Door County Businesses Co-op Could Cut Health Insurance Cost

As state and national legislatures appear content to tackle skyrocketing health care cost with patches and duct-tape, a Green Bay organization is attempting to flip the system on its head, and now they want to bring Door County businesses into the mix.

The Healthy Lifestyles Cooperative gathers small business owners together to create a large pool to bargain for better rates from health insurance providers. Healthy Lifestyles Executive Director Randy Connour toured the county Aug. 12 – 13 with Green Bay Area Chamber of Commerce (GBACC) Vice President of Member Services Ray Kopish, making stops in Sturgeon Bay, Ephraim, Washington Island, Ellison Bay, and Egg Harbor to promote the program.

The co-op aims to stabilize rates – in a health insurance industry where year-to-year increases often reach 30 percent or more – which amounts to keeping rate increases in the single digits.

The co-op was made possible with the passage of the Wisconsin Cooperative Care law in 2003 (revised in 2006), which allows businesses to come together to get insurance in a non-profit way.

Launched Jan. 1, 2007, Healthy Lifestyles is sponsored by the Non-Profit Resource Group and GBACC.

Connour said it is now one of the largest health insurers in Brown County, with 3,200 people in the program.

“That gives us a lot of clout when we negotiate with insurers,” Connour said.

There’s more to the program than the power of numbers, however. Connour emphasized the importance of the co-op’s wellness program throughout his presentation. At the crux of the Healthy Lifestyles model is an effort to encourage members to take better care and responsibility for their own health through incentives and education.

“We have a sick care system, not a health care system,” Connour said. “We need to make the system pro-active, and we do that with a lot of health and wellness.”

Connour said rate increases are driven by a person’s recent claims history and the underwriter’s forecast of future claims. “You must lower the forecast of sick care,” he explained, and you do that by improving health.

At the core of the wellness program is a yearly health risk assessment, which measures five key indicators of a person’s health. Thus far, Connour said 90 percent of their members are participating in the wellness program, and after the first year they saw improvement in each risk category – cholesterol, body fat, weight, blood pressure, and tobacco use.

The focus is not on making drastic changes in the lifestyles of severely unhealthy people, but on keeping healthy people from drifting toward high-risk behaviors.

“The return on investment comes from helping all those folks who are right on the edge of falling into bad health, and moving them back a little with small changes,” Connour said. “Those small changes make a big difference over time.”

Those changes include better food choices and exercise, spurred by a culture change in the workplace through greater accountability.

“We can’t as employers continue to stand back and say we can’t do anything about it,” Connour said. “Those businesses willing to actively promote healthier behavior will benefit. The key to success is the consumer taking charge of their own health.”

The program is being offered to members of the Door County Visitor Bureau and the Door County Economic Development Corporation and is available to any self-employed individual, for-profit or non-profit organization or partnership. Connour is making a major push to add businesses in Door County to the 172 already enrolled in Green Bay.

Healthy Lifestyles selected Humana as their insurance provider for 2009 – 2011, and the company has guaranteed rate increases will not exceed 15 percent from year to year. This year the rate was locked in at an eight percent average.

Connour said the program covers 97 percent of health care providers in Door County, and 118 hospitals and 9,300 physicians in the Wisconsin ChoiceCare Network.

For further information visit http://www.healthylifestylescoop.org.

Timeline

Businesses must turn in the membership application form and pay the administrative fee by Sept. 15 (the original deadline of Sept. 1 has been extended). The one-time fee is based on the number of eligible employees and ranges from $250 for businesses with 1–10, to $1,000 for those with more than 50. Individuals will receive a rate quote by Oct. 15, and businesses must decide whether to join the co-op by Nov. 7. Upon joining the co-op, the business must also join the Green Bay Area Chamber of Commerce.

Costs and Obligations

• One-time administrative fee based on number of eligible employees.

• $5 per employee monthly administrative fee built into premiums.

• $12.50 per adult employee monthly fee for wellness program built into premiums to cover health risk assessment, feedback session, and ongoing wellness coaching.

• Membership in the Green Bay Area Chamber of Commerce discounted 50 percent for members of the Door County Visitor Bureau or Door County Economic Development Corporation. Fee is based on number of employees. A business with 20-29 employees would pay $431 for GBACC membership.

• Members must make a three-year commitment (required by state law) to the co-op, which allows Humana to predict risk and stabilize pricing with greater certainty.

The Healthy Lifestyles Program

• Detailed health risk assessment every year for all adults.

• Personal development plans and coaching.

• High deductible insurance ($1,500 – $5,000): gets consumers more involved in their health care. Low deductibles lead to overuse of system.

• Rate caps tied to wellness program.

• Rewards for healthy lifestyles.

• Medical price reporting and transparency.

• Professional staff and committees working to keep improving performance.