Board of Supervisors Business Meeting · REPORT: Health Plan Update and Premium Review for...

Date of Meeting: September 20, 2017

# 12g

BOARD OF SUPERVISORS

BUSINESS MEETING

ACTION ITEM

SUBJECT: FINANCE/GOVERNMENT OPERATIONS AND

ECONOMIC DEVELOPMENT COMMITTEE

REPORT: Health Plan Update and Premium Review

for Countywide Group Health Plan

ELECTION DISTRICT: Countywide

CRITICAL ACTION DATE: September 20, 2017

STAFF CONTACTS: Jeanette Green, Human Resources

Nelia Larson-Mann, Human Resources

Cheryl L. Middleton, Finance and Procurement

RECOMMENDATIONS:

Finance/Government Operations and Economic Development Committee (FGOEDC): At its

September 12, 2017 meeting, the FGOEDC voted (5-0) to recommend the Board of Supervisors

(Board): 1) approve the contract renewals with the County’s Group Health Plan vendors; 2)

implement the plan design changes and medical reinsurance level recommended in this action

item; 3) adopt the premiums for the Countywide Group Health Plan, as provided in Attachment 1,

and Retiree Health Plan, as provided in Attachment 2 for Plan Year 2018 (January 1, 2018 -

December 31, 2018); and 4) authorize the Purchasing Agent and Benefits Manager to take the

necessary actions to implement.

Staff: Staff concurs with the FGOEDC recommendation.

BACKGROUND: In October 2010, both the Board and the School Board approved contract

awards to CIGNA HealthCare, Express-Scripts (formerly Medco Health Solutions), Delta Dental

of Virginia, and Davis Vision for third-party administrative (TPA) services in accordance with the

County’s health plan designs for employees and retirees. Claims under these plans for active

employees and pre-65 retirees are paid as received and are self-insured by the County (subject to

an individual reinsurance provision “stop-loss” for medical claims). Effective July 1, 2014, the

post-65 and Medicare eligible retiree group was transitioned to CIGNA Medicare Surround and

CIGNA Medicare RX.

The contracts were issued for an initial five-year term (January 1, 2011 through December 31,

2015), with five (5) one-year renewal options thereafter. As part of the 2016 renewal process

Item 12g, Health Plan Update and Premium Review for Countywide Group Health Plan

Board of Supervisors Business Meeting

September 20, 2017

terms were re-negotiated with CIGNA and Express-Scripts resulting in savings to the Plan.

CIGNA administrative fees were guaranteed for Plan Years 2016 – 2017, with a 2% escalator for

Plan Years 2018 – 2019. Express-Scripts provided additional discount guarantees and rebates on

medication pricing for Plan Years 2016 – 2018, increasing each year. Direct reimbursements in

the amount of $31,700 have been returned to the Plan in 2017 for participating in programs that

support medication adherence. Administrative fees for Delta Dental of Virginia and Davis Vision

will remain flat for 2018.

Time Line

Staff conducts annual utilization reviews with all health plan vendors during the 4th quarter (Apr-

Jun) for the upcoming calendar Plan Year. Projections are prepared by the county’s actuarial

consultant based on the most recent claims data and provided to staff in mid-July, followed by rate

equivalents which are used to determine the monthly premiums.

The Patient Protection and Affordable Care Act (PPACA) requires a 60-day advance written notice

of any material changes to health benefit information. The advance notice requirement is met if

the open enrollment window begins more than 60 days before the start of the new plan year.

Additionally, logistics for open enrollment requires adequate lead time for employee

communications, meetings and reconfiguration to the myLoudoun on-line Benefit Center including

the new premium structure in preparation for enrollment. Open Enrollment for Plan Year 2018

will begin on November 1, 2017.

Cost Containment

To mitigate costs, while continuing to maintain a competitive health plan offering, staff annually

evaluates a number of factors, including plan design, cost sharing, program audits, utilization

reviews and medical reinsurance level. The financial impact of changes implemented in Plan Year

2015 to mitigate escalating costs has proved significant as noted in the chart below, Table 2: Trend

of Health Care Cost (Annual % Increase). The Plan should continue to experience a positive trend in

claims through 2017.

The following cost factors were identified from 2014 utilization data as key areas for driving costs

in the County’s Health Plan. There have been notable improvements including:

Key Cost Factors Update Emergency Room Utilization – ER utilization was in line with the CIGNA norm over the

last 12-month period. Lower cost urgent care utilization increased 40%.

Catastrophic Claims – The average claims cost decreased slightly resulting in a -1.2%

trend over the prior 12-month period. The catastrophic claim threshold used in this

analysis was $100,000.

Prescription Drug Costs – Plan cost PMPM decreased 7.3%; specialty plan cost PMPM

decreased 5.1%. Generic fill rate increased 1.3 percentage points; 1.1 percentage points

higher than peer (local government).



September 20, 2017

Enrollment & Cost Trends

The number of eligible employees has increased 2.4% over the last 12-month period while

enrollment in the county-sponsored health plans experienced a slight decrease to 82% (less than

1%) of those eligible. The County’s medical and prescription drug cost trend is 4.1% (medical

only 3.3%). Vision and dental cost trend is -1.5%.

Enrollment continues to shift away from the more costly Point of Service (POS) plan to the more

cost effective Open Access Plus (OAP) Plan and Consumer Driven Health Plan (CDHP) options.

Focused employee communications are geared to raise awareness in evaluating available health

plan options based on family needs and monthly premium cost. Combined enrollment in the

Consumer Driven Health Plans is currently 9.0%. These plans encourage members to focus on

preventive care and become better consumers of health care, which improves utilization decisions

as well as overall health. Additionally, there has been an ongoing shift from the more traditional

Point-of-Service (POS) Plan to the Open Access Plus (OAP) Plan, which is more cost effective for

both the employee and the County; estimated to reduce overall Plan costs by approximately 12%

over the Point-of-Service Plan.

Table 1: Enrollment by Medical Plan

Medical Plan 2015 % Enrollment 2016 % Enrollment 2017 % Enrollment

Point-of-Service (POS) 71.9% 67.0% 64.5%

Open Access Plus (OAP) 19.9% 24.3% 26.5%

Health Savings Account (HSA) 5.0% 5.5% 5.9%

Health Reimbursement Arrangement

(HRA) 3.2% 3.2% 3.1%

Table 2: Trend of Health Care Cost (Annual % Increase)

2006 2015 2016 2017

Loudoun County

Government (fiscal year) 15.0% 10.3% 2.1%

3.3%

National Benchmark 16.2% 7.8% 8.0% 7.5%

Sources: 2015-2016-2017 Segal Health Plan Cost Trend Survey; Willis Towers Watson

Wellness Initiatives

One of the key strategies many organizations continue to use to reduce health care costs is to boost

employee health through preventive health and wellness benefits including rewards for

participating in wellness programs. The County provides numerous health advocacy, clinical and

disease management programs as well as incentives for participation in wellness programs and

events. These programs continue to provide a return on the County’s investment and cost savings

in claims. Health advocacy programs for the medical plan, including Specialty Case Management,

Gaps in Care, Chronic Condition Coaching and other disease/clinical management programs



September 20, 2017

generated approximately $2.5 million ($1.8M in 2015) in savings for the Loudoun County

Government Group Health Plan in 2016. Clinical programs are also in place for prescription drugs

generating an additional $1.8 million in savings, including prior authorizations, quantity limits and

step therapy, which help to mitigate future prescription drug costs, while protecting patient safety.

Employee Education Update o Health Assessment data continues to reflect a growing trend in the number of employees

that are ready to take action to improve their overall health including: increase physical

activity and cope better with stress. Education and communication campaigns have

targeted these areas of focus to encourage employees to be more active. Events during

2017 have included the annual Walk About Leesburg with Chair Randall, a Yoga

Roadshow and a four-week on-site fitness seminar series.

o Chronic conditions are a significant driver of medical cost and reduced productivity.

Coaching programs are available to assist members with managing chronic conditions,

lifestyle coaching and complex case management. While statistics reflect that employee

engagement is within 1% of the CIGNA norm, opportunities remain to educate employees

about the benefits of these programs.

Education Campaign for 2018

o High Quality, Lower Cost Providers

Utilization of CIGNA Care Designated providers is on the rise and well above the

norm, saving the Plan over $839,000 over the prior 12-month period.

CIGNA Collaborative Care and Centers of Excellence.

o Preventive Care Services and Health Advocacy Programs

Preventive care and age appropriate screenings are important to early detection,

result in minimizing invasive treatment and controlling costs. The focus on

preventive care continues to be the cornerstone of the County’s Wellness Program;

well-visits and cancer screenings are above the CIGNA norm in all categories.

Specifically, colon cancer screenings increased 10%.

o Home Delivery Prescription Drugs

Research shows that 90-day fills increase medication adherence and reduced

potential for resulting nonadherence events such as hospitalization. Currently

66.8% of Plan cost is for maintenance drugs filled at the retail pharmacy level.

ISSUES: Based on current enrollment, the estimated County health plan administrative and claims

expense costs for Plan Year 2018 (January 1, 2018 – December 31, 2018) are estimated to be

$57,053,451 for active and pre-65 retirees. The CIGNA Medicare Surround and CIGNA Medicare

RX expenses for Medicare eligible including post-65 and disability retirees are estimated to be

$2,220,151 for Plan Year 2018. Current projections reflect a change to medical and prescription

drug premium equivalents of 3.9% to ensure adequate funding in Plan Year 2018.



September 20, 2017

Staff recommends an average 3.9% increase in the medical plan premiums charged to active

County employees as displayed in Attachment 1. This increase reflects the projected trend and an

incremental cost sharing adjustment toward established goals for Plan Year 2018. Staff further

recommends an average 4.0% increase for pre-65 retirees and a 6.8% increase in premiums

charged to Medicare-eligible retirees based on each group’s claims experience, as displayed in

Attachment 2. The recommended premium increase for Medicare eligible retirees includes an

additional adjustment due to the 5% employer contribution cap established in 2013. This change

to a defined contribution approach was approved by the Board as part of the County’s Other Post-

Employment Benefits (OPEB) reduction efforts. No increase is being recommended for the dental

and vision plans.

The following plan design changes are recommended for Plan Year 2018 to the Group Health Plan.

Medical Coverage Change – Addition of Habilitative Therapy (Physical Therapy/

Occupational Therapy/Speech Therapy) and Applied Behavioral Analysis (ABA)

Therapy. Addition of Habilitative Therapy & ABA Therapy is a significant and

very positive change for families with children who have developmental disorders.

Medical Plan Option – Introducing a Consumer Driven Health Plan (CDHP) option

with Health Reimbursement Arrangement (HRA) to pre-65 retirees providing a

lower cost alternative. Same plan design as offered to active employees.

Increase Vision Coverage Contact Lens Allowance – An increase in the allowance

from $100 to $130 brings the plan benefit to current benchmark and matches the

frame benefit.

Change Vision Coverage Frame Frequency – A change in the frequency from 24

months to 12 months brings the plan benefit to current benchmark.

Compliance-Driven Plan Design Change – In November 2016, final

recommendations were released on the use of statins for prevention of

cardiovascular disease. As a result certain dosages are now considered preventive

and are covered under the ACA requiring a $0 copay.

Addition of Prescription Drug Clinical Management Program: ScreenRX – This

program identifies patients at-risk for nonadherence through engagement enabling

patient choice and predictive modeling. Helps patients overcome adherence

obstacles with auto-renewals, tips and reminders, specialist pharmacist

consultations, interactive mobile app and more.

Medical Individual Stop-loss Coverage — Staff recommends an increase from

$520,000 to $550,000. This change is transparent to members and will result in an

estimated $264,000 in direct savings to the Plan. An analysis is performed annually

to determine the cost/savings ratio. The stop-loss level is evaluated based on

existing claims history and projections.



September 20, 2017

Affordable Care Act

The Affordable Care Act (ACA) continues to impact overall plan costs. As additional requirements

come into play in the years ahead, the County must continue to implement those requirements and

determine their impacts on plan costs and administration. A total of $306,753 in associated fees

and taxes will be paid in 2017.

Temporary Reinsurance Fee – This fee will be collected over a three-year period from 2014

through 2016 to fund a reinsurance program, which is intended to lessen the impact of adverse

selection in the individual market. The final payment will be made in 2017.

Comparative Effectiveness Research Fee (CERF) – This fee will be collected through 2020 to

support the Patient-Centered Outcome Research Institute (PCORI) to conduct research that

determines the effectiveness of various forms of medical services that treat, manage, diagnose

or prevent illness or injury.

FISCAL IMPACT:

The cost of the Group Health Plan is funded by employee, retiree, and employer contributions.

Sufficient funding exists in the Fiscal Year 2018 Adopted Budget for the health plan expenses

indicated in this item. Group Health Plan rates, as provided in Attachments 1 and 2 for Plan Year

2018 (January 1, 2018 – December 31, 2018) will result in approximately $798,000 in additional

revenue to fund the Group Health Plan in 2018, representing an 19.1% blended contribution ratio.

The current year (Plan Year 2017) premiums for active employees and retirees are provided as

Attachments 3 and 4, respectively, for comparison purposes. Attachment 5 provides a side by side

comparison of 2017/2018 monthly premiums for active employees.

ALTERNATIVES:

1. Authorize the contract renewals with the County’s Group Health Plan vendors including

the plan design changes and medical reinsurance level recommended in this item; adopt

the premiums for the Countywide Group Health Plan and Retiree Health Plan as provided

in Attachments 1 and 2 for Plan Year 2018 (January 1, 2018 – December 31, 2018); and

authorize the Purchasing Agent and Benefits Manager to take the necessary actions to

implement.

OR

2. Do not recommend to renew the contracts with the County’s Group Health Plan vendors

and to implement the plan design changes and medical reinsurance level recommended in

this item or adoption of the premiums for the Countywide Group Health Plan and Retiree

Health Plan and direct staff on how to proceed. Failure to authorize the contract renewal

and proposed changes would result in an increased cost to the Plan. Failure to adopt the

premiums for Plan Year 2018 would result in a funding shortfall. Revenue would remain



September 20, 2017

level requiring the County to increase the amount of employer cost sharing for the Plan and

provide additional funding.

DRAFT MOTIONS:

1. I move the recommendation of the Finance/Government Operations and Economic

Development Committee that the Board of Supervisors approve the contract renewals with

the County’s Group Health Plan vendors and to implement the plan design changes and

medical reinsurance level recommended in the September 20, 2017 Board of Supervisors

Business Meeting Action Item; and authorize the Purchasing Agent and Benefits Manager

to take the necessary actions to implement.

I further move the recommendation of the Finance/Government Operations and Economic

Development Committee that the Board of Supervisors adopt the premiums for the

Countywide Group Health Plan and Retiree Health Plan as shown in Attachments 1 and 2

of the September 20, 2017 Board of Supervisors Business Meeting Action Item, effective

January 1, 2018 through December 31, 2018.

OR

2. I move an alternative motion.

ATTACHMENTS:

1. 2018 Employee Group Health Plan Monthly Premiums

2. 2018 Retiree Health Plan Monthly Premiums

3. 2017 Employee Group Health Plan Monthly Premiums

4. 2017 Retiree Health Plan Monthly Premiums

5. 2017/2018 Comparison of Employee Group Health Plan Monthly Premiums

EMPLOYEE GROUP HEALTH PLAN RATES

January 1, 2018 – December 31, 2018

Point-cal & prescription drugs only)

Employee(monthly share)

County(monthly share)

Total(monthly)

Employee(biweekly)

Employee Only 30 + hours/week

20-29 hours/week$ 135.20$ 443.26

$ 751.32$ 443.26

$ 886.52 $ 67.60$ 221.63

Employee + 1 30 + hours/week

20-29 hours/week$ 341.08$ 824.20

$1,343.29$ 842.17

$ 1,684.37 $ 170.54$ 412.10

Family 30 + hours/week

20-29 hours/week$ 593.20$1,409.56

$1,756.06$ 939.70

$ 2,349.26 $ 296.60$ 704.78

COBRA - POS Individual Individual + 1 Family

$ 904.25$1,718.06$2,396.25

Point-of-Service (POS) Plan (medical & prescription drugs only)

Open Access Plus (OAP) Plan (medical & prescription drugs only)



Total(monthly)

Employee(biweekly)


20-29 hours/week$ 60.28$ 376.78

$ 693.25$ 376.75

$ 753.53 $ 30.14$ 188.39


20-29 hours/week$ 193.28$ 715.86

$ 1,238.44$ 715.86

$ 1,431.72 $ 96.64$ 357.93


20-29 hours/week$ 459.28$1,198.12

$ 1,537.59$ 798.75

$ 1,996.87 $ 229.64$ 599.06

COBRA - OAP Individual Individual + 1 Family

$ 768.60$1,460.35$2,036.81

CIGNA Choice HSA / HRA (medical & prescription drugs only)


County Total

(monthly) Employee(biweekly) (monthly

share)

HSA/HRA Contribution

monthly annual


20-29 hours/week$ 30.88$ 321.00

$ 503.10$ 256.14

$ 83.33$ 40.17

$ 1,000.00$ 482.00

$ 617.31 $ 15.44$ 160.50


20-29 hours/week$ 111.70$ 646.70

$ 897.43$ 453.27

$ 166.67$ 75.83

$ 2,000.00$ 910.00

$ 1,175.80 $ 55.85$ 323.35


20-29 hours/week$ 294.84$ 982.80

$1,176.47$ 579.35

$ 166.67$ 75.83

$ 2,000.00$ 910.00

$ 1,637.98 $ 147.42$ 491.40

COBRA –CIGNA Choice

IndividualIndividual + 1Family

HSA HRA

$ 544.66$1,029.33$1,500.74

$ 629.66$1,199.33$1,670.74

September 16,

S E P T E M B E R 1 2 , 2 0 1 7

Attachment 1

Dental & Vision

Employee (monthly share)

County (monthly share)

Total (monthly)

Employee (biweekly)

Employee Only 30 + hrs/week 20-29 hrs/week

$ 7.40 $ 24.68

$ 41.98 $ 24.70

$ 49.38

$ 3.70 $ 12.34

Employee + 1 30 + hrs/week 20-29 hrs/week

$ 17.84 $ 44.60

$ 71.39 $ 44.63

$ 89.23

$ 8.92 $ 22.30

Family 30 + hrs/week 20-29 hrs/week

$ 30.88 $ 74.10

$ 92.60 $ 49.38

$123.48

$ 15.44 $ 37.05

COBRA Individual Individual + 1 Family

$ 50.37 $ 91.01 $125.95

EMPLOYEE GROUP HEALTH PLAN RATES January 1, 2018 – December 31, 2018

S E P T E M B E R 1 2 , 2 0 1 7

PRE-65 RETIREE GROUP HEALTH PLAN RATESJanuary 1, 2018 – December 31, 2018

Point-of Service (POS) 5% Annual

Cap

Open Access Plus (OAP)

Retiree (monthly)

County (monthly)

Total (monthly)

Retiree (monthly)

County (monthly)

Total (monthly)

Retirees with 25+ yrs Individual 2 Individuals 3+ Individuals (Family)

$ 252.83 $ 642.88 $ 1,299.61

$ 899.04 $ 1,545.67 $ 1,983.22

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 39.76 $ 68.29 $ 87.71

$ 95.61 $ 321.03 $ 877.29

$ 800.29 $ 1,381.18 $ 1,676.02

$ 895.90 $ 1,702.21 $ 2,553.31

Retirees with 20 – 24 yrs Individual 2 Individuals 3+ Individuals (Family)

$ 477.59 $ 1,106.21 $ 1,894.59

$ 674.28 $ 1,082.34 $ 1,388.24

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 29.82 $ 47.80 $ 61.39

$ 260.03 $ 671.02 $ 1,300.68

$ 635.87 $ 1,031.19 $ 1,252.63

$ 895.90 $ 1,702.21 $ 2,553.31


$ 792.93 $ 1,569.50 $ 2,489.55

$ 358.94 $ 619.05 $ 793.28

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 15.90 $ 27.32 $ 35.08

$ 539.97 $ 1,089.04 $ 1,807.88

$ 355.93 $ 613.17 $ 745.43

$ 895.90 $ 1,702.21 $ 2,553.31


$ 972.07 $ 1,878.39 $ 2,886.19

$ 179.80 $ 310.16 $ 396.64

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 7.95 $ 13.66 $ 17.54

$ 699.93 $ 1,364.20 $ 2,143.08

$ 195.97 $ 338.01 $ 410.23

$ 895.90 $ 1,702.21 $ 2,553.31

Pre-65 RETIREE DENTAL & VISION PLAN RATES January 1, 2018 – December 31, 2018

Retiree (monthly)

County (monthly)

Total (monthly)


$ 7.40 $ 18.32 $ 30.87

$ 41.98 $ 70.91 $ 92.61

$ 49.38 $ 89.23 $ 123.48

Retirees: 20 – 24 yrs Individual 2 Individuals 3+ Individuals (Family)

$ 17.90 $ 39.26 $ 58.65

$ 31.48 $ 49.97 $ 64.83

$ 49.38 $ 89.23 $ 123.48


$ 32.60 $ 60.67 $ 86.45

$ 16.78 $ 28.56 $ 37.03

$ 49.38 $ 89.23 $ 123.48


$ 40.99 $ 74.96 $ 104.96

$ 8.39 $ 14.27 $ 18.52

$ 49.38 $ 89.23 $ 123.48

S E P T E M B E R 1 2 , 2 0 1 7


NEW—CIGNA Choice HRA 5%

Annual Cap

Retiree (monthly)

County

(monthly) HRA

Monthly Contribution

HRA Annual

Contribution

Total (monthly)


$ 58.64 $ 176.37 $ 491.39

$ 475.34 $ 832.77 $ 979.92

$ 83.33 $ 166.67 $ 166.67

$ 1,000.00 $ 2,000.00 $ 2,000.00

$ 617.31 $ 1,175.81 $ 1,637.98

$ 39.76 $ 68.29 $ 87.71


$ 159.75 $ 406.99 $ 995.89

$ 374.23 $ 602.15 $ 475.42

$ 83.33 $ 166.67 $ 166.67

$ 1,000.00 $ 2,000.00 $ 2,000.00

$ 617.31 $ 1,175.81 $ 1,637.98

$ 29.82 $ 47.80 $ 61.39


$ 336.71 $ 704.32 $ 1,276.81

$ 197.27 $ 304.82 $ 184.50

$ 83.33 $ 166.67 $ 166.67

$ 1,000.00 $ 2,000.00 $ 2,000.00

$ 617.31 $ 1,175.81 $ 1,637.98

$ 15.90 $ 27.32 $ 35.08


$ 437.82 $ 874.23 $ 1,437.33

$ 96.16 $ 134.91 $ 33.98

$ 83.33 $ 166.67 $ 166.67

$ 1,000.00 $ 2,000.00 $ 2,000.00

$ 617.31 $ 1,175.81 $ 1,637.98

$ 7.95 $ 13.66 $ 17.54

Attachment 2

POST-65 MEDICARE ELIGIBLE1 RETIREE GROUP HEALTH PLAN RATES

January 1, 2018 – December 31, 2018 1 Medicare Eligible Disability Retirees

Medicare Surround Plan (MSP) - medical, prescription drugs, vision

DENTAL PLAN ONLY

Retiree (monthly)

County (monthly)

Total (monthly)

5% Annual Cap

Retiree (monthly)

County (monthly)

Total (monthly)

Retirees with 25+ yrs 1 Medicare 2 Medicare

$ 52.25 $ 104.49

$ 339.35 $ 678.71

$ 391.60 $ 783.20

$ 15.74 $ 31.49

$ 4.48 $ 8.96

$ 40.36 $ 80.72

$ 44.84 $ 89.68

Retirees: 20 – 24 yrs 1 Medicare 2 Medicare

$ 80.28 $ 160.56

$ 311.32 $ 622.64

$ 391.60 $ 783.20

$ 14.87 $ 29.74

$ 6.72 $ 13.45

$ 38.12 $ 76.23

$ 44.84 $ 89.68

Retirees with 15 – 19 yrs 1 Medicare 2 Medicare

$ 272.55 $ 545.11

$ 119.05 $ 238.09

$ 391.60 $ 783.20

$ 5.60 $ 11.20

$ 29.15 $ 58.29

$ 15.69 $ 31.39

$ 44.84 $ 89.68


$ 337.91 $ 675.82

$ 53.69 $ 107.38

$ 391.60 $ 783.20

$ 2.45 $ 4.90

$ 38.11 $ 76.23

$ 6.73 $ 13.45

$ 44.84 $ 89.68

S E P T E M B E R 1 2 , 2 0 1 7

EMPLOYEE GROUP HEALTH PLAN RATES

January 1, 2017 – December 31, 2017

Point-cal & prescription drugs only)



Total(monthly)

Employee(biweekly)


20-29 hours/week$ 128.00$ 426.62

$ 725.25$ 426.62

$ 853.24 $ 64.00$ 213.31


20-29 hours/week$ 324.22$ 810.58

$1,296.93$ 810.57

$ 1,621.15 $ 162.11$ 405.29


20-29 hours/week$ 565.28$1,356.66

$1,695.80$ 904.42

$ 2,261.08 $ 282.64$ 678.33

COBRA - POS Individual Individual + 1 Family

$ 870.30$1,653.57$2,306.30

Point-of-Service (POS) Plan (medical & prescription drugs only)

Open Access Plus (OAP) Plan (medical & prescription drugs only)



Total(monthly)

Employee(biweekly)


20-29 hours/week$ 58.02$ 362.62

$ 667.23$ 362.63

$ 725.25 $ 29.01$ 181.31


20-29 hours/week$ 186.02$ 689.00

$ 1,191.96$ 688.98

$ 1,377.98 $ 93.01$ 344.50


20-29 hours/week$ 451.66$1,153.16

$ 1,470.26$ 768.76

$ 1,921.92 $ 225.83$ 576.58

COBRA - OAP Individual Individual + 1 Family

$ 739.76$1,405.54$1,960.35

CIGNA Choice HSA / HRA (medical & prescription drugs only)


County Total

(monthly) Employee(biweekly) (monthly

share)

HSA/HRA Contribution

monthly annual


20-29 hours/week$ 29.86$ 310.58

$ 484.07$ 246.52

$ 83.33$ 40.17

$ 1,000.00$ 482.00

$ 597.27 $ 14.93$ 155.29


20-29 hours/week$ 107.82$ 624.14

$ 860.33$ 434.83

$ 166.67$ 75.83

$ 2,000.00$ 910.00

$ 1,134.80 $ 53.90$ 312.07


20-29 hours/week$ 284.90$ 949.66

$1,131.18$ 557.26

$ 166.67$ 75.83

$ 2,000.00$ 910.00

$ 1,582.75 $ 142.45$ 474.83

COBRA –CIGNA Choice

IndividualIndividual + 1Family

HSA HRA

$ 524.21$ 987.50$1,444.41

$ 609.21$1,157.50$1,614.41

September 16,

S E P T E M B E R 1 3 , 2 0 1 6

Attachment 3

Dental & Vision Employee

(monthly share) County

(monthly share) Total

(monthly) Employee(biweekly)

Employee Only 30 + hrs/week

20-29 hrs/week$ 7.40$ 24.68

$ 41.98$ 24.70

$ 49.38 $ 3.70$ 12.34

Employee + 1 30 + hrs/week

20-29 hrs/week$ 17.84$ 44.60

$ 71.39$ 44.63

$ 89.23 $ 8.92$ 22.30

Family 30 + hrs/week

20-29 hrs/week$ 30.88$ 74.10

$ 92.60$ 49.38

$123.48 $ 15.44$ 37.05

COBRA Individual Individual + 1 Family

$ 50.37$ 91.01$125.95

EMPLOYEE GROUP HEALTH PLAN RATES January 1, 2017 – December 31, 2017

S E P T E M B E R 1 3 , 2 0 1 6


Point-of Service (POS) 5% Annual

Cap

Open Access Plus (OAP)

Retiree (monthly)

County (monthly)

Total (monthly)

Retiree (monthly)

County (monthly)

Total (monthly)

Retirees with 25+ yrsIndividual2 Individuals3+ Individuals (Family)

$ 252.83 $ 642.88 $ 1,299.61

$ 899.04 $ 1,545.67 $ 1,983.22

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 39.76 $ 68.29 $ 87.71

$ 95.61 $ 321.03 $ 877.29

$ 800.29 $ 1,381.18 $ 1,676.02

$ 895.90 $ 1,702.21 $ 2,553.31

Retirees with 20 – 24 yrsIndividual2 Individuals3+ Individuals (Family)

$ 477.59 $ 1,106.21 $ 1,894.59

$ 674.28 $ 1,082.34 $ 1,388.24

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 29.82 $ 47.80 $ 61.39

$ 260.03 $ 671.02 $ 1,300.68

$ 635.87 $ 1,031.19 $ 1,252.63

$ 895.90 $ 1,702.21 $ 2,553.31


$ 792.93 $ 1,569.50 $ 2,489.55

$ 358.94 $ 619.05 $ 793.28

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 15.90 $ 27.32 $ 35.08

$ 539.97 $ 1,089.04 $ 1,807.88

$ 355.93 $ 613.17 $ 745.43

$ 895.90 $ 1,702.21 $ 2,553.31


$ 972.07 $ 1,878.39 $ 2,886.19

$ 179.80 $ 310.16 $ 396.64

$ 1,151.87 $ 2,188.55 $ 3,282.83

$ 7.95 $ 13.66 $ 17.54

$ 699.93 $ 1,364.20 $ 2,143.08

$ 195.97 $ 338.01 $ 410.23

$ 895.90 $ 1,702.21 $ 2,553.31

Pre-65 RETIREE DENTAL & VISION PLAN RATES January 1, 2017 – December 31, 2017

Retiree (monthly)

County (monthly)

Total (monthly)


$ 7.40 $ 18.32 $ 30.87

$ 41.98 $ 70.91 $ 92.61

$ 49.38 $ 89.23 $ 123.48

Retirees: 20 – 24 yrs Individual 2 Individuals 3+ Individuals (Family)

$ 17.90 $ 39.26 $ 58.65

$ 31.48 $ 49.97 $ 64.83

$ 49.38 $ 89.23 $ 123.48


$ 32.60 $ 60.67 $ 86.45

$ 16.78 $ 28.56 $ 37.03

$ 49.38 $ 89.23 $ 123.48


$ 40.99 $ 74.96 $ 104.96

$ 8.39 $ 14.27 $ 18.52

$ 49.38 $ 89.23 $ 123.48

POST-65 MEDICARE ELIGIBLE1 RETIREE GROUP HEALTH PLAN RATES

January 1, 2017 – December 31, 2017 1 Medicare Eligible Disability Retirees

Medicare Surround Plan (MSP) - medical, prescription drugs, vision

DENTAL PLAN ONLY

Retiree (monthly)

County (monthly)

Total (monthly)

5% Annual Cap

Retiree (monthly)

County (monthly)

Total (monthly)

Retirees with 25+ yrs 1 Medicare 2 Medicare

$ 42.38 $ 84.75

$ 323.60 $ 647.21

$ 365.98 $ 731.96

$ 15.74 $ 31.49

$ 4.48 $ 8.96

$ 40.36 $ 80.72

$ 44.84 $ 89.68

Retirees: 20 – 24 yrs 1 Medicare 2 Medicare

$ 69.54 $ 139.07

$ 296.44 $ 592.89

$ 365.98 $ 731.96

$ 14.87 $ 29.74

$ 6.72 $ 13.45

$ 38.12 $ 76.23

$ 44.84 $ 89.68


$ 252.53 $ 505.05

$ 113.45 $ 226.91

$ 365.98 $ 731.96

$ 5.60 $ 11.20

$ 30.49 $ 60.99

$ 14.35 $ 28.69

$ 44.84 $ 89.68


$ 314.74 $ 629.49

$ 51.24 $ 102.47

$ 365.98 $ 731.96

$ 2.45 $ 4.90

$ 38.52 $ 77.04

$ 6.32 $ 12.64

$ 44.84 $ 89.68

September 13, 2016 Attachment 4

Comparison of Employee Group Health Plan Monthly Premiums

Active EEs – medical & RX only

9-12-2017

Active EEs – vision & dental only

9-12-2017

Attachment 5

Board of Supervisors Business Meeting · REPORT: Health Plan Update and Premium Review for...

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Transcript of Board of Supervisors Business Meeting · REPORT: Health Plan Update and Premium Review for...