Dave Cannon knew health premiums for Delaware County employees would increase in 2010, but the county administrator wasn't prepared for a 14.9-percent increase.

"We anticipated about 5 percent," he told the three county commissioners at their Nov. 16 meeting.

With an already "too tight" budget, Cannon said he, county administrative services director Lisa Iannotta, and insurance and risk director Cindi Blair looked for ways to reduce the county government's health care costs.

Their recommendations were presented at the commissioners' Nov. 16 meeting. Commissioners were asked to approve the 2010 health insurance renewal rates along with changes to the county's benefit plan.

The vote was 2-1 with Todd Hanks voting no.

Hanks said he wasn't opposed to the plan as presented but wanted a one-year contract with CEBCO (County Employee Benefits Consortium of Ohio), the county's health insurance provider, not a three-year contract, until he sees what the U.S. Congress does with health care reform.

As county officials sat down to begin this year's budget process, they knew they had to rein in costs, Cannon said, or face lay-offs. Changing the health plan is one way to do that.

In 2009, employees had two plans to choose from. About 84 percent chose to pay a fixed monthly rate -- $32 for single coverage and $65 for family coverage -- and incurred lower costs when they visited a doctor, Cannon said.

Employees who chose the other plan made no contribution out of their paychecks but had higher co-pays and deductibles.

The first plan is what is driving up the premium costs for the county, Cannon told the commissioners.

Because employees don't have to pay anything for a doctor visit, they think there isn't a cost involved, he said. But CEBCO looked at utilization rates in determining the higher premium for 2020, he said.

With the new plan approved by the commissioners, all employees who chose to sign up for the insurance will pay $14.36 a month for single health care and prescription coverage or $36.20 a month for family coverage, Iannotta said.

The new plan also comes with a $100 in-network deductible for a single employee with a $1,000 maximum out-of-pocket cost annually. A family plan would have a $200 deductible and $2,000 maximum out-of-pocket cost.

The employee contributions will fall short of meeting the amount the county pays to the insurance company, said commission president Tommy Thompson, so the county will contribute $300,000 out of health care reserves.

"We can't push all of the cost to employees," Cannon said.

Co-pays for prescriptions also will increase with the new plan.

The biggest jump would be for nonpreferred, nongeneric drugs that currently cost $60 for a 90-day supply and will go to $100 under the new plan.

Commission vice president Ken O'Brien expressed concern about the high cost for employees who have no alternative but to choose the nonpreferred drugs

Cannon said the administration was aware of those concerns but looked for ways to get "the most bang for the buck" with the new plan and "do what is best for all employees."

Also at the meeting, the commissioners discussed plans to reduce the number of employees working in the code compliance department.

The workload for those employees is lighter than in the past, Cannon told the commissioners, and the office is "overstaffed."

Rather than let the surplus employees go, Cannon said they will be given the chance to move to other vacant positions within the county.

Thompson asked if the county would move them back if the workload in code compliance increased, and Cannon said it would.

"They've got the skills, training and certificates. ... It would be best to move them back than to train and educate someone new," he said.