The Texas Association of Counties made a mistake with the Health and Employee Benefits Pool – one that specifically impacted Ellis County.
When the United States Congress passed the Patient Protection and Affordable Care Act in March 2010, there was a provision included that allowed grandfathered health plans to preserve basic health coverage that was already in effect. According to the TAC plan sheet, a grandfathered plan may include some, but not all, consumer protections described in the ACA, such as the elimination of lifetime limits on benefits.
Financial consultant Brian Naiser stated that out of the 180 counties TAC serves, about half of them are on grandfathered health plans. He explained that a grandfathered health plan was a good option for some counties who did not want to submit to the full provisions of the ACA.
However, a 2014 audit revealed that 13 counties lost the grandfathered status. One of those was Ellis County.
“This has probably happened many thousands of times in the distribution of health plans,” Ellis County Judge Todd Little explained.
Naiser further noted that when the county was first paying into the grandfathered plan, the county was paying 95 percent of the employee costs, while county employees were paying into five percent. Naiser explained that TAC was initially advised that costs could be divided at that percentile and counties would still retain the grandfathered status.
However, upon the audit, their legal counsel advised them that was misinterpreted. The county would have required a zero contribution from the employee. The county lost its grandfathered status as a result of the audit.
“This was our error,” Naiser explained. “This was our mistake. Not the county’s.”
Director of Human Resources Teresa Taylor stated that TAC would consult with their actuary and reconvene on this issue again in April. The county would collaborate with TAC and bring a new plan before the commissioners’ court for consideration later in July before the next budget period in October.
“Once we get those numbers, it’ll be pretty fast and furious,” Taylor stated.