ERIK SANZENBACH / L’Observateur / May 27, 2000

LAPLACE – After a special session by both the St. John Parish Council andthe council’s insurance committee, parish employees will be covered by health insurance for at least another year.

The plan will be little more expensive than expected, and parish employees will pay some more out of their pocket. But as council chairmanDuaine Duffy put it, “We can provide a health plan at no real cost to parish employees.”The present health insurance policy for parish employees is scheduled to expire next week. However, because of a year of unusually high claims, thecouncil is also facing a budget shortfall of $250,000. The old health planwas an ill-advised self-financed program that could not meet the demands of so many claims.

Wednesday night’s meeting of the insurance committee brought together three insurance companies that presented their policies to the council: United Healthcare, Gulf South Health and The Oath, formerly known as SMA Health Plan.

In the end, the council voted to accept The Oath. With a yearly premiumprice tag of $1,498,536, The Oath policy was the second cheapest of the plans presented to the council. However, most of the other plans wouldhave forced employees to pay much higher deductibles. The Oath offered amuch simpler plan of co-payments that appealed to the council.

“The Oath is offering the best in co-payment schedules,” said Duffy. “Theemployee would only pay a little more for co-payment.”Under the old policy employees paid $10 for a visit to the doctor, now the co-payment rises to $15. Last year, parish employees paid a $15 co-payment to see a specialist, now that rate has gone up to $25. As forprescription drugs, the schedule of co-payments is $8, $18 and $35 depending on whether the patient chooses generic, preferred or non- preferred drugs.

The Oath’s regional sales manager Doug Jones also brought up another point that seemed to satisfy the council. The Oath is a local company withover $11 million in reserves.

“We pay all our claims within 20 days,” said Jones.

Earlier, the council heard a parish employee testify that a former parish insurer, United Healthcare, had taken its time in paying a hospital claim.

Employee Pete Cazalas said he had over $20,000 in hospital cost and that the insurance carrier took over a year to pay off the claim.

“I was threatened and harassed,” said Cazales, “because United wouldn’t pay for 12 months. I didn’t get any satisfaction from them.”The only issue that might delay the new insurance policy is The Oath’s continuing negotiation with River Parishes Hospital. At this point RPH andthe Oath are hammering out a new contract. The parish council said itwould go with The Oath only if it gets a letter from the company saying a deal is being negotiated with RPH. The council left itself an out saying itwill go elsewhere if The Oath does not have a contract with RPH.

The council also voted in favor of the Guardian company for the employee’s dental insurance. The new policy will cost the parish $126,910.32 a year. Employees will pay a $50 deductible with Guardian paying for 80 percent of preventative services and 50 percent for basic services.

Even with the coverage, the council still faces a shortfall in its budget.

However, councilman and chairman of the insurance committee, Steve Lee, feels two insurance escrow accounts will be able to cover half of the $650,000 shortfall. The council will have to look elsewhere to trim thebudget.

Both votes passed the council 8-0. Councilman Job Boucvalt was absentfrom both meetings.

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