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3 <br /> In summary: <br /> - Option A provides for the most cost savings identified with the least <br /> change from an employee standpoint. <br /> Option B provides for the most cost savings identified while still retaining <br /> HealthSource as a health plan option, and <br /> Option C provides for the greatest cost savings of all the options <br /> identified, but also results in the most employee change in terms of <br /> physician relationships. <br /> NCACC Health Insurance Trust <br /> Options A, B and C all provide for renewal of the Blue Cross plans through the <br /> NCACC Health Insurance Trust, contingent on negotiation of a satisfactory <br /> Interlocal Agreement with the Trust. The Trust's quoted rates for the various <br /> BC/BS plan options average about 2.5 percent lower than those quoted directly by <br /> BC/BS. Depending on the option,this cost savings ranges from about$36,000 to <br /> $39,000 on a full year basis. <br /> The Trust offers only Blue Cross plans, although at least currently, we have been <br /> advised the County may enroll in the Trust and also offer a health insurance plan <br /> through another health insurance provider as well. <br /> The Trust is a health insurance purchasing cooperative established by the NCACC <br /> effective July 1, 1995. As of August 1995, about 46 counties and other <br /> governmental units have decided to join the Trust. <br /> Many details related to how the Trust will be structured and operate remain to be <br /> worked out. For example,the rate quotes the Trust provided for Orange County's <br /> 1996 renewal are based on a different calculation method than would be used for <br /> 1997 and beyond. For 1997 and beyond, rates will be based on a planned <br /> actuarial study of the Trust participants and involve some form of experience <br /> rating based on all Trust participants and the County's individual experience. <br /> If the County participated in the Trust,the Trust advises Blue Cross would <br /> continue to provide the same services it now provides. The Trust representatives <br /> advise that employees would not see any change in services from Blue Cross. <br /> A key question considered in evaluating Trust participation has been what risk, if <br /> any,the County incurs by Trust participation. The County's current Blue Cross <br /> plans operate on a fully insured basis. There is no financial liability to the County <br /> beyond the monthly premiums for the contracted period. The County would join <br /> the Trust on a"fully insured"basis but in the context of the Trust as a legal entity <br /> this has some different ramifications. <br /> Through the negotiation of the Interlocal Agreement the County would seek to <br />