The city of Independence, facing rising health care costs, is making changes to its self-insured plan for employees and retirees.

The City Council on Tuesday approved the changes, which include higher deductibles and co-pays and the dropping of vision coverage and coverage of chiropractic care under the Stay Well insurance program. Those changes take effect Aug. 1.

“It is unfortunate that we need to make these changes,” said Debra Craig, the city’s human resources director.

The city also is putting more into the fund, with the council taking $100,000 from its “council goals fund” for Stay Well. Also, the proposed city budget for the fiscal year beginning July 1 includes an 8 percent increase in premiums.

Although the plan has cash on hand at the moment, costs exceeded revenues by more than $2 million in 2012 and again in 2013, according to the city. Costs went up 15.5 percent from 2011 to 2012, and in particular the number of large claims – $250,000 or more – has jumped.

The city has raised co-pays and other out-of-pocket costs already this year, but for the first three months of the year costs have risen sharply. On the current path, Craig said, the plan would be $4.3 million in the red by June 30, 2015.

The anticipated 8 percent premium increase in the 2014-15 budget would cut that deficit to $2.5 million. The council is expected to approve the budget next month.

Add in the changes approved Tuesday, the city estimates, and the fund stays in the black, standing at $495,000 as of June 15, 2015.

In addition to dropping chiropractic and vision coverage, the changes generally mean employees will be picking up a larger percent of the costs for a wide range of services, from doctor visits to emergency care.