University Medical Center has fallen 10 months behind in paying its employees' health insurance premiums, triggering concern about the public hospital's overall financial condition.

After more than a year of paying none or only a fraction of UMC workers' $1.3 million monthly premium, the taxpayer-supported hospital owes $14 million to the county's self-funded insurance plan.

The mounting debt has prompted County Manager Virginia Valentine to direct UMC's executives to deliver a plan in coming weeks for how they intend to pay off the balance.

"It can't go on indefinitely," Valentine said Wednesday. "The self-funded plan has to have money in it to pay the claims."

County officials stressed that county workers are not in danger of losing coverage. With a current balance of $27 million, the fund is nowhere near insolvency.

"It's not an imminent problem," said Rory Reid, chairman of the Clark County Commission, which acts as UMC's board of directors. "But it is a potential long-term problem if they (UMC administrators) don't convince us they have a plan to work their way out of it."

County Comptroller Ed Finger, chairman of the plan's executive committee, said the plan would have problems paying municipal employees' medical bills if UMC continued not paying its premiums for another year.

"We're not going to allow that to happen," Valentine said.

The fund UMC owes money to is the Clark County Self-Funded Group Medical and Dental Benefit Plan.

Rather than hire a private insurance provider to manage its employees' health coverage, the county and some of its affiliated agencies, such as UMC, the Las Vegas Valley Water District and the Las Vegas Convention and Visitors Authority, act as a self-funded insurance company.

Those entities make monthly premium payments to the plan that are combined with money deducted from municipal employees' paychecks as their contribution toward insurance coverage. Employees' medical bills are paid from the fund.

Although it isn't in immediate danger of going broke, county officials acknowledged that UMC being in arrears $14 million is costing the fund hundreds of thousands of dollars that money should be earning in interest.

"We are losing that income," Finger said.

That ultimately could spur increases in how much municipal workers have deducted from their paychecks as their contribution toward their health insurance.

Commissioners acknowledged last week they are apprehensive about the possible implications of the hospital allowing its insurance debt to swell to $14 million.

"It is cause for concern," Commissioner Bruce Woodbury said.

"I hope it's not an indication of how the hospital's doing generally," Reid said. "We've asked them to explain it to us."

Neither UMC Chief Executive Officer Lacy Thomas nor Richard Powell, the hospital's chief financial officer, were available to comment for this story Wednesday, Thursday or Friday, hospital spokeswoman Cheryl Persinger said.

Although eight county officials interviewed for this story were thoroughly familiar with UMC's insurance deficit, Persinger said in Thomas and Powell's absence no one else at the hospital with adequate knowledge to address the issue was available to comment last week.

Hospital administrators stopped filing required finance reports with the county in May, saying complications related to a new software system kept them from accessing figures they needed to compile a balance sheet.

The lack of financial information prompted commissioners recently to seek assurances from Thomas and Powell that the hospital is not in trouble.

"How're we doing?" Reid asked UMC's top administrators at the board's Nov. 21 meeting.

"I think we're doing quite well," Powell said.

"The perception is that the sky is falling at the hospital. Is that true?" asked commissioner Yvonne Atkinson Gates.

"No," Powell responded.

Although UMC lost an estimated $18.8 million in the year that ended in June, Powell told commissioners an aggressive cost-cutting program, coupled with price increases for most of the hospital's services, would likely result in UMC cutting its deficit to $15 million in the fiscal year ending in June 2007.