HomeMy WebLinkAboutAgenda - 09-11-2014 - 2ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: September 11, 2014
Action Agenda
Item No. 2
SUBJECT: Employee Benefits Updates and Preliminary Recommendations Regarding
Benefits Effective January 1, 2015
DEPARTMENT: Human Resources
ATTACHMENT(S):
A. Benefits Report
B. Mark III Presentation (Claims
Information and Renewal Options)
PUBLIC HEARING: (Y /N) No
INFORMATION CONTACT:
Brenda Bartholomew, Human Resources
Director, 919 - 245 -2552
Diane Shepherd, Benefits Manager, 919-
245 -2558
PURPOSE: To receive information and provide feedback to staff on employee pay and benefits
effective January 1, 2015.
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 employee benefits at the May 13, 2014 BOCC work
session and during the FY 2014 -15 budget process. The FY 2014 -15 Approved Budget
includes funds for a health insurance cost increase of up to 14.35% ($423,446) effective
January 1, 2015. An overview of current benefits and renewal options for health benefits are
discussed in Attachment A. Mark III Employee Benefits has provided claims information and
renewal options for the 2015 employee health insurance benefits in Attachment B.
An abstract outlining the Manager's recommendation will be presented at the September 16,
2014 Board of County Commissioners' Regular Meeting.
FINANCIAL IMPACT: Attachments A and B include the estimated costs of the health and dental
insurance renewal options.
RECOMMENDATION(S): The Manager recommends that the Board:
1) Discuss employee insurance and other benefits effective January 1, 2015; and
2) Provide feedback and direction to staff regarding employee health insurance and other
benefits in anticipation of Board action at the September 16, 2014 Board of County
Commissioners' Regular Meeting.
2
Attachment A
BENEFITS REPORT
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 20 — November 2, 2014 and changes will be
effective January 1, 2015. Communications to employees and affected retirees include
presentations at the Employee Relations Consortium and departments. Written and email
correspondence will be sent to employees describing the 2015 plan designs, and there will be
multiple enrollment meetings.
The following pages describe recent activities and considerations for 2015.
Topic
Page
Health Insurance
A -2
Wellness Activities 2013 -14
A -5
Supplemental Retirement Benefits
A -7
Flexible Compensation Plan and Health Savings
Accounts
A -8
Dental Insurance
A -9
Vision Benefits
A -9
Other Insurance Benefits
A -10
Employee Assistance Program (EAP)
A -11
Proposed Timeline of Renewal and Open
Enrollment Activities
A -12
A -1
3
HEALTH INSURANCE
Currently the County offers two fully insured health insurance plans contracted through
UnitedHealthcare. 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 and have the same health care services.
Both plans provide coverage for health care services as well as some additional programs that
help employees and the County save money. These include the United Healthcare 24 hour
nurse referral, which has helped employees get the most appropriate type of care while saving
money.
The 2014 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. In 2012 and
2013, the County contributed $1,237.20 ($103.10 /month) to the HSA. In 2014, the contribution
increased to $1,416 ($118 /month) so that the total County contribution for both plans was
comparable.
The County currently pays the cost of coverage for employees and retirees for both the HDP
and POS plans. The plan funding provides the same County contribution regardless of the plan
an employee selects. Each plan offers advantages and disadvantages to employees,
depending on the individual or family health care needs. Employees' semi - monthly premiums
are higher for the POS.
The County's contribution of $1,416 to a health savings account for each employee who
enrolled in the High Deductible Plan is a significant factor in the success of the High Deductible
Plan, (24% of employees participate in the HDP). When paired with the lower premiums, this
plan becomes more attractive to employees with dependents.
The following chart provides additional information regarding the two plans.
MWA
M
Comparison of 2014 Orange County Health Plans
Dependent Coverage
In addition to the cost of employee /retiree coverage, the County has also subsidized 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). This subsidy is approved each year when the health
renewal package is approved. The percentage of dependent subsidy has remained the same for
over ten years. When premiums increase, employees and retirees with dependent coverage
also have higher costs because they pay 48% of the cost of dependent coverage.
Employee cost for dependent coverage is directly tied to the total cost of the lower- priced plan,
currently the HDP. While all employees must weigh the risks associated with each plan by
comparing their potential out of pocket costs, employees with dependents must also factor in the
cost of premiums for their family members' coverage.
A -3
Point of Service Plan
High Deductible Plan
100% covered
Yes
Yes
preventive care
Co -Pays for Office
Yes, $20 primary care
No; 100% co- insurance
Visits and
Prescriptions
and $40 specialist
until the deductible is met
$500 /individual, $1,500/
Deductible
family, exclusive of
$1,500 /individual,
prescriptions and office
$3,000 /family
visit co -pays
County contribution to
In 2014, employees
deductible and co-
No
received $1,416 Health
Savings Account
insurance
contribution
Co- Insurance (20% of
$1,000 individual,
charges after the
$3,000 family, exclusive
Yes, $2,000 for individual
deductible is met)
of prescriptions and
and family
office visit co -pays
Maximum Out of
Pocket (includes
$1,500 individual
$3,500 individual
deductible and all co-
$4,500 family
$5000 family
pays /co- insurance)
Medical FSA ($2,500
Child /dependent care FSA
Flexible Spending
maximum) and
($5,000 maximum)
Account (FSA)
Child /dependent care
FSA ($5,000 maximum)
No Medical FSA
Health Savings
Not available
$3,300 maximum /individual
Account
$6,550 maximum /family
Dependent Coverage
In addition to the cost of employee /retiree coverage, the County has also subsidized 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). This subsidy is approved each year when the health
renewal package is approved. The percentage of dependent subsidy has remained the same for
over ten years. When premiums increase, employees and retirees with dependent coverage
also have higher costs because they pay 48% of the cost of dependent coverage.
Employee cost for dependent coverage is directly tied to the total cost of the lower- priced plan,
currently the HDP. While all employees must weigh the risks associated with each plan by
comparing their potential out of pocket costs, employees with dependents must also factor in the
cost of premiums for their family members' coverage.
A -3
5
Transition from a Calendar Health Coverage Plan Year to a Fiscal Plan Year
Currently, all Orange County's benefits plans are administered on a calendar year basis, from
January 1 to December 31. The County's Fiscal Year is July 1 to June 30. As such, budgeting
for health insurance is currently divided between two fiscal years. The January 1 through
December 31, 2014 health care rates were determined in September 2013 even though the
timeframe crosses two fiscal years. When the budget is approved in June, the actual rates for
the up- coming January renewal are projected and the BOCC does not determine the rates for
the upcoming Plan Year until September. The Plan Year may be changed to correspond with
the County's Fiscal Year. This transition to a fiscal year structure may be implemented by a six -
month renewal, effective January 1 to June 30, 2015. A 12 -month renewal period would begin
on July 1, 2015.
The cost of health coverage would be determined in Spring 2015, prior to the start of FY 2015-
16, in preparation for inclusion in the Annual Budget for FY 2015 -16. Open Enrollment for the
Plan Year of July 1, 2015 - June 30, 2016 would be held in the Spring after rate approval by the
BOCC.
All vendor contracts would be changed to align with the Fiscal Year. Staff will work closely with
Mark III Employee Benefits to implement any required changes.
2015 Options
The adopted budget for FY 2014 — 2015 included a maximum 14.35% increase in health care
premiums. The following options for the health insurance renewal administered by
UnitedHealthcare are for a six -month renewal period from January to June 30, 2015.
Option 1: Renewal of the current two plans, the Point of Service Plan (POS) and the High
Deductible Plan (HDP), without any change to plan design for six - months. Employees will
continue to pay 2014 rates for dependent coverage. The County will bear the increased cost for
dependent coverage for the six -month renewal period.
Option 2: Renewal of the two current plans with plan design changes to the Point of Service
Plan, with a 9% increase for both plans. The change in plan design for the POS plan increases
co -pays for office visits and prescription coverage. Employees will continue to pay 2014 rates
and for dependent coverage. The County will bear the increased cost for dependent coverage
for the six -month renewal period.
IM
A
WELLNESS ACTIVITIES 2013 -2014
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.
Below is a list of wellness activities and programs between October 2013 and August 2014
1. Flu Clinics
The Human Resources Department again partnered with the Health Department to
provide two flu clinics in 2013. The immunizations are no cost to employees as part of
their preventive health benefit. 207 employees were immunized at the 2013 Flu Clinics,
an 8% decrease over 2012. This decrease may be due to the easy availability of
immunizations through primary care doctors and pharmacies. Two employee flu clinics
will be held in Fall 2014, with one in Chapel Hill and one in Hillsborough.
Annual Employee Flu Shot Clinic Participants
2010
2011
2012
2013
204
169
225
207
2. Biometric Screenings
This year, Orange County partnered with the University of North Carolina's Wellness
@Work program to provide health screenings that assessed employee risks related to
cholesterol, blood pressure, blood sugar, and body mass. 153 employees participated
in the screenings in June 2014.
3. SportsPlex Membership
Highly discounted membership rates for the Orange County SportsPlex continue to be a
popular wellness benefit for employees. Currently 227 employees are members, a 2%
increase over 2013's membership of 212.
All employees are reminded annually about the Orange County SportsPlex discount,
and periodic postings are placed on the employee intranet homepage. New employees
are informed about the discount at employee orientation, and the SportsPlex rates and
schedules are on the County's Wellness Web page. SportsPlex representatives attend
the Employee Wellness Lunch (below), assist with National Nutrition Month activities
and provide occasional onsite classes. This is one of the most popular fringe benefits
offered.
A -5
7
4. Employee Appreciation and Wellness Lunch — June 2014
Over 300 employees attended and approximately 200 participated in activities such as
yoga, corn hole toss, line dancing, and disc golf. Representatives from Orange County
SportsPlex, UnitedHealthcare, UNC Wellness @ Work and Orange County nutritionists
were on hand to answer questions from employees. 775 lunches were served to
employees eating in and dining out.
5. WaIk4Life — One Step at a Time walking challenge
Over 133 employees registered to walk for a walking program that encourages physical
activity and encourages participation in the Aging in Stride 5K Run/Walk supporting the
Department on Aging's Aging in Place fund.
6. National Nutrition Month Activities and Challenges
The Health Department sponsored a health challenge focusing on healthy
eating /drinking habits during March 2014.
7. Nutritional Counseling
The County Health Department and Human Resources Department continue to publicize
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. In FY 2013 -14, 12 employees received services.
8. Mini - Grants
In FY 2013 -14, seven mini - grants were awarded in support of 61 employees
participating in healthy activities. Two grants have been submitted as of August 21,
2014 for twelve employees.
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 $41,500 over twelve
months.
Beginning 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 as
many employees recognized the value in doubling their investment. Effective July 1, 2014, the
County increased its matching contribution to $1,512 per year ($63 semi - monthly).
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 $88,208 annually in payroll taxes. Employee
contributions to the Roth 401(k), totaling $135,240 annually, are taxed at the time of the payroll
deduction, and do not provide any tax savings to either the employee or the County.
The amount the County matched on the first payday of August 2014 was $38,193 compared to
$23,585 in the first pay day of August 2013.
A -7
Monthly Employee
Contribution to All Plans
Annualized Employee
Contribution to Pre -Tax Plans
2010
$32,203
$386,436
2011
$37,638
$451,656
2012
$38,360
$460.320
2013
$73,678
$884,136
2014
$96,087
$1,153,043
Because the County does not pay Social Security or Medicare tax on the majority of these
contributions, there is a savings of approximately $88,208 annually in payroll taxes. Employee
contributions to the Roth 401(k), totaling $135,240 annually, are taxed at the time of the payroll
deduction, and do not provide any tax savings to either the employee or the County.
The amount the County matched on the first payday of August 2014 was $38,193 compared to
$23,585 in the first pay day of August 2013.
A -7
n
9
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). Federal IRS regulations only
allow a twelve -month plan year, and a special six -month transition plan year. The Plan Year is
not required to be a calendar year. If the County changes to a fiscal year health plan, the
Flexible Spending Account plan would be adjusted to ensure compliance with IRS regulations.
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 $5,000 to the Dependent/Child Care Spending
Account in a calendar year.
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 2015, the
maximum contributions are $3,350 (individual) or $6,650 (family). In 2014, the County
contributed $1,416 for each employee participating in the High Deductible Health plan for the full
Plan Year. This amount is pro -rated for new employees based on their hire date, at the rate of
$118 for each month remaining in the year. The County contribution counts towards the
maximum contributions above.
Every $100 an employee contributes to a Flexible Spending Account or Health Savings Account
saves the County $7.65 in Social Security taxes. In 2014, employees' expected contributions of
$309,000 to these accounts will result in approximately $23,650 tax savings for both the County
and employees.
Number of Employees Contributing to Accounts
Type of
2008
2009
2010
2011
2012
2013
2014
Account
Child Care
Spending
12
12
12
10
13
16
14
Account
Medical
Spending
95
138
178
214
170
132
142
Account
Health Savings
n/a
n/a
n/a
n/a
83
89
73
Account
ow
10
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 and the County
pays Delta Dental an administrative fee for this service.
Employee Dental Insurance is budgeted as part of departmental personnel costs. The current
$24.30 per employee cost includes a monthly administrative fee of $3.12 /month per employee
and a projected premium to cover claims. Employees pay the full cost of any dependent
coverage. The employee premiums have not changed since 2007.
At the end of FY 2012 -13, the dental plan's fund balance was approximately $128,000. At the
end of FY 2013 -14, the fund balance is $77,600 (pre- audit).
VISION BENEFITS
UnitedHealthcare covers one routine eye exam every other year. Members in the traditional
Choice Plus plan pay a $20 co -pay. Vision services for those in the High Deductible plan are
subject to the deductible and co- insurance.
Since January 2012, employees have been able to enroll in a vision plan with Community Eye
Care. Employees who enroll pay approximately $10 a month on a pre -tax basis and may enroll
family members. Benefits include an annual eye exam ($20 co -pay) and an $150 allowance for
eyeglasses or lenses.
461 employees are currently enrolled in the vision plan. There are no changes anticipated for
2015. The County does not contribute to the cost of this plan.
MW
11
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 premium increase since
2007. The monthly rate of $.225 per $1,000 of coverage (up to $50,000) was renewed until
December 31, 2015. 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 are shown below.
Number of Supplemental Benefits Policies
Product
Current
2009
2010
2011
2012
2013
2014
Carrier
Short Term
AUL (American
Disability
United Life)
62
91
136
199
214
226
Critical
Aflac (formerly
Illness /Cancer
Continental
Insurance
American)
17
21
92
150
162
182
Life Insurance
(Whole Life)
Boston Mutual
4
2
53
95
101
101
Aflac (formerly
Continental
Accident Insurance
American)
9
16
45
142
181
196
Total Policies
110
141
326
586
658
705
A change to Short Term Disability plan 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, 2015.
A -10
12
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, 2014. The County has budgeted $20,279 for the
Employee Assistance Program in Fiscal Year 2014 -15.
As part of its health insurance plans, UnitedHealthcare provides an employee assistance
program, Care240, as part of the administrative fee. Services include three counseling
sessions, legal and financial telephone consultations, and six hours of employee training
programs. Care240 services are only available to employees enrolled in the UnitedHealthcare
plans.
Mark III conducted a review of other available Employee Assistance Programs to determine if
another provider would offer similar services with a broader network at a comparable cost.
After reviewing the results, staff sees no benefit in changing providers because there was no
significant improvement in the network with different providers.
A -11
13
PROPOSED TIMELINE OF RENEWAL AND OPEN ENROLLMENT ACTIVITIES
Action
Date
Initial presentation of health insurance renewal
to Commissioners
September 11
Commissioners' decision regarding renewal of
health insurance
September 16
Employee Relations Consortium meeting
(discussion of renewal)
September 17
Mandatory mailing to all employees to include
details of Open Enrollment, Affordable Care
Act, an Medicare Part D
September 26
Open Enrollment, includes online access and
in- person meetings
October 20- November 2
Employee /Retiree Flu Clinics
October 15 and 24
Breast Cancer Awareness Days
October 30 and November 6
Employee Financial Health Day
tbd
New 2014 benefits payroll deductions begin
December 5
A -12
,11�1
MEDICAL PLAN UPDATE
2015 Renewal
Mark III
September 11, 2014
14
K
UHC Insured
2013
Renewal: UHC Self-funUbd
2014
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
Difference
0%
K
J
A P'
PPO Plan
Date
Subs
Medical
Pharmacy
Combined
Medical Claims
Claims Per Sub
Per Month
Total
Administration
Total Cost
Stop -loss
Credits
Net Costs
County
Budgeted
January-14
778
$141,278.45
$68,599.76
$209,878.21
$269.77
$104,360.92
$314,239.13
$0.00
$314,239.13
$634,038.88
February -14
776
$291,097.08
$102,181.31
$393,278.39
$506.80
$104,092.64
$497,371.03
$0.00
$497,371.03
$632,408.96
March -14
776
$625,686.29
$136,454.90
$762,141.19
$982.14
$104,092.64
$866,233.83
$134,831.00
$731,402.83
$632,408.96
April -14
777
$419,131.65
$154,741.65
$573,873.30
$738.58
$104,226.78
$678,100.08
$125,351.00
$552,749.08
$633,223.92
May -14
779
$401,845.21
$152,229.33
$554,074.54
$711.26
$104,495.06
$658,569.60
$13,128.00
$645,441.60
$634,853.84
June-14
780
$460,061.79
$151,610.53
$611,672.32
$784.20
$104,629.20
$716,301.52
$44,024.00
$672,277.52
$635,668.80
July-14
776
$544,000.00
$280,000.00
$824,000.00
$1,061.86
$104,092.64
$928,092.64
$10,944.00
$917,148.64
$632,408.96
Total
5,442
$2,883,100.47
$1,045,817.48
$3,928,917.95
$721.96
$729,989.88
$4,658,907.83
$328,278.00
$4,330,629.83
$4,435,012.32
HSA Plan
Date
Subs
Medical
Pharmacy
Combined
Medical Claims
Claims Per Sub
Per Month
Total
Administration
Total Cost
Stop -loss
Credits
Net Costs
County
Budgeted
January-14
201
$17,241.99
$265.02
$17,507.01
$87.10
$26,962.14
$68,187.15
$0.00
$68,187.15
$181,308.03
February -14
204
$73,040.73
$1,773.57
$74,814.30
$366.74
$27,364.56
$126,250.86
$0.00
$126,250.86
$184,014.12
March -14
198
$232,234.95
$1,114.45
$233,349.40
$1,178.53
$26,559.72
$283,273.12
$0.00
$283,273.12
$178,601.94
April -14
208
$31,793.11
$2,077.61
$33,870.72
$162.84
$27,901.12
$86,315.84
$0.00
$86,315.84
$187,622.24
May -14
206
$79,143.40
$2,603.32
$81,746.72
$396.83
$27,632.84
$133,687.56
$0.00
$133,687.56
$185,818.18
June-14
204
$37,252.57
$2,929.53
$40,182.10
$196.97
$27,364.56
$91,618.66
$0.00
$91,618.66
$184,014.12
July-14
205
$80,909.00
$3,891.00
$84,800.00
$413.66
$27,498.70
$136,488.70
$0.00
$136,488.70
$184,916.15
Total
1,426
$551,615.75
$14,654.50
$566,270.25
$397.10
$191,283.64
$925,821.89
$0.00
$925,821.89
$1,286,294.78
Combined
Date
Subs
Medical
Pharmacy
Combined
Medical Claims
Claims Per Sub
Per Month
Total
Administration
Total Cost
Stop -loss
Credits
Net Costs
County
Budgeted
January-14
979
$158,520.44
$68,864.78
$227,385.22
$232.26
$131,323.06
$382,426.28
$0.00
$382,426.28
$815,346.91
February -14
980
$364,137.81
$103,954.88
$468,092.69
$477.65
$131,457.20
$623,621.89
$0.00
$623,621.89
$816,423.08
March -14
974
$857,921.24
$137,569.35
$995,490.59
$1,022.06
$130,652.36
$1,149,506.95
$134,831.00
$1,014,675.95
$811,010.90
April -14
985
$450,924.76
$156,819.26
$607,744.02
$617.00
$132,127.90
$764,415.92
$125,351.00
$639,064.92
$820,846.16
May -14
985
$480,988.61
$154,832.65
$635,821.26
$645.50
$132,127.90
$792,257.16
$13,128.00
$779,129.16
$820,672.02
June-14
984
$497,314.36
$154,540.06
$651,854.42
$662.45
$131,993.76
$807,920.18
$44,024.00
$763,896.18
$819,682.92
July-14
981
$624,909.00
$283,891.00
$908,800.00
$926.40
$131,591.34
$1,064,581.34
$10,944.00
$1,053,637.34
$817,325.11
August -14
September -14
October -14
November -14
December -14
Total
1 6,868
1$3,434,716.221$1,060,471.981
$4,495,188.20
$654.51
$921,273.52
$5,584,729.72
$328,278.00
$5,256,451.72
$5,721,307.10
Change
101.08%
$464,855.38
Renewal Expectation
10
Orange County Government
Subscribers
Total
Claims
Stop Loss
Credits
Net
Claims
HSA
August -13
1,012
$609,311.64
$0
$609,311.64
$21,341.70
September -13
1,006
$494,158.67
$0
$494,158.67
$21,341.70
October -13
1,013
$636,751.28
$0
$636,751.28
$21,754.10
November -13
1,016
$946,271.22
$0
$946,271.22
$21,857.20
December -13
1,015
$631,855.00
$0
$631,855.00
$21,857.20
January -14
979
$614,054.44
$0
$614,054.44
$23,718.00
February -14
980
$685,672.00
$0
$685,672.00
$24,072.00
March -14
974
$995,490.59
$134,831
$860,659.59
$23,364.00
April -14
985
$607,744.02
$125,351
$482,393.02
$24,544.00
May -14
985
$635,821.26
$13,128
$622,693.26
$24,308.00
June -14
984
$651,854.42
$44,024
$607,830.42
$24,072.00
July -14
981
$908,800.00
$10,944
$897,856.00
$24,190.00
Total
11,930
$8,417,784.53
$328,278.00
$8,089,506.53
$252,229.90
Self- funded Calculation
Of the 13% increase,
Care Reform
5 %.
Health
is responsible for
Current PPO Plan Design
2015 Renewal
Claims - Without Benefit Change
$8,089,507
Trend 2015 -8%
111.30%
Trended 2015 Claims
$9,003,621
Administration
$495,095
Stop Loss Insurance
$1,276,868
PPACA - Fee for Comparative Effectiveness Research Agency
$3,188.00
PPACA - Transitional Reinsurance Fee - 2014 - 2016
$72,621.96
Copays Accumulate to Out of Pocket Maximum - 5%
$450,181.04
HSA Cost - $1,416
$288,864.00
Clinic Costs
$0.00
2015 Cost
$11,590,439
Current Contribution
$9,938,644
HSA Contribution Budget - $1,416
$288,864
Total Contribution for 2014
$10,227,508
Percentage Change over 2014
113.33%
U.,
J
W
5
UnitedHealthcare
100K/12/12/120%
2014
UnitedHealthcare
125K/Paid/12/120%
2015 - 6 Month Renewal
Current
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
Ded uct /20%
Ded uct /20%
Ded uct /20%
Ded uct /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
$1,416.00
$1,416.00
Lifetime Maximum
Unlimited
Unlimited
Unlimited
Unlimited
Change
N/A
13%
POS
HSA
POS
HSA
County
Employee
County
Employee
County
Employee
County
Employee
Change
115.50%
100.00%
115.50%
100.00%
Employee Only
$631.18
$0.00
$628.15
$0.00
$729.01
$0.00
$725.51
$0.00
Employee and Spouse
$922.61
$409.19
$922.61
$271.80
$1,065.61
$409.19
$1,065.61
$271.80
Employee and Children
1 $792.62
1 $229.90
$792.62
$151.82
$915.48
$229.90
$915.48
$151.82
Employee and Family
1 $1,158.71
1 $734.83
$1,158.71
$489.74
$1,338.31
$734.83
$1,338.31
$489.74
5
J
19
0
UnitedHealthcare
100K/12/12/120%
2014
UnitedHealthcare
125K/Paid/12/120%
2015 - 6 Month Renewal
Current
Renewal: Option 2
Current POS
Current HSA
Current POS
Current HSA
In- Network
In- Network
In- Network
In- Network
Primary Care Physician Visits
$20
Deduct /20%
$25
Deduct /20%
Specialist Physician Visits
$40
Deduct /20%
$50
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 Co pay
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/$45/$60
Deduct /20%
Vision Hardware
Not covered
Not covered
Not covered
Not covered
HSA
$1,416.00
$1,416.00
Lifetime Maximum
Unlimited
Unlimited
Unlimited
Unlimited
Change
N/A
9%
POS
HSA
POS
HSA
County
Employee
County
Employee
County
Employee
County
Employee
Change
111.00%
100.00%
111.00%
100.00%
Employee Only
$631.18
$0.00
$628.15
$0.00
$700.61
$0.00
$697.25
$0.00
Employee and Spouse
$922.61
$409.19
$922.61
$271.80
$1,024.10
$409.19
$1,024.10
$271.80
Employee and Children
$792.62
$229.90
$792.62
$151.82
$879.81
$229.90
$879.81
$151.82
Employee and Family
$1,158.71
$734.83
$1,158.71
$489.74
$1,286.17
$734.83
$1,286.17
$489.74
0
L Recommendations
The 2015 Plan Year renewal options: 20
Allow the County to transition to a fiscal year plan,
which aligns with budget planning.
The options ensure that the employees don't have a
premium increase for the first 6 months of the plan
yea r.
Gives the County six additional month of claims to
review in preparation for the new 2015 — 2016 plan
yea r.
21
Mark //I
limploy" Q�woeMs