Agenda - 09-15-2009 - 6c - Laserfiche WebLink

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a • Employees overwhelmingly preferred to be encouraged to be more health conscious rather than having benefits reduced or a premium required without encouraging healthy behavior. Health Insurance The County offers two fully insured health insurance plans. Both health plans are contracted through the NCACC Health Insurance Trust and administered by CIGNA. One plan is a Health Maintenance Organization (HMO) that requires participants to use a provider network of physicians and facilities. The second plan is a Preferred Provider Organization (PPO) that allows both in- and out-of-network services. When a PPO member uses out-of-network services, the cost is higher. Both plans offer physicals, health screenings and immunizations at no cost to the member. Orange County health insurance premiums have doubled between 2002 and 2010. The current number of employees enrolled in each plan, past rate changes, and past plan changes to employee health insurance are shown on Attachment 1. The County currently pays the entire monthly premium for individual coverage with both the HMO and PPO plans. The County also subsidizes the premium cost for the employee's dependent coverage at 52%, based on the lower priced plan (which is the PPO plan). This practice was established several years ago to provide affordable and thus, accessible health insurance coverage for dependents (spouse, domestic partner, children, or entire family) to employees. This is particularly attractive to lower salaried employees for whom dependent health insurance coverage is a significant percentage of salary. Continuation of the subsidy at this level maintains a "family friendly" feature that is highly valued by the 46% of employees with dependent coverage; however, it does present an equity issue for employees without dependent coverage. Employees with dependent coverage will see increases in their premiums this year. Efforts were initiated in October 2008 to further educate employees on the impact their actions have on the cost of health insurance and ways to most effectively use their benefits. Employee meetings were held with employees describing ways employees could become wise health care consumers and save money. Wellness Open Houses, Orange Alive articles, and discussions with the Pay and Benefits Committee and several departments further informed employees on how to use their health care most effectively. As a way to encourage healthy behavior and best utilize health insurance benefits, employees were encouraged to complete a health risk assessment (HRA) during Open Enrollment for 2009. In 2009, health insurance was renewed with one enhancement: the addition of Health Advisor, a CIGNA program which provides participating employees with a health coach who can assist an employee in improving his or her health. The HRA is a key component of Health Advisor because the assessment allows the creation of an individual health improvement plan. Since then, approximately 5% of employees have taken the Health Risk Assessment affiliated with this program. The goal for 2010 is to have 100% of employees completing the HRA. For 2009, the national health care trend (percentage increase in claims costs that actuaries expect to see in the next 12-month period) has been increasing 10% over the previous year. Orange County's increase has trended at 8%. The FY 2009-10 budget includes a 4% increase for health insurance. County staff requested a renewal from NCACC of the same health insurance plan with no increase. Negotiations with the NCACC resulted in an overall increase 2