Loading...
HomeMy WebLinkAboutHandout Employee Benefits Renewal Executive Summary GAPS COUN,y 1,44 N, Co a,'hi"' ,"usiiiii40. —\... Y AU1AA 4► -, � 2021 ' goo.,` ..flit- fr yj, • 'i rr / (IS1/ rs 47* :- j . I - - = - . e,'-'": _` w , 2023-2024 Employee Benefits }f� •` tea. * _ ,,,,� : s � �;;� � , . .�� r Pre-Renewal Summary' 'jamda 4.. ` - • ,t t. .x .. 0r' •,j,'1, _ . .. , ,, 4 • le . • „A - ,-/ , ,,/ 7 7 , , ...ii, , ,/14. /. . .. It. . . .. 4 * r• : t liCsit II , is 1A tBrown & Brown 2023 - 2024 Medical Review 2023-2024 Medical Review: CURRENT M Inpatient Outpatient Professional Pharmacy Rank Relationship Diagnosis Description Days Admits Paid Amt ® Paid Amt Services Paid Amt Paid Amt Total Paid FL Blue recently provided the BlueValue Amt Insight reports for claims incurred 1 DEPENDENT ACUTE KIDNEYRULAR FAILURE DISEASE IN SYSTEMIC LUPUS ERYTHEMATOSUS;END STAGE RENAL DISEASE; 32 5 $175,396.53 21 $51,859.23 181 $22,217.07 35 $1,317.69 $250,790.52 I 1/1/2022-12/31/2022, paid 1/1/2022- 2 SPOUSE SPINAL STENOSIS,LUMBAR REGION WITH NEUROGENIC CLAUDICATION;PHARMACY RX 2 1 $58,459.16 4 $93.48 29 $6,475.30 84 $6,432.06 $71,460.00 SPINAL STENOSIS,LUMBAR REGION WITHOUT NEUROGENIC CLAUDICATION 3/31/2023. 3 SUBSCRIBER PHARMACY R)(OTHER RHEUMATOID ARTHRITIS WITH RHEUMATOID FACTOR OF MULTIPLE 0 0 $0.00 0 $0.00 49 $1,283.03 45 $69,422.41 $70,705.44 SITES;INFLAMMATORY POLYARTHROPATHY 4 SPOUSE SYSTEMIC LUPUS ERYTHEMATOSUS;GLOMERULAR DISEASE IN SYSTEMIC LUPUS 0 0 $0.00 1 $1,282.12 78 $57,448.77 61 $3,015.17 $61,746.06 ERYTHEMATOSUS;PHARMACY RX _ CCUA continues to track above benchmark 5 SUBSCRIBER PAROXYSMAL ATRIAL FIBRILLA11ON;ATRIAL FLUTTER;PHARMACY RX 2 2 $25,018.00 1 $19,248.00 42 $7,394.21 22 $761.18 $52,421.39 for most annual preventive screenings, 6 DEPENDENT ENDOMETRIOSIS OF UTERUS;ENDOMETRIOSIS OF PELVIC PERITONEUM;OBSTETRIC HIGH 2 1 $8,208.83 1 $14,017.81 75 $24,865.56 4 $4.51 $47,096.71 VAGINAL LACERATION ALONE _ _ which is very positive. Virtual visit and 7 SUBSCRIBER PHARMACY R)(ACUTE APPENDICITIS;GENETIC CARRIER OF OTHER DISEASE 1 1 $14,827.17 0 $0.00 32 $5,744.97 31 $22,996.46 $43,568.60 telemedicine continue to be utilized well. 8 SUBSCRIBER BRADYCARDIA;CHEST PAIN;PHARMACY RX 0 0 $0.00 3 $34,184.26 31 $4,424.46 44 $4,945.77 $43,554.49 However, as you can see there are several 9 SUBSCRIBER PHARMACY RX;ESSENTIAL(PRIMARY)HYPERTENSION 0 0 $0.00 0 $0.00 3 $259.09 20 $41,869.26 $42,128.35 SECOND DEGREE PERINEAL LACERATION DURING DELIVERY;LABOR AND DELIVERY high-cost claimants. The 9 that are 10 DEPENDENT COMPLICATED BY MECONIUM IN AMNIOTIC FLUID;ENCOUNTER FOR FULL-TERM 2 1 $10,900.00 7 $10,653.90 72 $15,600.88 38 $1,317.27 $38,472.05 UNCOMPLICATED DELIVERY highlighted are projected to be ongoing, 11 SPOUSE SUPRAVENTRICULAR TACHYCARDIA;BIPOLAR II DISORDER;PHARMACY RX 0 0 $0.00 1 $31,504.20 11 $4,099.51 25 $234.54 $35,838.25 with the potential to carry significant PHARMACY RX;PERSONAL HISTORY OF COLONIC POLYPS;OBSTRUCTIVE SLEEP APNEA 12 SUBSCRIBER (ADULT)(PEDIATRIC) 0 0 $0.00 4 $3,061.58 63 $5,611.14 55 $21,058.29 $29,731.01 costs. - 13 SPOUSE PHARMACY RX ACUTE PHARYNGITIS 0 0 $0.00 0 $0.00 1 $105.00 4 $25,170.44 $25,275.44 14 SUBSCRIBER CALCULUS OF BILE DUCT WITHOUT CHOLANGITIS OR CHOLECYS11TIS WITHOUT OBSTRUC1ON; 2 1 $16,801.05 1 $1,183.89 37 $4,008.67 24 $2,279.01 $24,272.62 PHARMACY R)(ABNORMAL LEVELS OF OTHER SERUM ENZYMES Florida Blue provided an initial renewal of 15 SUBSCRIBER SEPSIS;FOOD IN ESOPHAGUS CAUSING OTHER INJURY,INITIAL ENCOUNTER;HYPO- 5 1 $17,463.29 1 $2,478.00 36 $4,282.40 3 $0.00 $24,223.69 OSMOLALITY AND HYPONATREMIA 13.8%. Brown & Brown requested a "no CALCULUS OF GALLBLADDER WITH CHRONIC CHOLECYSTITIS WITHOUT OBSTRUCTION; 16 SUBSCRIBER CALCULUS OF GALLBLADDER WITHOUT CHOLECYSTITIS WITHOUT OBSTRUCTION;ACUTE 0 0 $0.00 18 $17,517.83 33 $6,120.10 4 $0.00 $23,637.93 shop" renewal of 5%. Due to the CHOLECYSTITIS _ prognosis of the 9 highlighted claimants 17 SUBSCRIBER ACUTE CHOLECYSTITIS;RIGHT UPPER QUADRANT PAIN;PHARMACY RX 3 1 S15,827.17 0 $0.00 35 $5,954.89 20 $1,154.08 $22,936.14 I 18 SPOUSE PHARMACY RX;EXCESSIVE AND FREQUENT MENSTRUATION WITH REGULAR CYCLE;OTHER 0 0 $0.00 1 $8,202.00 18 $3,241.25 28 $10,773.59 $22,216.84 Florida Blue came back with 2 renewal SPECIFIED ABNORMAL UTERINE AND VAGINAL BLEEDING Total 51 14 $342,901.20 64 $195,286.30 826 $179,136.30 547 $212,751.73 $930,075.53 options illustrated on the next few slides. - 02019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 1 2023 - 2024 Medical Review Florida Blue Renewal Options: Option 1: • 1-month premium holiday approved, based on the renewal rates delivered (Approximately $242,000) • Taking the "1-month premium free" into consideration the overall premium increase will now be between 4-5%. (The monthly rates would be invoiced at the 13.8% increase). OR Option 2: • Underwriting approved -4.5% off the renewal rates delivered • Renewal Increase will now be approximately 9% overall *These are considered "no shop" options. If CCUA chooses to explore options in the market, the above options will be voided, and the renewal will revert to the initial 13.8% increase. ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 2023 - 2024 Medical Review OPTION 1: • 1-month premium holiday approved,based on the renewal rates delivered (Approximately$246,000) • Taking the"1-month premium free" into consideration the overall premium increase will now be between 4-5%. (The monthly rates would be invoiced at the 13.8% increase). FLORIDA BLUE FLORIDA BLUE CURRENT RATES INITIAL RENEWAL 100% 100% 90% RATING ANALYSIS EEs HDHP 03160/03161 EEs HMO 60 EES PPO 03769 Contributions 80% 72% 70% Employee Only 10 ► $804.85 587 $847.46 10 $942.67 BlueOptions HDHP 3160/61 BlueCare HMO 60 i BlueOptions 376• Employee+Spouse 2 ► $1,835.05 10► $1,932.21 1 $2,149.30 RATING ANALYSIS EEs EEs EEs ► ► Employee+Child(ren) 10 $1,609.69 32 $1,694.92 5 $1,885.35 Employee Only 10 $716.77 58 $742.29 10 $823.98 ► ► Employee+Spouse 2 $1,634.24 10 $1,692.42 1 $1,878.67 Full Family 9 ► $2,575.51 14► $2,711.87 3 $3,016.56 Employee+Child(ren) 10 $1,433.55 32 $1,484.57 5 $1,647.95 Monthl Premiumb Plan 31 $50,995.09 114 $160,678.40 19 $30,052.43 Full Family 9 $2,293.68 14 $2,375.33 3 $2,636.73 TOTAL MONTHLY PREMIUM $241,725.92 Month] Premium b Plan 31 $45,414.80 114 $140,737.88 ► 19 $26,268.41 Gross Increase/Decrease from Current 13.8% TOTAL MONTHLY PREMIUM $212,421.09 ANNUAL PREMIU Gross Increase Decrease from Current PREMIUM SHARING _ $41 Company's Share(monthly) _ _ PREMIUM SHARING Employee Only 10 ► $804.85 58 ► $847.46 10 $848.40 Company's Share(monthly) ► ► Employee+Spouse 2 $1,629.01 10 $1,628.48 1 $1,693.04 Employee Only 10 $716.77 58 $742.29 10 $741.58 ► ► ► Employee+Child(ren) 10 $1,448.72 32 $1,457.63 5 $1,508.28 Employee+Spouse $1,450.75 10 $1,426.38 1 $1,479.87 ► ► Employee+Child(ren) 1 $1,290.19 32► $1,276.73 5 $1,318.36 Full Family 9 $2,221.38 14 $2,189.84 3 $2,300.13 Full Family 9 $1,978.30 14► $1,918.08 3 $2,010.51 Employee's Share(monthly) Employee's Share(monthly) Employee Only 10 ► $0.00 58 ► $0.00 10 $94.27 Employee Only 10 $0.00 58► $0.00 10 $82.40 Employee+Spouse 2 ► $206.04 10 ► $303.73 1 $456.26 Employee+Spouse 2 $183.49 10► $266.04 1 $398.81 Employee+Child(ren) 10 ► $160.97 32 ► $237.29 5 $377.07 Employee+Child(ren) 10 $143.36 32► $207.84 5 $329.59 Full Family 9 ► $354.13 14 ► $522.03 3 $716.43 Full Family 9 $315.38 14► $457.25 3 $626.22 $5,208.95 $17,939.03 $5,433.58 $4,638.99 $15,712.71 $4,749.40 COST ANALYSIS COST ANALYSIS Total Monthly Cost $212,421.09 Total Monthly Cost $241,725.92 Payroll Recovery $25,101.09 Payroll Recovery $28,581.56 Company's Net Cost $187,320.00 -IICompany's Net Cost $213,144.36 Net Increase/Decrease from Current Net Increase/Decrease from Current 13.8% The plans and rates in this exhibit are controlled by various insurance contracts. The plans and rates in this exhibit are controlled by various insurance contracts. • ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 3 2023 - 2024 Medical Review OPTION 2 • Underwriting approved-4.5% off the renewal rates delivered • Renewal Increase will now be approximately 9% overall FLORIDA BLUE FLORIDA BLUE CURRENT RATES RENEWAL-BEST AND FINAL 100% 100% 90e/ RATING ANALYSIS EEs HDHP 03160/03161 EEs HMO 60 EEs PPO 03769 Contributions 80% 72% 70% Employee Only 10 $769.52 58 v $810.25 10 $901.29 BlueOptions HDHP 3160/61 ' •Care eOptio Employee+Spouse 2 $1,754.48 10 v $1,847.38 1 $2,054.94 RATING ANALYSIS EEs EEs EEs Employee+Child(ren) 10 $1,539.02 32 $1,620.51 5 $1,802.58 Employee Only 10 $716.77 58 $742.29 10 $823.98 - Employee+Spouse 2 $1,634.24 10 $1,692.42 1 $1,878.67 Full Family 9 $2,462.44 14 r $2,592.82 [ 3 $2,884.13 Employee+Child(reni 10 $1,433.55 32 $1,484.57 5 $1,647.95 Monthly Premium by Plan 31 $48,756.32 114 $153,624.10 19 $28,733.13 Full Family 9 $2,293.68 14 $2,375.33 3 $2,636.73 TOTAL MONTHLY PREMIUM $231,113.55 Monthly Premium by Plan $45,414.80 114 $140,737.88 ' 19 $26,268.41 Gross Increase/Decrease from Current 9% TOTAL MONTHLY PREMIUM $212,421.09 I.ANNUAL PREMIU, 2,773,362 •' Gross Increase/Decrease from Current PREMIUM SHARING ANNUAL PREMI $2,549,053.08 Company's Share(monthly) PREMIUM SHARING Employee Only 10 $769.52 58 v $810.25 10 $811.16 Company's Share(monthly Employee Only I 58r $742.29 10 $741.58 Employee+Spouse 10 I $1,556.98 $1,618.72 Employee+Spouse •I 10v $1,426.38 1 $1,479.87 Employee+Child(ren) 32 $1,393.64 $1,442.06 Employee+Child(ren) 10 $1,290.1932 $1,276.73 5 $1,318.36 Full Family 9 $2,123.86 14 v $2,093.70 3 $2,199.15 Full Family 9 $1,978.30 14' $1,918.08 3 $2,010.51 Employee's Share(monthly) Employee's Share(monthly) Employee Only 10 $0.00 58 v $0.00 ill $90.13 Employee Only 10 $0.00 58' $0.00 10 $82.40 Employee+Spouse $196.99 10 v $290.40 $436.22 Employee+Spouse 10' $266.04 1 $398.81 Employee+Child(ren) •I 32 v $226.87 5 $360.52 Employee+Child(ren) 10 $143.36 32 P' $207.84 5 $329.59 Full Family 9 $338.58 14 v $499.12 3 $684.98 Full Family 9 $315.38 14' $457.25 3 $626.22 $4,980.24 $17,151.57 $5,195.04 $15,712.71 $4,749.40 COST ANALYSIS COSANALYSIS Total Monthly Cost $231,113.55 Totalotal Monthlyy Cost $212,421.09 Payroll Recovery $25,101.09 Payroll Recovery - $27,326.85 Company's Net Cost $187,320.00 W ! Company's Net Cost ■ $203,786.71 ' Net Increase/Decrease from Current I Net Increase/Decrease from Current 9% The plans and rates in this exhibit are controlled by various insurance contracts. The plans and rates in this exhibit are controlled by various insurance contracts. -ifo ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 2023 - 2024 Dental Renewal 2023-2024 Dental Renewal 10/1/2023-9/30/2024 Florida Combined Life Florida Combined Life Summary: Choice Choice Plus Choice Choice Plus BENEFITS SUMMARIIIMIIIII Current Final Negotiated Florida Combined Life has Deductible l $50 / $150 $50 / $150 $50 / $150 $50 / $150 provided a flat renewal Annual Maximum $1,500 $1,000 $1,500 $1,000 (0% increase) for the dental In-Network Preventive Services 100% 100% 100% 100% coverage. Basic Services 80% 80% 80% 80% Major Services 50% 50% 50% 50% Out-of-Network Preventive Services 80% 100% 80% 100% Basic Services _ 50% 80% 50% 80% Major Services 50% 50% 50% 50% Out of Network R&C Fee Schedule Based MAC Fee Schedule Based MAC Endo/Perio Benefit Level Basic Basic Basic Basic Orthodontia None 50% None 50% Contract Language None $1,000 None $1,000 Waiting Periods None None None None Rate Guarantee 10/1/2024 10/1/2024 RATING ANALYSIS Employee Only 48 15 $30.58 $34.56 $30.58 $34.56 Employee + Spouse 15 5 $69.62 $83.88 $69.62 $83.88 Employee + Child(ren) 22 15 $54.18 $71.94 $54.18 $71.94 Full Family 23 21 $98.95 $122.84 $98.95 $122.84 Total Monthly Premium 108 56 $5,979.95 $4,596.54 $5,979.95 $4,596.54 $10,576.49 $10,576.49 Total Annual Premium $126,917.88 $126,917.88 — Gross Increase/Decrease 0% • ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 202 3 - 2024 Vision Renewal 10/1/2023-9/30/2024 Humana Humana 2023-2024 Vision Renewal I� RFN I _CFR1T CI1MMARV Current Renewal Summary: Benefit Frequency(Months) Exam 12 12 Lenses 12 12 Humana Vision renewal is a flat Frames 24 24 renewal (0% increase) with a rate Contacts(in lieu of glasses) 12 12 guarantee through 9/30/2027. Copayments In Network Exam $10 $10 Materials Copay $15 $15 Frame Allowance $130 Retail $130 Retail Contact Lens Allowance $55+10%off $55+10%off Out-of-Network Allowances Exam $30 $30 Materials Frames $65 $65 Lenses Single Lens $25 $25 Bifocal Lens $40 $40 Trifocal Lens $60 $60 Contact Lenses $0 $0 Rate Summary Employee Only 55 $6.03 $6.03 Employee+Spouse 21 $12.07 $12.07 Employee+Child(ren) 33 $11.46 $11.46 Full Family 31 $18.00 $18.00 Total Monthly Premium 140 $1,521.30 $1,521.30 Total Annual Premium $18,255.60 $18,255.60 Gross Increase/Decrease 0% RATE GUARANTEE 10/1/2027 • ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 2023 - 2024 Basic Life /AD & D Renewal 2023-2024 Life Renewal Summary: The USAble Basic Life renewal was a flat renewal (0% increase) with a rate guarantee through 9/30/2025. 10/1/2023-9/30/20234 USAble USAble Basic Life AD&D Basic Life/AD&D BASIC LIFE SUMMARY Current Renewal Basic Life Amount $50,000 $50,000 Guaranteed Issue Amount $50,000 $50,000 Age Reduction Schedule to 65% at age 65,to 50% at age 70,to 25% at age 75 to 65% at age 65,to 50% at age 70,to 25% at age 75 Basic Life Volume $8,580,000 $8,580,000 Basic Life Premium per$1,000 $0.18 $0.18 AD&D Premium per$1,000 $0.04 $0.04 Rate Guarantee 10/1/2023 Estimated Monthly Premium $1,887.60 $1,887.60 Estimated Annual Premium $22,651.20 $22,651.20 Increase/Decrease 0% • sup ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 2023 - 2024 Voluntary Life /AD & D Renewal 2023-2024 Life Renewal Summary: 10/1/2023-9/30/2024 USAble USAble Voluntar Life AD&D MIIMIMMI Voluntary Life/AD&D mill1= VOLUNTARY LIFE SUM14. Current Renewal The USAble Voluntary Life Benefit Amount Up to 5x Annual Salary or$500,000 (Increments Up to 5x Annual Salary or$500,000 (Increments of$10,000) of$10,000) renewal is a flat renewal Guaranteed Issue Amount $100,000 $100,000 (0% increase) with a rate Spousal Benefit Up to$250,000,not to exceed 50%of employee amount Up to$250,000,not to exceed 50%of employee amount (Increments of$5,000) (Increments of$5,000) guarantee through 9/30/2025. Spousal Guaranteed Issue $30,000 $30,000 Termination No longer eligible/Retirement No longer eligible/Retirement Employee AD&D Rate per$1,000 $0.04 $0.04 Spouse AD&D Rate per$1,000 $0.02 $0.02 Child Benefit $5,000 or$10,000 $5,000 or$10,000 Child Guaranteed Issue $10,000 $10,000 Child Life Rate per$1,000 $0.26 $0.26 Child AD&D Rate per$1,000 $0.01 $0.01 Rate Guarantee 10/1/2025 VOLUNTARY LIFE RATE SUMMARY Current Renewal MONTHLY RATE per$1,000 <30 $0.060 $0.060 30-34 $0.090 $0.090 35-39 $0.110 $0.110 40-44 $0.180 $0.180 45-49 $0.300 $0.300 50-54 $0.480 $0.480 55-59 $0.740 $0.740 60-64 $1.030 $1.030 65-69 $1.700 $1.700 70-74 $2.840 $2.840 75+ $5.410 $5.410 Increase/Decrease 0% Rate Guarantee 10/1/2025 • Nu ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS 2023 - 2024 Disability Renewal Short Term Disability Core Long-Term Disability 10/1/2023-9/30/2024 USAble USAble 10/1/2023-9/30/2024 USAble USAble Short Term Disabili I Short Term Disability Lon Term Disabili Long-Term Disability STD SUMMARY* AlII Current MIL_ Renewal LTD SUMMARY A Renew 0/0 of Monthly Earnings 60% 60% %of Weekly Earnings 60% $60 Maximum Monthly Benefit $6,000 $6,000 Maximum Weekly Benefit $750 $750 Elimination Period 180 Days 180 Days Elimination Period 0 Accident/7 Days Sick 0 Accident/7 Days Sick Benefit Duration 24 Months 24 Months Benefit Duration 26 Weeks 26 Weeks _ Own Occupation Period 24 Month Max 24 Month Max W-2 Services Included _ Included Mental&Nervous Disorder 24 Month Max 24 Month Max FICA Match _ Included Included Substance Abuse Treatment 24 Month Max 24 Month Max Rate Guarantee 10/1/2025 Pre-Exisiting Condition Limitation 3/12 3/12 STD Rates Renewal 'Rate Guarantee 10/1/2025 Monthly Rate per$10 $0.54 $0.54 LTD Rates Renewal — Monthly Rate per$100 $0.28 $0.28 Covered Weekly Payroll $108,828 $108,828 Covered Monthly Payroll $981,000 $981,000 Estimated Monthly Premium $5,876.71 $5,876.71 Estimated Monthly Premium $2,747 $2,747 Estimated Annual Premium $70,520.54 $70,520.54 Estimated Annual Premium $32,962 $32,962 Increase/Decrease 0% Increase/Decrease 0% 10/1/2023-9/30/2024 USAble USAble Bu -U Lon!-Term Disabili Buy-Up Long-Term Disability LTD SUMMARY 'ene 1%of Monthly Earnings I 60% _ $60 USAble STD, Core LTD and Maximum Monthly Benefit $6,000 $6,000 Elimination Period _ 180 Days 180 Days Buy-Up LTD coverages Benefit Duration 24 Months 24 Months Own Occupation Period 24 Month Max 24 Month Max received a flat renewal Mental&Nervous Disorder 24 Month Max 24 Month Max Buy-Up Long-Term Disability (0% increase) with a rate Substance Abuse Treatment 24 Month Max 24 Month Max Pre-Exisiting Condition Limitation 3/12 3/12 guarantee through 9/30/2025. Rate Guarantee 10/1/2025 111 Monthly Rate per$100 $0.30 $0.30 Covered Monthly Payroll $351,528 $351,528 Estimated Monthly Premium $1,054.58 $1,054.58 Estimated Annual Premium $12,655.01 $12,655.01 Increase/Decrease 0% ©2019 Brown&Brown,Inc.All rights reserved. WE MAKE YOUR PEOPLE OUR BUSINESS