HomeMy WebLinkAbout2003 07 14 Regular K Add-On Health Insurance Issues
ADD-ON
COMMISSION AGENDA
~DD-D~
ITEM K
CONSENT
INFORMATIONAL
PUBLIC HEARING
REGULAR X
July 14, 2003
Meeting
~
MGR~ /DEP~
Authorization
REQUEST: The City Commission Decide Issues Related to Health Insurance.
PURPOSE: To have the City Commission decide issues related to health insurance as follows:
1. Health Provider and Plan Type
2. Employee Contribution to Employee's Coverage
3. Monetary Incentive to Employee's Who Opt out of Plan
4. Dependent Care Subsidy
CONSIDERA TIONS:
1. Health Provider and Plan Type
The City's Third Party Agent previously presented the City Commission with a
spreadsheet detailing the various Health Providers, their Plan offerings and the associated
monthly cost. The Agent recommended that the City offer United Health Care's 399T
HMO and allow employees to buy-up to United Health Care's 499T PPO. United Health
Care's 399T HMO represents less than a 1 % increase over the City's current HMO rates
with Humana.
2. Employee Contribution to Employee's Coverage
The City's Third Party Agent recommends that the City begin sharing the cost of
employee coverage with the employee. Currently the City covers all full-time employees
100% with HMO coverage. If an organization pays 100% of the cost of an employee's
coverage then Health Care Providers will not allow employees to opt out of the plan. Our
agent has indicated that a number of employees would like to opt out of our plan as they
are covered under their spouses plan and they would like their spouses plan to be the
Primary plan but as long as they are covered here with the City paying 100% then the
City's plan is the Primary. In order to opt out of a plan, the City employees must share in
the cost of employee coverage and the employee who wants to opt out must provide proof
of insurance elsewhere. Our agent has indicated that the sharing amount can be as little
as 1 % that the employees pay in order to trigger the opting out provision.
3. Monetary Incentive to Employee's Who Opt out of Plan
Staff feels that the City should provide a monetary incentive to those employees that are
in a position to opt out of the plan as the City would ultimately save money for every
employee that obtains insurance elsewhere. The annual cost to the City for an employee
under United's 399T HMO is $3,396. If the City would offer $100/month or $1,200 a
year to those employees who are placed on their spouses plan, the City would save $2,196
a year per employee that opts out.
4. Dependent Care Subsidy
The City may want to consider reducing the City's contribution (subsidy) to employees
for their dependent care coverage. A subsidy was started a few years .ago when the rates
went up high and employees were given little notice to prepare for the cost increase;
however, the City may want to consider systematically reducing the subsidy for
dependent care coverage until it no longer exists and the employees bear their full burden
for the cost of their dependents.
ATTACHMENTS:
1. Exhibit A - Third Party Agents Spreadsheet Detailing the Various Providers, Plans and
Monthly Cost
2. Exhibit B - Options Recap and Spreadsheet
RECOMMENDATION:
Recommended Option:
Staff recommends that City Commission elect OPTION #7 which provides for the following:
1. Health Provider and Plan Type - United Healthcare 399T HMO and 499T PPO
(employees buy-up for additional PPO costs above and beyond what the City covers
under the HMO)
2. Employee Contribution to Employee's Coverage - Charge employees $25/month
($300/yr) in order to trigger the Opting Out Provision and have all employees begin
sharing in the cost of health care
3. Monetary Incentive to Employee's Who Opt out of Plan - Provide a $lOO/monthly
($1,200/yr) incentive to employees to opt out of plan
4. Dependent Care Subsidy - Subsidy amount remains the same as the current year
The elections above will result in an annual increase to the employee for health insurance as
follows:
Annual $ Increase
$300.00
$311.31
$311.34
$293.17
Annual % Increase
100.00%
9.30%
9.28%
7.48%
Alternative Options:
As an alternative the Commission may want to consider Option #4 which is the same as Option
#7 recommended above except the employee's contribution to their health care would be
$5/month versus the $25/month recommended. The effect of this change results in a smaller
increase in the cost of health care to our employees across the coverage types.
In addition, the Commission may want to consider the various Option's that reduce the City's
subsidy for dependent care coverage.
COMMISSION ACTION:
CITY OF WINTER SPRINGS
EXHIBIT B
FY 04. PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
~ ~ Q:1JYl. f&!!!l.Y ~ llil< ~ llil< ldi!IJ2 llil< f&!!!l.Y llil<
BASICAllY SAME AS PRIOR YEAR - NO EMPLOYEE PYMT & SAME SUB
NO OPT OUT OF PLAN
EMPLOYEE PAYS BI-MONTHLY (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $0.00 $ 140.G1 $140.32 $162.93
AFFECT ON EMPLOYEES $ MORE (LESS) $0.00 511.31 511.34 (5&.a3)
AFFECT ON EMPLOYEES $ MORE (LESS) 0.00% 0.34% 0,34% -0,17%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) $10.08 $10.05 $10.02 $10.07
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) 0.30% 0.21% 0.21% 0.20%
2 EMPLOYEES PAY 50 FOR EMPLOYEE COVERAGE & REDUCE SUBIDY %
NO OPT OUT OF PLAN
EMPLOYEE PA YS B~MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $0.00 $154.19 $154.19 $180.32
AFFECT ON EMPLOYEES $ MORE (LESS) $0.00 5351.51 5344.22 5410.41
AFFECT ON EMPLOYEES 5 MORE (LESS) 0.00% 10.50% 10.26% 10.48%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) $10.08 ($330.15) ($322.88) ($407.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) 0.30% -8.96% -8.81% -8.24%
3 EMPLOYEES PAY 50 FOR EMPLOYEE COVERAGE & REDUCE SUB TO SHARE 50%
NO OPT OUT OF PLAN
EMPLOYEE PAYS BI-MONTHLY (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $0.00 $169.19 $169.19 $184.62
AFFECT ON EMPLOYEES $ MORE (LESS) 50.00 $711.51 $704.22 $518.41
AFFECT ON EMPLOYEES $ MORE (LESS) 0.00% 21.25% 2D.98% 13.23%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) $10.08 ($69<l.15) ($682.86) ($515.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) 0.30% -14.54% -14.41% -10.42%
4 EMPLOYEES PAY $5 FOR EMPLOYEE COVERAGE & KEEP SUBSIDY THE SAME
OPT OUT OF PLAN AllOWABLE - CITY INCENTIVE TO EMPLOYEE 510ll/MONTH
EMPLOYEE PAYS B~MONTHLY (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $2.50 $142.51 $142.62 $165.43
AFFECT ON EMPLOYEES $ MORE (LESS) $60.00 $71.31 $71.34 $53.17
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 2.13% 2.13% 1.36%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($49.92) ($49.95) ($49.98) ($49.93)
AFFECT ON CITY PER EMPLOYEE % MORE 'LESS) -1.47% -1.05% -1.05% -1.01%
5 EMPLOYEES PAY $5 FOR EMPLOYEE COVERAGE & REDUCE SUBSIDY %
OPT OUT OF PLAN ALLOWABLE - CITY INCENTIVE TO EMPLOYEE $100/MONTH
EMPLOYEE PAYS BI-MONTHLY (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $2.50 $156.69 $156.69 $162.62
AFFECT ON EMPLOYEES $ MORE (LESS) $60.00 $411.51 5404.22 $470.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 12.29% 12.04% 12.01%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($49.92) ($390.15) ($362.86) ($467.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -1.47% -8.22% -8.08% -9.45%
6 EMPLOYEES PAY $5 FOR COVERAGE & REDUCE SUB TO SHARE 50%
OPT OUT OF PLAN ALLOWABLE - CITY INCENTIVE TO EMPLOYEE $100/MONTH
EMPLOYEE PAYS B~ONTHLY (2 SKI? WEEKS) - 24 PAYMENTS IN TOTAL $2.50 $169.19 $169.19 $184.82
AFFECT ON EMPLOYEES $ MORE (LESS) 560.00 $711.51 5704.22 $518.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 21.25% 20.98% 13.23%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($49.92) ($690.15) ($682.68) ($515.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -1.47% -14.54% -14.41% -10.42%
7 EMPLOYEES PA Y $25 FOR COVERAGE & KEEP SUBSIDY THE SAME
OPT OUT OF PLAN AllOWABLE - CITY INCENTIVE TO EMPLOYEE 51 DO/MONTH
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $12.50 $152.51 $152.62 $175.43
AFFECT ON EMPLOYEES $ MORE (LESS) 5300.00 5311.31 5311.34 $293.17
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 9.3/lU 9.28% 7.48"
AFFECT ON CiTY PER EMPLOYEE $ MORE (LESS) ($289.92) (5269.95) 1$289.98) ($289.93)
AFFECT ON CiTY PER EMPLOYEE" MORE (LESS) -8.66% -8.11% -8.12% -5.87%
6 EMPLOYEES PAY $25 FOR COVERAGE & REDUCE THE SUBSIDY %
OPT OUT OF PLAN ALLOWABLE - CITY INCENTIVE TO EMPLOYEE $100/MONTH
EMPLOYEE PAYS BI-MONTHL Y ,2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $12.50 $159.19 $159.19 $165.32
AFFECT ON EMPLOYEES $ MORE (LESS) 1300.00 $471.51 5464.22 5530.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 14.08% 13.83% 13.54%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($289.92) ($450.15) ($442.88) ($527.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -8.56% .-9.48% -9.35% -10.86%
9 EMPLOYEES PAY $25 FOR COVERAGE & REDUCE THE SUBSIDY TO 50%
OPT OUT OF PLAN ALLOWABLE . CITY INCENTIVE TO EMPLOYEE 5100/MONTH
EMPLOYEE PAYS B~MONTHLY (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $12.50 $169.19 $169.19 $184.62
AFFECT ON EMPLOYEES $ MORE (LESS) 5300.00 $711.51 5704.22 5518.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 21.25% 20.98% 13.23%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($289.92) ($690.15) ($682.86) ($515.17)
AFFECT ON CITY PER EMPLOYEE % MORE"LESS) -8.56% -14.54% -14.41% -10.42%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04 . PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE CHILD FAMILY EMPLOYEE INC SPOUSE INC CHILD !!ffi FAMILY INC
BASICALLY SAME AS PRIOR YEAR . NO EMPLOYEE PYMT & SAME SUB
NO OPT OUT OF PLAN
CITY PAYS 100% HMO FOR EMPLOYEE $283.00 $283.00 $283.00 $283.00 $3,396,00 $3,396.00 $3,396.00 $3,396.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $113.35 $112.74 $129.77 $0.00 $1,360.20 $1.352.88 $1.557.24
TOTAL CITY PA Y $283.00 $396.35 $395.74 $412,77 $3,396,00 $4,756.20 58.6% $4,748.88 58.5% $4,953.24 55.9%
EMPLOYEE PAYS FOR EMPLOYEE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $280.02 $280.63 $325.86 $0.00 $3,360.24 $3,367.56 $3,910.32
TOTAL EMPLOYEE PA Y $0.00 $280.02 $280.63 $325.86 $0.00 $3.360.24 41.4% $3,367.56 41.5% $3,910.32 44.1%
TOTAL PREMIUM $283.00 $676.37 $676.37 $738.63 $3.396.00 $8,116.44 $8,116.44 $8.863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $0.00 $140.Q1 $140.32 $162.93
AFFECT ON EMPLOYEES $ MORE (LESS) $0.00 $11.31 $11.34 ($6.83)
AFFECT ON EMPLOYEES $ MORE (LESS) 0.00% 0.34% 0.34% .0.17%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) $10.08 $10.05 $10.02 $10.07
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) 0.30% 0.21% 0.21% 0.20%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04 - PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE CHILD ~ EMPLOYEE lli!;;, SPOUSE lli!;;, CHILD lli!;;, ~ INC
2 EMPLOYEES PAY $0 FOR EMPLOYEE COVERAGE & REDUCE SUBIDY %
NO OPT OUT OF PLAN
CITY PAYS 100% HMO FOR EMPLOYEE $283.00 $283.00 $283.00 $283.00 $3,396.00 $3.396.00 $3,396.00 $3,396.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $85.00 $85.00 $95.00 $0.00 $1.020.00 $1.020.00 $1,140.00
TOTAL CITY PAY $283.00 $368.00 $368.00 $378.00 $3,396.00 100.0% $4.416.00 54.4% $4,416.00 54.4% $4,536.00 51.2%
EMPLOYEE PAYS FOR EMPLOYEE $0.00 $0.00 $0.00 $0.00 $0,00 $0.00 $0.00 $0.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $308.37 $308.37 $36D.63 $0.00 , $3,700.44 $3,700.44 $4.327.56
TOTAL EMPLOYEE PA Y $0.00 $308.37 $308.37 $360.63 $0.00 0.0% $3,700.44 45.6% $3,700.44 45.6% $4.327.56 48.8%
TOTAL PREMIUM $283.00 $676.37 $676.37 $738.63 $3.396.00 $8,116.44 $8.116.44 $8.863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $0.00 $154.19 $154.19 $180.32
AFFECT ON EMPLOYEES $ MORE (LESS) $0.00 $351.51 $344.22 $410.41
AFFECT ON EMPLOYEES $ MORE (LESS) 0,00% 10.500/. 10.26% 10.48%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) $10,08 ($330.15) ($322.86) ($407.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) 0.30% -8.96% -8.81% -8.24%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04 . PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE CHILD FAMILY EMPLOYEE !!::ll< SPOUSE !!::ll< CHILD INC FAMILY INC
3 EMPLOYEES PAY SO FOR EMPLOYEE COVERAGE & REDUCE SUB TO SHARE 50%
NO OPT OUT OF PLAN
CITY PAYS 100% HMO FOR EMPLOYEE $263.00 $283.00 $263.00 $263.00 $3.396,00 $3,396.00 $3,396.00 $3,396.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $55.00 $55.00 $86.00 $0.00 $660 .00 $660,00 $1,032.00
TOTAL CITY PA Y $263.00 $338.00 $338.00 $369.00 $3.396.00 100.0% $4.056.00 50.0% $4,056.00 50.0% $4,428.00 50.0%
EMPLOYEE PAYS FOR EMPLOYEE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $338.37 $338.37 $369.63 $0.00 $4,060.44 $4.060.44 $4.435.56
TOTAL EMPLOYEE PA Y $0.00 $338.37 $338.37 $369,63 $0.00 0.0% $4,060.44 50.0% $4,060.44 50.0% $4,435.56 50.0%
TOTAL PREMIUM $283.00 $676.37 $676.37 $738.63 $3,396.00 $8.116.44 $8.116.44 $8,863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAl $0.00 $169.19 $169.19 $184.82
AFFECT ON EMPLOYEES $ MORE (LESS) $0.00 $711.51 $704.22 $518.41
AFFECT ON EMPLOYEES $ MORE (LESS) 0.00% 21.25% 20.98% 13.23%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) $10.08 ($690.15) ($682.86) ($515.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) 0.30% -14.54% -14.41% -10.42%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04. PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE CHILD ~ EMPLOYEE INC SPOUSE !!ffi Qi!!Q !!ffi ~ INC
4 EMPLOYEES PAY $5 FOR EMPLOYEE COVERAGE & KEEP SUBSIDY THE SAME
OPT OUT OF PLAN ALLOWABLE. CITY INCENTIVE TO EMPLOYEE $1001MONTH
CITY PAYS FLAT AMOUNT HMO FOR EMPLOYEE $278.00 $278.00 $278.00 $278.00 $3,336.00 $3,336.00 $3,336.00 $3,336.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $113.35 $112.74 $129.77 $0.00 $1,360.20 $1,352.88 $1,557.24
TOTAL CITYPAY $278.00 $391.35 $390.74 $407.77 $3,336.00 98.2% $4,696.20 57.9% $4,688.88 57.8% $4 ,893.24 55.2%
EMPLOYEE PAYS FOR EMPLOYEE $5.00 $5.00 $5.00 $5.00 $60.00 $60.00 $60.00 $60.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $280.02 $280.63 $325.86 $0.00 $3,360.24 $3,367.56 $3,910.32
TOTAL EMPLOYEE PA Y $5.00 $285.02 $285.63 $330.86 $60.00 1.8% $3,420.24 42.1% $3,427.56 42.2% $3,970.32 44.8%
TOTAL PREMIUM $283.00 $676.37 $676.37 $738.63 $3;396.00 $8,116.44 $8,116.44 $8,863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS.lN TOTAL $2.50 $142.51 $142.82 $165.43
AFFECT ON EMPLOYEES $ MORE (LESS) $60.00 $71.31 $71.34 $53.17
AFFECT ON EMPLOYEES $ MORE (LESS) 1 OO.OO~. 2.13~. 2.13~. 1.36~,
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($49.92) ($49.95) ($49.98) ($49.93)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -1.47% -1.05% -1.05% -1.01%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04. PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE CHILD ~ EMPLOYEE !!ffi SPOUSE INC Qi!!Q INC FAMILY INC
5 EMPLOYEES PA Y $5 FOR EMPLOYEE COVERAGE & REDUCE SUBSIDY"
OPT OUT OF PLAN ALLOWABLE. CITY INCENTIVE TO EMPLOYEE $100/MONTH
CITY PA YS FLA T AMOUNT HMO FOR EMPLOYEE $278.00 $278.00 $278.00 $278.00 $3,336.00 $3,336.00 $3,336.00 $3,336.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $85.00 $85.00 $95.00 $0.00 $1,020.00 $1,020.00 $1,140.00
TOTAL CITY PA Y $278.00 $363.00 $363.00 $373.00 $3,336.00 98.2% $4,356.00 53.7% $4,356.00 53.7% $4,476.00 50.5%
EMPLOYEE PA YS FOR EMPLOYEE $5.00 $5.00 $5.00 $5.00 $60.00 $60.00 $60.00 $60.00
EMPLOYEE PA YS FOR DEPENDENT CARE $0.00 $308.37 $308.37 $360.63 $0.00 $3,700.44 $3,700.44 $4,327.56
TOTAL EMPLOYEE PA Y $5.00 $313.37 $313.37 $365.63 $60.00 1.8% $3,760.44 46.3% $3,760.44 46.3% $4,387.56 49.5%
TOTAL PRE~/UM $283.00 $676.37 $676.37 $738.63 $3,396.00 $8,116.44 $8,116.44 $8,863.56
EMPLOYEE PA YS BI-MONTHL Y (2 SKIP WEEKS) - 24 PA YMENTS IN TOTAL $2.50 $156.69 $156.69 $182.82
AFFECT ON EMPLOYEES $ MORE (LESS) $60.00 $411.51 $404.22 $470.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 12.29% 12.04% 12.01"
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($49.92) ($390.15) ($382.86) ($467.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -1.47% -8.22% -8.08% -9.45%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04. PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE Qi!!Q ~ EMPLOYEE !lli<. SPOUSE !lli<. Qi!!Q !lli<. ~ INC
6 EMPLOYEES PAY $5 FOR COVERAGE & REDUCE SUB TO SHARE 50%
OPT OUT OF PLAN ALLOWABLE. CITY INCENTIVE TO EMPLOYEE $100IMONTH
CITY PAYS FLAT AMOUNT HMO FOR EMPLOYEE $278.00 $278.00 $278.00 $278.00 $3,336.00 $3,336.00 $3,336.00 $3,336.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $60.00 $60.00 $91.00 $0.00 $720.00 $720.00 $1,092.00
TOTAL CITYPAY $278.00 $338.00 $338.00 $369.00 $3,336.00 $4,056.00 50.0% $4,056.00 50.0% $4,428.00 50.0%
EMPLOYEE PAYS FOR EMPLOYEE A FLAT AMOUNT $5.00 $5.00 $5.00 $5.00 $60.00 $60.00 $60.00 $60.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $333.37 $333.37 $364 .63 $0.00 $4,000.44 $4,000.44 $4,375.56
TOTAL EMPLOYEE PA Y $5.00 $338.37 $336.37 $369.63 $60.00 $4 ,060 .44 50.0% $4,060.44 50.0% $4,435.56 50.0%
TOTAL PREMIUM $283.00 $676.37 $676.37 . $738.63 $3,396.00 $8,116.44 $8,116.44 $8,863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $2.50 $169.19 $169.19 $184.82
AFFECT ON EMPLOYEES $ MORE (LESS) $60.00 $711.51 $704.22 $518.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 21.25% 20.98% 13.23%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($49.92) ($690.15) ($682.86) ($515.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -1.47% -14.54% 014.41% -10.42%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04. PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE Qi!!Q FAMILY EMPLOYEE INC SPOUSE INC Qi!!Q !lli<. ~ INC
7 EMPLOYEES PAY $25 FOR COVERAGE & KEEP SUBSIDY THE SAME
OPT OUT OF PLAN ALLOWABLE. CITY INCENTIVE TO EMPLOYEE $100IMONTH
CITY PAYS FLAT AMOUNT HMO FOR EMPLOYEE $258.00 $258.00 $258.00 $258.00 $3,096.00 $3,096.00 $3,096.00 $3,096.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $113.35 $112.74 $129.77 $0.00 $1,360.20 $1,352.88 $1,557.24
TOTAL CITY PAY $258.00 $371.35 $370.74 $387.77 $3,096.00 91.2% $4,456.20 54.9% $4,448.88 54.8% $4,653.24 52.5%
EMPLOYEE PAYS FOR EMPLOYEE A FLAT AMOUNT $25.00 $25.00 $25.00 $25.00 $300.00 $300.00 $300.00 $300.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $280.02 $280.63 $325.86 $0.00 $3,360.24 $3,367.56 $3.910.32
TOTAL EMPLOYEE PA Y $25.00 $305.02 $305.63 $350.86 $300.00 8.8% $3,660.24 45.1% $3,667.56 45.2% $4,210.32 47.5%
TOTAL PREMIUM $283.00 $676.37 $676.37 $738.63 $3,396.00 $8,116.44 $8.116.44 $8,863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $12.50 $152.51 $152.82 $175.43
AFFECT ON EMPLOYEES $ MORE (LESS) $300.00 $311.31 $311.34 $293.17
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 9.30% 9.28% 7.48%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($289.92) ($289.95) ($289.98) ($289.93)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -8.56% -8.11% -8.12% -5.87%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04. PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE Qi!!Q ~ EMPLOYEE INC SPOUSE !lli<. CHILD INC FAMILY !lli<.
8 EMPLOYEES PAY $25 FOR COVERAGE & REDUCE THE SUBSIDY %
OPT OUT OF PLAN ALLOWABLE. CITY INCENTIVE TO EMPLOYEE $1001MONTH
CITY PAYS FLAT AMOUNT HMO FOR EMPLOYEE $258.00 $258.00 $258.00 $258.00 $3,096.00 $3,096.00 $3,096.00 $3,096.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $100.00 $100.00 $110.00 $0.00 $1,200.00 $1,200.00 $1,320.00
TOTAL CITY PAY $258.00 $358.00 $358.00 $368.00 $3,096.00 91.2% $4,296.00 52.9% $4,296.00 52.9% $4,416.00 49.8%
EMPLOYEE PAYS FOR EMPLOYEE A FLAT AMOUNT $25.00 $25.00 $25.00 $25.00 $300.00 $300.00 $300.00 $300.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $293.37 $293.37 $345.63 $0.00 $3,520.44 $3,520.44 $4,147.56
TOTAL EMPLOYEE PA Y $25.00 $318.37 $318.37 $370.63 $300.00 8.8% $3,820.44 47.1% $3,820.44 47.1% $4,447.56 50.2%
TOTAL PREMIUM $283.00 $676.37 $676.37 $738.63 $3,396.00 $8,116.44 $8,116.44 $8,863.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $12.50 $159.19 $159.19 $185.32
AFFECT ON EMPLOYEES $ MORE (LESS) $300.00 $471.51 $464.22 $530.41
AFFECT ON EMPLOYEES $ MORE (LESS) 100.00% 14.08% 13.83% 13.54%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($289.92) ($450.15) ($442.86) ($527.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESS) -8.56% -9.48% -9.35% -10.66%
CITY OF WINTER SPRINGS
HEALTH INSURANCE PREMIUMS
FY 04 . PROPOSED RATES UNITED HEALTH CARE'S 399T HMO
MONTHLY ANNUALLY
EMPLOYEE & EMPLOYEE & EMPLOYEE & % EMPLOYEE & % EMPLOYEE & % EMPLOYEE & %
EMPLOYEE SPOUSE Qi!!Q FAMILY EMPLOYEE INC SPOUSE INC CHILD !!ffi ~ INC
9 EMPLOYEES PAY $25 FOR COVERAGE & REDUCE THE SUBSIDY TO 50~.
OPT OUT OF PLAN ALLOWABLE. CITY INCENTIVE TO EMPLOYEE $1001MONTH
CITY PAYS FLAT AMOUNT HMO FOR EMPLOYEE $258.00 $256.00 $258.00 $258.00 $3,096.00 $3,096.00 $3,096.00 $3,096.00
CITY SUBSIDY FOR DEPENDENT CARE $0.00 $60.00 $60.00 $111.00 $0.00 $960.00 $960.00 $1,332.00
TOTAL CITY PA Y $256.00 $338.00 $336.00 $369.00 $3,096.00 91.2% $4,056.00 50.0% $4,056.00 50.0% $4,426.00 50.0%
EMPLOYEE PAYS FOR EMPLOYEE A FLAT AMOUNT $25.00 $25.00 $25.00 $25.00 $300.00 $300.00 $300.00 $300.00
EMPLOYEE PAYS FOR DEPENDENT CARE $0.00 $313.37 $313.37 $344.63 $0.00 $3,760.44 $3,760.44 $4,135.56
TOTAL EMPLOYEE PA Y $25.00 $336.37 $336.37 $369.63 $300.00 6.6% $4,060.44 50.0% $4,060.44 50.0% $4,435.56 50.0%
TOTAL PREMIUM $283.00 $676.37 $676.37 $736.63 $3,396.00 $6,116.44 $6,116.44 $8,663.56
EMPLOYEE PAYS BI-MONTHL Y (2 SKIP WEEKS) - 24 PAYMENTS IN TOTAL $12.50 $169.19 $169.19 $184.62
AFFECT ON EMPLOYEES $ MORE (LESS) $300.00 $711.51 $704.22 $518.41
AFFECT ON EMPLOYEES $ MORE (LESS) 1 OO.OO~. 21.25% 20.98% 13.23%
AFFECT ON CITY PER EMPLOYEE $ MORE (LESS) ($269.92) ($690.15) ($662.66) ($515.17)
AFFECT ON CITY PER EMPLOYEE % MORE (LESSl -8.56% -14.54% -14.41% -10.42%
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CITY OF WINTER SPRINGS
~~03
Lifetime Office Visit Prescription Out-of-Pocket Hospital Emergency I
Deductible Maximum Coinsurance Copay Copay Limit AdmissloA COO8'I CO{ilolly SpOuse Children Family
PlaIt Current Rates
.. Ulinited NA 1115/$25 $15 11115 I I3l5 1 1100 11S>> J $3O!llI) ..... m li2I!IIZ.ll!1 I Rlf4.O!f Rlf4.0!l :!If-'ll.~
C- Ut:l~.. ...... Renewa i Rates
~.:D I U;s9.Oti 5739.1l6 ~lU.UU
C;urrent Rates
! NA.~ UnInited - In NA-~ 1115/$25- ~ $151 ~10 I $25 11!Cl1O 113000 - " le.._, 5.....-" $eO aoJ31.41 I tf1f"4C.:.:lI :!IfH".l.:.:lI :5lltlf.lllf
$400 J S800 . OW $1,000,000 - out 70/3O-out DeclJct+3O% - OW seooo/l~ 0MId + 311*- OW Renewa Rates
~41 auo._ lStill.li9 tf;)'.4i:4
AMRa HMO NA Urjmlted NA $15/$25 $10/$301$50 $1500 I $3000 $200 per dlr1, 5 dlr1 mu $100 $2M.74 $63l5.41 $634.66 1834.71
I
Aatna QPOS NA-In UrjrriteO-ln NA-In $151 $25-1n $10/$30/$50 $1500 I $3OOO-ln $200 per day, 5 day max-In $100 $331.33 $736.56 $619.63 $967.57
$5OOI$1000-0ut $1,OOO,OOO-Out 70/3O-Out Oed + 3O%-Out $5000 I $10,000-0ut Oed + 3O-OU
, Florida Municipal P08 NA.ln $1,000,000 90 110 .In $20 +10%' -In $10/$20/$35-1n $1000 I $2000 - In '$100+ 10% .In $100 $234.02 $715.31 $712.49 $1,193.78
Gold $300 1$900- out 70/3O-out 70/30 of Wholesale PI1ce, less 13%, $2000 I $4000 - out $500 + S300 + 30% t:A
i reasonable charges..out less In netwoI1< copay . out re~ charges- out
,
FIortda Municipal P08 NA.ln $1,000,000 80/2O-ln $25 +2O%0-ln $10/$20/$35-ln $1500/$3000. In ' $250 + 20% -In $100 $213.54 $652.n $664.14 $._.~
Sf,"r $500 1$1500 - out 60/40-out 60/40 of -. Wholesale PI1ce, less 13%, $2500 1$5000- out $500 + $500 + 40% of
reasonable less In networi< CODaV - out reSonabIe chames- OW
I , $1,000,000 70/30 -In $30 +3O%'-In $10/$20/$35. In $2000 1$4000. In $ too I~SIU. $l!i01.54 I~ $41,..917
" Florida Munlc!pal P08 NA-In $100 a day 5 day mal(-In
Ikonze .' $500/$1500; OUt 50/50-0Ut 50/50 of Wholesale PI1ce, less 13%, $3000 1$6000- out $500 + $500 + 50% of
V. reasonable less In netwoI1< CODaV. out resonable chal"lle!<- OW
United Health eare 389T HMO NA 'J Urjmlted NA $10 $10/$30/$50 $1500 I $3000 $400 per acrnlsslon $100 $283.00 $676,37 ~.~ I73U3
I~- .- ....'r ..ir
t --
;,rt United Health Care <l89T PPO NA-In UnlIrriteO-ln NA-In $10-1n $10 I $30 I $5()..ln $1500 1$3000-ln $400 per acrnlssl~ln $100 $295.12 $705.35 $705.35 V!O.27
- $500 I $1000 .oUt $2,OOO,OOO-Out Oed + 3O%-OU Oed + 3l)%'.QuI Oed + 3O%-Out $3000 I $6OO()..()ut Oed + 30% - out
United Health Care 599T HMO NA Urjmlted NA $15 $10/$30/$50 $15lXl.13OOO $500 $100 $278.66 $666.00 $666.00 $n7.3O
, 'i'
,
United Health Cara 888T PPO NA-In UrjrriteO-ln NA-In $15-ln $10J$30J$5()..1n $1500 I $3OOO-ln $500-ln $100 $290.59 $694.52 $694.52 $758,45
$500 I $1000 .QuI $2,OOO,OOO-Out Oed + 3O%-OU Oed + 3O%*.QuI Oed + 3O%-Out $3000 I $6O()O..()ut Oed + 30% - out
,
United Health earell99T HMO NA UnlmIted NA $15 $10 I $30 I $50 $1500 I $3000 $500 per day 3 day mal( $100 $266.35 $636.57 ".57 _.f7
United Health Care 1000T PPO NA Urjmlted NA $15 $10/$30/$50 $1500 I $3000 $5Op per day 3 day mal( $100 5275.41 $658.24 $6(i8.:N $71Ia.8'3
$500 I $1000 .QuI S2,OOO,OOO-Out Oed+~ Oed + 3O%'.QuI Oed + 3O%-Out $3000 I $6OO()..Out Oed + 30% - out
....
CITY OF WINTER SPRINGS
~6-03
Deductible
Lifetime
Maximum
Preacci.ption
C
NA
Unimlted
NA
$15/$25
$S/$15 1$35 1$100
NA.1n U!*r4led - In NA-In $151$25.11'I $51 $10 1 $25
$400 1 $800 - CIA $1000ooo. CIA 70130. Out DecU:t+3O'l(, - Out
u...d HeaJth Care EC14B $3000 1 $600() $2,000,000 NA S35 $10/$30/$50
United Health Ca,.. ECPe8 $500 1 $1 OOO-In $2,000,000 80 1 ~In S2l>>l $10/$30/$50
$750/$15OO-Out 60 I40-Out DecI + 60 14O-Out
United Health Cere EC14B $3000 1 $600() $2,000,000 NA $35 $10/$30/$50
IPlan Option
annual PBA $1000
ona _
IIonOlIr fee $UB X 230=$1280.
Annu.tBanklng fee $5,800.00
ratal collt $20 725.00 .
- '. ..' ',. .,i..-
"
Out-of-Pocket Hoep!tat &r-!)8'l<:Y
Limit Admission C C
51500 I $3000 S250 1* day $75
11t 3 dIyI per ~
$1500 1 $3OOO-1n $100 per diy, 5 day mlIX-1n $50
$5000 1 $1 OO()().OU 0eclJCt + 30% - out
$12,000 1$24,000 !50% at eIgIIlIe e)CJleflSeS $200 It90.S3 "'J>> toAD.1 $eUf1
$2000 I $4000-11'I 20% -In $100 $2IW.o1 $IIS:'JIU7 ~.W'i _,CDS
$5000 1$1 O,()OO..()ut Oed + 4O%-Out I
$12,000 1 $24,000 !50% at eIgIIlIe expenses $200 $ 181.75 $434.37 IOU7 . .fTUIS