December 13, 2022 Camden County Commission meeting at 10:00 a.m.

I attended the December 13, 2022 Camden County Commission meeting at 10:00 a.m.

All commissioners were present. This post is a little late, but the Gadfly has been pretty busy running around attending the Junior Gadflies’ band concerts, choir concerts, and dance recitals during the holiday season.

This meeting was held in the Commission Building conference room and it was pretty crowded. The water was shut off in the building because of construction. Not a great omen for the project.

The previous Commission meeting was almost entirely about Veregy and the $4.7 million renovation project. You can read about that meeting here. It was a good one.

At that meeting, Veregy’s Regional Manager for Missouri said he would see if he could get the development team who prepared the scope of work in the contract to attend this Tuesday meeting. Unfortunately, nobody from Veregy decided to show up and answer questions. Or their lawyers decided nobody was going to show up.

As the meeting was starting, the Treasurer mentioned Veregy had installed the carpet in her office before they painted the walls. She anticipated that the carpet might have to be replaced as a result.

There was no public comment from the attendees during general Public Comment.

The first agenda item was a Letter of Support for the Lake of the Ozarks Multiplex.

The Lake of the Ozarks Multiplex is what everybody else in Camden County calls the outlet mall. They are pursuing an economic development grant. The commissioners all signed the Letter of Support.

The second agenda item was an E911 Road Name Change.

The property owners want to change a road name from Pecan Road to Papa’s Ranch Road. I hope this name change wasn’t supposed to be a surprise, but in case it was, nobody tell Papa about this. The property owners own all of the land adjacent to the road. The Commission approved this unanimously and waived the fees for the road change.

The third agenda item was Tax Abatements.

The Commission unanimously approved the abatements.

The fourth agenda item was the Collector/Assessor/Recorder Flooring Bid.

Commissioner Gohagan explained that Veregy found additional asbestos in these offices, but Veregy had not anticipated that there would be any asbestos there. As a result, this work was not included in the scope of work for the Veregy contract.

One bid was submitted by Richardson’s Carpet. The last time this was put out for bid, there were no bids. The current bid was for a total of $47,633.78 to install 6,606.76 square yards of vinyl flooring. $17,073.57 of this were labor costs.

The Commission voted unanimously to table this bid so it could be reviewed by the elected officials.

The fifth agenda item was Stop Loss Renewal.

I’m going to do my best to explain how this works. Approximately 8 years ago, Camden County made the decision to move away from using traditional medical insurance plans and become self-insured. The county hired Mutual Medical to administer its medical coverage (the Camden County Healthcare Plan). As part of this medical coverage, there is pool of money that is used to pay for medical costs for the employees. So far this year, Camden County’s total medical claims under this system were $1,190,510. The total plan cost for all of it (prescriptions, claims, administrative costs) this year has been $1,846,000.

Mutual Medical was at the meeting to present the Commission with its options for the renewal of its Stop Loss coverage. According to the Mutual Medical representatives, Stop Loss protects Camden County in the event that an employee or family member suffers a catastrophic medical event that incurs unusually high medical expenses. Once the subscriber reaches a certain dollar amount in medical costs in a year, Stop Loss would cover the remainder of the expense.

The current threshold is $67,500 in medical expenses. If Camden County wanted to keep that threshold, the county would have to pay a 3% higher annual premium ($16,000). If Camden County wanted to keep their current premium, the threshold would increase to $70,000.

One individual exceeded the Stop Loss deductible in 2022. They said the amount they exceeded it by, but out of respect for that person’s privacy, I won’t repeat it here.

The conversation began to veer into other aspects of Camden County’s medical coverage for its employees and their families. Commissioner Gohagan asked about the county’s administrative fees for the medical coverage? The Mutual Medical representatives responded that Camden County is currently charged a flat fee of $35 per employee per month. They are currently in the second year of a three year deal regarding administrative fees. Camden County can request that these fees be recalculated if the number of employees changes by more than 10%.

Nathan Rinne started asking questions about Mutual Medical’s use of the Affordable Care Act. It seems that if an employee’s medical costs become too high, instead of insuring those high claims, Mutual Medical can contact the subscriber and get their consent to terminate them from their medical insurance. This creates a qualifying event that the subscriber then uses to allow special enrollment into the Affordable Care Act health insurance exchange. Once they are enrolled, Mutual Medical pays their ACA premiums and their out of pocket expenses.

The problem with this is that the ACA qualifying event for termination of coverage is actually described as an “involuntary termination of coverage.” The healthcare.gov website clearly states that if you voluntarily dropped your coverage, you don’t qualify for special enrollment. The Mutual Medical representatives made it clear they only would do this if the subscriber agrees to do it.

https://www.healthcare.gov/blog/special-enrollment-qualification-coverage-loss/

So in effect, they incentivize those subscribers whose higher medical costs would be a financial burden to the medical plan to sign up for the ACA insurance and avoid those high costs. This places the burden for those costs onto the ACA insurance and the taxpayers (US) who subsidize it. It hardly sounds like an involuntary termination of coverage when the subscriber agrees to be terminated and is offered a benefit (paid premiums and expenses) for being terminated. Sometimes employees contact Mutual Medical to be terminated and sometimes Mutual Medical contacts the employees.

This doesn’t sound like an “involuntary” termination at all.

Rinne said he had spoken with the Department of Labor and they told him that this was fraud. However, since a governmental body is doing it, the Department of Labor will only investigate it if someone decides to file a lawsuit. He also said that an employer is not allowed to pay ACA premiums. (I’ll be honest. I’m friends with Nathan Rinne, but I can’t figure out how he learns about all of this stuff.)

The Mutual Medical representative stated that Camden County doesn’t pay the premiums. They are paid by the Camden County Healthcare Plan. The Plan does not receive any tax credits for the ACA policy enrollments. It pays the full premium charged by the insurance carrier. There is no gap or break in coverage when subscribers are moved to the ACA exchange.

(Sheesh. I’ll let the readers give this the sniff test themselves. It seems like the most expensive medical cost members are being dumper off on ACA, right?)

Presiding Commissioner Hasty explained that Camden County has saved a lot of money and controlled its overall costs in the past eight years using this system.

(I’m sure they have since they can send their highest cost subscribers over to the ACA exchange.)

The Mutual Medical representatives pressed for the Commission to make a decision on the Stop Loss renewal since it needed to be decided before the end of the year.

After this discussion, the Commission voted unanimously to table the Stop Loss renewal so they could review the premium costs.

The final agenda item was Veregy.

The water turned backed on and Presiding Commissioner Hasty then decided to call an intermission for the meeting so everyone could take a five minute break. Frankly, at this point even you Readers might need a break.

Commissioner Gohagan asked Commissioner Williams to call Veregy Project Manager Jason Trickey to see if he would show up at the meeting. (At the last meeting Commissioner meeting, Williams was nominated as the point of contact for Veregy.) Williams responded that he didn’t have Trickey’s phone number.

Since nobody from Veregy showed up at the meeting, citizens in the audience had some questions for County Auditor Jimmy Laughlin. There have been a lot of unanswered questions about who first approached Veregy about bidding on the $4.7 million renovation project and the timeline on how Veregy became involved with it. As the County Auditor, Jimmy Laughlin is supposed to be the elected official who regulates the financial transactions of Camden County.

When did the Auditor first engage with Veregy regarding the remodel? He responded that they came up to look at his office but he couldn’t remember when that was. Probably February of 2022.

Why was the Auditor involved with Veregy before the bid was requested? Apparently, months ahead of the bidding process, Veregy was given a tour of the Auditor’s office and Veregy wrote the scope of work for Camden County’s Request for Bids. Kathy Fewell from the Auditor’s Office said that it is a common practice that when you need a specific function, you would ask that expert to assist in preparing the request for bid for that function. (Maybe, but the company who wrote the Request For Bid probably should not be allowed to bid on it. Too easy to tailor the bid to their strengths.)

Presiding Commissioner Hasty interjected that this project was publicly bid. It was advertised in accordance with the law and the scope of work was discussed in a Camden County Commission meeting. (That means they put the bid in the weekly paper.)

Who authorized the maintenance staff to sign the change orders for the project? Nobody from Camden County would admit to authorizing them to sign off on change orders. Melvin Miller from the Maintenance Department’s signature was on the change orders, but nobody would say who had authorized him to sign them.

Have the change orders been paid yet? Presiding Commissioner-Elect Ike Skelton was looking at the documents for the project and he said it looked like Veregy had already been paid on the first two change orders for the temporary housing of the Camden County departments. Was this true? County shrugs all around.

Skelton asked if there was anything in writing that said that the project was supposed to be completed by December 19? There was not. He felt the contract was very vague about whether the work was going to be completed in December or January. Ike Skelton made it very clear that there would be no contracts like this one in the next four years.

Nathan Rinne asked Commissioner Williams if he had even read the Veregy contract before he signed it? Williams shook his head “No” and Rinne responded, “I didn’t think so.”

Rinne told Commissioner Williams that if he was going to be the point of contact for the Veregy project, Williams would need to start putting in 40 hours a week and actually be there in the office. Williams became angry and asked if Rinne was insinuating that he (Williams) was not in the office? (It was pretty clear to everyone in the office that there was no “insinuating” going on.)

Commissioner Williams stated that he signed the Veregy contract at the same time that Commissioner Gohagan did.

Just to clarify if I understood what had happened, I pushed forward a bit and asked the Commission and Camden County officials out loud:

“If I understand this part correctly, Veregy was invited in to write the scope of work and then Veregy read the Lake Sun advertisement in the weekly paper and decided they were going to bid on the project. Like, an executive in Saint Louis happened to be reading the Lake Sun and said, ‘Oh hey, remember the project that we did the scope of work on? Let’s bid on that project.’ So Veregy wrote the scope of work and was the only bidder on the work.”

Nobody in government would respond, but one citizen muttered, “Magic.”

I asked, “Whose idea was it to bring Veregy in to do the walkthrough?”

I will give Melvin Miller the credit that he responded. He said they had two previous projects with Veregy when they were previously named CTS.

I then asked who let Veregy know that the $4.7 million Courthouse Renovation bid had been advertised? Who had called them? Nobody in the room would admit to having done that. Anyone?

And that was that.