Orange County NC Website
4 <br />accessible health insurance coverage for dependents (spouse, domestic partner, children, or <br />entire family) to employees, particularly lower salaried employees for whom dependent health <br />insurance coverage is a significant cost. Continuation of the subsidy at this level maintains a <br />"family friendly" feature that is highly valued by the 45% of employees with dependent coverage; <br />However, this practice does present an equity issue for employees without dependent <br />coverage. By paying the dependent subsidy, total compensation for employees with <br />dependents is greater than for those without dependents. <br />An added component of the health insurance for all options is Health Advisor, a CIGNA <br />program which provides each healthy and at-risk employee with a health coach who can assist <br />an employee in improving his or her health. Additionally, Orange County has partnered more <br />closely with NCACC to enhance the Wellness Committee and wellness activities. Because <br />healthier employees have a higher quality of life, are more productive, and generally require <br />less costly health care, wellness activities will continue to be an important benefit for County <br />employees and retirees. Highly discounted membership rates for the Triangle Sportsplex <br />continue to be a popular wellness benefit for employees. Currently 155 employees are <br />members (based on payroll deductions). <br />Staff has considered several .options for the 2009 plan year that are within the 8% increase <br />budgeted for FY 08-09. The health care trend (percentage increase in claims costs that <br />actuaries expect to see in the next 12-month period) would have, required a premium increase <br />of 10-12% over the 2008 rates. Because Orange County's actual medical experience in health <br />care claims in FY 07-08 was under the 10-12% trend, staff was able to negotiate a rate lower <br />than the annual trend for a renewal of the current plan design with no changes in copays, <br />deductibles or coinsurance. Staff has provided information for renewal and two alternatives. A <br />comparison of plan designs is shown on Attachment 4 and the costs for the renewal and <br />options is provided in Attachment 5A. Attachment 5B shows total monthly ,premium costs per <br />employee; Attachment 5C shows employee monthly costs, and Attachment 5D shows County <br />costs. Advantages and disadvantages of the renewal and options are shown on Attachment 6. <br />Renewal of Current Plan Des~n-HMO premiums are higher than PPO. Renewing with no <br />change to plan designs results in an increase to the County of approximately $199,700 for FY <br />08-09. In the past, premiums for the PPO plan have been higher than the premiums for the <br />HMO. 2009 reverses that pattern and the premiums for the HMO are. thus more expensive <br />because of the high volume of claims and because it provides greater benefits to employees. <br />PPO employees will continue to pay higher out of pocket expenses because the PPO plan has <br />a 10% co-insurance requirement up to $1,000/year per member (to a maximum of $3000 per <br />family) for services such as hospitalization and diagnostic medical services. <br />Option 1 Buy up Plan. This option provides the same plans as the Renewal Plan, but requires <br />employees to pay an additional premium (e.g., $20.48/month for employee only coverage) for <br />the higher priced plan. Because the HMO would be the higher priced plan, employees who <br />choose to remain in the HMO would be required to pay the difference (buy-up) between the <br />premium for the PPO and the HMO. <br />This option would result in an increase for the County of approximately $130,970 for FY 08-09. <br />The increase in premiums for employees would be $79,500, assuming that only 25% of <br />employees (based on NCACC projections) chose to stay with the HMO and pay the additional <br />monthly premium. Employees who choose the PPO will have a smaller increase in premiums <br />for dependent care, but they will have higher out of pocket costs for services compared to <br />