Orange County NC Website
Browse       Search
7 <br /> Option 1 <br /> Same plan as the renewal, with the addition of: <br /> • In Network simple labs (e.g., throat cultures) included in office co-pay (covered at 100%) <br /> instead of additional charges subject to deductible or coinsurance <br /> • Pharmacy benefits with co-pays of$4/$25/$45, and all generics in Tier 1 <br /> • Office surgery included in office co-pay instead of additional charges subject to <br /> deductible or coinsurance (e.g., mole removals) <br /> • Contribution of$1,237.20 to Health Savings Account for members of High Deductible <br /> Plan <br /> Option 2 <br /> Same plan as Option 1, with the addition of obesity services, including obesity surgery <br /> Costs <br /> Attachment 3 provides cost details for the renewal and options. <br /> Self-Funding <br /> The renewal information presented by UnitedHealthcare and Mark III is based on less than six <br /> months of claims. As a fully-insured plan, the County would continue to pay a premium for <br /> health insurance, and would bear no additional risk. If claims exceed the amount of premiums <br /> paid, UnitedHealthcare pays the cost of those claims. If the County is self-insured, the County <br /> pays all claims as well as additional stop-loss insurance. <br /> Self-funding allows greater flexibility in addressing the health care needs of employees and <br /> retirees. An insurance carrier providing fully insured coverage is limited by standardized plans <br /> approved by the North Carolina Department of Insurance. <br /> Staff will review the feasibility of self-insuring in 2014 when the County has twelve months of <br /> claims information, in the spring of 2013. A third-party administrator would be determined <br /> through a competitive process and employee input would be requested in designing the plan <br /> components. <br /> Should self-funding be implemented, a County-operated employee clinic would potentially offer <br /> increased cost reductions and productivity. An employee clinic would offer a no-cost option to <br /> employees for minor illnesses and preventive care, save employees' time, and reduce health <br /> care expenses for both the County and employees. <br /> A - 5 <br />