When Sutter Health shopped for members at its new HMO plan for 2014, Sacramento County became the biggest client. Roughly one in five Sutter Health Plus members are Sacramento County employees or their dependents.
Worried about over dependence on Kaiser Permanente and hammered by rising costs at Blue Shield and a decision by Health Netto bow out of the pool in 2014, the county decided to replace Blue Shield and Health Net with two local plans: Sutter Health Plus and Western Health Advantage.
Between them, the two plans offer access to all local health systems except Kaiser.
“The strategy was to get all three to roughly the same price — with hope to restore a semblance of competition,” county employee benefits manager Dave Comerchero said.
For example, Sutter, Western Health and Kaiser offered health savings account-qualified high-deductible plans with very little spread between rates. Individual coverage runs from $474 per member per month at Western Health to $482 at Sutter and $484 at Kaiser. Family coverage runs from $1,213 at Western Health to $1,233 at Sutter an $1,238 at Kaiser.
Sacramento County has 10,800 employees. Between 1,800 and 2,000 decline health coverage. Sutter and Western Health Advantage each got about 1,100 for 2014. Kaiser kept the rest.
“Sutter has a good reputation and worked very hard to make a standalone plan (with just Sutter doctors and hospitals),” Comerchero said. “It’s a local entity — like Western Health Advantage — and the board was very favorable about that.”
Approved by state regulators last year, Sutter Health Plus kicked off coverage in eight counties in the Sacramento and the San Joaquin Valley region on Jan. 1. The health plan currently has more than 5,000 members.
Date: May 19, 2014