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2 <br /> 1 <br /> 2 In FY2016/2017, the Board of County Commissions approved the recommendation of the <br /> 3 County Manager to continue with UnitedHealth Care (UHC) as the County's Third Party <br /> 4 Administrator for health insurance programs and granted authority to the County Manager to <br /> 5 renew the Third Party Administrator contract with United Health Care. <br /> 6 <br /> 7 The UHC renewal was negotiated from $41.50 per employee per month to $29.50 per <br /> 8 employee per month with a guaranteed fee for 2 years and a 3 percent rate cap for July 1, <br /> 9 2018's renewal. UnitedHealth Care will also fund $25,000 for FY 2017/2018 for wellness <br /> 10 programs. <br /> 11 <br /> 12 Health Insurance <br /> 13 The FY2016/2017 total adopted budget for health coverage for employees is $8,645,863 and <br /> 14 $2,189,174 for retirees. The net increase for FY2017/18 is $524,433 based on the current <br /> 15 enrollment of employees and participating pre-65 retirees. The net increase assumes that the <br /> 16 pharmacy services will be independent of the UnitedHealth Care contract as described below. <br /> 17 The increase represents 5.05 percent to the County's health insurance appropriation. <br /> 18 <br /> 19 An addition to the current plan design is trans-inclusive health care coverage effective July 1, <br /> 20 2017. Trans-inclusive health coverage includes benefit coverage for the treatment of gender <br /> 21 dysphoria, a condition when a person's gender at birth is contrary to the one with which they <br /> 22 identify. The coverage for the treatment of gender dysphoria allows member access to medical <br /> 23 services based on gender identity and is not restrictive to services associated by a member's <br /> 24 gender at birth. More specifically, services will include cross-sex hormone therapy administered <br /> 25 by a medical provider, genital surgery, and pharmacy therapy, laboratory testing to monitor the <br /> 26 safety of continuous cross-sex hormone therapy, and mental health services including <br /> 27 psychotherapy and associated psychiatric diagnoses. <br /> 28 <br /> 29 All other health benefits, co-pays, co-insurance and deductibles will remain the same. The <br /> 30 County Manager is recommending no increase in premium equivalent for employees or <br /> 31 participating pre-65 retirees for FY2017/2018. <br /> 32 <br /> 33 The County participated in a Pharmacy Benefit Manager (PBM) Bid Comparison to "carve out" <br /> 34 pharmacy coverage with another PBM for July 1, 2017 coverage. The County evaluated the <br /> 35 PBM marketplace to accomplish two goals: 1) review the current contract with UHC-Optum Rx <br /> 36 and 2) review proposals from other PBM vendors for consideration of changing pharmacy <br /> 37 coverage effective July 1, 2017. <br /> 38 <br /> 39 Eights bids were received and two vendors were interviewed, the current vendor UHC-Optum <br /> 40 Rx and Envision Rx. Staff provided the analysis for review and recommendation by the County <br /> 41 Manager. The County Manager is recommending contracting with Envision Rx for pharmacy <br /> 42 benefits. Envision Rx will offer the following: <br /> 43 • Expenditure reduction of$141,000 annually is projected compared to the current <br /> 44 contract with UHC-Optum Rx. <br /> 45 • The County will only be responsible for paying an administrative fee for each <br /> 46 prescription. <br /> 47 dispensed offering more transparency to actual cost because there is no undisclosed <br /> 48 revenue. This is defined as a 100% pass-through offer. <br /> 49 • If Envision Rx negotiates deeper rates with network pharmacies during the contract, the <br /> 50 County is the beneficiary. It is likely that the network rates will exceed the minimums, <br />