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Gehring Group Health Insurance Presentation
The Village of North Palm Beach Medical Insurance Renewal Evaluation Effective Date: October 1, 2018 Current Enrollment (4/1/18) 1/nw m* JUL 19 2018 R"".4d Current rmwmr GEHRING GROUP' EMPLOYEE BENEFITS I RISK MANAGEMENT SCHEDULE OF BENEFITS BASE Florida Blue - BlueCare BUYUP Florida Blue - .. BUYUP Plan Basics Plan 126/227 In -Network Only Plan 05180/05181 In -Network Out -of -Network Plan 67 In -Network Only Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Calendar Year Deductible (CYD) Single $1,500 $1,500 $3,000 $1,000 Family $3,000 $3,000 $6,000 $3,000 Out of Pocket Maximum Includes All Costs Includes All Costs Includes All Costs Includes All Casts Single $3,000 $3,000 $6,000 $4,000 Family $6,000 $6,000 $12,000 $8,000 Coinsurance (Member Responsibility) 10% 10% 40% 0% Non Hospital Services Primary Care Physician CYD + 10% CYD + 10% CYD + 40% $25 Specialist CYD + 10% CYD + 10% CYD + 40% $45 Urgent Care Center CYD + 10% CYD + 10% CYD + 10% $50 Preventive Services No Charge No Charge CYD +40% No Charge Advanced Imaging - CT, PET, MRI CYD + 10% CYD + 10% CYD +40% $250 Hospital Services Inpatient Hospital CYD+ 10% CYD+ 10% CYD +40% $250 Per Day (Max $750) Outpatient Facility CYD + 10% CYD + 10% CYD + 40% $350 Physician Services at Hospital CYD + 10% CYD + 10% CYD + 40% No Charge Emergency Room (Waived if Admit) CYD + 10% CYD + 10% CYD + 10% $250 Mental Health/Sub. Abuse Inpatient Hospital CYD + 10% CYD + 10% CYD + 40% No Charge Outpatient Services CYD + 10% CYD + 10% CYD + 40% No Charge Retail Pharmacy Plan Level 1 Generic Drugs Tier 1 - $10 After CYD Tier 1- $10 After CYD Tier 1- $10 Level 2 Preferred Brand Drugs Tier 2 - $50 After CYD Tier 2 - $50 After CYD Tier 2 - $30 Level 3 Non -Preferred Brand Drugs Tier 3 - $80 After CYD Tier 3 - $80 After CYD Copay for Tier+ 40% Tier 3 - $50 Specialty Drugs Tier 1-3 Tier 1-3 Tier 1-3 Mail Order 2.5 x Retail Copay After CYD 2.5 x Retail Copay After CYD 2.5 x Retail Copay Monthly Premium 126/27 5180/1 67 Employee Only 36 7 10 $460.82 $518.71 $512.42 Employee & One 7 13 9 $1,028.60 $1,143.47 $1,219.55 Employee & Family 18 25 9 $1,348.41 $1,499.01 $1,598.55 Monthly Cost 61 45 28 $48,061 $55,971 $30,487 Annual Cost $576,733 $671,656 $365,845 $Increase / Decrease N/A N/A N/A Y Increase / Decrease N/A N/A N/A Total Premium $1,614,234 Total Increase N/A Total % Increase N/A Health Savings Account Employee 36 7 0 $1,500 $1,500 $0 Family 25 38 0 $3,000 $3,000 $0 Annual HSA Premium 61 45 0 $129,000 $124,500 $0 TOTAL ANNUAL MED + HSA $705,733 $796,156 $365,845 $ INCREASE (MED + HSA) N/A N/A N/A INCREASE (MED + HSA) N/A N/A N/A The Village of North Palm Beach Medical Insurance Renewal Evaluation Effective Date: October 1, 2018 Current Enrollment (4/1/18) Initial Renewal E:Wmr,, GEHRING GROUP EMPLOYEE BENEFITS I RISK MANAGEMENT SCHEDULE OF BENEFITS BASE Florida Blue - BlueCare BUYUP Florida Blue - .. BUYUP Plan Basics Plan 126/127 In -Network Only Plan 05180/OS181 In -Network Out -of -Network Plan 67 In -Network Only Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Calendar Year Deductible (CYD) Single $1,500 $1,500 $3,000 $1,000 Family $3,000 $3,000 $6,000 $3,000 Out of Pocket Maximum Includes All Costs Includes All Costs Includes All Costs Includes All Costs Single $3,000 $3,000 $6,000 $4,000 Family $6,000 $6,000 $12,000 $8,000 Coinsurance (Member Responsibility) 10% 10% 40% 0% Non Hospital Services Primary Care Physician CYD + 10% CYD + 10% CYD + 40% $25 Specialist CYD + 10% CYD + 10% CYD + 40% $4S Urgent Care Center CYD + 10% CYD + 10% CYD + 10% $50 Preventive Services No Charge No Charge CYD +40% No Charge Advanced Imaging - CT, PET, MRI CYD + 10% CYD + 10% CYD + 40% $250 Hospital Services Inpatient Hospital CYD+ 10% CVD+ 10% CYD +40% $250 Per Day (Max $750) Outpatient Facility CYD + 10% CYD + 10% CYD + 40% $350 Physician Services at Hospital CYD + 10% CYD + 10% CYD +40% No Charge Emergency Room (Waived if Admit) CYD+ 10% CYD+ 10% CYD+ 10% $250 Mental Health/Sub. Abuse Inpatient Hospital CYD + 10% CYD + 10% CVD + 40% No Charge Outpatient Services CYD + 10% CYD + 10% CYD + 40% No Charge Retail Pharmacy Plan Level 1 Generic Drugs Tier 1 - $10 After CYD Tier 1- $10 After CYD Tier 1- $10 Level 2 Preferred Brand Drugs Tier 2 - $50 After CYD Tier 2 - $50 After CYD Tier 2 - $30 Level 3 Non -Preferred Brand Drugs Tier 3 - $80 After CYD Tier 3 - $80 After CYD Copay for Tier + 40% Tier 3 - $50 Specialty Drugs Tier 1-3 Tier 1-3 Tier 1-3 Mail Order 2.5 x Retail Copay After CYD 2.5 x Retail Copay After CYD 2.5 x Retail Copay Monthly Premium 126/27 5180/1 67 Employee Only 36 7 10 $499.37 $595.64 $569.57 Employee & One 7 13 9 $1,163.89 $1,367.59 $1,355.59 Employee & Family 18 25 9 $1,525.78 $1,792.81 $1,777.07 Monthly Cost 61 45 28 $53,589 $66,768 $33,890 Annual Cost $643,063 $801,221 $406,676 $ Increase / Decrease $66,330 $129,565 $40,830 % Increase / Decrease 11.5% 19.3% 11.2% Total Premium $1,850,960 Totallncrease $236,725 Total % Increase 14.7% Health Savings Account Employee 36 7 0 $1,500 $1,500 $0 Family 25 38 0 $3,000 $3,000 $0 Annual HSA Premium 61 45 0 $129,000 $124,500 $0 TOTAL ANNUAL MED + HSA $772,063 $925,721 $406,676 $ INCREASE (MED + HSA) $66,330 $129,565 $40,830 % INCREASE (MED + HSA) 9.4% 16.3% 11.2% The Village of North Palm Beach Medical Insurance Renewal Evaluation Effective Date: October 1, 2018 Current Enrollment (4/1/18) Negotiated Renewal C GEHRING GROUP EMPLOYEE BENEFITS I RISK MANAGEMENT BASE Florida Blue - BlueCare BUYUP Florida Blue - .. BUYUP SCHEDULE OF BENEFITS Plan Basics Plan 126/127 In -Network Only Plan 0180/05181 In -Network Out -of -Network Plan 67 In -Network Only Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Calendar Year Deductible (CYD) Single $1,500 $1,500 $3,000 $1,000 Family $3,000 $3,000 $6,000 $3,000 Out of Pocket Maximum Includes All Costs Includes All Costs Includes All Costs Includes All Costs Single $3,000 $3,000 $6,000 $4,000 Family $6,000 $6,000 $12,000 $8,000 Coinsurance (Member Responsibility) 10% 10% 40% 0% Non Hospital Services Primary Care Physician CYD + 10% CYD + 10% CYD + 40% $25 Specialist CYD + 10% CYD + 10% CYD + 40% $45 Urgent Care Center CYD + 10% CYD + 10% CYD + 10% $50 Preventive Services No Charge No Charge CYD +40% No Charge Advanced Imaging - CT, PET, MRI CYD + 10% CYD + 10% CYD + 40% $250 Hospital Services Inpatient Hospital CYD + 10% CYD + 10% CYD +40% $250 Per Day (Max $750) Outpatient Facility CYD + 10% CYD + 10% CYD + 40% $350 Physician Services at Hospital CYD + 10% CYD + 10% CYD + 40% No Charge Emergency Room (Waived if Admit) CYD + 10% CYD + 10% CVD + 10% $250 Mental Health/Sub. Abuse Inpatient Hospital CYD + 10% CYD + 10% CYD + 40% No Charge Outpatient Services CYD + 10% CYD + 10% CYD + 40% No Charge Retail Pharmacy Plan Level 1 Generic Drugs Tier 1 - $10 After CYD Tier 1- $10 After CYD Tier 1- $10 Level 2 Preferred Brand Drugs Tier 2 - $50 After CYD Tier 2 - $50 After CYD Tier 2 - $30 Level 3 Non -Preferred Brand Drugs Tier 3 - $80 After CYD Tier 3 - $80 After CYD Copay for Tier +40% Tier 3 - $50 Specialty Drugs Tier 1-3 Tier 1-3 Tier 1-3 Mail Order 2.5 x Retail Copay After CYD 2.5 x Retail Copay After CYD 2.5 x Retail Copay Monthly Premium 126/27 5180/1 67 Employee Only 36 7 10 $475.59 $567.28 $542.45 Employee & One 7 13 9 $1,108.47 $1,302.47 $1,291.04 Employee & Family 18 25 9 $1,453.12 $1,707.44 $1,692.45 Monthly Cost 61 45 28 $51,037 $63,589 $32,276 Annual Cost $612,440 $763,069 $387,311 $ Increase / Decrease $35,707 $91,413 $21,466 Increase / Decrease 6.2% 13.6% 5.9% Total Premium $1,762,820 Totallncrease $148,586 Total % Increase 9.2% Health Savings Account Employee 36 7 0 $1,500 $1,500 $0 Family 25 38 0 $3,000 $3,000 $0 Annual HSA Premium 61 45 0 $129,000 $124,500 $0 TOTAL ANNUAL MED + HSA $741,440 $887,569 $387,311 $ INCREASE (MED+ HSA) $35,707 $91,413 $21,466 % INCREASE (MED + HSA) 5.1% 11.5% 5.9% The Village of North Palm Beach Dental Insurance RFP Evaluation: DMO Effective Date: October 1, 2018 C GEHRING GROUP' EMPLOYEE BENEFITS I RISK MANAGEMENT Current Renewal SAMPLE PROCEDURES Humana Humana Office Visit (Observation) No Charge No Charge Initial Oral Exam & Diagnosis 0120 No Charge No Charge X -Ray Bitewings 2 films 0272 No Charge No Charge X -Ray Bitewings 4 films 0274 No Charge No Charge Complete Prophylaxis 1110 No Charge No Charge Resin - One Surface 2330 No Charge No Charge Resin - Two Surfaces 2331 No Charge No Charge Root canal per molar 3330 $210 $210 Gingivectomy or Gingivolplasty 4210 $110 $110 Osseous Surgery 4260 $300 $300 Complete Upper Denture 5110 $325 $325 Immediate Upper Denture 5130 $350 $350 Crown / Porcelain 6240 $245 $245 Bridge Pontic / Porcelain fused 6241 $245 $245 Extraction of Single Tooth 7111 $5 $5 Extraction of Soft Tissue Impaction 7220 $50 $50 Extraction of Fully Bony Impaction 7240 $80 $80 Orthodontics - Comp. Treatment - Adolescent 8070 $1,850 $1,850 Orthodontics - Comp. Treatment - Adult 8090 $1,850 $1,850 Orthodontics - Retention 8680 $300 $300 Rate Guarantee Expires 09/30/2018 Expires 09/30/2019 Employee 32 $14.88 $14.88 Family 51 $43.62 $43.62 Monthly Premium 83 $2,701 $2,701 Annual Premium $32,409 $32,409 $ Increase N/A $0.00 Increase N/A 0.0% The Village of North Palm Beach Dental Insurance RFP Evaluation: PPO Effective Date: October 1, 2018 rwm, GEHRING GROUP- ,4 BENEFITS I RISK MANAGEMENT Current Renewal SCHEDULEOF • Plan PPO Plan Plan Basics In -Network Out -of -Network In -Network Out -of -Network Annual Benefit Maximum $1,500 $1,500 Deductibles Single $50 $50 Family $150 $150 Deductible Waived for Preventive Yes Yes Services Benefits Preventive 100% 100% Basic 80% 80% Major 50% 50% Orthodontic Services 50% 50% Service Information Out of Network Benefits Payable U&C U&C Level Waiting Period (Timely Entrants) None None Orthodontic Lifetime Maximum $1,000 $1,000 Rate Guarantee Expires 09/30/2018 Expires 09/30/2019 Monthly Premium Employee 19 $31.78 $31.78 Family 33 $95.54 $95.54 Monthly Premium 52 $3,757 $3,757 Annual Premium $45,080 $45,080 $ Increase N/A $0.00 % Increase N/A 0.0% The Village of North Palm Beach r7NZ LO H R I N G GROUP' M EMPLOYEE BENEFITS I RISK MANAGEMENT Vision Plan Insurance Evaluation Effective Date: October 1, 2018 CURRENT SCHEDULE OF -• In -Network Non -Network Exam Copay $10 Materials Copay $10 Frequency Exam 12 months Lenses 12 months Frames 24 months Benefits Payable Copay Reimbursement Eye Exam $10 Up to $35 Single Lenses $10 Up to $25 Bifocal Lenses $10 Up to $40 Trifocal Lenses $10 Up to $60 Lenses and Frames Reimbursement Contact Lenses (Elective) Up to $135, then 15% discount Up to $95 Contact Lenses Paid in Full Up to $200 (Medically Necessary) Frames Up to $120, then 20% discount Up to $48 Rate Guarantee Expires 09/30/2019 Monthly Premium Employee 22 $6.67 EE + 1 16 $12.69 Employee + 2 or more 28 $18.62 Monthly Premium 66 $871.14 Annual Premium $10,453.68 $ Increase N/A Increase N/A Village of North Palm Beach Life Insurance Evaluations Effective Date: October 1, 2018 C GEHRING GROUP' EMPLOYEE BENEFITS I RISK MANAGEMENT CURRENT RENEWAL Basic Life / AD&D Cigna Cigna Class Description Class 1- Village Manager Class 1- Village Manager Elibibility Class 2 -All other full-time employees (32 Class 2 -All other full-time employees (32 or more hours per week) or more hours per week) Features Class 1- Lesser of 2x's BAE to a max of Class 1- Lesser of 2x's BAE to a max of Benefit $350,000 $350,000 Class 2 - $50,000 Class 2 - $50,000 Accelerated Benefit 75% to a maximum of $250,000 75% to a maximum of $250,000 Waiver of Premium Included Included Conversion Included Included Age 65 - Benefit reduces 35% Age 65 - Benefit reduces 35% Age Reduction Schedule Age 70 - Benefit reduces 50% Age 70 - Benefit reduces 50% Rate Guarantee Period Expires 09/30/18 Expires 09/30/2020 Basic Life Rate / $1,000 0.12 0.12 AD&D Rate / $1,000 0.025 0.025 Total Life and AD&D Rate 0.145 0.145 Estimated Volume $12,413,000 $12,413,000 Total Monthly Premium $1,800 $1,800 Total Annual Premium $21,599 $21,599 $ Increase N/A $0.00 % Increase N/A 0.00% Village of North Palm Beach Supplemental Life Insurance Evalaution Effective Date: October 1, 2018 C GEHRING GROUP' EMPLOYEE BENEFITS I RISK MANAGEMENT CURRENT RENEWAL Cigna In increments of $10,000 Cigna In increments of $10,000 Employee Formula Not to exceed $500,000 Not to exceed $500,000 Guarantee Issue $100,000 $100,000 In increments of $5,000 In increments of $5,000 Spouse Formula Not to exceed $150,000 Not to exceed $150,000 Guarantee Issue $30,000 $30,000 Birth to 6 months: $500 Birth to 6 months: $500 Child Formula 6 months thru age 20: $10,000 6 months thru age 20: $10,000 Not to exceed 50% of Employee Amount Not to exceed 50% of Employee Amount Guarantee Issue $10,000 $10,000 Rate Guarantee Expired 9/30/2018 Expires 09/30/2020 AD&D Rate $0.03 per $1,000 $0.03 per $1,000 EE Life Rates Age Bracket Rate/$1,000 Age Bracket Rate/$1,000 0-19 $0.084 0-19 $0.084 20-24 $0.084 20-24 $0.084 25-29 $0.084 25-29 $0.084 30-34 $0.085 30-34 $0.085 35-39 $0.118 35-39 $0.118 40-44 $0.181 40-44 $0.181 45-49 $0.282 45-49 $0.282 50-54 $0.440 50-54 $0.440 55-59 $0.766 55-59 $0.766 60-64 $0.852 60-64 $0.852 65-69 $1.447 65-69 $1.447 70-74 $2.573 70-74 $2.573 75-79 $9.874 75-79 $9.874 80+ $9.755 80+ $9.755 Child(ren) $.05 per $1,000 Child(ren) $.05 per $1,000 Village of North Palm Beach Long Term Disability Insurance Evaluation Effective Date: October 1, 2018 C GEHRING GROUP EMPLOYEE BENEFITS I RISK MANAGEMENT CURRENT RENEWAL Long Term Disability Cigna Cigna All Employees working 30 or more All Employees working 30 or more Eligibility hours per week hours per week Elimination Period 90 Calendar Days 90 Calendar Days Benefit Percent 60% 60% Maximum Monthly Benefit $6,000 $6,000 Own Occupation Period 24 Months 24 Months Duration of Benefit To age 65 To age 65 Mental Illness/Substance Abuse 24 Months 24 Months Pre -Existing Condition Limitation 3/12 3/12 Rate Guarantee Period Expires 09/30/2018 Expires 09/30/2020 LTD Rate / $100 $0.43 $0.43 Estimated Volume $507,627 $507,627 Monthly Premium $2,183 $2,183 Annual Premium $26,194 $26,194 $ Increase N/A $0.00 % Increase N/A 0.0% The Village of North Palm Beach Employee Benefits EE/ER Cost Comparison Effective Date: October 1, 2018 Current Negotiated Renewal - 85%/15% r!Ww* GEHRING GROUP' EMPLOYEE BENEFITS I RISK MANAGEMENT • Plan Total Florida Blue Employer Employee Total Florida Blue Employer Employee EE Per Pay Current EE Per Pay (24) Increase Per Pay HMO BASE PLAN 126/127 HMO BASE PLAN 126/127 Employee Only 36 $460.82 $460.82 $0.00 $475.59 $475.59 $0.00 $0.00 $0.00 $0.00 Employee +One Dependent 7 $1,028.60 $872.91 $155.69 $1,108.47 $942.20 $166.27 $77.84 $83.14 $5.30 Employee + Family 18 $1,348.41 $1,144.32 $204.09 $1,453.12 $1,235.15 $217.97 $102.05 $108.98 $6.94 61 PPO Buy -UP Plan 05180/05181 PPO Buy -UP Plan 05180/05181 Employee Only 7 $518.71 $438.75 $79.96 $567.28 $482.19 $85.09 $39.98 $42.55 $2.57 Employee +One Dependent 13 $1,143.47 $967.26 $176.21 $1,302.47 $1,107.10 $195.37 $88.11 $97.69 $9.58 Employee + Family 25 $1,499.01 $1,268.01 $231.00 $1,707.44 $1,451.32 $256.12 $115.50 $128.06 $12.56 45 HMO Buy -Up Plan 67 HMO Buy -Up Plan 67 Employee Only 10 $512.42 $434.82 $77.60 $542.45 $461.08 $81.37 $38.80 $40.68 $1.88 Employee +One Dependent 9 $1,219.55 $1,034.87 $184.68 $1,291.04 $1,097.38 $193.66 $92.34 $96.83 $4.49 Employee + Family 9 $1,598.74 $1,356.64 $242.10 $1,692.04 $1,438.23 $253.81 $121.05 $126.90 $5.85 Health Savings Account 18 H.S.A on HDHP Plans H.S.A on HDHP Plans Employee Only 43 $1,500 $1,500 $0.00 $1,500 $1,500 $0.00 Employee + Family 63 $3,000 $3,000 $0.00 $3,000 $3,000 $0.00 MONTHLY PREMIUM 106 $21,125 $21,125 $0.00 $21,125 $21,125 $0.00 ANNUALPREMIUM $253,500 $253,500 $0.00 $253,500 $253,500 $0.00 TOTAL MEDICAL PREMIUM 134 MONTHLY PREMIUM $155,646 $137,640 $18,006 $168,023 $148,556 $19,467 ANNUAL PREMIUM $1,867,755 $1,651,684 $216,071 $2,016,276 $1,782,678 $233,598 $ INCREASE N/A N/A N/A $148,521 $130,994 $17,527 % INCREASE N/A N/A N/A 8.0% 7.9% 8.1% vow Q� Q