HomeMy WebLinkAboutAgenda - 09-08-2011 - 8bORANGE COUNTY
BOARD OF COMM1SS10NERfi
ACTION AGENDA ITEM ABSTRACT
Meeting Date: .September 8, 2011
Action Agen~da~
Item No..,..--~
SUBJECT: Employee Health Insurance and Other Benef~#s for 2012
DEPARTMENT: Human Resources PUBLIC HEARING: (Y/N) No
ATTACHMENT(S):
1. 2012 Renewal Option Costs Detail for
Active Employees and Pre-65 Retirees
2. Original Health Insurance Renewal
Proposals
3. Comparison of Plan Designs
4. UnitedHealthcare Information
5. Vision Plan Designs
6. Revised Work Session Attachment
INFORMATION CONTACT:
Katherine Cathey, Interim Human
Resources Director, 245-2553
Diane Shepherd, Benefits Manager, 245-
2558
PURPOSE: To consider the County Manager's recommendations for employee health
insurance and other benefits for the 2012 calendar year.
BACKGROUND: The County provides employees with a comprehensive benefits plan
including County-paid health, dental and life insurance, an employee assistance program,
flexible compensation plan and paid leave for permanent employees. Additionally, the County
contributes to the Local Governmental Employees' Retirement System and a supplemental
retirement plan for each permanent employee.
Staff provided information relating to FY 2011-12 employee benefits at work sessions on May
10, 2011, June 9, 2011, August 30, 2011, and in the County Manager's recommended budget
for FY 2011-12. The FY 2011-12 Approved Budget includes funds for up to a 15.0% ($552,598)
health insurance premium increase. Over atwelve-month period, this increase is equivalent to a
3% salary increase for all permanent employees.
2012 Benefit Plans
The following employee benefits are recommended for implementation for the 2012 calendar
year:
Health Care
After an extensive bid process, staff, in consultation with broker Mark Ill, has provided options
for the 2012 employee health insurance benefits from UnitedHealthcare. Premiums for
employee health insurance are shown on Attachment 1. For additional. re~#erence, Attachment 2
provides details of the original quotes received from three major insurers. .Attachment 3
provides details of current and alternate plan. designs for four renewal options with
UnitedHealthcare, and Attachment 4 includes reference information related to UnitedHealthcare.
2
Recommendations:
• Approve the renewal of the fully-insured health insurance plans with UnitedHealthcare,
choosing one of the following options:
o Option 3, with an overall premium increase of 5.24%, or
o Optiorl4, with an overall premium increase of 8.64%.
• Authorize the County Manager to sign a contract with UnitedHealthcare, following review
by the C,'ounty Attorney and Hen Resources staff.
Dental Insurance
The County provides aself-ipcursd dental plan through Delta Dental of North Carolina. Over the
past four years, the County has been systematically increasing claim reimbursements to match
Delta Dental's maximum payable amount (MPA). The last step in shifting all reimbarsements to
the MPA can .occur effective January 1, 2012, and doing so will end the unique Orange County
Table of Allowances. Delta Dental is also allowing new reimbursements in accordance with
industry best practices.
Recommendation:
• Replace the Orange County Table of Allowances with the maximum payable amounts
reimbursed by Delta Dental.
Flexible Compensation Plan
The County provides a Section 125 Flexible Compensation Plan administered by Tucker
Administrators. The plan consists of: a) tax sheltering of health and dental premiums and b)
Flexible Spending Accounts for medical expenses and dependent/child care expenses.
Currently, the Plan Year for Flexible Spending Accounts (FSA) is December 1 to November 30,
while all other plan years, including Health Insurance, are January 1 to December 31.
Federal tax regulations prohibit employees from participating in both a Flexible Spending
Account and a Health Savings Account at the same time. If the County implements a Health
Savings Account, it will be advantageous to change the Flexible Spending Account Plan Year to
the same dates as the Health Insurance Plan Year to align the FSA and HSA plan years. Both
Plan Years would be January 1 to December 31, effective January 1, 2012. Employees who
elect a Health Savings Account, effective January 1, 2012, must incur all expenses prior to
December 31, 2011 to remain compliant with federal laws; however all employees will have an
additional grace period in which to claim incurred expenses.
Recommendations:
• Align the Flexible Compensation Plan Year with the health insurance plan year, and.
• Reduce the grace period allowed fo incur medical expenses in the can-ent plan year fo
one month, ending December 31, 2011, for employees electing a Health Savings
Account, effective January 1, 2012.
Vision Benefits
The County's current health insurance benefits and the proposed options for 2012 do not
provide a benefit for eyeglass frames or lenses. With UnitedHealthcare, employees will be
authorized a routine eye exam bi-annually. Er~+ployees have requested benefits that include a
higher level of vision. coverage. This benefit would be a voluntary benefit and paid by
employees through payroll deduction.
After reviewing three options (shown in Attachment 5) presented by Benefits Consultant Mark
III, staff determined that Community Eye Care has the most extensive benefits and network of
providers. It has been endorsed by the North Carolina Association of County Commissioners
and serves over twenty North Carolina counties and numerous cities.
Recommendation:
• Authorize employee payroll deductions for the Community Eye Care vision plan.
Community, Home Trust
The Community Home Trust has been a subgroup of the NCACC County Health Plan. They
have requested continued participation as the County seeks other health insurance for 2012.
The Patient Protection and Affordability Act establishes health care exchanges and other
potential remedies to the high cost of health insurance for small employers that will ~e effective
in 2014. Allowing the Community Home Trust to remain on the county's health insurance until
December 31, 2013 will enable them to research other possibilities for coverage.
Recommendation:
Authorize the County Attorney to develop a two year Memorandum of Understanding
between the County and Community Home Trust and authorize the County Manager to
sign the agreement.
Revised Work Session Attachment
Attachment 6 is a revision of responses from the employee survey, originally provided as part of
the August 30, 2011 work session materials. The original charts inadvertently contained
inaccurate information.
FINANCIAL IMPACT: Attachment 1 includes the estimated costs of the health insurance
options.
RECOMMENDATION(S): The Manager recommends the Board:
• Approve the renewal of the fully-insured health insurance plans with UnitedHealthcare,
choosing one of the following options:
o Option 3, with an overall premium increase of 5.24%, or
o Option 4, wifh an overall premium increase of 8.64%.
• Authorize the County Manager to sign a contract with UnitedHealthcare, following review
by the County Attorney and Human Resources staff
• Replace fhe entire Orange County Table of Allowances with the maximum payable
amounts reimbursed by Delta Dental;
• Align the Flexible Compensation Plan Year with the calendar year;
• Reduce the grace period allowed to incur medical expenses in the current plan year to
one month, ending December 31, 2011, for employees electing a Health Savings
Account, effective January 1, 2012, and
• Authorize employee payroll deductions for the Community Eye Care vision plan.
Current and Renewal Option Costs Detail for Active Employees and Pre-65 Retirees
Renewal Effective January 1, 2012
Monthly Costa Calendar Year Coats Percentage Increase Over 2011 Premiums
Type of
Plan Tier # of
Participants Total Premium County
Contribution Employee
Contribution Total Premium Annual County
Cost Employee
Contribution Total County
Contribution Employee
Contribution
Individual 457 $531 $531 $0 $2,914 417 52,914 417 $0
~ IndlChiid 115 $744 $615 $129 $1026692 $848,552 $178,141
O1 HMO Ind/Children 77 $1,026 $755 $270 $947,710 $697,794 $249,916
IndIS use 85 $1,121 $803 $319 $1143746 $818,876 $324,870
e^ Fami 78 $i 594 $1 038 $556 $1 492 246 $971,953 $520,293
a a Total 812 $7,524,812 $6,251,592 $1,273,220 0.00• 0.00% 0.00%
c ~ Individual 64 $509 $509 $0 $390,927 $390,927 $0
o Ind/Child 12 $713 $615 $98 $102,617 $88,546 $14,072
v v
PPO Ind/Children 10 $982 5755 $227 $117 890 $90 622 $27 269
~ Ind/S se 12 $1,074 $803 $271 $154 659 $115,806 $39,053
V Famil 19 $1 527 $1,038 $489 $348,174 $236 760 $111,414
Total 117 $1,114,268 $922,460 $191,808 0.00% 0.00% 0.00%
Current Plan Totals $8,639,080 $7,174,052 $1,465,028 0.00% 0.00% 0.00%
_ Individual 457 $621 $621 $0 $3 407,648 $3 407 648 $0
~
ar IndlChild 115 $1007 $828 $179 $1,389163 $1,142750 $246413
c ~ HMO IndlChildren 77 $1 007 $828 $179 $930,135 $765 146 $164,988
c Ind/S use 85 $1 311 $988 $323 $1,337 332 $1,008 100 $329,232
p a Femil 78 $1,864 $1,279 $585 $1,744,835 $1 197,522 $547 313
a ~ Total 812 $8,809,114 $7,521,166 $1,287,947 17.07% 20.31% 1.i6X
tu. ~ Individual 64 $629 $629 $0 $483 026 $483 026 $0
~' v POS Irxl/Chlld 12 $1 019 $828 $191 $146,719 $119 244 $27,475
_ `o
(Point of Ind/Children 10 $1,019 $828 $191 $122,266 $99 370 $22 896
~~~ Ind/S se 12 $1,327 $988 $339 $191,097 $142,320 $48,777
~ d Fami 19 $1887 $1,279 $607 $430,193 $291,704 $138,489
~ Total 117 $1,373,300 $1,135,663 $237,636 23.25% 23.11°~6 23.89%
O on 1 Totals =10,182,413 $8,656,829 61,525,584 17.86•k 20.87°~ 4.13%
Individual 457 $621 $621 $0 $3 407 648 $3,407 648 $0
Ind/Child 115 $1,007 $769 $238 $1,389,163 $1061,138 $328,025
c HMO Ind/Children 77 $1,007 $789 $238 $930 135 $710 501 $219,634
Ind/S use 85 $1,311 $886 $426 $1 337 332 $903 267 $434,065
p Famil 78 $1,864 $1,097 $767 $1,744,835 $1027141 $717694
~ Total 812 58,809,114 $7,109,694 $1,699,420 17.07% 13.73•~G 33.47%
~ Individual 64 $621 $621 $0 $477 220 $477,220 $0
~ IndlChild 12 $905 $768 $136 $130 342 $110 727 $19,674
HeeRh indlChildren 10 $905 $769 $136 $108,618 $92273 $16345
~ Savings
Arxount IndIS se
Fami 12
19 $1129
$1 537 $886
$1,097 5244
$439 $162635
$350,379 $127,520
$250 201 $35,115
$100 178
Total 117 $1,229,193 61,057,941 6171,252 10.31% 14.69% -10.72%
0 'on 2 Totals 510,038,307 68,167,635 51,870,672 16.20% 13.85% 27.69%
Option 2 includes an annual County contribution to an HSA of $1,984. The HSA contribution is determined by the dffference in individual premiums between the HMO and HSA plans. For example, the
individual premium for the HMO plan is $621.38 and the individual permium for the HSA plan is $457.68, a difference of $163.70 per month or $1,964.40 per year. The County-HSA contribution has bean
inducted in the total monthly premiums for the HSA plan.
Current and Renewal Option Costs Detail for Active Employees and Pre-ti5 Retirees
Renewal Effective January 1, 2012
Monthly Cosh Calendar Year Costs Percentage Increase Over 2011 Premiums ,
Type of
Tier # of
Total Premium County
ntributian
C Employee
Contribution
Total Premium Annual County
Cost Employee
Contribution
Total County
Contribution Employee
Contribution
Plan Participants o
individual 457 $531 $531 $0 $2 914 417 $2 914 417 50
Ind/Child 115 $744 5615 5129 $1,026,682 $848,552 5178141
w
O1 Ind/Chfldren 77 51 026 5755 5270 5947 710 $697 794 5249 916
HMO Ind/S use 85 51,121 $803 $318 $1,143,746 $818,876 $324870
~ - Famii 78 51 594 51,038 $556 51 492,246 $971 953 $520,293
a ~' Total 812 57,524,812 56 251,582 51,273 220 0.00% 0.00% O.OOX
c ~ Individual 64 $509 5509 $0 5390,927 5390 927 $0
c IndlChild 12 5713 .5615 . 598 $102 617 $86,546 514 072
V v Ind/Children 10 $882 5755 3227 $117 890 $90 622 827 269
Z PPO Ind/S se 12 $1,074 $803 $271 $754,859 $115606 $39 053
~ Famii 19 $1 527 51 038 $489 $348,174 $236 760 5111414
~
U Total 117 51,114,268 5922,460 5181,808 0.00% 0.00% O.OOX
Current Plan Totals 58,639,080 57,174,052 31,465,028 O.OOX 0.00°~ 0.00%
Indvidual 457 5561 5561 50 53 074 495 $3 074 495 SO
Ind/Child 115 $908 $708 $200 $1 253,344 $977,303 5276 041
,,, POS
f
i
t
P Ind/Children 77 $908 $708 5200 5839,195 5654,388 5184 827
o o
n
o
( IndIS se 85 $1
183 5825 $358 S1 206,578 5841 302 5365,277
a
O Service)
Famii
78 ,
$1,682
$1037
$645
51,574,240
5970279
5603,961
~ Total 812 57,947,852 56,517,746 51,430,106 5.62X 4.26% 12.32%
~ Individual 64 $561 $561 $0 $430,564 3430 564 $0
m Ind/Child 12 $844 $708 $136 5121,594 $101,979 $19614
Heekh IndlChildren 10 $844 5708 5136 5101 328 584,983 816 345
$244 $153 887 772
5118 $35 115
Savings Ind/S use 12 51 069 5825 ,
~ Amount Famii 19 51476 $1,037 $439 $336,528 $236,350 5100178
Total 117 51,143,900 5972,648 5171,252 2.66°~ 5.44X -10.72%
O on 3 Totals 59,091,752 57,490,394 51,601,358 5.24X 4.41X 8.31%
Individual 457 $579 $579 S0 $3,172,988 $3 172 988 50
Ind/Child 115 $937 $732 5205 51,293 502 51,010,003 5283 499
POS
P
f
i
t Ind/Children 77 $937 $732 $205 $866 084 $676 263 5189 821
c
~ (
o
n
o
Service) Ind/S se 85 $1,221 $853 $388 $1,245247 5870,102 $375145
O Famf 78 $1,736 51073 $663 $1,624,681 $1004421 5620,259
~ Total 812 58,202,500 56,733,776 57,468,724 9.01% 7.71% 15.38X
8 Individual 64 $579 5579 50 5444,357 5444,357 $0
r Ind/Child 12 $873 5732 $142 5125,768 $105,392 $20,377
Heakh Ind/Children 10 .5873 5732 $142 5104,807 587,826 $16,980
Savings. IndlSpouse 12 51,106 5853 $253 5158,319 $122,838 $36,481
~ Account Family 19 $1,530 51,073 $456 $348,742 $244,667 5104,075
Total 117 $1,182,993 31,005,080 5177,813 8.17% 8.86% -7.24X
O lion 4 Totals 59,385,493 57,738,855 51,646,638 8.64% 7.87X 12.40%
Option 3 includes an annual County contribution to an HSA of $1,235 and Option 4 includes an annual County contribution to an HSA of $1,237.
Cigna Original Proposal
Current Plans Cigna Option i :Current Plans Cigna ption 2: Akernate Plans
NCACC - PPO NCACC -HMO PPO HMO PPO HSA
ZOll 2011 2012 2012 2012 2012
In-Network In-Network In-Network In-Network In-Network Io-Network
Primary Care
Physldan
Visits $15 $15 $15 $15 520 80%after0ed.
Specialist
Physician
visits $30 $30 $30 $30 $40 ' 80%after Ded.
Preventive
Gre 100% 100% 100% 100% 100% 100%
Deductible 5250 $250 $250 $250 $750 $1,500
Deductible-
amity Max $750 $750 $750 $750 $2,250 $3,000
Coinsurance
Umh $1,000 $0 $1,000 $D $1,000 ~ $2,000
Coinsunnee
Family Max $3,000 $0 $3,000 SD $3,000 $2,000
In-patient
Hospital 90%after 9096 after 80%after
Services Ded. 100%afterDed. Ded. 100%akerDed. Ded. 80%afterDed.
Out-patent
Hospital 90%aher 9096 after 80%after
Services Oed. 300%afterDed. Ded. 100%afterDed. Ded. 80%afterDed.
Emergency
Room 5150 $150 $150 5750 $200' 80%afterDed.
Pharmacy $0/$15/$30 $0/$15/$30 $0/$15/$30 $0/$35/$30 $0/530/545 80%afterDed.
Lifetime
Maximum Unlimted Unlimited Unlimited Unlimted Uniimhed Unlimited
Rates Subs Monthly Premium Subs Monthly Premium Monthly Premium Monthly Premium Monthly Premium Monthly Premium
Employee
Only 64 $509.02 532,577.28 457 5531.44 5242,868.08 $622.82 $39,860.48 $647.89 $296,085.73 $572.24 $261,513.68 $436.06 $27,907.84
Employee &
Spouse 12 $1,074.02 $12,888.24 SS $1,121.32 $95,312.20 $1,307.84 $15,694.08 $1,360.49 $115,641.65 $1,201.63 $102,138.55 $915.64 $10,987.68
Employee &
Child 12 $712.62 $8,551.44 115 $743.98 $85,557.70 $1,183.46 $14,201.52 $1;231.08 $141,574.20 $915.91 $105,329.65 $698.02 $8,376.24
Employee &
Children 10 $982.42 $9,82420 77 51,025.66 $78,975.82 $1,183.45 $11,834.50 $1,231.08 $94,793.16 $1,287.37 599,127.49 $980.96 $9,809.60
Employee &
Family 19 $1,527.08 529,01452 76 $1,594.28 5124,353.84 $1,868.61 535,50359 $1,943.81 $151,617.18 51,716.87 $133,915.86 $1,308.32 524,858.08
Monthly Cost 117 $92,855.68 812 $627,067.64 $117,094.17 $799,711.92 $702,025.23 $81,939.44
HSA ConMbution
$750 $87,750.00
Mnwl $1,114,268.16 $7,524,811.68 $1,405,130.04 $9596,543.04 $8,424,302.76 $1,071,023.28
Total $8,639,079.64 $11,001,673.08 $9,495,326.04
Increase over
current 12735% Flrm 10953%
UnitedHealthcare Original Proposal
Current Plans UnitedHealthcare O tion 1: Curcent Plans Uni tedHealthcare 0 on 2: Akernate Plans
NCACC-PPO NCACC-HMO POS: HMO POS HSA
20ll 2011 2012 2012 2012
2012
Irr-Network ImNetwork In-Network ImNetwork ImNetwork In-Network
Primary Gre
Physidan
visits $15 $15 $15 $15 520 80%afterDed.
Specialist
Physician
Ysns $30 $3D $30 $30 540 90%aher Ded.
Preventive
Gre 100% 100% 100% 100% 100% 100%
Deductible $250 $250 $250 $750 5750 $1,500
Deductible -
Famlly Max $750 $750 $750 $750 $2,250 53,000
Coinsurance
Umft $1,000 $0 $1,000 $0 $1,000 52,000
Coinsurance
Umit -Family
Max $3,000 $0 $3,000 $0 $3,000 $2,000
In-patient
Hosprol
Services 90%after Ded. 100%after Ded. 90%after Ded. 100%after Ded. 8096 after Ded. 80%after Ded.
out-patient
Hospital
Services 90%after Ded. 100%after Ded. 90%after Ded. 100% after Ded. 80%after Ded. 8096 after Ded.
Emergenry
Room $150 5150 $150 $150 ~ $200 ~ 80%ah:erDed.
Ded/$10/530/550 up
Pharmary $o/SLS/53D SO/535/530 59/525/$45 59/$25/545 57/530/550 to OOP
Ufetime
Maximum Unlimited Unlimited Unlimted Unlimted Unlimted Unlimted
Rata Subs Monthly Prcmlum Subs Monthly Premium Monthty Premium Monthly Premium Monthly Premium Monthly Premium
Employee
Only 64 $509.02 $32,577.28 457 $531.44 $242,868.08 $628.94 $40,252.16 $621.38 $283,970.66 $560.63 $256,207.91 $457.68 $29,29152
Employee &
Spouse 12 $1A74.02 $12,888.24 85 51,121.32 $95,312.20 $1,327.06 $15,924.72 $1,311.11 $111,444.35 $1,182.92 $100,548.20 $965.71 $11,58852
EmpMyee &
Child 12 $712.62 $8,551.44 115 $743.98 $85,557.70 $1,018.88 $12,22656 $1,006.64 $115,763.60 $906.22 $104,445.30 $74L45 $8,897.40
Employee &
Children 10 $982.42 $9,824.20 77 $1,025.66 $78,975.92 $1,016.88 $10,168.80 $1,006.64 $77,511.28 $908.22 $69,932.94 $741.45 $7,41450
Employee &
Famiy 19 $1,527.08 $29,01452 78 $1,594.28 $124,353.84 $1,886.81 535,849.39 $1,864.14 $145,402.92 $1,681.88 $131,186.64 $1,373.05 $26,087.95
Monthty Cost 117 $92,855.68 612 $627,067.64 5114,441.63 $734,092.81 $662,320.99 $$3,279.89
HSA ContrWutfon
5750 $67,750.00
Mnual $1,114,268.16. $7524,911.68 $1,373,29956 $8,809,113.72 $7,947,851.86 $1,087,108.68
Total $8,639,079.64 $10,182,413.28 59,034,96056
Increase over
86%
117
-Firm
104.58%
current .
J
BCBS Original Proposal: Experience Through September Required
Current Plans B[BS Option 1: Single PPO Option Only BCBS Option 2: Alternate Plans
NCACC-PPO NCACC-HMO .PP0:3557039 PPO:3536197 HSA:167066
2011 2011 2012 2012 2012
In-Network In-Network In-Network In-Network In-Network
Primary Care
Physcian
visits $15 $15 $15 520 80%sfter0ed.
Specialist
Physician _
Ysits 530 S30 $30 540 80%afterDed.
Preventive
Carc 100% 100% 100% 100% 100%
Dedudibk $250 $250 $250 $750 51,500
Oeductlble -
Family
Mazlmum $750 5750 $750 $2,250 $3,000
Coinsurance
Umit $1,000 - $0 $1,000 $1,000 $2,000
Coinsurance
Limit -Family
Max $3,000 $0 $3,000 $3,000 $2,000
In-patient
Hospital
Services 9096 afterDed. 100%afterDed. 90%afterDed. 80%afterDad. 80%afterDe'd.
Out-patient
Hospital
Services 90%afterDed. 100%afterDed. 90%afterDed. 80%afterDed. 80%afterDed.
Emergency
Room $150 $150 $150 $200 80%afterDed.
Pharmacy 50/8'15/830 SO/$15/$30 $4/$30/$45/25% $4/535/550/25% 8096after Ded.
Ufetime
Mazlmum Unlimited Unlimited Unlimited Unlimted Unlimited
Rata Subs Monthly Pranlum Subs. Monthly Prcmlum Total Subs Monthly Premium Monthly Premium Monthly Premium
Employee
Onh/ 64 $SD9.02 $32,577.28 457 $531.44 $242,868.08 521 $701.49 $365,476.29 $636.11 $290,702.27 5474.23 $30,350.72
Employee &
spouse 12 51,074.02 $12,888.24 85 $1,121.32 $95,33L20 97 $1,461.45 $141,760.65 $1,325.45 $112,663.25 $940.23 $11,282.76
Employee &
Child 12 $712.62 $8551.44 115 $743.98 $85,557.70 127 $959.94 $121,912.38 $87052 $100,109.80 $573.55 $6,882.60
Employee &
Chiidrcn 30 $962.42 $9,824.20 77 $1,025.66 $78,975.82 87 $1,310.28 $113,994.36 $1,188.32 $91,500.64 $736.92 $7,369.20
Employee &
Family 19 $1,527.06 $29,01452 78 51$9418 $124,353.84 97 $2,096.88 5203,397.36 $1,901.78 $148,338.84 $1,363.98 $25,915.62
Monthly Cost 117 $92,855.68 812 $627,067.64 929 $946,54L04 $743,314.80 $81,800.90
HSAContribution
$750 $87,750.00
Annual $1,114,268.16 $7,524,811.68 $11,358,492.48 $8,919,777.60 $1,069,360.80
Total $8,639,079.84 $11,358,492.48 $9,989,138.40
haease over
arrcnc 13196 Not Firm 115.63%
CQ
Comparison of Plan Designs
Current Plans Option 1 Option 2 Option 3 Option 4
NCACC - PPO NCACC -HMO POS HMO HMO HSA POS HSA POS HSA
ZOll 2011 2012 2012 2012 2012 2012 2012 2012 2012
In-Network In-Network In-Network In-Network In-Network In-Network In-Network In-Network In-Network In-Network
Primary Care Physician
$15
$15
$15
$15
$15
80%afterDed.
$20
80%after Ded.
$20
80%after Ded.
Visits
Specialist Physician
$30
$30
$30
$30
$30
80%afterDed.
$40
80%afterDed.
$40
80%afterDed.
Visits
Preventive Care 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Deductible $250 $250 $25D $250 $250 $1,500 $750 $1,500 $500 $1,500
Deductible -Family $750 $750 $750 $750 $750 $3,000 $2,250 $3,000 $1,500 $3,000
Maximum
Coinsurance Limit $1,000 $D $1,000 $0 $0 $2,000 $1,000 $2,000 $1,000 $2,000
Coinsurance Limit- $3,000 $0 $3,000 $0 $0 $2,000 $3,000 $2,000 $3,000 $2,000
Family Max
In-patient Hospital g0%after Ded. 100% after Ded. 90%after Ded. 100% after Ded. 100% after Ded. 80%after Ded. 80%after Ded. 80%after Ded. 80%after Ded. 80% after Ded.
Services
Out-patient Hospital g0%after Ded. 100% after Ded. 90%after Ded. 100% after Ded. 100% after Ded. 80%after Ded. 80%after Ded. 80%after Ded. 80%after Ded. 80%after Ded.
Services
Emergency Room $150 $150 $150 $150 $150 80%after Ded. $200 80%after Ded. $150 80% after Ded.
Pharmacy $0/$15/$30 $0/$15/$30 $8/$25/$45 $8/$25/$45 $g~$25~$g5 Ded./$10/$30/$50 $7/$30/$50 Ded./$10/$30/$5 $8/$25/$45 80%after Ded.
up to OOP up to OOP
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited
Monthly Rates
Employee Only $509.02 $531.44 $628.94 $621.38 $621.38 $621.38 $560.63 $560.63 $578.59 $578.59
Employee and Spouse $1,074.02 $1,121.32 $1,327.06 $1,311.11 $1,311.11 $1,129.41 $1,182.92 $1,068.66 $1,220.83 $1,106.38
Employee and Child $712.62 $743.98 $1,018.88 $1,006.64 $1,006.64 $905.15 $908.22 $844.40 $937.32 $873.39
Employee and Children $982.42 $1,025.66 $1,018.88 $1,006.64 $1,006.64 $905.15 $908.22 $844.40 $937.32 $873.39
Employee and Family $1,527.08 $1,594.28 $1,886.81 $1,864.14 $1,864.14 $1,536.75 $1,681.88 $1,476.00 $1,735.77 $1,529.57
County HSA
Contribution
$1,964.40
$1,235.40
$1,237.20
Total Annual Cost $8,639,079.84 $10,182,413.28 $10,038,307.20 $9,091,822.56 $9,385,492.92
Increase over current 117.86% 116.20% 105.24% 108.64%
..~
Co-insurance for Out of Network benefits is 60% (paid by UnitedHealthcare).
Attachment 4
~n
UniitedHealthcare Information
Personal contacts with the following jurisdictions resulted in favorable reviews from
current customers of UnitedHealthcare:
1. Guilford County (Carol Campbell, Benefits Manager)
Guildford County has been self-insured with UHC since 1995 and has found them to
be very professional and accommodating. Claims accuracy is excellent and bills are
generally paid very quickly, and all their concerns are addressed immediately. Big
issues with customer service are rare and are fixed quickly with a call to the account
manager. Ms. Campbell stated, "They are a very professional organization, and
they are very shrewd business people."
2. Columbus County (Virginia Taylor, HR Director)
530 Full-time employees, 25 retirees on the health insurance plan
Columbus County was with UnitedHealthcare (UHC) for three years until the price
went up (due to high claims) in 2009. They joined the NCACC, .but returned to UHC
in July 2011. Ms. Taylor was very happy to return to UHC and stated that the
employees were also happy to return to UHC. Payments are on time and the
network is large. UHC has worked with providers who were not in-network to
encourage their participation and has been successful in most cases.
Their plan designs changed this year to include a deductible of $1,500 individual in-
network and $3,000 family in-network; Office visit co-pays increased to $30/primary
care and $60/specialist, and the Emergency Room co-pay increased from $150 to
$300.
3. Town of Carrboro (Desiree White, HR Director)
Carrboro was with UHC for three years until the rates increased. They were
satisfied with them'and would have continued if the rates had not increased. Ms.
White stated that three years is a typical stay with a health insurer.
4. Diane Shepherd, Benefits Manager, was able to personally ask UnitedHealth
Group's senior vice president Lewis Sandy, about Commissioner Jacobs' concerns
at a conference on September 2. He acknowledged that there were issues with
provider payment several years ago but that UHC worked closely with the provider
community to upgrade their systems. Dr. Sandy was pleased to relay that the 2011
AMA Health Report Card acknowledged UHC as the only insurer to make significant
improvement in claims processing (referenced in the August 30, 2011 work session
abstract and below).
Attachment 4
5. Please note the following websites which .include 2011 information about
UnitedHealthcare's services.
Based on tens of thousands of telephonic surveys, physicians and their ofifice
staff report a 90% satisfaction rate with UnitedHealthcare (as of Q1 2011).
UnitedHealthcare works with more than 650,000 physicians and health care
professionals and more than 5,000 hospitals nationwide.
According to the American Medical Association, UnitedHealthcare received the
highest marks of any national carrier on several important measures of claim
payment accuracy in the AMA's annual Health Insurer Report Card (6/21/11)
The full report is posted at http://www.ama-assn.orq/ama/pub/physician-
resources/solutions-managinc~Your-practice/coding-billing-insurance/heal-claims-
process/national-health-insurer-report-card.page
A press release from UHC summarizes the report here:
http~!/www unitedhealthgroup com/newsroom/news.aspx?id=22019074-533d-
4930-9408-8a796285cf5b
According to Fortune Magazine, UnitedHealth Group is the Most Admired
Company in the health care industry in 2011 (3/11/11), moving up from #2 in
2011. It scored #1 in criteria that includes innovation, social responsibility,
financial soundness and people management, with a #2 score only in global
competitiveness. The full report is located here:
http~//money cnn com/magazines/fortune/mostadmired/2011/industries/23.html
According to J.D. Power and Associates, UnitedHealthcare ranks highest in
employer satisfaction among self-insured commercial health plans (6/23/11)
http~l/www unitedhealthgroup com/newsroom/news.aspx?id=9ba11836-4664-
4b5b-88e3-b38af6d84985 -
A link to the J.D. Power and Associates report for the Southeast is here:
http~//www Idpower comlhealthcare/ratings/member-health-plan-ratings/south-
atlantic-(qa,-nc,-sc)/
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Attachment 6 Revised page A-11 (August 30, 2011 work session agenda)
13
SUPPLEMENTAL RETIREMENT CONTRIBUTIONS
A recent employee survey asked for input relating to the relative value of the 401(k) in light of
rising health care costs. When asked what the County should do with the $715 contribution to a
supplemental retirement plan, responses were divided nearly evenly among the choices. One-
third wanted the $715 contribution to continue towards a supplemental retirement benefit;
another one-third wanted it to go towards health insurance, and the remaining one-third wanted
the health insurance plan to be developed without loss of the $715.
When given a choice between (a) continuing to receive the $715 supplemental retirement
benefit and (b) using the $715 to defray their own employee health care premiums, employees
would choose to continue receiving the $715 towards their supplemental retirement benefit, as
shown below.
The percentages for "Employees with Dependents" in the chart below have been revised to
correct a typo.
As of 8/20/20'12 Number of Continue receiving $715 Use the $715
Respondents as Supplemental towards health
Retirement Benefit remiums
All Em to ees 372 59% 41
*Sworn Law
Enforcement Officers 21 76% 24%
General Em to ees 351 58% 42%
All Employees without
De endents 178 65% 35%
Employees with
De endents 182 53% 47%
*Sworn iaw enforcement officers would not be able to reduce the state-mandated County
contribution to 401(k).
Attachment 6
Revised page A-14 (August 30, 2011 work session agenda}
~~'
Responses for "AII Employees" have been revised below to correct a duplication in the original
charts.
August 2011 Benefits Survey Responses
3.Orange County contributes $27.50 per pay period to a supplemental retirement account for each permanent
general employee, and pays the full premium for each permanent employee's health insurance. H health care
costs continue to increase, which action would you prefer the County take?
Answer Qptions All Employees LEO General Dependents No.
Dependents
A. Continue the County's contribution to
a supplemental retirement account for 32.5% 23.8% 33.0% 18.1% 46.6%
all ermanent em to ees.
B. Discontinue the County's contribution
to a supplemental retirement account
for all permanent general (non-sworn 33.3% 33.3% 33.3% 37.9% 29.2%
law enforcement) employees and put
the move towards health insurance.
C. Reduce health care benefits. 1.6% 0.0% 1.7% 1.1% 2.2°l0
D. Offer a choice of plans that may
reduce total premiums for the County 32 5% 42.9% 31.9% 42.9% 21.9%
and employees with dependent
covera e.
Answered Question 372 21 351 182 178
4. As an alternative to the current health insurance plans, Orange County could offer two different plans: One
plan with reduced benefits that would not require an employee premium for employee coverage and a second
plan with greater benefits, a monthly premium for employee coverage and a higher premium for dependent
coverage (a "buy-up" plan). If you had the following choices involving health insurance and the supplemental
retirement contribution, which would you select?
Answer Options All Employees LEO General Dependents No
Dependents
A. Continue receiving the County's
annual contribution for supplemental 26.6% 33.0% 26.2% 27.5% 25.8%
retirement and choose the LOWER
cost health lan.
B. Continue receiving the County's
.annual contribution for supplemental
retirement and pay the employee 32.3% 42.9°!0 31.6°!0 25.8°l0 38.8°>°
portion of the "buy up" health insurance
remium.
C. Use the $715 per year to reduce the
employee portion of the "buy-up"
premium in place of the County
°
contribution to a supplemental 41.1 % 23.8% 42.2% 46.7% 35.4
k
retirement account. (This option is not
avai{able for sworn law enforcement
officers.
Answered Question 372 21 351 182 178