverage, Sikora said.
When Monongalia County has applied for coverage, it has often had trouble getting coverage because of a high level of claims, Sikora said.
Some carriers "won't even provide a proposal because of our experience," he added.
When the county shifts to an ICHRA strategy, the employees will get a choice of 37 plans from three carriers, and the county won't have to worry about being rejected because of its poor claims experience, he said.
The company believes the ICHRA plan will be a good deal for the employees, even if Congress lets the current high level of ACA premium subsidies snap back to the low levels in effect before the start of the COVID-19 pandemic.
Reactions: Sam Melamed, the chief executive officer at NCD, a supplemental benefits provider, said in a post on LinkedIn that this is the first time he's heard of a county moving to an ICHRA plan.
"I fully expect to see a lot more of these reports coming as carriers continue to build quality off-exchange plans for the employer market," Melamed said in a post on LinkedIn. "This might seem like one small group, but it feels like a really big deal to me."
Mimi Sibley, general manager for ICHRA programs at Gravie, a Take Command competitor, said in an email that the Monongalia move is encouraging.
"While many employers still prefer not to publicize their benefit structure changes, we're seeing widespread exploration and adoption across both public- and private-sector organizations, from counties and school districts to health care systems and service industries," she said.
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