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WALKER-Cass County commissioners voted Tuesday to keep the county's major medical charges to the county and employees the same in 2018 as in 2017.

This marks the third year in a row for rates to remain the same.

Cass has a self-insurance program for major medical coverage. The county contracts with Blue Cross Blue Shield to administer the program, but the county chooses premium rates and decides how much reserve funding to maintain.

Chief Financial Officer Sandra Norikane reported the county has more in its insurance reserve than Blue Cross Blue Shield has recommended.

The county pays employees $1,045 per month for insurance. Of that, $4.90 goes toward a basic life insurance policy. The employees must use the balance to purchase one of the major medical options the county offers from its self-insurance program.

They can choose a plan for a single individual or family. In 2018 for the first time, they also will have a third option for a single person, plus one additional individual rather than having to buy coverage for a whole family.

Within the single option, they can select from a $1,000, $2,000, $3,000 or $3,375 deductible, but if they choose the $3,375 deductible they also must set up a health savings account.

With single, plus one or a family plan, they can select from a $1,000, $2,000, $3,000 or $6,750 deductible. Those choosing the highest deductible must also set up a health savings account.

Employee costs, like the county contribution, will not change in 2018.

For single plans, the employee major medical cost ranges from $616 for the $3,375 deductible to $725 for a $1,000 deductible. This employee then has between $424.10 and $315.10 extra money the county paid him that he does not need for his medical insurance.

The employee will pay income tax on that excess money just like wages. He is allowed to use the county payment to buy other insurance like dental or disability or to open a health savings account or just spend it.

For single, plus one plans, the employee major medical plans cost between $1,417 and $1,668, depending upon the deductible. Those employees have to pay in addition to the county payment another $376.90 to $627.90 per month for their major medical coverage.

For family plans, the employee major medical plans cost between $1,593 and $1,719 per month, depending upon deductible. Those employees have to pay in addition to the county payment another $552.90 to $678.90 per month for their major medical coverage.

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