Agenda - 10-09-2007-6e - Laserfiche WebLink

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Attachment 7 North Carolina Association of County Commissioners ~~ Group Benefits Pool Rates Effective January 1, 2008 to January 1, 2009 for Orange County Alternate #1: Add Employee /Child Rate Standard Funding Kates PPO PPO Rates Renewal HMO cts Co HMO Rates Monthly Rates Contracts Current 84 $475 $526.83 473 $405 64 $44910 Employee 47 7 . 003.94 $1 $1,111.52 114 $855.52 $947.19 Employee /Spouse , $737:55 0 na $628.72 Emp /Child p 3 na 30 $918 $1,016.69 145 $7216 2 $ Employee /Children 0 . 427.46 $1 $1,580.41 118 $1, 1 347.32 ' Family Total /Annual Amount 57 , $385,764 $427,101 850 $6,558,169 $7,1 60o26i 10.7% Rate Change _._. Health Benefits Current PPO Renewal PPO 1 Current HMO $10 Renewal HMO $10 PCP Copay $10 $20 $10 $20 $20 $20 Specialist Copay $150 $150 $150 $150 Emergency Room Copay $250 $250 $250 $250 In-Network Deductible 000 $1 $1,000 $0 $0 ~In-Network Out-of-Pocket , 3 times 3 times 3 times s Family Limit 90% 90% 100% 100% In-Network Coinsurance In-Network OP Laboratory Services 100% 100% 100% 100% 100% Preventive Care Program 100% $5-15-30 100% $5-15-30 100% $5-15-30 $5-15-30 Rx Copay -Retail $13-26-60 $13-26-60 $13-26-60 $13-26-60 Rx Copay -Mail Order $10 $10 $10 $10 Vision Exam Deductible na na Vision Hardware na na 1. No change from Current Benefits Please Note: 1. Annual cost projections are based upon "Number Enrolled" as shown above. Actual cost will vary based upon actual enrollment. 2. At least 75% of eligible employees must participate in this plan. 3. Standard Funding covers eligible claims which are incurred during the contract period. 4. Please indicate your acceptance of this renewal offer by signing below. Please submit to NCACC at least 30 days prior to the effective date of the contract period. Accepted by the County or Group Name: Title: n~+o• This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. Financial Officer Date: