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Mendocino County Today: March 29, 2012

IF IT RAINS hard for 8 or more hours solid, as it did Tuesday, 128 at Navarro will be closed at Flynn Creek. Sure ‘nuff. The gates were drawn across the highway Tuesday afternoon and opened Wednesday about noon. The Navarro River rises fast even if the ground isn’t saturated, which it wasn’t before this week’s deluge, but it began raining shortly after midnight on Tuesday morning and was still raining hard late afternoon 12 hours later. When the big rains close the road, locals get to and from the Mendocino Coast through Comptche or Elk. The Garcia between Manchester and Point Arena spilled over Highway One near Point Arena, which it also always does, and only Jan the Mail Lady is bold enough to traverse it both ways. Nothing stops her, nothing! Everyone between Cloverdale and the Point Arena Air Force Station get their Netflicks even if Noah himself has called, “All aboard!”

MICHAEL HARRIS is a bigwig in the State Parks bureaucracy. He said Tuesday that only a few of the 70 California parks scheduled for closing this summer will actually really truly close. Harris said 11 of the parks have already been rescued by state, federal and community entities while some 40 more parks on the hit list are also likely to be similarly spared. He estimated about 15 parks remain as likely victims of the state budget cuts that threw State Parks into crisis mode. Harris said he expects most parks will be run by for-profit concessionaires and nonprofit organizations. The Legislative Analyst's Office has recommended a variety of ways to keep the parks open, which include transferring park ownership to cities and counties, allowing private and nonprofit companies to operate parks, increasing entrance fees and expanding concession contracts. There is no definitive word yet on Hendy Woods’ (Philo) prospects.

THE HAZARDS of trying to deal with the mess that healthcare has become lately, were made quite clear at the March 12, Board of Supervisors meeting. They were trying to see how much it would cost to “blend” a few dozen non-Medicare eligible retirees into the County’s employee insurance plan pool. (These kinds of slicings and dicings of real people into this category or that sub-category are one of the primary problems with American healthcare that a simple single-payer system would solve like a hot knife going through several Gordian knots. But of course single payer is “not politically feasible” at this time because our elected officials prefer a giant, expensive private mess to a streamlined cost-effective system like most of the rest of the developed world has.)

Mr. E. PETER McNAMARA, “Senior Vice President with Keenan Associates Health Care Consulting for Muncipalities”: “The dollar amount that the County, for lack of a better term, could be on the hook for— If a person were to have a stroke, you're talking about maybe half a million dollars for, you know, if they survive the stroke and go into rehab and everything that goes with that, half a million, easily. So for that one claim it would be it would be $375,000! You know, if somebody has open-heart surgery —”

Supervisor Dan Hamburg: “Okay, yeah, I know all the horror stories. But if you're talking about the period from September to the end of December, don't we already have that experience? We are thinking about the past.”

McNamara: “No, if they left the plan we wouldn't have any idea what --”

Hamburg: “So if they left the plan then we would be on the hook for anything over $125,000 during that period?”

McNamara: “No.”

Hamburg: “They're not in the plan, so how would we be…?”

McNamara: “The stop loss I was talking about is going forward.”

Hamburg: “Yeah.”

McNamara: “So quite frankly they don't care what happened in September, October, November and December. That's already covered under a different contract. So you renew a contract, for — say — you have a new carrier every year, every plan year, there’s a new contract with a stop-loss carrier. It could be the same dollar amount — it’s going to be the same dollar amount, it's the $125,000 specifically per the reinsurance policy. But it's year to year. So at the end of the year, on midnight December 31, they don't care what happens because this new contract won't cover it. The old contract will. So if somebody incurred a claim in October, say $1 million, then left the plan in November, the reinsurance contract would pick up every penny over $125,000 to $1 million. Because they were on the plan. In October. When they incurred the claim.”

McCowen: “But if they…”

McNamara: “Make sense?”

Hamburg: “I’m still trying to make sense out of it. But my time is up.”

McCowen: “Just to follow up. If I may. So, but, if they left the plan prior to December 31 and then they come back into the plan now and they have this medical emergency then they would not be covered by the stop loss…”

McNamara: “That’s right.”

McCowen: “Whereas anyone who was covered through December 31 and left the plan but now comes back in even though the event might have happened in January, they would still be eligible for stop loss?”

McNamara: (Long pause.) “They would be eligible from the time that they were in the plan.”

McCowen: “Okay. But the person who left prior to 12/31 and came back in in March would not be eligible.”

McNamara: “The claims that were incurred prior to coming back into the plan would not count against the deductible or the specific reinsurance attachment point. That's correct. So that $125,000 attachment point would only begin at the time they come back in the plan.”

McCowen: “Right. “

McNamara: “It’s not different than—”

McCowen: “But then the County would be covered by the stop loss for those people.”

McNamara: “Correct. “

McCowen: “So the whole distinction is they were either in the plan on 12/31 or they were out. If they were in the plan on 12/31 they would not be covered by the stop loss — I mean, if they were in by 12/31, they would be covered; if they were not in on 12/31, even though they went out later and came back and they would be covered from the day they come back in going forward?”

McNamara: “No.”

McCowen Rolls His Eyes

McCowen: “(Dramatically rolls eyes.)”

McNamara: “No. No. If they were covered—”

(Laughter in the board chambers.)”

McNamara: “So, so, so. It's not as difficult as we are making it. If I am a retiree and I was on the retiree plan on December 31, 2011, but I canceled my coverage. I didn't pay because it was going up to $922 a month. I didn't pay it. I decided I couldn't afford it and right now I'm not covered. The reinsurer is saying as of April 1 we will agree to cover any of their claims from April 1 to December of 2012. They will be subject to your reinsurance contract. If, however, they were someone who was on the plan in September, left the plan in October or November or December 15 and you say we are going to let them come back on, that's fine. But they will not be covered under the stop loss contract. Period.”

McCowen (clearly tired of the discussion): “I think we may have that.”

THE BOARD, obviously more confused than when they began, gave up and went on to approve blending the under-65 retirees and have staff figure out how much it’ll cost. (Most estimates are in the hundreds of thousands of dollars for the County, on top of increases in health insurance premiums for all remaining active employees.)

IF I CANCEL my coverage today

You can be sure that somebody’ll pay

For my cancer or stroke

while they all blow smoke

But insurance companies will still have their way.

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