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Slightly less than half the San Benito County employees will absorb the majority of the 2014 health insurance premium increases unless they switch plans or coverage. Without changes, the total healthcare premiums for employees will increase $392,000 in 2014 to $4.2 million; $50,000 of the increase will be absorbed by the county and $342,000 by the employees. Even then, the county will still pay 81%, of the average employee health insurance premiums.

This forecast was made using the December 2013 health plan data for more than 97% of the 304-person county permanent workforce assuming the employees remained with their 2013 plan selections through 2014. Part of the problem for the county and its employees is trying to predict the year over year changes in plan costs.

The PERS Choice Plan premiums for Northern California stayed steady, falling and average of 1.3% from 2013 to 2014, but the popular PERS Select increased an average of 29.4% while PERS Care, the most expensive PERS plan, fell 36.7%. The result is a lot of upside down. In 2013 PERS Care coverage for an “employee plus one” plan cost about $1,100 a month more than the PERS Select plan; in 2014, the difference is only $110. Much of employee costs are determined by these rollercoaster changes.

The wild swings do not instill confidence and can result in dramatic changes; that is what happened to 49 employees, 16% of the workforce, who used the PERS Select Family Plan in 2013. The plan monthly premium was $1,234 with the county paying for all but $20.16, the employee share. That was a real bargain, but in 2014 that total monthly premium jumped to $1,596. The county continues to pay $1,214 a month, which leaves $382 for the employees. Twenty-bucks a month to $382, that’s a shock, and it is now the least expensive PERS family plan.

We also have 30 employees who, because of where they reside, selected the more expensive bay area plans – those planes became even more expensive in 2014. Here are some details.

About 93 employees (31% of the force) will have no insurance costs. These are “employee only” selections for PERS Choice, PERS Select and PRORAC; the latter is for enrolled public safety members only. These groups paid no premiums in 2013 and will pay none in 2014; county cost will be $710,000, an increase of $20,000 over 2013. About 67 employees (22% of the force) will see a modest reduction of 5% to 7% ($271 to $209 each) in annual premiums. Total employee savings are $16,000; county cost is $906,000, the same as in 2013.

Together, the healthcare costs for those 160 employees remained the same or had slight decreases; total county costs were $1.6 million.

The remaining nine plans covering 135 employees (about 45% of the workforce) saw major cost increases that ranged from $478 a year to more than $4,300 a year per employee. These are expensive plans, the county’s costs remain at $1.8 million (78% of the group cost) and the employee costs rose to $499,000 (22% of the group cost).

Following these cost changes, the county contributes an average of $11,346 per employee annually and the employees contribute an average of $2,587.

That’s a lot of numbers, and they are only valid until employees start changing plans in response to cost if they can, which is how the system works. The major disappointments are the continued inability of anyone to control or even predict the cost of healthcare.