By Katie Vane
To many, the Mammoth Town employee dental and vision coverage reimbursement plan might sound like too sweet a deal. Since 2003, the Town has supported a “self funded” plan in which the Town gives each employee a certain, fixed amount of money to use each year on dental and vision expenses. As of July 1, 2010, that amount is $1,400 for unit members and $750 for dependents. By July 1, 2011, it will be $1,500 and $800.
This means the Town could spend up to $2,150 per employee with dependents in 2010. And with roughly 100 full-time employees, this means in 2010 the Town could spend up to $215,000 on all employees’ dental and vision care.
For comparison, the City of Bishop spends about $1,609 annually per employee with dependents. With only 40 or so employees, Bishop’s total spending is about $64,393 a year on employee dental and vision care. Bishop does not use the reimbursement system, but provides dental and vision benefits through Security Life (for dental) and VSP (for vision). The Bishop plan covers 100 percent of the premiums for dental and vision coverage, dependents included.
From the numbers, then, it looks like Mammoth is willing to spend about $550 more per employee per year. But the numbers can be deceiving.
For one thing, not all Mammoth Town employees use the reimbursement plan. “Overall,” says Cyndi Myrold of the Town Finance Department, “we have many employees that don’t take advantage at all. Some do use 100 percent, but some are also right in the middle.” This means not every employee takes advantage of the full $2,150.
One unique advantage of the Town reimbursement plan (for employees) is that 80 percent of each employee’s unused money gets “rolled over” to the next year, for up to three years. While a traditional employer dental and vision plan pays money to an insurance company regardless of whether an employee actually uses dental and vision services, the Mammoth plan doesn’t pay more than the employee needs, and allows the employee to carry over most of the remainder of their reimbursement amount for a time of future need.
The Mammoth reimbursement plan has a few more things to offer that traditional plans, like Bishop’s, do not. The Mammoth plan avoids administrative fees built into premiums by insurance companies, and it also keeps business local. Insurance companies tend to dictate where clients can get services.
Under the Mammoth plan, Town employees are free to choose where they seek dental and vision services; most stay local. “Most people do seek their care here locally, unless there’s something that can’t be done here,” observed Cyndi Myrold. For dental services, Town employees go to Mammoth dentists, such as doctors Schrager, Sansom and Kaylor. For vision services, employees usually have to go to Dr. Reed in Bishop. However, the reimbursement plan feeds much of the Town’s money directly back into Mammoth businesses, rather than losing a percentage to insurance companies.
So far, the Town reimbursement plan sounds like a good deal. Town money goes back into the town, and Town employees get good coverage for dental and vision care. Most other employees in Mammoth tend to get only medical coverage, if that.
Snowcreek Resort, for example, offers no dental or vision insurance for employees, but does offer medical insurance through Blue Shield. While Snowcreek covers 100 percent of the premium for medical insurance, only some coverage is extended to dependents, and that for an extra charge.
Mammoth Mountain Ski Area offers employees dental coverage, even if it doesn’t offer vision coverage: for dental, MMSA pays 100 percent preventative (cleanings), 80 percent basic (getting a crown or cap), and 50 percent major (oral surgery).
That “major” expense is where the Town reimbursement plan falls short. Without actual insurance, a Town employee in need of a ‘major’ emergency procedure might find themselves footing most of the bill. Or, if that employee is lucky, a single ‘major’ procedure could consume their entire reimbursement amount for the year. Employees with a three year build-up of ‘roll over’ might have some cushion—presumably why one employee in February 2010 was reimbursed $3,592 for a dental procedure—but those without a cushion would encounter difficulties.
Overall, however, this Town reimbursement deal might actually be pretty sweet. Not just for Town employees, but also for the Town itself. Although the Town has to make available $215,000 a year for dental and vision reimbursements, this past year, employees only used $187,241 of that money. For comparison, if Bishop had 100 employees, it would spend $160,984. Perhaps that $20,000 difference is the price Mammoth pays for bypassing insurance companies and giving money directly to local dentists. Or perhaps that $20,000 bypass exists at the expense not just of Mammoth taxpayers, but also employees with ‘major’ needs.
In the end, the Mammoth reimbursement money left unused — this year $27,758 — “rolls over” for employees’ future use, and also replenishes Town internal funds for the reimbursement plan. So it looks as though, barring any emergencies, Town employees might just have the sweetest deal in Mammoth.