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7 <br />Attachment 1 <br />Orange County Claims Experience and Wellness Program Update <br />The County's health insurance rate increase for 2006 results largely from claims <br />experience during the 200.5 plan year to date, Increases in frequency and cast of medical <br />services figured most prominently. Outlined below is additional information related to the <br />County's claims experience and an update on the employee wellness program, <br />Contributions Compared to Claims <br />During the two year period of 2003-04 and 2004-05, there was a close margin between <br />County premiums paid versus actual claims casts, The chart below shows Orange County <br />premiums paid as compared to total claims and related costs for these two fiscal years. <br />Fiscal Year Premiums Claims* Difference <br />2004-05 $4,975,764 $4,767,684 $208,080 <br />2003-04 $3,921,838 $3,892,386 $29,452 <br />'Includes administrative costs and costs for stop loss insurance. Premiums paid amount is from <br />County records and claims cost is from the NCACC.. <br />Utilization Trends <br />While the County experience is below the NCACC norm in some areas of utilization such <br />as inpatient hospital admissions and emergency room visits, it is above the norm in other <br />areas such as outpatient visits, physician visits and prescription drugs. Several highlights <br />of Orange County plan utilization during May 2004 through April 2005 are shown below: <br />^ Hospital outpatient visits increased six percent during the period as compared to the <br />previous year and were above the NCACC norm, <br />^ While the average number of emergency room visits for Orange County has decreased <br />and was below the NCACC norm, the average cost per visit rose 21 percent and <br />exceeded the NCACC norm, <br />^ While the primary care visit rate has remained relatively stable and was comparable to <br />the NCACC norm, the average allowed charge per office visit increased 22 percent and <br />exceeded the NCACC norm. <br />^ Prescription drug costs and number of prescriptions per member increased for Orange <br />County, and were above the NCACC norm, The increase in large part was due tc an <br />increase in cost of brand name dn~gs without generic equivalents. <br />^ All measures of hospital inpatient utilization were below NCACC averages including the <br />total number of admissions, as well as the average cost per admission. The admission <br />rate far Orange County employees was 21 percent below the NCACC norm and the <br />average days per admission were 24 percent below the norm, <br />