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Friday
Oct242014

Mesa County Employee Healthcare Options in Question. No Real Answers from Frank Whidden regarding St. Mary's.

VetTheGov received an email from Dennis Simpson regarding his findings in the recent budget items for Mesa County Government employees involving their tax payer self-funded health care plan.  It appears with the Nationalization of health care, local county employees can and must travel out of state to Salt Lake City University of Utah Hospital for specialized urgent care in lieu of St. Mary's which is obviously much closer.  Frank Whidden has been playing magic man lately and having to defend the insiders and how they manipulate our tax dollars.  Stay tuned as progressive big government continues to get in the way of progressive big government.  It's truly amazing to watch when they can no longer hide the facts!

Here is the email sent to all Mesa County Commissioners from Dennis Simpson:

Subject: Confusion over Health Insurance
Commissioners:  Last Friday, I submitted a CORA request asking for a copy of the recent Email sent to County employees regarding 2015 health insurance.  I also asked for a copy of any documentation that will be distributed at the upcoming  "open enrollment". Yesterday, Angela provided two documents which are attached.

Please note that the Email sent from Frank Whidden to staff on October 14 says that "St. Mary's hospital will be in network for services that Community Hospital cannot provide at this time (such as maternity, emergencies, radiology, etc.)".

The handout to employees defines (on page 5)  in network hospitals to be  "Community Hospital and University of Utah Hospital"  All other hospitals are out  of network  "except  for emergency care and maternity".   By this definition there are only two services that will be treated as in network if provided at St. Mary's.   This is way different than what was said in Frank's email.  If this wording is to be believed, many patients will be faced with choosing between paying through the teeth to stay at St. Mary's or being shipped to Salt Lake City.   Think of pre-mature babies, pediatric ICU,  cancer patient, heart patients, neurosurgery, etc.

I have attached the 2014 EPO schedule of benefits which lists  (on page 4) a whole variety of services that are treated as in network if provided at St. Mary's.  No such list is included for 2015 and there is no disclosure to employees that  the option of using St. Mary's has been changed. In fact, at the top of page 6 of the employee handout it says "EPO Plan Design - No Change".

Obviously one of the stories has to be changed quickly and I imagine the temptation will be to stick to what Frank said in the Email because that will cause the least grief to employees.  But the financial impacts of taking the easy way out should be considered carefully.

On October 6, Frank distributed the attached document with the title "Hand out 10_6_14."  On page 4, the "Claims @ maximum"  line is $7.6 million if there is "no change to benefits or network" and $6.4 million "with U of U and Community as in-network facilities".   At the meeting Frank explained that these amounts are the aggregate  limits for the two options assuming the same premium amount is paid to Sun Life of Canada.   Frank also explained that the reason Sun Life has the two quotes is because they were told that--except for maternity and ER--St. Mary's would be treated as out of network.   Several times he emphasized the word "steerage"  to describe the intentional effort to steer business away from St. Mary's.,

If Sun Life has been told that the St. Mary's changes have been implemented and the County instead allows in network treatment at St. Mary's as defined in Frank's email, the County may be breeching its contract with Sun Life.  If the County goes back to Sun Life and changes the rules, Sun Life will surely either increase the premiums it charges or increase the level of risk assumed by the County. If either action is taken, the 2015 budget will need to be increased even further to make up for the mismanagement of the plan.

The Commissioners need to take control of this process--NOW!  Obviously the staff is way over its head and is creating as unacceptable level of risk for Mesa County. 

The employees deserve to be told the truth.

Dennis

P.S.  The handout to employees does not disclose the out of pocket max for out of network services.  Does that mean there is no out of pocket max?   If there is no out of pocket max, the decision to make St. Mary's out of network could be even more catastrophic to county employees.

P.P.S.  The 2015 "travel benefit" is limited to $1.000 per year.  The cost to transport a premie baby to Salt Lake is probably closer to $20,000.   Will the employee be responsible for the difference?

Now let's sit back and watch who caters to Federal Overreach from the progressive big government insiders of Mesa County government headquarters when the tax payer funded paychecks get smaller and smaller for the little people inside those same walls.  Stay tuned!

Friday
Sep262014

Breaking News: Mesa County Insurance Funds being Depleted. Commissioners Ignore!

Mesa County taxpayers VetTheGov has been made aware by a local citizen Dennis Simpson who has kept tabs on the local County Budget over the last several years has once again located some very concerning inconsistencies in the Mesa County Insurance Fund. 

Today VetTheGov received the following email from Dennis and he asked it to be shared as his concern moving forward will effect all Mesa County tax paying stakeholders.

Commissioners:

As you may recall, I attended your August 11 meeting and made a presentation regarding the rapid decline of the fund balance in your Insurance Fund.  As I explained at the meeting, my entire financial analysis used data that is available on your website as my source. 

Six weeks have now passed and the problems I identified have not been discussed with you by your staff.  I found this odd so I sent a CORA request to Angela asking for all Emails on this subject.  Today she sent the attached  email  from Frank to the three of you.  It is now more clear why you have not felt any urgency to address this issue.   Frank's statement that "it is clear that the fund is much healthier than stated in public hearing this morning"   has apparently  led you to believe that this is a back-burner issue.

At my presentation, I pointed out that the fund balance in the insurance fund had plummeted from $2.7 million to $1 million in 2013.  I also pointed out that the projections for 2014 (PREPARED BY COUNTY STAFF) showed that 12/31/14 fund balance would drop to below $100,000. 

So Frank visited Eleanor who told him that the fund balance on 8/11/14 was 2.2 million.  He mentions that Eleanor had provided some caveats to publishing that number but did not bother to provide any specifics of  what these caveats were.    There are many ways that an unadjusted fund balance in the middle of a month may be very misleading.    Almost no private company or public body publishes financial information in the middle of the month and there is good reason.  The accounting staff needs time to make sure all entries for a month are posted before things like "fund balance" are meaningful.

If you take the time to look at the financial statements on your website you will see that the fund balance on June 30, 2014 was $967,705 and that the fund balance on July 31 was $1,073,609.  Neither of these numbers are anywhere near $2.2 million  Using Frank's logic, the fund balance more than doubled in 7 business days.  While it is possible that some magic windfall occurred,  Frank should have recognized and explained what magical event occurred.  I have attached a copy of the July report so you can see how the actual July 31 fund balance is calculated. I have drawn arrows to three number which are: fund balance January 1, 2013-$1,005,806,  2014 revenue through July 31, 2014-$5,030,806, and 2014 expenditures through July 31, 2014-$4,963,033.  If you add the first two numbers and subtract the third,  the total comes to $1,073,609.

As bad as it was for Frank to conclude, without explanation, that fund balance had doubled in 7 days, the bigger issue is that he totally ignored the comments I made regarding the projection of fund balance on December 31, 2014.  One of the most important factors in the development of the 2015 budget is to apply the best logic available to projecting what will happen in the remainder of 2014.  The comment that seems to have totally escaped Frank was that I had stated that COUNTY STAFF had projected the fund balance on December 31, 2014 to be $85,370 (down from the $2.7 million of 1/1/13). When the July statements were published, this projection changed to be $355,452 (circled on attached report).   Either projected number should have caused immediate corrective action. 

Worse yet, the staff projections may be too optimistic.  As I pointed out, the staff seriously underestimated the 2013 claims expenditures when the 2014 budget was being developed.  The fund balance projected for 12/31/13 on  6/30/13 was $2.6 million. The actual 12/31/13 fund balance was $1 million.  No explanation has been provided for how the staff was so far off in 2013 and no evidence has been presented. that the 2014 projection methods have been changed.  if 2013 history repeats itself in 2014, it is very possible  that the insurance fund balance with be totally depleted by the end of the year.

Frank's email states that "management is well aware of the health care issue".    While it is true that the existence of the problem has been recognized,  it is obvious that management has not recognized the severity of the problem.  At a recent meeting Steve  stated that they my presentation was not a surprise and that almost all of what I said had been previously presented to the Commissioners.  Rose stated that most of my information was news to her.  Steve then said that Rose must have missed the meetings where this data was shared.  Rose disagreed that she had missed such important meetings.  The fact that the staff obviously does not comprehend how deep of a hole has been dug should make it obvious which Commissioner spoke the truth.

I am even more concerned that you are relying too heavily on Frank for advice.  While he may be very knowledgeable about data processing, he has demonstrated no competency in supervising the financial affairs of the County.  At a minimum, you should explain to the taxpayers why it is that you believe he has sufficient experience in financial management to have such a large impact on the decision-making process.  I attended your recent unrecorded meeting discussing the budget for 2015 Capital Expenditures.   I also attended the June meeting where the 2015 budget was discussed.   Evelyn attended the June meeting but it was obvious that she was not able to speak her mind.  No one from accounting attended the more recent budget meeting.   It is obvious that Frank and Tom intend to filter all information that you receive and that they intend to limit the need for you to make any decisions by controlling what information is provided to you and when it is provided.

I hope you totally change the process for development of the 2015 budget before it is too late.  If you don't actively seek input from your accounting staff and knowledgeable community members, the results could be very unpleasant.

Dennis

Stay Tuned as VetTheGov through recent CORA request regarding the 2013 Insurance payouts to see if the Brickey v. Sgt. Matt Lewis 4th Amendment settlement has affected the Funds Balance!  The Brickey Settlement occurred in 2013 and if you look at the fund balances you will see it went almost 900K in the negative direction.  2014 Insurance Fund half way through not looking much better! 

It is the hope of VetTheGov that the County Commissioners will see a history of public employee insiders withholding Public Information and demand a full investigation for the reasons why!!!  Once again where is the TRANSPARENCY?

Mesa County the time is now to have those being paid by your hard earned tax dollars to stop flushing these dollars down the toilet with zero accountability and begin to grapple with the realities of a local government that has become TOO BIG TO FAIL and Unable to hold itself accountable to the people that fund it.  Enough is Enough!