HomeMy WebLinkAbout2010 08 09 Regular 601 Health And Related Insurance Proposal For Fiscal Year 2011 COMMISSION AGENDA
CONSENT
INFORMATIONAL
ITEM 1 PUBLIC HEARING
REGULAR X
August 9, 2010 MGR /DEPT
Meeting Authorization
REQUEST: The City Manager and Finance Department requests The City Commission consider
the Health and related Insurance Proposal for FY11.
SYSNOPSIS:
This agenda item is needed for the Commission to consider the Health and related Insurance Proposal for FY
2011.
CONSIDERATIONS:
Health Insurance
The City has received its FY2011 Health Insurance quote from our current provider, UnitedHealthcare. The
renewal for the current Plan (38) represents a 6.2% increase over last year. The summary of the quotes has
been provided below:
Proposed FY2011 Proposed FY2011
Coverage Type Current FY2010 Rate Primary Plan (38) Buy -Down Plan (34)
Employee $433.08 $459.95 $433.08
Employee + Spouse $1,038.32 $1,102.70 $1,038.32
Employee + Children $1,038.32 $1,102.70 $1,038.32
Family $1,134.12 $1,204.40 $1,134.12
As seen in the chart above the City would like the Commission to consider adding Plan (34) for FYI 1. Plan 34
will have the same monthly premium cost as last year with a few changes to the structure. The primary
difference between the base Plan (38) and the "Buy- Down" Plan 34 is the 10% co- insurance requirement. A
co- insurance requires the employee to pay 10% of certain expense incurred during the plan year.
It is the recommendation that the subsidy for both plans be the same ($454.95 = $459.95 PIan38 - $5). The
City currently pays all but $5 of the entire cost of Employee coverage. Additionally, the City currently pays
28% of the difference between the Dependent coverage premium and the Employee coverage premium. The
chart below demonstrates the recommended subsidy for both plans.
Employee Employee & Spouse Employee & Dependent Employee & Family
Plan 38 (Base) $454.95 $643.92 $634.92 $663.40
Plan 34 (Buy -Down) $454.95 $643.92 $634.92 $663.40
The final chart represents only the portion of the premium that the employee will pay for their health
insurance. Note that the actual cost to the employee under Plan 34 is less than FY10, due to the subsidy
increasing 6.2 %.
Proposed FY2011 Proposed FY2011
Coverage Type Current FY2010 Rate Primary Plan (38) Buy -Down Plan (34)
Employee $5.00 $5.00 _ $ -21.87
Employee + Spouse $440.77 $467.78 $403.40
Employee + Children $440.77 $467.78 $403.40
Family $509.75 $541.00 $470.72
For Example, if an employee chooses Plan 34 and winds up in the hospital with a broken foot and that bill
comes to $1,000, the employee would be responsible for $100 (emergency room) co -pay and 10% of the bill
($100) for a total of $200. If that same employee has chosen Plan 38, the total cost for the same incident
would be $100.
Why would any employee choose Plan 34? One answer might be that the cost differential for a family
between Plan 38 and Plan 34 for one year is $843.36. If a family was healthy and did not anticipate any major
healthcare needs they could save and pocket the entire difference between Plan 38 and Plan 34. If that same
family had a major healthcare crisis during the year the maximum cost would be $656.64 ($1,500 max. out of
pocket limit - $843.36 savings).
FISCAL IMPACT:
If both plans and the new subsidies are agreed to by the Commission the City's health care cost will increase
annually by approximately $60,000. If a large number of employees sign up for Plan 34, the City may begin to
experience a reduction in its cumulative loss ratio which is the single most important indicator of future health
care rate increases.
COMMUNICATION EFFORTS:
Each healthcare plan will be explained thoroughly during open enrollment starting on August 23`
Final employee selections and open enrollment will be concluded by September 30`
RECOMMENDATION:
The City Manager recommends that the City Commission approve:
1) The Florida League of Cities' Florida Municipal Insurance Trust for FY11, based on their
submitted Plans.
2) City offer two plans 38 (base) and 34 (buy- down).
3) Authorize for the City Attorney and City Manager to prepare and execute all contracts and
documents necessary to facilitate the above recommendations.
ATTACHMENTS:
Summary of FY 11 Health Insurance Quotes
CITY OF WINTER SPRINGS
Medical Comparison 2010
CURRENT PLAN
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Plan 38 Plan 34
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Deductible (Individual / Family) N/A N/A
Coinsurance 100% 90% / 10%
Out of Pocket Max (Individual / Family) $1,500 / $3,000 $1,500 / $3,000
Copays Apply to Out of Pocket Max No No
Lifetime Max $3,000,000 $3,000,000
Employee Assistance Program Included Included
Office Visits
Primary Office Visit $15 Copay $15 Copay
Special Office Visit $15 Copay $15 Copay
Diagnostics
MRI, Cat Scan, PET Scan, Nuc. Med 100% 90% / 10%
Hospital & Outpatient Fadiity
Inpatient Hospitalization $250 Copay $250 Copay + 10% (PF)•
Outpatient Surgical Care 100% 90% / 10%
Emergency Room $75 Copay $100 Copay
Urgent Care $35 Copay $50 Copay
Prescription Drugs
Formulary Generic Drugs $15 Copay $20 Copay
Formulary Brand -Name Drugs $30 Copay $30 Copay
Non - Formulary Brand -Name & Generic Drugs $45 Copay $60 Copay
Mail Order 21/2 Copays for 90 Days 2 1/2 Copays for 90 Days
Deductible (Individual / Family) N/A N/A
Coinsurance N/A N/A
Inpatient Hospitalization N/A N/A
Out of Pocket Max (Individual / Family) N/A N/A
Employee Only $43308
Employee + Spouse $1,038.32
Employee + Child(ren) $1
Family $1,334
Employee Only $453 95 $43308
t% f i P
ae��. � g��� �S ,:�'>� �• s ' ,r' x'm• -�' a' �" .r ; 3 .i'
Employee +Spouse $1,102.70 $103 $.32'
Employee +Child(ren) $1402.70 $],03u3k
Family $1,204.40 $143412
6.307E
Medicare Supplement Rate 434$.87 $346,87
This summary is only intended to highlight certain benefits. Fora complete description of benefits, please refer to the Summary Plan Beneflts.
• Professional Fees 6(25/2010