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PRESENTATION OF ANNUAL INSURANCE CONTRACTS October 25, 2011. HEALTH INSURANCE TEAM “HIT” MEMBERS. Human Resources Finance Contracts Purchasing Utility Fire Insurance Broker Recreation & Parks Last, but not least …. YFCM. GROUP HEALTH INSURANCE PROGRAM OVERHAUL
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PRESENTATION OF ANNUAL INSURANCE CONTRACTS October 25, 2011
HEALTH INSURANCE TEAM “HIT” MEMBERS • Human Resources • Finance • Contracts • Purchasing • Utility • Fire • Insurance Broker • Recreation & Parks • Last, but not least …. YFCM
GROUP HEALTH INSURANCE PROGRAM OVERHAUL 2010 – 2011 ACCOMPLISHMENTS • Entered into Flat-Fee contract with insurance broker Brown & Brown • Converted from fully-insured to self-insured • Implemented Employee Clinic • Implemented New Plan Designs • Added High-Deductible Plan Option • Created Wellness Sub-Committee to promote healthy workforce through enhanced wellness programs
Received 3 competitive quotes for the self-insured product 1. Aetna 2. Blue Cross Blue Shield of Florida (BCBSFL) 3. United Health Care (UHC) Florida Health Care submitted a competitive quote; however, it is a fully insured plan (contradictory to our long term goal). 2012 QUOTES HEALTH INSURANCE
2012 RESULTS ANCILLARY INSURANCES
HEALTH INSURANCE ADMINISTRATION & STOP LOSS Change to BLUE CROSS BLUE SHIELD DENTAL and ANCILLARY INSURANCES Stay with MUTUAL OF OMAHA HIT RECOMMENDATIONS for 2012
In current health care plan discrepancies exist between retail and mail order pharmacy pricing • Common Cholesterol Medication • Common High Blood Pressure Medication PHARMACY
NEXT UP: Conduct review of pharmacy benefit to ensure best practice. • Pharmacy included with group health insurance is non-transparent • Data is considered “proprietary” • City desires transparency in cost to reduce drug costs • Proposals from PBMs may be transparent, thus providing savings to both City and the employees • Monitor future pharmacy pricing to determine if exploration of 3rd party provider is cost effective PHARMACY ???
Maintain status quo except for: • PHARMACY: • Local Preference – Addition of 90 day local retail and no mail order incentives • Step Therapy for name brand prescriptions • Mandatory Generic or employee pays the difference • OTHER: • Combined the 2 network plans into 1 network plan • Colonoscopy covered 100% (Diagnostic & preventative) • Convenience Clinics (at Primary Care Physician co-pay) • Eye & Hearing exams (1 per year vs. every 24 months) 2012 ADJUSTMENTS
Questions and Discussion THANK YOU!