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2 <br /> In FY2017/2018, the Board of County Commissioners approved "carving out" pharmacy <br /> coverage from UnitedHealth Care and contracted with Envision Rx as the County's Pharmacy <br /> Benefit Manager (PBM). This resulted in an expenditure reduction of $141,000 annually for <br /> FY2017/2018. The FY2017/2018 total County budget for health insurance for employees and <br /> pre-65 retirees was approximately $11.6 million dollars. <br /> For FY2018/2019, the Board of County Commissioners approved the County's participation in <br /> the North Carolina Health Insurance Pool (NCHIP), which included Blue Cross Blue Shield as <br /> the health care provider, and approved increasing Health Insurance funding (County share) by <br /> $750,000 and the Dental Insurance funding (County share) by $125,521. The County <br /> maintained current premium equivalent rates for health insurance and dental coverage for <br /> employees and pre-65 retirees. The total FY2018/2019 budget was projected to be <br /> approximately $13.3 million (including health savings account contributions) based on increases <br /> to current enrollment of 1,068 employees and pre-65 retirees. The County contribution was <br /> projected at $11.9 million; representing a 5.9 percent increase. <br /> Health Insurance <br /> The total FY2019/2020 budget is projected to be approximately $13.3 million (including health <br /> savings account contributions) based on current enrollments for employees and pre-65 retirees. <br /> The County contribution is projected at $11.9 million assuming that no changes are made to the <br /> current employee contribution structure. This represents no increase to the FY2019/2020 <br /> budget. <br /> Through December 2018, Orange County is in a very good position from a reserve perspective <br /> with NCHIP. Reserve levels are recommended at 1.25 times total monthly claims; $6.4 million <br /> has been funded by Orange County through December 2018; $819,000 has been paid in fixed <br /> costs; and $3.9 million paid in claims which results in a $1.7 million reserve. This is well over <br /> the recommended reserve level. <br /> Comparatively, $21.4 million has been funded by all participants of NCHIP through December <br /> 2018. A total of $16.9 million has been paid for claims resulting in a $4.5 million reserve. Of <br /> these reserves, $1.7 million is tied to Orange County. <br /> The following represents total health care appropriations over the last five years (County and <br /> Employee shares): <br /> 2015-16 2016-17 2017-18 2018-19 2019-20 <br /> Health Insurance $11,082,953 $11,784,305 $12,585,606 $13,333,299 $13,333,299 <br /> Budget <br /> Health Budget% 6.33% 6.80% 5.94% 0.00% <br /> Increase <br /> It is recommended that the premium equivalent for the high-deductible plan be decreased by <br /> $118 per month for each plan tier. The $118 per month represents 1/12th of the Health Savings <br /> Account County funding of $1,416 annually. A total of $363,912 is funded for Health Savings <br /> Accounts for FY2018/2019 and is 100% paid by the County. These funds are currently not paid <br /> to NCHIP and therefore not necessary to include as part of the high-deductible premium <br /> equivalent. The Health Savings Account funding is budgeted separately in the Health Insurance <br /> 70 Fund. <br />