Minutes 09-11-2014 - Laserfiche WebLink

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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. Mark Browder said option 1 has no benefit design changes and has a 13 percent increase in cost. He said option 2 reflects a benefit design change to offer some relief on the renewal. He said there is a 5 dollar increase on the primary physician co-pay, and a 10 dollar increase on the specialist co-pay. He read through several changes to the pharmacy benefits. He said this option reflects a 9 percent increase in funding, and the rates and details are included on slide 19. Mark Browder said the staff recommendation on slide 20 is to transition the plan from being a calendar year plan to a fiscal year plan. He said this would align with the budget process, and it would provide an additional 6 months of claims data to prepare for the new plan year. Commissioner Rich said the pharmacy increases seem to be a large jump. Mark Browder said this is purely to help with cost relief. He said the $4, $45, and $60 co-pays are common within the County government plans. Chair Jacobs asked for an explanation of the pharmacy tiers. Mark Browder said tier 1 is typically for the low cost and generic medications; the second tier is for the preferred medications from a cost and efficacy perspective, and these are typically brand names. He said the third tier includes the most expensive medications. Commissioner Rich asked which tier birth control falls under. Mark Browder said these fall under tier one. Diane Shepherd said due to health care reform birth control is in the first tier or free. Commissioner porosin asked about the differences in the listed change percentages. Mark Browder said there were discussions on how to insulate employees from an increase in their premium cost structure. He said staff looked at what it cost for the County to bear the entire increase, and these numbers are reflected. Commissioner Rich asked if staff has looked into other insurance companies. Mark Browder said this has not been done for this year. He said United Healthcare was the most competitive in the past. He said if you look at the renewal based on the fully insured for this year, it would probably be a 4 to 5 percent higher cost structure. He said it is typically more cost effective to be self-funded, especially for the size of the group. Chair Jacobs asked if there would there be a point where it would make sense to pursue other companies. Mark Browder said this would usually be done every three years. Chair Jacobs said he knows there is not enough experience with the self-funded option yet. Bonnie Hammersley said staff will continue to look all of this. She said staff is also looking into an in-house clinic. She said the next six months will give a better track record to consider. Chair Jacobs thanked the staff for listening. He said this will not be exactly aligned with the budget adoption but it will be closer than 8 or 9 months out. Bonne Hammersley said she has experience with this, and it does become very much a part of the budget process.