HomeMy WebLinkAboutDocumentation_Regular_Tab 17_08/09/2018 . • •
Memo
To: Michael R Couzzo, Jr., Village Manager
From: Merlene Reid, HR Director ?
Dabe: July 23, 2018
Re: Health and Dental Insurance 2018/19
Due to the current uncertainties surrounding the Healthcare Act and predictions of significant
increases, a 10% increase was budgeted for FY2018/19 renewals. Florida Blue released the
Village's renewal numbers in mid-July 2018 with proposed increases of 13.2%to retain current
benefits for the Traditional plan and 19.82% for the High Deductible Health plan. Subsequent
negotiations returned an overall increase of 6.8%for the Traditional plan and 13.04%for the
HDHP, or a total annual cost increase of$93,653.28. These numbers include four retirees and
one ex-Council members who are responsible for paying their full premiums which totals
$49,479. With respect to Florida Blue's BlueOptions plan renewals, the average trend increase
is 10-12% across their book of business. There will be no increase to the MetLife premiums.
The attached cost evaluation is based on the number of employees at July 1, 2018 and their
current choice of plans (family/individual). At its meeting on July 13, 2018, the Benefits
committee reviewed the numbers and alternate proposals provided and unanimously agreed
to recommend to the Village Manager that the final numbers be accepted. HR is therefore
requesting that the following recommendations be approved:
1. Renew the health insurance with Florida Blue, and
2. Renew the dental insurance with MetLife.
Benefits Committee Members
Management Reps. Union Reps
Brad Gomberg, I.T. Director Jason Fawcett, IAFF
Chris Quirk, Finance Director Ray Korkowski, PBA
Merlene Reid, HR Director/Chair Joe Petrick, CWA
vi��age of req�esta . C G E H R I N G G R O U P
Medical Insurance Renewal Evaluation
/ EM�LO�EE BENEFITS I RISK MANAGEMENT
Effective Date:October 1,2018
CURRENT INITIAL RENEWAL NEGOTIATED RENEWAL
� •
-�. � :� � �. � :i i -�. i :� �
Pian Basics In Nefwork , Out of Network In Network • Out of Network In Network ' Out of Network
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited
Plan Year Deductible(PYD)
Single $1,500 $3,000 $1,500 $3,000 $1,500 $3,000
Family $3,000 $6,000 $3,000 $6,000 $3,000 $6,000
Out of Pocket Maximum Includes all cost share Includes all cost share Includes all cost share
Single 53,000 $6,000 $3,000 $6,000 53,000 $6,000
Family $6,000 $12,000 $6,000 $12,000 $6,000 $12,000
Coinsurance 10% 40% 10% 40% 10% 40%
Physician Servlces
Primary Care Physician 10%after PYD 409'o after PYD 10�'o after PYD 40�o after PYD 10�o after PYD 40%after PYD
Specialist 10%after PYD 40%after PYD 10%after PYD 40%after PYD 10�a after PYD 40%after PYD
Preventive Benefits No Charge 40% No Charge 4090 No Charge 40%
Laboratoty Svcs.(Indep.Diag.Testing Ctr.) PYD 40�o after PYD PYD 40qo after PYD PYD 40%after PYD
X-Rays 10%after PYD 40%after PYD 10�o after PYD 40%after PYD 10�o after PYD 40%after PYD
Urgent Care Facility 109'a after PYD 10%after PYD 10%after PYD 10�o after PYD 10�'o after PYD I 109'o after PYD
Hospital Services
Inpatient Hospital 10�after PYD 403'o after PYD 109'o after PYD 409'o after PYD 10�o after PYD 40%after PYD
Outpatient Surgery 10%after PYD 40%after PYD 10%after PYD 40�o after PYD 10%after PYD 40%after PYD
Advanced Imaging(Independent) 10%after PYD 40%after PYD 10%after PYD 40�o after PYD 10%after PYD 40%after PYD
Emergency Room 10�o after PYD 10%after PYD 10%after PYD 10%after PYD 10�o after PYD 10%after PYD
Physician Services 10%after PYD 10%after In-Net PYD 10�o after PYD 10%a after In-Net PYD 10%after PYD 10%after In-Net PYD
Ambulance 10�o after PYD 10�o after In-Net PYD 10%after PYD 10%after In-Net PYD 103'o after PYD 10%after In-Net PYD
Outpatient Therapy 10%after PYD 40%after PYD 109'o after PYD 40%a after PYD 10%after PYD 40%after PYD
Mental Health&Substance Abuse
Inpatient Hospital 10%after PYD 40%after PYD 10%after PYD 40%after PYD 10%after PYD 40%after PYD
Outpatient Services 10%after PYD 40%after PYD 10�o after PYD 40%after PYD 10%after PYD 40%after PYD
Pharmacy Plan
Generic S10 after PYO $10 after PYD 510 after PYD
Preferred Brand $50 after PYD 50%after In-Net PYD $50 after PYO 50%after In-Net PYD $50 after PYD 509�o after In-Net PYD
Non Preferred Brand $80 after PYD $80 after PYD $80 after PYD
Mail Order Copay 2.Sx after PYD N/A 2.Sx after PYD N/A 2.Sx after PYD N/A
Monthl Premium HDHP'� HDHP' HDHP'
Employee 1 $552.24 $643.65 $607.22
Employee+Spouse 1 $1,219.06 51,478.75 $1,395.05
Employee+Child(ren) 0 $942.47 $1,143.23 $1,078.52
Family 0 $1,598.09 $1,938.53 $1,828.80
Mo�thly Premium $1,771.30 $2,122.40 $2,002.27
Annual Premium $21,255.60 $25,468.80 $24,027.24
Total$Increase N/A $4,213.20 $2,771.64
Total%Increase N/A 19.82% 13.04%
•Premiums do not include HSA administration fee
village of Tequesta C G E H R I N G G R O U P
-
Medical I�surance Renewa)Evaluation I EMPLOVEE BENEGITS � RISK MANAGEMENT
Effective Date:October 1,2018
CURRENT ALTERNATIVE ql(HMO)
� � -
-�. � :i �
Plan Basics In Network , Out of Network ,.- . . Out of Network
Lifetime Maximum Unlimited Unlimited Unlimited '
Plan Year Deductible(PYD) '�
Single 51.500 !� $3,000 $1,500
family $3,000 I $6,000 $3,000
Out of Pocket Maximum Includes all cost share Includes all cost share Not Covered
Single $3,000 I 56,000 53,000 ,
family $6,000 ' $12,000 $6,000 �
Coinsurance 10°/a j 40% 10% I
Physician Services
Primary Care Physician 10%after PYD I� 40%after PYD 10�o after PYD i
Specialist 10%after PYD i 40%after PYD 10%afterPYD �
Preventive Benefits No Charge i 409'o No Charge i Not Covered
Laboratoty Svcs.(Indep.Diag.Testing Ctr.) PYD ! 40%after PYD 10%after PYD i
X-Rays 10%after PYD I 40%after PYD 10%after PYD I
Urgent Care Facility 10%after PYD I� 10%after PYD 10�o after PYD
Hospital Services
Inpatient Hospital 10%after PYD � 40%after PYD 10%after PYD
Outpatient Surgery 10%after PYD � 40%after PYD 10%after PYD Not Covered
Advanced Imaging(Independent) 10%after PYD 40%after PYD 10%after PYD
Emergency Room 10%after PYD I 10�o after PYD 109'o after PYD
Physician Services 10%after PYD 10%after In-Net PYD 10%after PYD Not Covered
Ambulance 10%after PYD 10%after In-Net PYD 10%after PYD
Outpatient Therapy 10%after PYD � 40%after PYD 10%after PYD I Not Covered
Mental Health&Substa�ce Abuse
Inpatient Hospital 10%after PYD � 40%a after PYD 10%after PYD Not Covered
Outpatient Services 10%after PYD I 40�o after PYD 10%after PYD
Pharmacy Plan
Generic $10 after PYD $10 after PYD
Preferred Brand $50 after PYD 509'o after In-Net PYD $50 after PYD
Non Preferred Brand $80 after PYD � Not Covered
$80 after PYD
Mail Order Copay 2.5x after PYD N/A 2.Sx after PYD
Monthl Premium HDHP• HDHP•
Employee 1 $552.24 $505.02
Employee+Spouse 1 $1,219.06 $1,177.59
Employee+Child(ren) 0 $942.47 $910.41
Family 0 $1,598.09 $1,543.73
Monthly Premium $1,771.30 $1,682.61
Annual Premium $21,255.60 $20,191.32
Total$Increase N/A -$1,064.28
Total%Increase N/A -5.0%
'Premiums do not indude HSA odministration fee
Village of Tequesta C G E H R I N G G R O U P
�
Medical Insurance Renewal Evaluation I EMFLO�EE 6ENEFITS � RISK MANAGEMENT
Effective Date:October 1,2018
CURRENT INITIAL RENEWAL NEGOTIATED RENEWAL
� •
-�. � •�. i �. i
Plan Basics In Network Out of Network In Network Out of Network In Network Out of Network
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited
Plan Year Deductible(PYD) I
Single $250 51,000 $250 $1,000 5250 51,000
Family 5750 $3,000 $750 j $3,000 $750 $3,000
Out of Pocket Maximum Includes all costs Includes all costs Includes all costs
Single $3,000 $6,00� $3,000 I $6,000 $3,000 I $6,000
Family $6,000 $12,000 $6,000 �� $12,000 $6,000 $12,000
Coinsurance O�o 50% 09'o I� SO�o O�o SO�o
Physician Services
Primary Care Physician $20 ' S0%after PYD $20 I� 50%after PYD $20 50%after PYD
Specialist $45 I SO�o after PYD $45 � 509�o after PYD $45 50%after PYD
Preventive Benefits No Charge , 50% No Charge , 50°� No Charge 50%
Laboratory Svcs.(Indep.Diag.7esting Ctr.) No Charge 50'Yo after PYD No Charge � 50%after PYD No Charge 509'o after PYD
X-Rays $50 ' S0%after PYD $50 50%after PYD $50 509�o after PYD '
Urgent Care Facility $50 i $50 copay+PYD $50 i 550 copay+PYD $50 $50 copay+PYD
Hospital Services Option 1/Option 2 Option 1/Option 2 Option 1/Option 2
Inpatient Hospital $700/$1,000 �, 50�o after PYD $700/$1,000 �� 509�o aker PYD $700/$1,000 50%after PYD
Outpatient Surgery $300/$600 ', 50%after PYD $300/$600 ', 50%after PYD $300/5600 50%after PYD
Advanced Imaging(Independent) $200 ', 50%after PYD $200 , 50%after PYD $200 50%after PYD
Emergency Room $200 $200 $200 �' $200 $200 � $200
Physician Services $50 ' $SO $50 ' $50 550 I $50
Ambulance PYD i In-Network PYD PYD li In-Network PYO PYD In-Network PYD
Outpatient Therapy $45/$60 I 50%after PYD $45/$60 I 50%after PYD $45/$60 509'o after PYD
Mental Healh&Substance Abuse
Inpatient Hospital No Charge 50% No Charge � 50% No Charge � SO�o
Outpatient Services No Charge 50% No Charge � 50% No Charge � 50%
Pharmacy Plan
Generic $10 $10 $10
Preferred Brand $50 SO�o 550 50%
$50 50%
Non Preferred Brend $80 $80 , $80
Mail Order Copay 2.Sx N/A 2.Sx I N/A 2.Sx N/A
Monthly Premium Tradltlonal Traditiona/ Tiadltionol
Employee 49 $638.89 $722.97 $682.05
Employee+Spouse 3 $1,502.55 $1,720.68 $1,623.28
Employee+Child(ren) 15 51,175.55 $1,330.27 $1,254.97
Family 29 $1,99333 $2,255.67 $2,127.99
Monthly Premium $111,253.08 $125,956.05 $118,826.55
Annua)Premium $1,335,036.96 $1,511,472.60 $1,425,918.60
Total$Increase N/A $176,435.64 $90,881.64
Total%Increase N/A 13.2% 6.8%
Village of Tequesta C G E H R I N G G R O U P
�
Medical Insurance Renewal Evaluation I EMFLO�EE BENEFITS � RISK MANAGEMENT
Effective Date:October 1,2018
CURRENT ALTERNATIVE til ALTERNATIVE p2(HMO)
� �
• � � i
Plan Basics In Network Out of Network In Network Out of Network _ �t��«crk�nty Out of Network
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited
Plan Year Deductible(PYD)
Single $250 $1,000 $S00 $1,500 $500
Family $750 $3,000 $1,500 $4,500 $1,000 Not Covered
Out of Pocket Maximum Includes all costs Indudes all costs Includes all costs '
Single $3,000 $6,000 $3,000 $6,000 $3,500
Fa m i ly $6,000 $12,000 $6,000 $12,000 $7,000
Coinsurance 0% 509�0 20°� 50% 10%
Physician Services
Primary Care Physician $20 SOYo after PYD $25 50%after PYD $15
Specialist $45 50%after PYD $60 50%after PYD $35
Preventive Benefits No Charge 50% No Charge 50% No Charge Not Covered
Laboratory Svcs.(Indep.Diag.Testing Ctr.) No Charge 50%after PYD No Charge 50%after PYD No Charge
X-Rays $50 50%after PYD $50 SO�o after PYD $35 j
Urge�t Care Facility $50 $50 copay+PYD $65 $65 copay+PYD $35 'I
Hospital Services Option 1/Option 2 Option 1/Option 2
Inpatient Hospital $700/$1,000 50�o after PYD 20Ya after PYD SO�o after PYD $500
Outpatient Surgery $300/$600 50%after PYD 20°h after PYD 50%after PYD $350 Not Covered
Advanced Imaging(Independent) $200 50%after PYD 20°�after PYD S0�'o after PYD $75
Emergency Room $200 $200 $300 $300 $300
Physician Services $50 $50 $100 $S00 No Charge � Not Covered
Ambulance PYD In-Network PYD 20%after PYD 20%after In-net PYD 10%after PYD
Outpatient Therapy $45/$60 50%after PYD 545/$60 50%after PYD $55 � Not Covered
Mental Healh&Substance Abuse
Inpatient Hospital No Charge SO�o No Charge 50% No Charge � Not Covered
Outpatient Services No Charge 50% No Charge 50% No Charge �
Pharmacy Plan
Generi� $10 $10 $10
Preferred Brand $50 50% $50 50% 550
Not Covered
Non Preferred Brand $80 $80 580
Mail Order Copay 2.Sx N/A 2.Sx j N/A 2.Sx
Monthly Premium Traditional T�aditional Traditional
Employee 49 $638.89 $674.13 $575.22
Employee+Spouse 3 $1,502.55 $1,604.43 $1,369.02
Employee+Child(ren) 15 51,175.55 51,240.40 $1,058.40
Fa m ily 29 $1,993.33 $2,103.28 $1,794.68
Monthly Premium $111,253.08 $117,446.78 $100,214.56
Annual Premium $1,335,036.96 $1,409,361.36 $1,202,574.72
Total$Increase N/A $74,324.40 -5332,462.24
Total%Increase N/A 5.6% -9.9%
Village of Tequesta C G E H R I N G G R O U P
Medical Insurance Renewal Cost Evaluation I EMPIOYEE BENEFITS I RISK MANAGEMENT
Effective Date:October 1,2018
CURRENT RENEWAL NEGOTIATED RENEWAL
. . . ..- . . . . . . ..• . . � . . . ..• .. . .
Active EEs-Traditional
Employee 45 $0.00 $638.89 $638.89 $0.00 $722.97 $722.97 $0.00 $682.05 $682.05
Employee+5pouse 3 $215.92 $1,286.64 $1,502.55 $249.43 $1,471.25 $1,720.68 $235.31 $1,387.97 $1,623.28
Employee+Child(ren) 15 $134.17 $1,041.39 $1,175.55 $151.83 $1,178.45 $1,330.27 $143.23 $1,111.74 $1,254.97
Family 29 $338.61 $1,654.72 $1,993.33 $383.18 $1,872.50 $2,255.67 $361.49 $1,766.51 $2,127.99
Retirees&COBRA-Traditional
Employee 4 $638.89 $0.00 $638.89 $722.97 $0.00 $722.97 $682.05 $0.00 $682.05
Employee+Spouse � $1,502.55 $0.00 $1,502.55 $1,720.68 $0.00 $1,720.68 $1,623.28 $0.00 $1,623.28
Employee+Child(ren) � $1,175.55 $0.00 $1,175.55 $1,330.27 $0.00 $1,330.27 $1,254.97 $0.00 $1,254.97
Family � $1,993.33 $0.00 $1,993.33 $2,255.67 $0.00 $2,255.67 $2,127.99 $0.00 $2,127.99
Ac[ive EEs-HDHP
Employee 1 $0.00 $552.24 $552.24 $0.00 $643.65 $643.65 $0.00 $607.22 $607.22
Employee+Spouse � $166.71 $1,052.36 $1,219.06 $208.78 $1,269.98
$1,478.75 $196.96 $1,198.09 $1,395.05
Employee+Child(ren) � $97.56 $844.91 $942.47 $124.90 $1,018.34 $1,143.23 $117.83 $960.70 $1,078.52
Family � $261.46 $1,336.63 $1,598.09 $323.72 $1,614.81 $1,938.53 $305.40 $1,523.41 $1,828.80
Retirees&COBRA-HDHP
Employee � $552.24 $0.00 $552.24 $643.65 $0.00 $643.65 $607.22 $0.00 $607.22
Employee+Spouse 1 $1,219.06 $0.00 $1,219.06 $1,478.75 $0.00 $1,478.75 $1,395.05 $0.00 $1,395.05
Empioyee+Child(ren) � $942.47 $0.00 $942.47 $1,143.23 $0.00 $1,143.23 $1,078.52 $0.00 $1,078.52
Family � $1,598.09 $0.00 51,598.09 $1,938.53 $0.00 $1,938.53 $1,828.80 $0.00 51,828.80
Monthly Premium 98 $16,254.53 $96,769.85 $113,024.38 $18,508.36 $109,570.09 $128,078.45 $17,460.69 $303,368.13 $120,828.82
Annual Premium $195,054.36 $1,161,238.20 $1,356,292.56 $222,300.35 $1,314,841.05 $1,536,941.40 $209,528.25 $1,240,417.59 $1,449,945.84
$Increase N/A N/A N/A $27,045.99 $153,602.85 $180,648.84 $14,473.89 $79,17939 $93,653.28
%Increase N/A N/A N/A 13.87% 13.23% 13.32% 7.42% 6.82% 6.91%
Village of Tequesta C G E H R I N G G R O U P
I EMPLOYEE BENEFITS � RISK MANAGEMENI
Dental Insurance Renewal Evaluation
Effective Date: October 1, 2018
CURRENT RENEWAL
� • :
�• •� �- •�
Plan Basics In Network Non Network In Network Non Network
Calendar Year Maximum $1,500 $1,500
Deductibles
Single $25 $50 $25 $50
Family Maximum $75 $150 $75 $150
Deductible Waived for Preventative
Svcs Yes No Yes No
Benefits
Preventative 100% 100% 100% 100%
Basic 100% 80% 100% 80%
Major 60q 50�'0 60qo 50%
Orthodontia 509'0 509� 50% 50%
Service Information
Out of Network Benefits Payable
Level 90th percentile 90th percentile
Be�efits Waiting Period(Timely
Entrants) None None
Orthodontia Lifetime Maximum $1,000 $1,000
Endodontics/Periodontics Payable
Level Basic Basic
Rate Gua�antee Expires 9/30/2019 12 Mo�ths
Premium per Month
Employee 56 $41.02 $41.02
Employee+Family 42 $110.74 $110.74
Monthly Premium $6,948.20 $6,948.20
Annual Premium $83,378.40 $83,378.40
$Increase N/A $0.00
%Increase N/A 0.090
VillageofTequesta C GEHRING GROUP�
Vision Insurance Renewal Evaluation � EMPLOYEE BENEFITS � RISK MANAGEMENT
Effective Date: October 1, 2018
CURRENT INITIAL RENEWAL NEGOTIATED RENEWAL
� • :
In Network Non Network In Netwoifc Non Network In Network Non Network
Exam Copay $20 $20 $20
Materials Copay $20 $20 $20
F�equeocy
Exam 12 months 12 months 12 months
Lenses 12 months 12 months 12 months
Frames 24 months 24 months 24 months
Benefits Payable
Eye Exam $20 Up to$45 $20 Up to$45 $20 Up to S45
Single Lenses $20 Up to$30 $20 Up to$30 $20 Up to$30
Bifocal Lenses $20 Up to$50 $20 Up to$50 $20 Up to$50
Trifocal Lenses $20 Up to$65 $20 Up to$65 $20 Up to$65
Lenses and fremes
Contact Lenses(Elective) Up to$100 Up to$80 Up to$100 Up to$80 Up to$100 Up to$80
Contact Lenses(Medically Necessary) Paid in Fuil Up$210 Paid in Full Up$210 Paid in Full Up$210
Frames Up to 5100 Up to$55 Up to$100 Up to$SS Up to$100 Up to$55
Rate Guarantee Expires 09/30/2019 12 Months 12 Months
Premium per Month
Employee 35 $5.90 $6.14 $5.90
Employee+Spouse 9 $11.83 $12.30 $11.83
Employee+Children 10 $10.01 $10.41 $10.01
Employee+Family 11 $16.51 $17.17 $16.51
Monthly Premium $594.68 $618.57 $594.68
Annual Premium $7,136.16 $7,422.84 $7,136.16
$Increase N/A $256.68 $0.00
%Increase N/A 4.0X 0.0%