Towns consider pool for health-care coverage

Donovan’s proposal calls for municipal employees to join a state employee health insurance plan. The Connecticut Healthcare Partnership, he said, could achieve millions in annual taxpayer savings through "pooling," which essentially creates a larger pool of insured and would improve the state’s ability to bargain with health-care providers.

Aside from increased bargaining leverage, the plan should also lower administrative costs by streamlining the system. The savings could be as high as $50 to $100 million statewide and $1,000 per municipal employee.

New Haven could stand to save as much as $8,664,337. Tolland, a much smaller town, could save as much as $50,551.

Donovan is traveling the state trying to get municipalities and unions to sign up.

He explained some of the details in Kent last week. There would be three different types of medical plans: point- of-service, point-of-enrollment and point-of-enrollment with gatekeeper plans.

According to the Connecticut state comptroller’s Web site, point- of-service plans are plans that offer health-care services both within and outside a defined network of providers. No referrals are necessary to receive care from in-network providers. Health-care services obtained outside the network would require preauthorization but could be reimbursed at 80 percent of the allowable cost after the annual deductible is paid.

Point-of-enrollment plans offer health-care services only from a defined network of providers. However, out-of-network care is covered in emergencies. No referrals are necessary to receive care from in-network providers.

Point-of-enrollment gatekeeper plans offer health-care services only from a defined network of providers; out-of-network care is covered in emergencies. Patients select a primary care physician to coordinate all care and referrals are required for all specialist services.

State-provided health coverage would also include dental and out-of-area plans.

Some of the gathered municipal officials said they want to take time to scrutinize all the pros and cons. They want to analyze the cost benefits in their own towns, and determine whether the health-care plans would offer the level of service that municipal and union employees have now.

They also worried about putting themselves at the mercy of state mandates.

Donovan ended the meeting on an upbeat note, expressing confidence in the plan and saying he hopes it can eventually be made available to all state residents.