Laguna will implement Affordable Care Act on Jan. 1

Some part-time city employees will be able to buy medical insurance as Laguna Beach begins to comply with the Affordable Care Act.

City employees who work more than 30 hours may purchase health coverage through a health-maintenance organization beginning Jan. 1, said Barbara Salvini, personnel services manager.

“We didn’t have to offer it, but we made a conscious decision to offer insurance to these employees in advance of the 2015 effective date,” Salvini said, referring to the play-or-pay provision of the federal law, which mandates employers offer coverage to qualified part-time employees or pay a fine.

To be eligible for health insurance, city employees must work 30 or more hours per week for 12 consecutive months. The city has fewer than 10 employees who fall into this category.

The projected cost of the added health insurance is less than $1,000 a year, according to a information present at the July City Council meeting.

Laguna budgeted nearly $264,000 more for health coverage for employees for the 2013-14 year, to about $3.7 million from $3.4 million in 2012-13. The figure was $4.2 million in 2014-15.

City officials attributed the anticipated increases to compliance with the Affordable Care Act and the expired negotiated agreement with Aetna Health of California, an HMO, which capped fees for two years, according to a description in the budget.

To identify which employees are eligible for medical coverage, city staff will count an employee’s hours from Nov. 1 through Oct. 31, Salvini said.

Employees who enroll will be guaranteed 12 months of coverage, even if their hours decrease.

The city currently offers part-time insurance to three lifeguards because they work more hours than their seasonal colleagues. That agreement was negotiated by the Marine Safety department’s collective bargaining unit, Salvini said.

The city has 244 full-time employees, Salvini said, some of whom have seen the effects of the Affordable Care Act, which President Obama signed into law in March 2010.

“Mandates requiring coverage for preventive care, as well as coverage for dependents up to age 26, have already been implemented by the city,” Salvini said in an email.

Full-time school district employees will not see changes to the amount of money taken out of their paychecks for monthly health insurance premiums this year, regardless of the plan, according to Dean West, the district’s assistant superintendent of business services.

District teachers and classified staff members with a Blue Shield preferred-provider plan (PPO) or a Kaiser HMO plan will pay $50 per month for a single-person policy and $100 for a two-person plan, West said in an email.

The district will spend $135,360 more than last year on medical benefits because of the Affordable Care Act, but the increase could have been greater, West said.

The district opted for its current Blue Shield plan instead of continuing with plans from previous years, which would have meant a 14.2% increase in premiums, he said.

“It would have significantly increased an employee’s out-of-pocket contribution: $300, $400 or $500 could have been taken out of their checks instead of $50 [for a single-person policy],” West said. “We restructured the plan to maximize the money employees are paying.”

Though employees will not see changes to their premiums this year, they could face other costs. “What could change is what a person is billed from the doctor,” West said.

He said about one-third of district employees are enrolled in the Kaiser HMO (96) while about two-thirds have a Blue Shield PPO policy (208).

Even before the Affordable Care Act, the district had provisions for certain part-time employees to purchase health insurance, West said.

Employees who work four to six hours per day can purchase health benefits, but they pay 50% of the monthly premium, he said.