March 14, 2024, Camden County Commission meeting at 10:00 a.m.

I attended the March 14, 2024, Camden County Commission meeting at 10:00 a.m.

All commissioners were present.

There were a ton of uniformed Sheriff’s employees at the meeting. The room was practically filled with them. It felt like I was at a multi-location search warrant briefing.

The first agenda item was Bid Award-240307 Assessor’s Annex Roof Replacement.

The bid from Wright Roofing was recommended and accepted unanimously by the Commission.

Okay. That didn’t seem to be very controversial.

The second agenda item was County Health Fund Discussion.

Bingo. This was what drew in the crowd.

Jeremy Billington from Billington Insurance addressed the Commission. I’m not sure what Jeremy’s official title is, but he is the de facto manager of the county’s self-funded health plan.

I’m not an expert on the county’s health plan and I’ve written about it in more detail before, but I’ll try to summarize what was discussed and how the medical plan operates.

Basically, the employees contribute money into the pot (depending on what coverage they choose) and the county contributes money into the pot. The money from the pot pays for the medical treatment, prescriptions, etc. (not including possible co-pays and the employees’ deductible) for all of the employees.

If an employee has a costly medical situation, they are contacted by Billington and offered the option to be placed on Obamacare. (It’s my understanding that the county also pays the employee’s out of pocket Obamacare costs.) This saves the county money that would otherwise be spent from the pot on significant medical expenses.

Billington confirmed this as he discussed the plan. He mentioned that if an employee has a heart attack, that extra cost has to be spread among everyone in the plan. By putting the stricken employee on the ACP (Obamacare), the county avoids those high impact events.

(The legal questions regarding this plan’s operation revolve around how the employee is able to claim the loss of county coverage as an Obamacare special enrollment event when they chose to lose their coverage. It’s also questionable whether the county can agree to pay the employee’s out of pocket costs and this can have significant tax implications for the employee. In effect, this policy defrays costs by dumping the most costly members into Obamacare, an insurance plan that is subsidized by the federal government. In other words, the taxpayers. )

Anyway, it appears the pot is now empty. Every last penny has been squeezed out of that piggy bank.

Billington pointed out that the contribution per employee has remained at $515 per employee (I assumed this was monthly) for the last 8 years while inflation has increased costs. The county also recently agreed to cover shots for treatment of Type-2 diabetes and weight loss and those medications can get very expensive.

As they were discussing the shortfall, Billington mentioned that the county had received a large rebate on their prescription plan that should put the pot back into the black.

County Treasurer Kendra Hicks told the Commission that she had discussed this issue with the County Auditor and they both agreed the monthly premiums should be increased by $50. There are no more reserve investments left to support the medical plan. It is currently running on fumes.

The Commission directed the Auditor to prepare budget amendments that would increase the county’s contribution per employee. One amendment would raise the contribution by $50/month. The second amendment would raise the contribution by $100/month.

During the meeting, quite a few of the employees raised their hands to indicate they were happy with the current plan. The Commission also recently distributed a survey to the county employees to measure their satisfaction with their current medical coverage.

(I later spoke to a Sheriff’s employee who explained that the rumor had been that the Commission was going to cancel their medical insurance plan. That might explain the big turnout of heavily armed and armored county employees.)

In other news, Camdenton is seeking to annex property down Business 5 to the Ozark Amphitheater and wants right-of-ways for water access. Commissioner Skelton also reported that the follow-up meeting with DNR at Three Brothers Meat Company went well. Skelton didn’t think they were going to see that particular inspector out there again after speaking with his boss.

In Public Comment, engineer Jim Jackson spoke to the Commission about Camden County Public Water District #2’s plans to improve their infrastructure. They have been waiting for DNR to approve their plans and haven’t been able to lock anyone into a contract yet because of the approval delays. Their concern is that ARPA money was earmarked to fund this project and the ARPA rules mandate that all ARPA expenditures have to be under contract by 2024. The Commission seemed eager to engage with DNR once again and see if they could speed up the process.

And that was that.