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.Continues to increase the cost to the County and to the 45% of employees with dependent coverage .Requires HMO participants with dependent coverage to pay higher premiums than in past. .Does not provide employees with plans that represent a significant difference in cost and benefit level. Option 1 Buy Up Plan (chart) Option 1 "Buy Up Plan" Employee pays monthly premium when choosing the higher level plan or selects core plan at no premium cost Advantages: •Addresses inequity between the cost of two plans ■Allows choice of plan best meeting employee needs •Controls claims by cost sharing (paying for a premium or co-insurance) because more attention is paid to out of pocket costs. Disadvantages: •Affects 877 HMO employees who must decide to pay, even for employee only coverage, or to receive the same benefits as the PPO at no cost •The County saves but the employees' benefits are reduced in the no-cost option. •Increases the costs for HMO dependents more than the renewal rate. Option 2 (One Plan) (chart) Option 2 "One Plan" Combines HMO and PPO into one PPO Plan. Advantages .No difference in cost of dependent coverage .PPO would have decrease in co-insurance from $1,000 to $500. .Cost increase to employees with dependents is the lowest of all options. ■877 HMO members would gain access to out of network providers. .Cost to County is lower than renewal rate. Disadvantages .Affects all employees. ■877 employees/retirees in HMO would have a 5% co-insurance to a maximum of $500 vs. current $0 co-insurance. This will affect members with medical claims other than office visits/prescriptions. (Projections indicate 10-14% of members would be affected.) .Cost to County is slightly higher than Option 1. 2009 Options--Health Care Calendar Year Costs County Employee Total Increase 2008 Current Plan $6,380,253 $1,190,056 $7,570,309 Renewal of Current Plan $6,877,746 $1,293,552 $8,171,324 7.9% Option 1 (Buy Up Plan)