HomeMy WebLinkAbout2000 10 03 Regular E Changes in Employee Heath Insurance Program
COMMISSION AGENDA
ITEM E
Consent
Information
Public Hearing
Regular :xx
October 3.2000
Special Meeting
MGR. ~ /Dept.
REQUEST: The General Services Department wishes to advise the City Commission of
changes that will take place in the employee health insurance program, effective October 16,
2000, the reasons therefor, and an alternative that is available.
PURPOSE: The purpose of this agenda item is for the Commission to consider the Florida
Municipal Insurance Trust (Florida League of Cities) notification of changes in the employee
health insurance program,.
FINDINGS AND CONSIDERATIONS:
--- During the month of September, the City was notified that, in accordance with the
contract between the League and the City, certain provisions of the employee health
insurance program would be changing on October 1, 2000.
--- In turn, the League was notified that there was not sufficient time to advise employees
and the City Commission of the anticipated changes, so the effective change date was
moved to October 16, 2000.
--- The changes are outlined on the attached spreadsheet, which shows that all co-pays
and co-insurance levels will be higher, and out-of-pocket limits will increase.
--- The League has provided loss information to show that usage has been
extraordinarily high during the past contract year, and the loss ratio for the year has been
129.65% through 9/1100.
--- The contract between the League and the City calls for a maximum 10% increase in
premiums effective January 2001, but until then, the League finds it mandatory to change
plan coverages to make up for losses.
City Commission Special Meeting
Regular Agenda Item "E"
October 3, 2000
--- As an alternative to reducing coverages in the current plan (called the "Silver" plan),
the city could elect to purchase the so-called "Gold" plan, but at an immediate increase in
premium costs of 15%, or an additional dollar cost for employee coverage of over $100,000.
The aforementioned 10% increase in premium costs would still apply on January 1,2001,
making the total cost for employee coverage almost $150,000 more than current premium
costs.
RECOMMENDATION:
--- Staff recommend that the City Commission accept the "Silver" plan changes, effective
October 16, 2000, and authorize staff to negotiate with the League for a return to better
coverages in anticipation of the 10% premium increase which takes effect on January 1,
2001.
ATTACHMENTS:
--- Spreadsheet "Medical Plan Comparison"
--- Loss Ratio Report Breakdown, lFMIT, dated 10/02/2000
COMMISSION ACTION:
City of Winter Springs
Medical Plan Comparison
Florida Municpal Trust Florida Municpal Trust Florida Municpal Trust
Silver New Silver Gold
Deductible $0 - In Network $0 - In Network $0 - In Network
$500/ $1500 - Out of Network $500/ $1500 - Out of Network $300 / $900 - Out of Network
Lifetime Maximum 1,000,000 Unlimited Unlimited - In Network
$1,000,000 $1,000,000 1,000,000 Out of Network
Coinsurance $0 - In Network 80/20 - In Network 90/10 - In Network
70 / 30 - Out of Network 60 / 40 Out of Network 70 / 30 Out of Network
Office Visit Co pay $15 -In Network $25 - In Network $20 - In Network
Deductible+30% - Out of Network Deductible+40% - Out of Network Deductible+ 70% - Out of Network
Prescription Copay $5/ $10 -In Network $10/ $20 / $35 $10/ $20 / $35
Wholesale price, less 10%, Wholesale price, less 10%, Wholesale price, less 10%,
less in-network co-pay less in-network co-pay less in-network co-pay
Out-of-Pocket Limit $1000/ $2000 - In Network $1500/ $3000 -In Network $1000/ $2000 - In Network
$2500 / $5000 - Out of Network $2500 / $5000 - Out of Network $2000/ $4000 - Out of Network
Hospital Admission Copay $250 per admission - In Network $250 per admission then 20% of covered $100 per admission then 10% of covered
Deductible+30% - Out of Network expenses - In Network expenses - In Network
Deductible +40% - Out of Network Deductible + 30% - out of network
Emergency Room Copay $50 $100 $100
'.
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FLORIDA MUNICIPAL INSURANCE TRUST
CUMULATIVE LOSS RATIO REPORT BREAKDOWN
CLAIMS PAID FROM 09/01/99 TO 08/31/00 Report Date: 10/02/00
Mo/ Member Med/Den/STD Pharmacy Total Med/Den/STD Loss Cancel
Yr Number Name Eff Date Claims Claims Claims Premiums Ratio Date
---------------------------------------------------------------------------------------------------------------------------------
09/99 9 CITY OF WINTER SPRINGS 01/01/99 40,296.90 10,161.72 50,458.62 53,570.83 94.19\
0.00 0.00
0.00 0.00
10/99 9 CITY OF WINTER SPRINGS 01/01/99 59,166.03 13,484.20 72,650.23 61,544.53 118.0H
0.00 0.00
0.00 0.00
11/99 9 CITY OF WINTER SPRINGS 01/01/99 55,868.45 11,939.25 67,903.82 45,276.01 149.98\
96 .12 0.00
0.00 0.00
12/99 9 CITY OF WINTER SPRINGS 01/01/99 21.812.25 11,790.32 33.602.57 53,580.80 62.71\
0.00 0.00
0.00 0.00
01/00 9 CITY OF WINTER SPRINGS 01/01/99 36,270.95 10,946.39 47,217.34 53,263.70 88.65\
0.00 0.00
0.00 0.00
02/00 9 CITY OF WINTER SPRINGS 01/01/99 123,484.60 11,506.03 134,990.63 54,325.57 248.48\
0.00 0.00
0.00 0.00
03/00 9 CITY OF WINTER SPRINGS 01/01/99 62,531.08 14.967.64 77,498.72 49,369.06 156.98\
0.00 0.00
0.00 0.00
04/00 9 CITY OF WINTER SPRINGS 01/01/99 56,681.33 10.949.76 67,631. 09 53,059.21 127.46\
0.00 0.00
0.00 0.00
05/00 9 CITY OF WINTER SPRINGS 01/01/99 37,681.67 11,678.05 49,359.72 55,677.86 88.65\
0.00 0.00
0.00 0.00
06/00 9 CITY OF WINTER SPRINGS 01/01/99 73,546.35 14,185.86 87,732.21 54,970.83 159.60\
0.00 0.00
0.00 0.00
07/00 9 CITY OF WINTER SPRINGS 01/01/99 34,446.49 12,897.43 47.343.92 56,706.58 83.49\
0.00 0.00
0.00 0.00
08/00 9 CITY OF WINTER SPRINGS 01/01/99 88,382.19 13,852.65 102.234.84 55,514.61 184.16\
0.00 0.00
0.00 0.00
Grand Total
690,264.41
148,359.30
838,623.71
646,859.59 129.65\