HomeMy WebLinkAboutAgenda - 09-05-2013 - 7a1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: September 5, 2013
Action Agenda
Item No. 7 -a
SUBJECT: Employee Benefits Updates and Preliminary Recommendations Regarding
Calendar Year Benefits for 2014
DEPARTMENT: Human Resources
ATTACHMENT(S):
1. Benefits Report
2. 2014 Renewal Option Costs Detail for
Active Employees and Pre -65 Retirees
3. Health Insurance History
4. Benefits Survey Responses by
Jurisdiction
5. Benefits Presentation
PUBLIC HEARING: (Y /N) No
INFORMATION CONTACT:
Nicole Clark, Human Resources
Director, 245 -2552
Diane Shepherd, Benefits Manager, 245-
2558
PURPOSE: To receive information and provide feedback to staff on employee pay and benefits
for calendar year 2014.
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.
Staff provided information regarding FY 2013 -14 employee benefits at the April 11, 2013 Board
work session and during the FY 2013 -14 budget process. The County conducted a Request for
Proposals (RFP) process for health insurance administration and requested responses for both
a fully insured and self- funded plan. Retiree health insurance was discussed at the June 19,
2013 regular meeting. The FY 2013 -14 Approved Budget includes funds for up to an 8.0%
($226,444) health insurance premium increase effective with the January 1, 2014 renewal. An
overview of current benefits and proposed changes to health benefits are discussed in
Attachment 1.
United Healthcare has provided options for the 2014 employee health insurance benefits,
including the renewal of the existing 2013 fully insured plan and a self- insured option.
Attachment 2 provides cost details of current and alternate plan designs. A recommendation to
consider and approve the self- insured option will be presented at the September 17, 2013 Board
of County Commissioners' Regular Meeting.
Additional information regarding Orange County benefits is found in Attachment 3. An overview
of County benefits compared to other jurisdictions is found in Attachment 4.
FINANCIAL IMPACT: Attachment 2 includes the estimated costs of the health insurance
options.
RECOMMENDATION(S): The Manager recommends that the Board:
1. Discuss employee insurance benefits for calendar year 2014; and
2. Provide direction to staff regarding consideration and approval of the options as
presented by staff and Mark III Employee Benefits at the September 17, 2013 Board of
County Commissioners' Regular Meeting.
Attachment 1
BENEFITS REPORT
K
The County benefits package helps attract and retain employees as evidenced by comments
from employees at orientations, exit interviews and surveys. Benefits are a key component of
total compensation, providing approximately 40% of a permanent employee's total
compensation package.
Open Enrollment dates are scheduled for October 14 — October 28, 2013 with an effective date
of January 1, 2014. Communications include presentations at the Employee Relations
Consortium and to departments; written and email correspondence sent to employees
describing the 2014 plan designs; and multiple enrollment meetings.
The following pages describe recent activities and considerations for 2013.
Topic
Page
Enrollment Highlights
A -2
Health Insurance
A -4
Wellness Activities 2012 -13
A -7
Supplemental Retirement Benefits
A -9
Flexible Compensation Plan and Health Savings
Accounts
A -10
Dental Insurance
A -12
Vision Benefits
A -13
Other Insurance Benefits
A -14
Employee Assistance Program (EAP)
A -15
Proposed Timeline of Renewal and Open
Enrollment Activities
A -16
A -1
Plan Year Enrollment Highlights and
UnitedHealthcare Activity
Open Enrollment Highlights as of January 1, 2013
Health Insurance Enrollments
Annual Optional Benefits New Enrollments
Benefit
2011
2012
2013
Traditional Plan
n/a
610
605
High Deductible Plan
n/a
187
197
Total Health Plan Participation
n/a
797
802
Health Savings Account
(employee contribution)
n/a
81
89
Waived Health Insurance
20
22
21
Annual Optional Benefits New Enrollments
Benefit
2012
2013
Medical Flexible Spending Account
165
132
Dependent Care Spending Account
11
16
Community Eye Care
369
42
Accident Insurance
114
36
Critical Illness
79
23
Disability
97
18
Whole Life
55
18
owl
Annual Employee Flu Shot Clinic Participants
2010
2011
2012
204
169
225
UnitedHealthcare Activities and Programs
Date(s)
Event
12/13/12
Town Hall Meeting
1/24/13
Health and Wellness Website Demonstration
2/12 - 2/14/13
Know Your Numbers Biometric Screenings
3/28/13
Health Care Cost Estimator
4/25/13
Demystifying Your Pharmacy Benefits
5/23/13
Fitting Fitness Into a Busy Day & Sportsplex Tour
6/27/13
Sun Protection and Skin Damage
9/26/13
Avoiding Burnout Presentation
Health Assessment Participants
2012 2013
334 457
A -3
HEALTH INSURANCE
Currently the County offers two fully insured health insurance plans contracted through
United Healthcare. Over 75% of employees participate in the Point of Service (POS) Choice
Plus plan, which is frequently referred to as a traditional plan. The second plan is a High
Deductible Health Plan paired with a Health Savings Account. Both plans allow services in and
out of network. A history of employees enrolled in each plan, rate changes and plan changes to
the health insurance are on the following pages.
Both health insurance plans provide coverage for health care services but have the most value
in the event of catastrophic illness or injury. Changing health insurance companies and plan
designs provided the County an opportunity to encourage healthy behaviors that can lead to
lower long -term health insurance costs. United Healthcare incentive programs to improve
employee health are discussed in the Wellness Section below.
The 2013 plan options available are a) Point of Service Plan (POS), referred to as a traditional
plan because of its co -pays, deductible and co- insurance, and b) a High Deductible Plan (HDP)
which is paired with a Health Savings Account (HSA). Health Savings Accounts provide a way
to pay for medical expenses during the plan year, and in the future with portable, tax -
advantaged funds. The premium for the POS is more expensive than the HDP. When Orange
County implemented the High Deductible Plan in 2012, the County contributed the full difference
between premiums to a Health Savings Account for employees electing the lower -cost HDP. In
2013, the County maintained the 2012 contribution of $1,237.20 ($103.10 /month) to the HSA.
The charts below provide additional information regarding the two plans. Each plan offers
advantages and disadvantages to employees, depending on the individual or family health care
needs.
Comparison of 2013 Orange County Health Plans
MM
Traditional Plan: Point
High Deductible Plan/
of Service Plan
Health Savings Account
Choice Plus POS
Definity HSA
100% covered
Yes
Yes
preventive care
Co -Pays for Office
Visits and
Yes, $20 primary care
No; 100% co- insurance
Prescriptions
and $40 specialist
until the deductible is met
Deductible
$500 /individual, $1,500/
family, exclusive of
$1,500 /individual,
prescriptions and office
$3,000 /family
visit co -pays
County contribution to
Yes, in 2013 $17237.20
deductible and co-
None
contributed to Health
insurance
Savings Account
Co- Insurance (after
$1,000 individual,
Yes, $2,000 for individual
the deductible is met)
$3,000 family, exclusive
and family
of prescriptions and
MM
7
The plan funding provides the same County contribution regardless of the plan an employee
selects, within each option. In 2012, the County contributed $1,237.20 to a health savings
account on behalf of each employee who enrolled in the High Deductible Plan. This was a
significant factor in the success of the High Deductible Plan, with over 20% of employees
enrolling during the first year and a 6% increase in enrollment from 2012 to 2013.
Dependent Coverage
The County currently pays the cost of coverage for employees and retirees for both the HDP
and POS plans. The County also subsidizes the premium cost for the employee's and pre -65
retiree's dependent coverage at 52 %, based on the lower priced plan (currently the HDP plan).
Continuation of the subsidy at this level maintains a "family friendly" feature of employment with
Orange County.
Employee cost for dependent coverage is directly tied to the total cost of the lower- priced
HDP /HSA. The more the County contributes for the individual HDP /HSA, the lower the
employee cost for dependent coverage. Employees with dependents who elect the POS have
significantly higher premiums, but may have lower out of pocket costs for health care services.
2014 Options
The Fiscal Year 2013 -14 budget approved up to an 8% increase in health care premiums (six
months of benefits). A competitive bid process was conducted for the 2014 plan year and
included requests for pricing for fully insured and self- funded plans. Four insurance carriers
provided responses, but only United Healthcare provided a firm response for both fully- insured
and self- insured options. The renewal information presented by Mark III is based on 17 months
of claims, from January 2012 to May 2013.
The United Healthcare quote for renewal of the current Point of Service (POS) and High
Deductible Plan with Health Savings Account (HDP) was approximately 106.4% of current
premiums. The self- insured option with our current plan design would cost the same as 2013.
A -5
office visit co -pays
Traditional Plan: Point
High Deductible Plan/
of Service Plan
Health Savings Account
Choice Plus POS
Definity HSA
Maximum Out of
$1,500 individual
$3,500 individual
Pocket
$4,500 family
$4,500 family
Out of network
Yes
Yes
providers available
Flexible Spending
Medical FSA ($2,500
Child /dependent care FSA
Account
maximum) and
($5,000 maximum)
child /dependent care
FSA ($5,000 maximum)
Health Savings
Not available
$3,250 maximum /individual
Account
1
$6,250 maximum /family
The plan funding provides the same County contribution regardless of the plan an employee
selects, within each option. In 2012, the County contributed $1,237.20 to a health savings
account on behalf of each employee who enrolled in the High Deductible Plan. This was a
significant factor in the success of the High Deductible Plan, with over 20% of employees
enrolling during the first year and a 6% increase in enrollment from 2012 to 2013.
Dependent Coverage
The County currently pays the cost of coverage for employees and retirees for both the HDP
and POS plans. The County also subsidizes the premium cost for the employee's and pre -65
retiree's dependent coverage at 52 %, based on the lower priced plan (currently the HDP plan).
Continuation of the subsidy at this level maintains a "family friendly" feature of employment with
Orange County.
Employee cost for dependent coverage is directly tied to the total cost of the lower- priced
HDP /HSA. The more the County contributes for the individual HDP /HSA, the lower the
employee cost for dependent coverage. Employees with dependents who elect the POS have
significantly higher premiums, but may have lower out of pocket costs for health care services.
2014 Options
The Fiscal Year 2013 -14 budget approved up to an 8% increase in health care premiums (six
months of benefits). A competitive bid process was conducted for the 2014 plan year and
included requests for pricing for fully insured and self- funded plans. Four insurance carriers
provided responses, but only United Healthcare provided a firm response for both fully- insured
and self- insured options. The renewal information presented by Mark III is based on 17 months
of claims, from January 2012 to May 2013.
The United Healthcare quote for renewal of the current Point of Service (POS) and High
Deductible Plan with Health Savings Account (HDP) was approximately 106.4% of current
premiums. The self- insured option with our current plan design would cost the same as 2013.
A -5
Employees will see no change in coverage and /or network providers as a result of this bid. The
self- insured option allows the County to increase its contribution to the Health Savings Account,
resulting in lower employee dependent cost. An increase to the HSA would also reduce the
discrepancy between the cost of the individual plans.
Comparison of POS and HSA/HDP Individual Costs
Staff presents options for health insurance with United Healthcare on the following pages. As a
rule, whenever premiums increase, employees and retirees with dependent coverage face
increased costs because they contribute to the cost of dependent care.
Option 1, the renewal of the current two plans, a Point of Service Plan (POS) and a Health
Savings Account/High Deductible Health Plan, is lower than the FY 2013 -14 health insurance
budget. The renewal is a fully- insured plan, with the County continuing to pay premiums for
each member. Health care reform now requires the inclusion of POS co -pays towards
deductibles and co- insurance limits.
Option 2 is a self- insured plan. The County will pay claims costs, administrative fees, and re-
insurance fees. Overall, the costs associated with health care reform with self- insured plans are
lower than fully- insured plans. This option also includes increased County contribution to the
Health Savings Account for those who elect the High Deductible Plan.
Self- Funding
As a fully- insured plan, the County would continue to pay a premium for health insurance, and
would bear no additional risk. If claims exceed the amount of premiums paid, United Healthcare
pays the cost of those claims. If the County is self- insured, the County pays all claims as well
as additional stop -loss insurance.
Self- funding allows greater flexibility in addressing the specific health care needs of Orange
County employees and retirees. An insurance carrier providing fully insured coverage is limited
by standardized plans approved by the North Carolina Department of Insurance.
The total cost for administrative fees, re- insurance (stop loss coverage) and fees associated
with health care reform would be the same as 2013 premiums. Wellness programs would
become an important element of cost containment with savings being transferred to the County
and employees.
MW
Annual HDP
Annual Health
Annual POS Premium
Premium
Savings Account
Difference
Contribution
$7,574.16
$6,121.80
$1,237.20
$215.16
$7,574.16
$6,121.80
$1,416.00
$36.36
Staff presents options for health insurance with United Healthcare on the following pages. As a
rule, whenever premiums increase, employees and retirees with dependent coverage face
increased costs because they contribute to the cost of dependent care.
Option 1, the renewal of the current two plans, a Point of Service Plan (POS) and a Health
Savings Account/High Deductible Health Plan, is lower than the FY 2013 -14 health insurance
budget. The renewal is a fully- insured plan, with the County continuing to pay premiums for
each member. Health care reform now requires the inclusion of POS co -pays towards
deductibles and co- insurance limits.
Option 2 is a self- insured plan. The County will pay claims costs, administrative fees, and re-
insurance fees. Overall, the costs associated with health care reform with self- insured plans are
lower than fully- insured plans. This option also includes increased County contribution to the
Health Savings Account for those who elect the High Deductible Plan.
Self- Funding
As a fully- insured plan, the County would continue to pay a premium for health insurance, and
would bear no additional risk. If claims exceed the amount of premiums paid, United Healthcare
pays the cost of those claims. If the County is self- insured, the County pays all claims as well
as additional stop -loss insurance.
Self- funding allows greater flexibility in addressing the specific health care needs of Orange
County employees and retirees. An insurance carrier providing fully insured coverage is limited
by standardized plans approved by the North Carolina Department of Insurance.
The total cost for administrative fees, re- insurance (stop loss coverage) and fees associated
with health care reform would be the same as 2013 premiums. Wellness programs would
become an important element of cost containment with savings being transferred to the County
and employees.
MW
9
WELLNESS ACTIVITIES 2012 -2013
Research has shown that every dollar spent on wellness activities generates at least $3 in
return. Fewer sick days, increased productivity, and greater ability to deal with stress are all
common results of wellness programs. A healthier workforce results in greater productivity and
employee satisfaction as well as lower health insurance costs.
Investing in preventive screenings for high blood pressure and cholesterol can reduce health
care costs. Employees have shown their willingness to engage in healthy, or healthier, activities
to keep health insurance benefits at current levels and minimize both their costs and County
costs. United Healthcare funds onsite biometric screenings, employee newsletters, payroll
stuffers and promotional posters. The United Healthcare SimplyEngaged® programs offer
employees incentives in the form of gift cards for completing an online health assessment, and
for participating in both online and telephone health counseling.
Highly discounted membership rates for the Orange County SportsPlex continue to be a popular
wellness benefit for employees. Currently 212 employees are members, a 2% increase over
2012's membership of 208.
Below is a list of wellness activities and programs between October 2012 and August 2013.
1. Flu Clinics
The Human Resources Department again partnered with the Health Department to
provide two flu clinics in 2012. The immunizations are no cost to employees as part of
their preventive health benefit. 225 employees were immunized at the 2012 Flu Clinics,
a 41 % increase over 2011. Flu Clinics will be held in October 2013, one in Chapel Hill
and one in Hillsborough.
2. Biometrics Screenings, Health Assessment and Health Coaching
United Healthcare sponsored biometric screenings in February 2013, and 224
employees learned their numbers related to blood pressure, blood glucose, and
cholesterol. 457 employees, retirees and their spouses /domestic partners completed
the online health assessment between January 1 and July 31, 2013. Access to the
health assessment will continue whether fully- funded or self- insured.
After completing the health assessment, employees were able to enroll in one or more
online health coaching programs related to exercise, stress, weight loss, tobacco
cessation and others.
3. SportsPlex Membership
Employees are reminded annually about the Orange County SportsPlex discount, and
periodic postings are placed on the employee intranet home page. New employees are
informed about the discount at employee orientation, and the SportsPlex rates and
schedules are on the County's Wellness Web page. Representatives attend the
Employee Wellness Lunch (below), assist with National Nutrition Month activities and
provide occasional onsite classes.
A -7
10
4. Employee Appreciation and Wellness Lunch — May 2013
Over 270 employees attended and approximately 190 participated in activities such as
yoga, bean bag toss, bocce ball, disc golf, recipe sharing and others. Orange County
SportsPlex representatives taught a Zumba and stretch band mini -class and
United Healthcare representatives, Emergency Services, smoking cessation coaches
and other health related activities were available. 775 lunches were served to
employees eating in and dining out.
5. In Tune Stress Management Challenge
Over 90 employees participated in a stress management challenge in June /July 2013.
6. National Nutrition Month Activities and Challenges
The Health Department took the lead in arranging exercise classes and a health
challenge during March 2013.
7. Nutritional Counseling
The County Health Department continues to publicize its nutritional counseling and
diabetes self- management program to employees. Employees can use funds from
either their Health Savings Account or Medical Spending Account for these services.
8. Cubicle Crunch "Flash Mob" and Friday Dance Day
Employees throughout the County completed a stretch or dance routine on a designated
Friday morning in June and July.
9. Smoking Cessation Opportunities
As part of the Smoke Free Orange County regulations implemented in January 2013,
the Health Department arranged a number of smoking cessation opportunities.
10. Mini - Grants
As part of FY 2013 -14 budget, mini - grants were available to groups of employees
participating in healthy activities. Four grants have been submitted as of August 15, two
for County Co -Ed Rec softball teams, and one to provide lunches at employee smoking
cessation classes; and a third to encourage Department on Aging employees to become
more active.
ow
11
SUPPLEMENTAL RETIREMENT CONTRIBUTIONS
Orange County contributes $715 per year ($27.50 per pay period) to either a 401(k) or a 457(b)
Supplemental Retirement Account for each permanent employee. Employees can designate
one of three Plans: Prudential 401(k), ICMA -RC 457, or Nationwide 457 for the County's
contribution and may elect to make a payroll deduction up to legal limits. The $715 per
employee is approximately $543,000 over twelve months. The County does not pay any Social
Security /Medicare taxes on these contributions, for a payroll savings of $41,000 over twelve
months.
Effective July 1, 2013, the County matched employee contributions for up to an additional
$1,200 per year ($50 semi - monthly). This had a significant impact on employee contributions
because many employees recognized the value in doubling their investment. The chart below
shows employee contributions to all supplemental retirement plans from 2010 (when the
contribution was suspended) to present.
Because the County does not pay Social Security or Medicare tax on the majority of these
contributions, there is a savings of approximately $60,000 annually in payroll taxes. Employee
contributions to the Roth 401(k), totaling $105,000 annually, are taxed at the time of the payroll
deduction, and do not provide any tax savings to either the employee or the County.
ow
Monthly Employee
Contribution to All Plans
Annualized Employee
Contribution to All Plans
2010
$32,203
$386,436
2011
$37,638
$451,656
2012
$38,360
$460.320
2013
$73,678
$884,136
Because the County does not pay Social Security or Medicare tax on the majority of these
contributions, there is a savings of approximately $60,000 annually in payroll taxes. Employee
contributions to the Roth 401(k), totaling $105,000 annually, are taxed at the time of the payroll
deduction, and do not provide any tax savings to either the employee or the County.
ow
12
FLEXIBLE COMPENSATION PLAN AND HEALTH SAVINGS ACCOUNTS
The County provides a Section 125 Flexible Compensation Plan administered by Tucker
Administrators, with a plan year from January 1 to December 31. This Plan consists of a) tax
sheltering of health and dental premiums and b) two Flexible Spending Accounts (a medical
spending account and dependent/child care spending account).
The Spending Accounts enable employees to contribute money on a pre -tax basis to a separate
account to be used for certain medical expenses or dependent care. Employees and the
County save money because no income or Social Security taxes are deducted from
contributions made to the Flexible Spending Account(s). Employees may contribute a maximum
of $2,500 to the Medical Spending Account and up to $5,000 to the Dependent/Child Care
Spending Account in 2013 and these amounts remain unchanged for 2014.
When the High Deductible Plan /Health Savings Account began in 2012, the grace period
associated with the Flexible Spending Account (medical) was discontinued to create a greater
distinction between the two plans. This grace period allows employees to continue using funds
that have accrued during the Plan Year, for up to two and a half months after the Plan Year
ends.
As part of the High Deductible Plan, employees may contribute to a Health Savings Account at
either the Local Government Federal Credit Union or the State Employees' Credit Union. The
federal government limits the annual amount contributed on an employee's behalf. In 2014, the
maximum contributions are $3,300 (individual) or $6,550 (family). In both 2012 and 2013, the
County contributed $1,237.20 for each employee participating in the High Deductible Health
plan, which counted towards the maximum contributions above. By making this contribution, the
County was paying approximately the same annual cost per employee, regardless of the health
plan. Increasing the Health Savings Account contribution continues the philosophy of treating
employees as equitably as possible, regardless of health insurance plan selected.
Every $100 employees contribute to a Flexible Spending Account or Health Savings Account
saves the County $7.65 in Social Security taxes. In 2013, employees' expected contributions of
$290,000 to these accounts will result in approximately $22,000 tax savings for both the County
and employees.
A -10
13
Number of Employees Contributing to Accounts
Type of Account
2008
2009
2010
2011
2012
2013
Child Care
Spending
12
12
12
10
13
16
Account
Medical Spending
Account
95
138
178
214
170
132
Health Savings
Account
n/a
n/a
n/a
n/a
83
89
A -11
14
DENTAL INSURANCE
The County provides a self- insured dental plan through Delta Dental of North Carolina. The
County pays all costs for employee coverage (claims and an administrative fee to Delta Dental).
Dental claims are paid according Delta Dental's standard reimbursement rates. Previously, the
County paid claims according to a unique Orange County Table of Allowances that was often
confusing to employees and their providers. Beginning in 2009 until 2012, the County gradually
increased its reimbursement levels for services with the goal of matching the Delta Dental
maximum payable rates. This transition has reduced employees' out of pocket dental
expenses, minimized confusion and provided greater satisfaction with the dental coverage.
Employee Dental Insurance is budgeted as part of departmental personnel costs. The $24.30
charge includes a monthly administrative fee of $2.80 /month per employee and a projected
premium to cover claims. Employees pay the full cost of any dependent coverage.
At the end of FY 2012 -13, the dental plan's fund balance was approximately $128,000.
A -12
15
VISION BENEFITS
The County offers employees and eligible dependents two options for vision care. As a part of
their overall plan, United Healthcare members are eligible for one routine eye exam every other
year. Members in the traditional Choice Plus plan are subject to a $20 co -pay. Vision services
for those in the High Deductible plan are subject to the deductible and co- insurance.
In addition to the coverage provided by United Healthcare, employees may purchase a separate
vision plan through Community Eye Care. Employees who enroll pay a premium on a pre -tax
basis. The plan includes a routine eye exam for a $20 co -pay and an $150 allowance for
eyeglasses or lenses.
413 employees are currently enrolled in the Community Eye Care vision plan. There are no
changes anticipated for 2014.
A -13
16
OTHER INSURANCE BENEFITS
The County continues to provide term life insurance for all permanent employees at no cost to
the individual employee. MetLife has provided this coverage with no increase in price since
2007. The monthly rate of $.225 per $1,000 of coverage (up to $50,000) was renewed last year
for a three year term ending December 31, 2014. Employees may purchase group discounted
term life insurance for themselves, spouse /domestic partner and /or children.
Employees may elect additional income protection paid through payroll deductions. Employees
benefit from group purchasing if they wish to purchase whole life insurance, Accident Insurance,
Critical Illness (including cancer), and /or Short Term Disability. In 2011, the County changed its
provider from Colonial Insurance for all products to Mark III recommended providers.
Participants in each of the supplemental benefits is shown below.
Number of Supplemental Benefits Policies
Product
Current Carrier
2009
2010
2011
2012
2013
Short Term
AUL (American
62
91
136
199
214
Disability
United Life)
Critical
Continental
17
21
92
150
162
Illness /Cancer
American
Insurance
Life Insurance
Boston Mutual
4
2
53
95
101
(Whole Life)
Accident Insurance
Continental
9
16
45
142
181
American
Total Policies
110
141
326
586
658
A change to Short Term Disability in 2013 allowed employees enrolling for the first time to have
a benefit of $1,000 /month (increased from $500) of coverage without an extensive review
process.
There are no changes to these benefits effective January 1, 2014.
A -14
17
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Magellan Behavioral Health provides the County's EAP for County employees and their
dependents. The EAP provides confidential assessment and counseling services, 24/7
emergency services, and legal consultation. It also serves as a complement to services
provided through the County Health Plan at no cost to employees or their dependents.
The current contract ends December 31, 2013. The County has budgeted $15,500 for the
Employee Assistance Program in Fiscal Year 2013 -14.
As part of its health insurance plans, United Healthcare provides an employee assistance
program, Care 24 ® as part of the premium and the administrative fee if the County is self -
insured Services consist of three counseling sessions, legal and financial telephone
consultations, and six hours of employee training programs. Care 24 ® services are only
available to employees enrolled in the United Healthcare plans.
A -15
PROPOSED TIMELINE OF RENEWAL AND OPEN ENROLLMENT ACTIVITIES
Action
Date
Initial presentation of health insurance renewal
to Commissioners
September 5
Commissioners' decision regarding renewal of
health insurance
September 17
Employee Relations Consortium meeting
(discussion of renewal)
September 18
Mandatory mailing to all employees regarding
health exchanges to include details of Open
Enrollment
September 23
Open Enrollment
October 14 -28
Employee /Retiree Flu Clinics
October 18 and 25
Employee Financial Health Day
October 22
New 2014 benefits payroll deductions begin
December 6
A -16
19
Attachment 2
Monthly Costs of Current Plans and 2014 Renewal Options
2014
Renewal
(5.8
increase in
premiums)
Plan
ype o
Coverage
Total
Premium
County
Pays
Employee
Pays
2013 Plans
Point of Service
Individual
$ 631.18
$ 631.18
$ -
Ind /Children
$ 1,022.52
$ 777.72
$ 244.80
Ind /Spouse
1 $ 1,331.80
1 $ 907.71
1 $ 424.09
Family
$ 1,893.54
$ 1,143.81
$ 749.73
High Deductible
Plan /Health
Savings Acct.
$ 103.10
Individual
$ 613.25
$ 613.25
$ -
Ind /Children
$ 929.54
$ 777.72
$ 151.82
Ind /Spouse
$ 1,179.51
$ 907.71
$ 271.80
Family
$ 1,633.55
$ 1,143.81
$ 489.74
2014
Renewal
(5.8
increase in
premiums)
Point of Service
Individual
$ 677.99
$ 677.99
$ -
Ind /Children
$ 1,098.35
$ 777.92
$ 320.43
Ind /Spouse
$ 1,430.57
$ 907.94
$ 522.63
Family
$ 2,033.97
$ 1,144.11
$ 889.86
High Deductible
Plan /Health
Savings Acct.
$ 125.00
Individual
$ 635.30
$ 635.30
$ -
Ind /Children
$ 951.68
$ 799.82
$ 151.86
Ind /Spouse
$ 1,201.73
$ 929.84
$ 271.89
Family
$ 1,655.90
$ 1,166.01
$ 489.89
Option 1 Self
Insured (no
increase in
costs)
Point of Service
Individual
$ 631.18
$ 631.18
$ -
Ind /Children
$ 1,022.52
$ 777.72
$ 244.80
Ind /Spouse
$ 1,331.80
$ 907.71
$ 424.09
Family
$ 1,893.54
$ 1,143.81
$ 749.73
High Deductible
Plan /Health
Savings Acct.
$103.10
Individual
$613.25
$ 613.25
$ -
Ind /Children
$929.54
$ 777.72
$ 151.82
Ind /Spouse
$1,179.51
$ 907.71
$ 271.80
Family
$1,633.55
$ 1,143.81
$ 489.74
Option 2 Self
Insured
(increased
contribution
to Health
Savings
Account
Point of Service
Individual
$ 631.18
$ 631.18
$ -
Ind /Children
$ 1,022.52
$ 799.62
$ 222.90
Ind /Spouse
$ 1,331.80
$ 922.61
$ 409.19
Family
$ 1,893.54
$ 1,158.71
$ 734.83
High Deductible
Plan /Health
Savings Acct.
$118.00
Individual
$628.15
$ 628.15
$ -
Ind /Children
$944.44
792.62
$ 151.82
Ind /Spouse
$1,194.41
$ 922.61
$ 271.80
Family
$1,648.45
$ 1,158.71
$ 489.74
20
Summary of Health Insurance Participation and Plan Changes 2008 -2013 Attachment 3
As of August 2013
Plan Year
Plan Design Changes
% Increase in
Total Premium
Membership
# Covered
2013
Enhanced Point of Service plan by reducing
prescription co -pays and included lab work and
minor surgery in office visit co -pay
8.51%
budgeted
Active POS
617
Active HDP
195
Retiree POS
139
Retiree HDP
4
Post -65
170
Total
1,125
2012
New carrier: UnitedHealthcare, and
two new plans, High Deductible Plan /Health
Savings Account and Point of Service.
Increased costs including higher deductibles
and co- insurance /co- payments.
$2500 allowance for hearing aids, increased
therapy visits.
8.64%
Active POS
612
Active HDP
188
Retiree POS
125
Retiree HDP
7
Post -65
147
Total
1,079
2011
$1000 allowance for hearing aids
Mental health visits covered at 100%
Opened dependent status to all children up to
age 26
6.50%
Active HMO
693
Active PPO
112
Retiree HMO
127
Retiree PPO
15
Post -65
129
Total
1,076
2010
Provided $0 generics
Increased Physical Therapy visits by 50%
Added 100% covered visits to Convenience
Care Clinics
Removed student status criteria for children
over 19
2.50%
Active HMO
730
Active PPO
102
Retiree HMO
121
Retiree PPO
13
Post -65
109
Total
1,075
2009
Added Health Advisor program
Right- priced" premiums based on claims & co-
insurance so HMO became more costly plan
7.90%
Active HMO
743
Active PPO
80
Retiree HMO
94
Retiree PPO
11
Post -65
92
Total
1,020
2008
Increased Office Visit co -pays from $10/$20 to
$15/$30
Added Employee /Child tier
9.70%
Active HMO
752
Active PPO
46
Retiree HMO
75
Retiree PPO
13
Post -65
unavailable
Total
886
Summary of Benefits Provided by Other Jurisdictions Attachment 4
21
Orange County
Cxmboro
Gary
Hillsborough
Mebane
OWASA
Alamance County
Chatham County
Durham County
Durham City
Penton County
Guilford County
5% of premium (PPO)
100% of Core Level
Percent paid for
100% for both POS and
$0 HOP
Coverage IF employee
94% (Core Level
Employe Coverage
e
High Deductible Plan
100%
95%
HOP is only plan
100%
100%
100%
100%
gets Health Risk
Coverage)
100% POS Plan
93%
available to employees
Assessment - if not, Co.
hired after 7/1/12
pays 95% of Basic Level
Percent paid for
52% of amount after
50% towards dependent
50% of the cost towards
72% (Core Level
53% after individual
Family Coverage
individual premium is
coverage
50%
0%
0
50%
0%
t'i^ ^e
dependent coverage
Coverage)
premium is paid
0
$201$40 FOS) Co-
Core- $20/$40
20% in-network co-
$15/$25 (in-network);
Basic - $25/$50 Core -
Primary/Specialist Copay
insurance (HDP)
$10/$20
Basic – $25/$50
$20/$30 (PPO)
$15/$25
$10/$20
insurance
70% after deductible
$20/40 Premium-
$20/$40
$20/$40
$20/$35
(Out -of- network)
$15/$30
Urgent Care $20 (Core),
Urgent Care Copay
Urgent Care/ER Copay
$30/$150
$20/$150
$25 (Basic) ER $150
$100
$15/$100
$20/$150
20% in- network co-
$25/$150 (In- network
same as office visit
$20/$300
40% after deductible
$35/$75
first visit, $450
ce
nd Out-cf- network)
copays above -All plans
subsequent visits
have a $150 ER copay
Medical
Insurance
Plan Deductible
$5001$1000 (POS)
$400/$800 (PPO)
$3001$400 ind.
$150/$300 ("network);
Basic-$1000 Core$500
(Individual/Family)
$15001$3000 (HDP)
$5001$1000
no deductibles
$2400/$4,800 (HDP)
$300/$600
$500/$1,000
$6001$900 family
$50001$1000 (Out-of-
- $250
premium -$250
$750/$1,500
$1000/$2000 POS
$200 in network
network)
Plan Coinsurance
80% (POS)
90% for hospital
90% for hospital
100%
20% in- network ce-
work); $6000 $9
network);
Basio -80% Core -80 %
$2,000/$4,000
$2,000/$4,000
90%
(individual/Family)
80% (HDP)
services
85% PPO
services
insurance
(Out-of-network)
- network)
premium -90%
80% (Core), 70% (Basic)
80% HDP
HSA or HRA contribution
$1237.20 max
Basic Only: $400 to flex
$1,430 max
None
None
None
account
Max out -of- pocket
$1,500/$4,500 (POS)
Basio-- $2,500/$5,000
$1,500/$3000 (PPO)
Basio-$3000/$6000
(Individual /Family)
$3,500/$5,000 (HDP)
$1000/$2000
Core--$4,000/$8,000
$4,000/$8,000 (HDP)
$1,0001$2,000
$ 500 1$1, 000
$ 2000 /$4000
$2000/$6000
Core- $2000/$4000
$2,75045,500
$3000/$6000
$2,000/$4,000
Premium - $1000/$2000
Rx Co -pay
$41$251$45 (POS)
$10/$25/$40 w25%
$51$201$40 (POS)
Mail Order:
$0 copay for generics for
(Generic/Preferred Brand/
80 % after deductible
coinsurance specialty
80% after deductible
$
$101$251$401$75
10 %20 %/30%
$101$301$45/75%
all plans Basic-$30 /50
$01$301$45
$10/$45/$6025%
$7/$35/$50/$65
Brandt
Non-Preferred Brand/ Specialty)
(HDP)
a of$1
mods for a max of $100
Core – $0/$25/$50/$0
(HDP)
il:$50/$115
Retail: $51$201$40
Core$251$50 Premium-
(Nexium)
Basi- $O/$30/$50/$O
$201$35
Same coverage options
Hired before 7/12006:
Same coverage options
as active employees-
100% of premium for
Discontinued eligibility
Requires 10 years of
Continuation of medical
does not extend to
employees retiring with
r con
for future
total service priors
is
Same benefits for
benefits for City
dependents. OWASA's
20 or more yrs. of
s eff. /l /09
to new hires eft.
7/1/12 or 20 years
retirees. Must have 15
employees who have
premium contribution is
Same coverage options
Same coverage options
service. Hired 7 /12006
eas o,
but still have retirees on
continuous service
yrs of svc to be eligible
completed 15 years of
based on years of
If hired before 7/1 /05,
as active employees-
or thereafter 100% of
the plan.
hired after 7/1/12
1
for 50% subsidy towards
service with the City,
service and age at time
100% paid coverage.
does not extend to
premium for employees
Same coverage as
for 100% coverage.
Same coverage as
premiums. Amt
have retired directly from
of retirement.
Requires 10 years of
dependents; premium
retiring with 30 or more
alive employees
County pay $50% after 20
Set up retirement health
Retiree Medical Coverage (Pre -65)
May be eligible for 50%
alive employees
of sub
of subsidy goes up 5%
None
City service with
10 years of service at
total service on or after
contribution is based on
yrs. of service. The
10 -15 Yrs 50% Subsidy
years, 75% after 25 years,
savings plan for new
coverage if disabled or
for each addt'I year. At
eligibility for immediate
age 60 = 50%
7/1/05 @ 50 %cost of
years of service and age
retiree pays 100% of
15 -20 Yrs 75% Subsidy
and 100% after 30 years
employees; no other
aver 65 at retirement
25 yrs, revs 100%
retirement benefits, and
15 years of service at
coverage, 15 years
at time of retirement
dependent cost.
20 + yrs = 100% Subsidy
retiree health benefits
with 5 or 10 years of
subsidy towards indiv el
elect to receive
age 60 = 75%
service ic 7@ 1
Retirees must complete
service
premium
immediate payment of
20 years of service at
0
years service @ 100 %.
HRA to get Co.
All County retiree health
as alive employees.
benefits under the plan.
age 60 or 30 years of
contribution of 100 %-
contributions were held
Same premiums
service at any
cost of Core premium;
flat moving forward.
age =100%
otherwise Co. pays 95%
of Basic option.
Part D and Plan J
100% of Medicare Part
Employer Contribution
100% paid coverage in
100% of Medicare Part
D and Plan F Requires
Post-65 are enrolled in
based on years of servi
Medicare Advantage
D and Plan F cost if
Medicare supplement for
10 years of total service
Medicare Part D and
ce and age at the time of
Plan If hired before
hired before 7/12006
employees with at least
prior to 7/1/12 or 20
Medicare supplement
rMiremeMlO years of
7/1/05. Requires 10
Refer to our plan's (Blue
with 20 or more yrs. of
years service. City pays
Retiree Medical Covens Post -65
Coverage ( )
Years continuous Service
Medicare Supplement
coverage. Subsidy li is
None
Medicare Supplement
Service at age 60 = 50%
years of total Service on
Crass Blue Shield
Service. 100 %of
$93 -$109 per month
None
Same benefits a5
if hired on or after 7 /1/12
plan
the same and i5 applied
plan
15 years of service at
or after 7 /1/05 @ 50%
la
NC) Supplemental plant
) su
Medicare Part D and
based upon age of
Pre65 retirees
for 100% coverage.
to the cost of
age 60 = 75%
cost of coverage, 15
through broker
Plan F cost if hired
retiree
Eligible for 50%
Supplement Voice
20 years of service at
years service @ 75 %,
7/12006 or thereafter
coverage if disabled or
age 60 or 30 years of
20 years service @
with 30 or more yrs. of
age 65 at retirement.
service at any
100 %.
service.
age =100%
Summary of Benefits Provided by Other Jurisdictions
22
Orange County
C-boro
Cary
Hillsborough
Mebane
OWASA
Alamance County
Chatham County
Durham County
Durham City
Person County
Guilford County
Vision is included for
100% employer paid for
emps in cost of health
100% employee paid
EVERVOne in
employee's family. $10
Employee may enroll in
coverage. Administered
Vision Service Plan, $10
Community Eye Care
In -house
w/ Superior Vision.
Eye exam screening i5
copay for annual exam,
Community Eye Care
Covered under medical
by Superior Vision; $0
co-pay for annual exam
plan, $20 co-pay for
Reimbursement
$10 co -pay office visit;
$10
covered at 100% in-
$150 allowance for
vision plan i5 part of
Vision
plan, $20 co-pay for
insurance plan, $0
co-pay for exams; $15
8 20 %di5counl for
office visit; $150
Program available to
$10 co-pay
network (not covered out
contacts/fitting, $130
medical plan. Covers eye
Yes, voluntary
office visit; $150
copay for exam;
co -pay for materials or
glasses, 15 %off contact
allowance for lenses,
employees and
glasses/contacts, $100
of- network); lens and
frames allowance with
exam and up to $150 for
allowance for lenses,
hardware not covered
contact lens filling; $150
lens fitting 8 evaluation
frames
dependents up to $405
allowance frames bi-
frame reimbursement is
lens at $0amell
hardware
frames
allowance, for frames;
exam
per fiscal year
yearly
$50 per benefit period
employee. Frames /lens
$200 allowance for
or contacts can be
contacts
obtained every year.
Diagnostic and
Employer s 100%
pays
preventative 100%;
premium for employee's
Basic care 80% after
dental reimbursement
Diagnostic 8 Preventive:
Diagnostic 8 Preventive:
Diagnostic 8 Preventive:
Diagnostic 8 Preventive:
Diagnostic 8 Preventive:
Diagnostic 8 Preventive:
deductible; Major care
plan reach member has
County pays 100 % of
t00 %' Basic
1ajor 80i Ba
100 %, Basic
100 %, Restorative:
100 %, Basic
100 %, Basic
50% after deductible;
$1500 benefit that can
dental for employees. Max
Restorative: 85%, Major
80
Major Services; 80%
Restorative: 80%, Major
80%, Major Restorative:
Restorative: 80%, Major
Restorative: 85%, Major
Benefit period deducible
be used to purchase
benefit $750 with a $250
Dental Insurance
Restorative 8
orthodontic svcs, no age
Restorative8
50% Co -pay of
Restorative: 50%
Restorative: 50%
$50 for individual and
ANY service/product
carry over for keeping
Yes
Orthodontia: 50%
maximum; $2000
Orthodontia: 50%
$50, Maximum
Deductible of $50,
Co -pay of $25,
$150 for family;
from dentist /orthodontist
claims under $500 per
Cmum of
annual
io $4000
Co-pay of $50
$ 1000 /year
Maximum $1000/year
Maximum $1500/year
Combined benefit period
1st $400 in charges pd.
year. Maximum carry aver
00/
Maximum $1200/year
lifetime max for ortho
max
maximum $1000;
at 100 %, remainder paid
is $1000.
Orthodontic care 50 %'
at 80% until $1500
Lifetime orthodontic
benefit is used
maximum $1000
Employee can contribute
at any time and any
$27.50 too a
5% employer
amount. Employer
supplemental retirement
contribution into ether
contributions are 4 -9
5% employer
plan of employee's
NC401(k) Or ING 401(x)
years of service $40 per
4.5% for regular
4.5% (Regular
contribution; has been
Supplemental Retirement (401 K, 457 plans)
choice. County matches
3%/5% for LEO
option. Employee
5% of salary
pay period, 10-14 years
None
employees; 5% for law
5 %employer
Employees) 5%
proposed for b
up 00 a$ additional
choice Of plan except for
of service $60 per pay
enforcement
contribution
(Police and Fire)
flat
change from flat
$1200 ($50 x 24 pay
Police who must rcv
period, 15-19 years of
contribution 10 match for
periods) eff. 711113.
contribution in 401(k)
service $80 per pay
all non -sworn employees
period, 20+ years of
service $100 per pay
period
5% employer contribution
Employees hired after
10-14 years of service
7/1/12 not eligible until 5
1.5% of salary, 15-19
years. 5 yrs but <10 1%
For employees hired
0.5 rs 1% of gross
y g
years of service 2.25%
annual salary; 10 yrs but
$100 per year of service
Starts at 10 years, 1.5%
Slams at 5 years - flat
before 7/1/2009, based
6 -10 yrs 2 %
of salary, 2424 years et
After 5 yrs - 2.5%; After
<15 2 % annual salary; l5
to max of $3000;
Longevity
of salary and increases
dollar amount increases
Na
on years of service - -1 %
11 -15 yrs 3%
service 3.25% of salary,
10 yrs - 4 %; After 15 yrs
None
Unfunded for FY1314
None
yrs but <20 3.25 %annual
discontinued for new
to 4.5 % at 25 years
as years of service
(3 years) to 5% (20
16-20 yrs 4%
25+ years of Service 5%
- 5%; After 20 yrs - 6%
salarynu yrs but <25
employees hired on or
increase
years)
20 + yrs 5%
of salary Longevity
4.5% annual salary;25 yrs
after 7 /12011
benefit will end July 1,
or more eannual
2013
salary- al I longevity paid
out in the month of
November
Pay for Performance
Pay for Performance -
Employeas achieving a
plan. are
3.25% for Meets
None, non -base salary
proficient rating receive
budgeted for 3 % per
d for
Information not available
Expectations rating,
effective 7/1/13 2% for
2% is in proposed 2014
Merit Increase
award of $50041000
$500 lump sum; those
amp, however, can
1 -4%
None
None
4.25% for Exceed
None
achieves standards and
budget
at the time.
available
with superior rating
received up to 5%. Merit
Expectations rating ($0
3% for exceeds standards
receive $1000
based awards
for Needs Improvement
rating)
Cost of Living Adjustment/ Date
2% eff. July 1, 2013
Na
3%
None
recommended 5%
3% comparative
Noce
None
None
None
Jul 1, 2013 w/ Board a
July 1, 2013
advantage adjustment
$2,500/fiscal year (if
With prior approval,
Up to $500 per fiscal
Up to $600 per fiscal
Tuition
up to $1,220 per fiscal
funded funding
First
reimbursement for
year, with prior approval,
$400 year tuition, books,
year, subject
Assistance
Up to $600Miscel year
year
dependent upon annual
a
Afterwards 50%
Afterwartls 50%
Up to $1,OOOMiscel year
tuition and books for job
and reimburses for
fees for job related
Up to $800 per fiscal year
y of budgeted
availability g
Budget adoption)
related training upon
tuition and books forjob
classes
funds
d
Up to $300/fiscal year
completion.
related education
Petty /Personal Leave
None
14 Hours Per Year
Na
8 Inns per yr
8 Hours Per Year
None
14 hours per year
None
None
None
None
Hrs)
<2yrs= 10days; 2-
0.4 years = 3.7 hrs/ pay
5 - <10 yrs = 15 Days
<5= 12days; 5- <10 =15
period (12 days);
37.5 hr. wk. <2
(120 Has)
Annual Leave Accrual at
days; 10. <15 =18 days;
5-9 years= 4.62 hrs/pay
0.5 years = 10 days/yr;
yrs =11.87 days per yr. ,
10 - <15 yrs = 18 Days
hire is 4.84 hours per
Annual leave accrual
15- <20 =21 days;
Annual leave begins at
period (15 days); 10.14
6 -10 years= 13 days/yr,
40 hr. wk. <2 yrs. _
12 days (1 -3 years),
12/yr up to 5 years; 15
(144 Has)
Vacation Leave
pay period
starts at 12 days/yr and
120 =24 days. More
Accrues at rate of 12-
10 daysyr and increase
years = 5.54 hrs/pay
11 -15 years = 16
11.75 days per yr., 42
15 days (49 years),
after 5 years, 18 after 10
15 - <20 yrs = 21 Days
/Annual
increases
hrsyear) and increases
10.01 hrs /pay
increases with years of
than 240 hours rolls into
26.7 days per year
by 2 days after 2yrs,
10 15 8
period (18 days;
15 6.47
daysyr,
16 21
12 -25 days/year
hr. wk. <2 yrs. = 11.67
days
18 days (10.15 years),
years, 20 after 15 years,
(168 Has)
to period
sernce
sick accrual at the end
5yrs, yrs, yrs,
-19 years =
-20 years =
per yr. (8.4
21 days (16-20 years),
21 after 20 years
20+ yrs = 24 Days (192
(260.3/yr) at 20 years
of each fiscal year.
20 yrs.
hrs/pay period (21
daystyr,
hrs.day), 42 hr. wk.
24 days (21+ years)
Hrs)
service
Vacation payout of 240
days);
21+ years = 25 days/yr
<2 yrs. = 8.17 days per
or less upon separation
20+ years = 8.31
yr. (12 hrs. /day)
Hours over 240 rolls to
with two weak notice
h./pay period (27 days)
sick. Pay out for leave
on books at separation
Summary of Benefits Provided by Other Jurisdictions
23
Orange County
Cambone
Cery
Hillsborough
Mebane
OWASA
Alamance County
Chatham County
Durham County
Durham City
Person County
Guilford County
Effective 1/29/11
37.5 hr. wk., 40 hr. wk.
Sick Leave
3.7 hours/pay period (12
12 days/yr
3.7 hours per pay period
12 days
12 daysyr
3.7 hrs /pay period
12 days/yr
12 days year
and 42 hr. wk.
3.692 hours/2 -week pay
Yes, 12 days per year
Yes, 12 days per year
days/year)
(12 days per year)
employees all earn a
period
total of 12 days per year
11 or 12 depending on
11 -12 (follows state
11 most Years; 12 in years
11 most Years; 12 in
# of Holidays
11
11
how holiday falls wAn
11
12
11
schedule)
12
12 or 13
11
that Christmas falls mid-
years that Christmas
the calendar
week
falls mid -week
Healthcare ($2500 max)
Medical - $2500
Healthcare ($2,500) and
Health ($2500) and
Healthcare ($2,500) and
dependent care
Health ($2500) and
Healthcare ($2500 max)
Healthcare ($2500 max)
Healthcare ($2500 max)
and dependent care
Dependent Care -
$5000
Health ) and
Medical and Dependent
Flexible Spending Plans
dependent care ($5,000)
Dependent Care ($5000)
- voluntary contributions
contributions s
12 Nov
Dependent Care ($5000)
and dependent care
and dependent care
and dependent care
($5000 max) Parking &
Parking - Monthly up
Dependent Care ($5000)
t Care
Care FSA Plan
only
($5000 max)
($5000 max)
($5000 max)
Transportation up to
to
$240 per month
Basic Town provided
$15,000 basic benefit -
policy of 1X salary to
Employees may
max of $250,000. Emp
purchase additional up
may purchase up to
1X Salary, up to $50,000
to $75,000- Dependent
$200k additional
1X Salary, up to $70,000
1x salary life and AD &
1X Salary paid by City
$10 k provided by
Employee may purchase
cove rage available at
guaranteed issue w!n
1x salary up to $50,000.
Employee may purchase
$10,000 policy provided
D paid by County.
$10 k provided by county;
county; employee can
additional up to $200k
$5000 per dependent.
30 days of hire. $1,500
Employees may
for general
2X Salary, up to
additional up to $150k
with option purchase
Employee may purchase
Voluntary amounts to
employee can purchase
purchase 4X gross
Life Insurance
max. Voluntary
New offering effective
basic dependent policy.
purchase additional
employee,
employee, $50K for
$100,000
max. Voluntary
o
additional coverage for
additional up to $300k
additional 2X salary.
ry
up to 100K. Voluntary
30to
comp (300k max).
spopurchas life may be
-iV
7/1/11 Voluntary
Emp may purchase up
coverage for theselves
dept. head
spopurchas life may be
employee and
max. Voluntary
spouse/dep life may be
Voluntary spouse/dep
purchased also.
i
Whole Life Insurance
to $50k addMl spouse
and dependents
purchased also.
dependents
spouse/dep life maybe
Voluntary $5k available
purchased also.
life may be purchased
offered through
coverage Win 30 days of
purchased also.
for spouses /children
also.
Municipal Benefits
hire. May also purchase
(NCLM)
one of four offered
dependent child policies
w!n 30 days of hire
Town provided annual
benefit -# of wks
dependent on yrs of svc.
<12mths =6wks; 12-
23mths=8wks; 24-
City Provides up to six
35mths= l2wks; 36-
weeks paid leave every
Voluntary Plan. 70% of
$250 month paid for up
47mths= l6wks; 48-
Voluntary Plan. 60% of
Voluntary plan up with
2 years. Leave does not
compensation up to
to 2 years - Employees
59mths= 20wks;
Up to 26 weeks disability
Town provided pays up
compensation up to
weekly benefits in $100
roll over if unused.
Voluntary Plan offered
Short Term Disability
$2000. 7 d elimination
ay
m ay purchase additional
60+
pay available after
to 60% for up to 26
Not offered by OWASA -
$6000. 14 day
Voluntary
increments from $100 to
Voluntary
with no employer
period and benefits paid
coverage for a max of
Beet
t pays 50%
pays 50% of
probationary period,
weeks. 7 urination
Supplemental Only
elimination
up
benefit
Voluntary
contribution
up to 1 year.
$2000 /month.
regular salary. Must
paid by Town.
Period.
period.
id
benefits Paid to 3
to 3
amt. ca not ex
amt. cannot exceed 66
66
through
available through
exhaust all avail Sick
months. .
and 2/3 of Salary
colonial. 60% of
leave before elig for
compensation up to
benefit + 7 day waiting
$3,000 up to 6 months
period for illness /no
waiting period for injury
after exhaustion of sick
leave
G'
1 <2!
I /)
�b
70
ATTACHMENT5
HEALTH INSURANCE
UPDATE
2013 Plan Highlights /Bid Update /2014 Plan
Year Recommendations
September 5, 2013
25
2013 Summary
Second year with United Healthcare
2013 Plan design changes addressed concerns from
2012 Employee Survey
No significant complaints
Increased employee educational opportunities
Request for Proposals for fully insured and self- funded for
i�lTiL!
LREMIL
3
Health Insurance Enrollment Comparison
-V 0 M
Traditional Plan
High Deductible Plan
Total Participation
Employee Health Savings Account
Waived Health Insurance
610 605
187 197
797 802
81 89
22 21
4
Optional Benefits
New Enrollment Comparison
Medical Flexible Spending Account 165 132
Dependent Flexible Spending Account 11 16
Community Eye Care 369 42
Accident Insurance 114 36
Critical Illness 79 23
Disability 97 18
Whole Life 55 18
0 M 28
Benefits Activities and Programs
Flu Clinics
Biometrics Screenings, Health Assessment, Coaching
SportsPlex Membership
Employee Appreciation and Wellness Lunch
Smoking Cessation Opportunities
Mini Grants
Monthly Programs:
UHC Website Demonstration (January)
Know Your Numbers (February)
Health Care Cost Estimator (March)
National Nutrition Month (March)
Employee Appreciation and Wellness Lunch (May)
In Tune Stress Management Challenge (June)
Sun Safety Awareness (June)
Cubicle Crunch "Flash Mob" (June)
National Dance Day (July)
29
Proposed Timeline for Renewal and Open
Enrollment Activities
September 5th: Initial presentation of the health insurance
renewal to the Commissioners
September 17th: Commissioners' decision regarding
renewal of health insurance
September 18th: Discuss September 17th meeting
outcome with the Employee Relations Consortium
September 23rd: Mandatory mailing to all employees
regarding health exchanges and open enrollment
October 14th-25th: Open enrollment
December 6th: 2014 benefits payroll deductions begin
W
% rtfj
Cat°
Medical Plan Update
Bid Update and Recommendation
Ma r-k- III
A-31
Experience
With over 130 public sector customers and 30
years of experience, Mark III implements and
manages the programs for the long haul.
We design the right solutions for your
organization and your employees, which are best
in class.
Mark III Customers
32
North Carolina Government Medical Plan customers include:
Mark III Customers
Funding
Mark III Customers
Funding
Mark III Customers
Funding
Alleghany County
Insured
Cleveland County
Self- funded
Lincoln County
Self- funded
Bertie Martin Jail
Insured
Columbus County
Insured
Martin County
Insured
Brunswick County*
Self- funded
Cumberland County
Self- funded
Moore County
Self- funded
Burke County
Self- funded
Dare County
Self- funded
Onslow County
Self- funded
Burke Catawba Jail
Insured
Duplin County
Self- funded
Orange County
Insured
Cabarrus County*
Self- funded
Edgecombe County
Self- funded
Polk County
Self- funded
Cabarrus Water & Sewer
Insured
Forsyth County*
Self- funded
Randolph County
Self- funded
Caswell County
Insured
Gaston County
Self- funded
Robeson County
Self- funded
City of Monroe
Self- funded
Halifax County
Self- funded
Rowan County
Self- funded
City of Rocky Mount
Self- funded
Henderson County
Self- funded
Town of Smithfield
Insured
City of Sanford
Self- funded
Hertford County
Insured
Transylvania County
Self- funded
City of Shelby
Insured
Iredell County
Self- funded
Wilkes County
Self- funded
City of Washington
Insured
Lee County
Insured
Yancey County
Insured
30 Counties
6 Cities /Towns
* Transitioned from fully- insured to self- funded
0
W IF
Medical Plan RFP Responses
Below is the list of payors that received the RFP:
Aetna
: WIR0
CIGNA
First Carolina Care — Declined to Quote
MedCost — Declined to Quote
Municipal Insurance Trust — Self- funded Only
United Healthcare
Wel I Path — No Quote
Of the quotes that we received, only UHC is firm
The earliest that we will have firm quotes from the respondents
is September 2013
The increase represents a 6.35% increase or $641,000.
Current Plans
United Healthcare
Renewal: Option 1:
United Healthcare: Same plan but all copays counting towards total
out of pocket per Healthcare Reform Legislation
POS: SSE -P -MS
2012
HSA: C3Z -PM
2012
POS: BBI -M
2013
HSA: FBQ -M
2013
In- Network
In- Network
In- Network
In- Network
Primary Care Physician Visits
$20
80% after Ded.
$20
80% after Ded.
Specialist Physician Visits
$40
80% after Ded.
$40
80% after Ded.
Preventive Care
100%
100%
100%
100%
Deductible
1 $500
$1,500
$500
$1,500
Deductible - Family Maximum
$1,500
$3,000
$1,500
$3,000
Coinsurance Limit
$1,000
$2,000
$1,000
$2,000
Coinsurance Limit - Family
Max
$3,000
$2,000
$3,000
$2,000
In- patient Hospital Services
80% after Ded.
80% after Ded.
80% after Ded.
80% after Ded.
Out - patient Hospital Services
80% after Ded.
80% after Ded.
80% after Ded.
80% after Ded.
Emergency Room
$150
80% after Ded.
$150
80% after Ded.
Pharmacy
$4/$25/$45
80% after Ded.
$4$25/$45
80% after Ded.
Lifetime Maximum
Unlimited
Unlimited
Unlimited
Unlimited
Rates
Subs
Monthly
Premium
Subs
Monthly
Premium
Monthly
Premium
Monthly
Premium
Employee Only
517
$631.18
$326,320.06
116
$510.15
$59,177.40
$677.99
$350,520.83
$510.30
$59,194.80
Employee and Spouse
66
$1,331.80
$87,898.80
16
$1,076.41
$17,222.56
$1,430.57
$94,417.62
$1,076.73
$17,227.68
Employee and Children
162
$1,022.52
$165,648.24
46
$826.44
$38,016.24
$1,098.35
$177,932.70
$826.68
$38,027.28
Employee and Family
41
$1,893.54
$77,635.14
31
$1,530.45
$47,443.95
$2,033.97
$83,392.77
$1,530.90
$47,457.90
Monthly Cost
786
$657,502.24
209
$161,860.15
$706,263.92
$161,907.66
HSA Contribution
$1,237.20
$258,574.80
HSA Contribution
$1,500
$313,500.00
Annual
$7,890,026.88
$2,200,896.60
$8,475,167.04
$2,256,391.92
Total
$10,090,923.48
107.42%
$10,731,558.96
102.52%
Increase over current
106.35%
Firm
Firm
The increase represents a 6.35% increase or $641,000.
Orange County Government
Subscribers
Premium
Total
Claims
Loss
Ratio
Net
Claims
HSA
June-12
947
$735,005.35
$430,666.60
58.59%
$430,666.60
$20,207.60
July-12
995
$762,928.61
$499,640.83
65.49%
$499,640.83
$21,135.50
August -12
990
$760,191.09
$586,067.78
77.09%
$586,067.78
$21,341.70
September -12
984
$754,703.39
$597,897.17
79.22%
$597,897.17
$21,341.70
October -12
987
$753,274.33
$554,237.84
73.58%
$554,237.84
$21,444.80
November -12
994
$758,491.00
$561,559.75
74.04%
$561,559.75
$22,372.70
December -12
994
$755,867.34
$609,873.76
80.69%
$609,873.76
$22,682.00
January-13
1,005
$820,823.13
$614,054.44
74.81%
$614,054.44
$21,857.20
February -13
994
$818,221.00
$685,672.00
83.80%
$685,672.00
$21,547.90
March -13
991
$815,966.65
$765,244.19
93.78%
$765,244.19
$21,651.00
April-13
988
$814,079.35
$620,474.22
76.22%
$620,474.22
$21,238.60
May -13
994
$813,672.00
$668,568.00
82.17%
$668,568.00
$21,341.70
Total
1 11,863
$9,363,223.24
$7,193,956.59
76.83%
$7,193,956.59
$258,162.40
Self- funded Calculation
Current PPO Plan Design
2014 Renewal
Claims - Without Benefit Change
$7,193,957
Trend 2014 - 8% -19 Months
112.67%
Trended 2014 Claims
$8,105,431
Administration
$1,567,577
PPACA - Fee for Comparative Effectiveness Research Agency
$1,649.00
PPACA - Transitional Reinsurance Fee - 2014 - 2016
$103,887.00
PPACA - Health Insurance Industry Fee
$0.00
HSA Cost - $1,416
$293,112.00
Total Cost
$10,071,656
Current Contribution
$10,065,433
Percentage Change over 2014
100.06%
If the County transitions to a self- funded arrangement, no
increase in funding is required.
6
Current Carrier
Renewal: Option 1
Current POS
Current HSA
Current POS
Current HSA
In- Network
In- Network
In- Network
In- Network
Primary Care Physician Visits
$20
Deduct /20%
$20
Deduct /20%
Specialist Physician Visits
$40
Deduct /20%
$40
Deduct /20%
Preventive Care
100%
100%
100%
100%
Deductible
$500
$1,500
$500
$1,500
Deductible - Family Maximum
$1,500
$3,000
$1,500
$3,000
Out of Pocket Limit (includes deductible)
$1,500
$3,500
$1,500
$3,500
Out of Pocket Limit - Family Max
$4,500
$5,000
$4,500
$5,000
Radiology
Deduct /20%
Deduct /20%
Deduct /20%
Deduct /20%
Minor Surgery in Office
Office Copay
Deduct /20%
Office Copay
Deduct /20%
Hospital Services
Deduct /20%
Deduct /20%
Deduct /20%
Deduct /20%
Urgent Care
$50
Deduct /20%
$50
Deduct /20%
Emergency Room
$150
Deduct /20%
$150
Deduct /20%
Pharmacy
$4/$25/$45
Deduct /20%
$4/$25/$45
Deduct /20%
Vision Hardware
Not covered
Not covered
Not covered
Not covered
HSA
$1,237.20
$1,237.20
Lifetime Maximum
Unlimited
Unlimited
Unlimited
Unlimited
Plan Administration Fee
$38.35
Network Access Fee
$0.00
Vision Administration
$0.00
Specific Stop -loss
$88.80
Aggregate Stop -loss
$4.99
Total Administration Fees (A)
$132.14
Expected Monthly Paid Claims /EE /Month
$609.14
Expected Monthly Cost /EE /Month
$741.28
Claims Margin /ee /mth
$121.83
Maximum Claim Liability (B)
$730.97
Total Liability (A+ B)
$863.11
Employees
995
Estimated Monthly Cost
$737,573.60
Estimated Annual HSA - $1,416
$293,112.00
Estimated Annual Cost
$8,850,883.20
Estimated Annual With HSA
$10,090,923.48
$9,143,995.20
90.62%
Maximum Monthly Cost Without HSA
$858,792.46
Maximum Annual Cost
$10,305,509.52
Estimated Annual HSA - $1,416
$293,112.00
Maximum Annual with HSA
$10,090,923.48
$10,598,621.52
Difference
1
105.0%
6
Self Funding
Components of aSelf- funded Contract
Hire an administrator to pay claims
Purchase insurance for large claims (Stop -loss Insurance)
Hire a network (doctors /medical specialists /hospitals)
Plus
Claims
Reserves
SELF FUNDING FORMULA:
Rates = Administrator +Claims +Stop Loss +Reserves
■
Pros of aSelf- funded Contract
Greater Plan Flexibility
Pricing /premium structure established by the organization
Overall lower costs over time
Tax avoidance — State and Federal
Ability to establish a reserve for the plan
Easier framework to structure wellness strategies
Self Funding
Cons of a Self- funded Contract
If claims come in higher than expected, the organization is
responsible for funding the high claims (Reserve is
established for this purpose)
Plan subgroups (ABC Board and Community Home Trust)
are responsible for paying their own claims
t
Pros of a Fully Insured Contract
Total cost is fixed
Cons of a Fully Insured Contract
Plan Flexibility is reduced because of carrier filings with
the State Department of Insurance
Pricing is set by the Carrier
Higher Cost over time
Tax —State and Federal
Wellness strategies are harder to implement, because cost
is in addition to premium paid
Recommendation:
Transition to a self- funded contract with United
Healthcare
Includes increasing the County's Health Savings Account
contribution from $103.10 to $118 per pay period
The County will purchase stop -loss insurance to
protect against catastrophic claims
Aself- funded plan will provide greater flexibility for
wellness strategies
Lower long term cost by avoiding Health Care Reform
and State Premium taxes ($440,000)
43
Afark III
��plo ro. e e is