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Schools choose new health insurance plan

For the second time in three years, Hernando County school employees have a new health insurance provider.

HIP Health Plan of Florida Inc. of Holiday was chosen unanimously by the School Board on Tuesday night to replace Humana Health Care. HIP's contract takes effect Jan. 1.

HIP was chosen by a 16-member district insurance committee last week to replace Humana, which had been the district's health insurance company since 1995.

The district sought bids for a new carrier when it discovered this spring that Humana was planning to increase its premium by 55 percent.

By signing on with HIP, there will be an 18 percent increase, but the premium will remain at that rate for two years.

"If Humana had had a very low percentage increase, we would have considered renewing with Humana," district finance director Tim Bargeron said. "There was never an absolute that there was not going to be another bid, but we would have definitely given serious consideration to Humana."

Currently, a single employee on Humana's health maintenance organization plan pays a monthly $20 co-payment and the board pays a monthly $118.88 fee. Under HIP, the employee will have a $15 co-payment; the monthly fee will be $140.40, a $21.52 increase. Bargeron is not certain whether the board will continue to pay the entire monthly fee or require the employee to pay a portion.

Humana offers employees two health plans: a preferred provider organization plan, or PPO, and a health maintenance organization plan, or HMO.

With an HMO, patients choose a primary care physician who is responsible for coordinating their health care from a list of participating doctors. The district pays the health plan a fixed fee per patient to cover the cost of all care.

In a PPO, members pay less for their care as long as they use a network of doctors and hospitals that have contracts with the insurance company. Members are allowed to go outside the network at a higher cost.

Under its contract, HIP will also offer an HMO, plus a Point of Service plan, or POS. Bargeron calls the POS a hybrid of an HMO and PPO. If an employee chooses a physician inside the network, the patient is responsible only for the co-payment. If employees go outside of the network, they pay more for their care.

As with Humana, all three of the county's hospitals have agreed to accept HIP clients.

The hiring of Humana ended almost 20 years of coverage provided to school employees by Acordia Benefits of Florida. Acordia had become too expensive and did not give employees enough options, officials said.

The vote for Humana was controversial. In workshops, three School Board members said they were concerned about hiring Humana. When it came to the vote, four of the five board members endorsed Humana.

Earlier this year, School Board Chairwoman Gail Coleman, who cast the dissenting vote, raised questions about the final vote, and the Hernando Sheriff's Office opened an investigation into the vote and several other school-related issues. The results of that inquiry have not been released.

For months before the vote, school officials were lobbied on Humana's behalf by former Florida Gov. Bob Martinez and his son. The Martinezes had spoken with several school employees and four board members prior to the vote. The Martinezes and Humana and school officials have maintained that they did nothing improper.

Bargeron said he has no regrets about the district's affiliation with Humana.

One of the reasons the district sought a new carrier, he said, was to boost the number of school employees participating in the district health insurance plan. Once the school system signed on with Humana, the participation rate climbed from 50 to 75 percent, Bargeron said.

As of Wednesday, 1,530 of the district's nearly 2,000 employees were using the district's insurance plan. Part-time employees and student workers are not eligible for coverage.

"I think they served their purpose," Bargeron said of Humana.