The Greene County Commission's Insurance Committee voted Wednesday to continue negotiations on health insurance costs.

Pam Gaut, account executive for BlueCross BlueShield of Tennessee Inc., offered the committee a renewal rate with a 10 percent increase.

She said underwriters originally offered a 13.9 percent increase, which she was able to negotiate down to 10 percent.

Based on last year's claims of nearly $4 million, a 10 percent increase would result in additional cost of $400,000.

"I don't know how we'll handle that," County Attorney Roger Woolsey said of the county's ability to cover a $400,000 increase.

Greene County Sheriff Steve Burns asked for a recommendation from Jim Jordan, president of Health Insurance Services, Inc.

Jordan recommended asking for a 7 percent increase, which would result in an approximately $300,000 increase.

Woolsey said the committee had three options:

* return to self-insurance for health coverage;

* seek bids from other insurance companies; or

* reach an agreement with BlueCross BlueShield to keep continuity.

Sheriff Burns said the county has a good working relationship with BlueCross BlueShield, and the employees are satisfied with the coverage.

Woolsey asked if the county government can afford $300,000 in a time when he anticipates no increases in employee salaries.

Mary Shelton, county budget director, added that county sales tax revenues are down.

Gaut said she will try to negotiate a 7 percent increase, with the understanding that the county would agree to renew its plan.

It was noted that some benefits could change to reduce the cost.

Gaut said the current proposal includes one benefit enhancement required by the Mental Health Parity and Addiction Equity Act of 2008.

For renewals on or after Oct. 1, 2009, the law requires the elimination of all day limits and visit limits related to treatment for mental illness and substance abuse, she said.

Such treatments must be treated the same as medical treatments, Gaut said.

This change should be discussed with employees during the open-enrollment period, Gaut told the committee.

In the past two years, Greene County has had a large number of large claims, Gaut said. From Feb. 1, 2009, to Jan. 31, 2010, the county had 26 members with claims in excess of $25,000, Gaut noted.

These claims totaled $1,531,802, or 39.9 percent of the total paid claims but only 1.3 percent of the total members, she said.

Overall, county employees are doing well with the plan, staying within the network of providers and using generic medications, Gaut said.