PA 152 Compliance Plan Design Strategic Initiative July 24, 2012 - PowerPoint PPT Presentation

PA 152 Compliance Plan Design Strategic Initiative July 24, 2012 Presented by: Brenda White, Vice President Leslie Foster, Senior Account Specialist Aon 171 Monroe Avenue NW, Suite 525 Grand Rapids, MI 49503

Hard Cap Contribution  Michigan Publically Funded Health Insurance Contribution Act  Requires a hard cap on employer contributions to the cost of medical & prescription coverage – $5,500 x number of employees with Single coverage – $11,000 x number of employees with Double coverage – $15,000 x number of employees with Family coverage  Payments can then be allocated among employees and plans as the County sees fit  Hard cap is adjusted annually based on U.S. CPI  On December 22, Allegan County’s Board opted to exempt the County from the requirements in 2012 so that alternative plan options could be implemented effective January 1, 2013

2012 PA 152 Impact (absent Board action to exempt Allegan County) 100% PPO New Traditional High Deductible Single Double Family Single Double Family Single Double Family Enrollment 46 36 88 16 40 65 0 2 0 Current Monthly Illustrative Rate $615.90 $1,478.15 $1,847.70 $541.34 $1,299.22 $1,624.03 $407.31 $977.52 $1,221.91 Impact on EMPLOYEE Payroll Single Double Family Single Double Family Single Double Family Contribution Rate Current Contribution Strategy $61.59 $147.82 $184.77 $13.53 $32.48 $40.60 $10.18 $24.44 $30.55 Remainder of Annual Hard Cap Costs $78.78 $280.74 $298.85 $41.50 $191.28 $187.02 $0.00 $30.43 $0.00 Notes: • Includes medical, prescription, dental, and vision • Current Contribution Strategy for most groups is 80% employer contribution to the cost of the 100% plan and 95% employer contribution to the cost of the other two plans • Remainder of Annual Hard Cap Costs is the employee contribution that would have been in effect if the Board had not acted to exempt Allegan County from the Hard Cap Costs in 2012. Employee contributions under the hard cap are calculated as the total cost less the hard cap contribution, divided by 24 pay periods

Overview of Cost in Self Funded Environment

Self Funded Illustrative Rates CURRENT Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 8 Option 9 100% PPO New Traditional High Deductible PPO 1 PPO 2 80% PPO HSA Design 1 HSA Design 2 In-Network In-Network In-Network In-Network In-Network In-Network In-Network Individual Deductible $250 $1,000 $100 $500 $250 $1,250 $3,000 None F amily Deductible $500 $2,000 $200 $1,000 $500 $2,500 $6,000 Individual Out-of-Pocket Max $1,000/contract $1,000 $500 $1,000 $1,000 $1,000 $1,000 N/A F amily Out-of-Pocket Max $1,000/contract $2,000 $1,000 $2,000 $2,000 $2,000 $2,000 Coinsurance 100% 80% 80% 90% 70% 80% 100% 80% Physician Office Visits $20 $20 $30 $10 $20 $20 100% after ded 80% after ded Preventive Care 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits $50, waived if $100, waived if $75, waived if $100, waived if $50, waived if Hospital Emergency Room 80% after ded 100% after ded 80% after ded admitted, acc injury admitted, acc injury admitted, acc injury admitted, acc injury admitted, acc injury G eneric $10 $10 $10 $15 $10 $10 $10 after ded $10 after ded Brand F ormulary $15 $40 $60 $25 $40 $40 $40 after ded $40 after ded Brand Non-F ormulary $20 $40 $60 $35 $40 $40 $80 after ded $80 after ded F INANCIALS Monthly Illustrative Rates (Per mont h) Single $581.06 $503.31 $367.06 $501.62 $399.72 $434.02 $332.10 $481.32 $1,041.68 Double $1,394.55 $1,207.96 $880.93 $1,203.89 $959.35 $797.05 $1,155.17 Family $1,743.17 $1,509.93 $1,101.17 $1,504.86 $1,199.17 $1,302.08 $996.30 $1,443.96 Payroll Contributions (Per pay check; 24 pays/ year) Single $84.96 $46.09 $0 $45.24 $0 $11.44 $0 $35.09 Double $203.91 $110.62 $0 $108.58 $0 $27.48 $0 $84.22 Family $254.88 $138.26 $0 $135.73 $0 $34.34 $0 $105.28 Annual Contributions (Per year) Single $2,039 $1,106 $0 $1,086 $0 $275 $0 $842 Double $4,894 $2,655 $0 $2,606 $0 $659 $0 $2,021 Family $6,117 $3,318 $0 $3,257 $0 $824 $0 $2,527 Notes : • Rates have been re-configured so that family contributions are higher than double • Contributions are under the hard cap contributions • Figures in blue represent costs that fell below the re-tiered annual hard cap amt of either $4,933.63 (S), $11,840.72 (D), or • If you elect not to enroll in medical insurance through Allegan County you will receive an opt- $14,800.90 (F) out credit of $3,000 • Rates shown in the "Financials" section are 2013 rates • New Traditional U&C applies out-of-network • Out-of-Network benefit for all options are located on Sharepoint • Option 8 assumes $0 ER contribution

Self Funded Illustrative Rates CURRE NT Option 1 Opt ion 2 Option 3 Opt ion 4 Option 5 Opt ion 6 Option 8 Opt ion 9 100% PPO New Traditional High Deductible PPO 1 PPO 2 80% PPO HSA Design 1 HSA Design 2 In-Network In-Network In-Network In-Network In-Network In-Network In-Network Individual Deduct ible $250 $1,000 $100 $500 $250 $1,250 $3,000 None F amily Deduct ible $500 $2,000 $200 $1,000 $500 $2,500 $6,000 Individual Out -of-Pocket Max $1,000/contract $1,000 $500 $1,000 $1,000 $1,000 $1,000 N/ A F amily Out- of- Pocket Max $1,000/contract $2,000 $1,000 $2,000 $2,000 $2,000 $2,000 Coinsurance 100% 80% 80% 90% 70% 80% 100% 80% Physician Office Visit s $20 $20 $30 $10 $20 $20 100% after ded 80% after ded Preventive Care 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits 100%, visit limits $50, waived if $100, waived if $75, waived if $100, waived if $50, waived if Hospital E mergency Room 80% after ded 100% after ded 80% after ded admitted, acc injury admitted, acc injury admitted, acc injury admitted, acc injury admitted, acc injury G eneric $10 $10 $10 $15 $10 $10 $10 after ded $10 after ded Brand F ormulary $15 $40 $60 $25 $40 $40 $40 after ded $40 after ded Brand Non- F ormulary $20 $40 $60 $35 $40 $40 $80 after ded $80 after ded F INANCIALS Monthly Illustrat ive Rates (Per mont h) l/ Single $581.06 $503.31 $367.06 $501.62 $399.72 $434.02 $332.10 $481.32 a ic x R d $1,041.68 Double $1,394.55 $1,207.96 $880.93 $1,203.89 $959.35 $797.05 $1,155.17 e M Family $1,743.17 $1,509.93 $1,101.17 $1,504.86 $1,199.17 $1,302.08 $996.30 $1,443.96 l ta Single $32.26 $32.26 $32.26 $32.26 $32.26 $32.26 $32.26 $32.26 n e Double $77.41 $77.41 $77.41 $77.41 $77.41 $77.41 $77.41 $77.41 D Family $96.77 $96.77 $96.77 $96.77 $96.77 $96.77 $96.77 $96.77 n Single $5.82 $5.82 $5.82 $5.82 $5.82 $5.82 $5.82 $5.82 io is Double $13.97 $13.97 $13.97 $13.97 $13.97 $13.97 $13.97 $13.97 V Family $17.46 $17.46 $17.46 $17.46 $17.46 $17.46 $17.46 $17.46 Single $619.14 $541.39 $405.14 $539.70 $437.80 $472.10 $370.18 $519.40 ta l o Double $1,485.93 $1,299.34 $972.31 $1,295.27 $1,050.73 $1,133.06 $888.43 $1,246.55 T Family $1,857.40 $1,624.16 $1,215.40 $1,619.09 $1,313.40 $1,416.31 $1,110.53 $1,558.19 Payroll Cont ribut ions (Per pay check; 24 pays/ year) Single $104.00 $65.13 $0 $64.28 $13.33 $30.48 $0 $54.13 Double $249.60 $156.31 $0 $154.27 $32.00 $73.17 $0 $129.91 Family $312.00 $195.38 $0 $192.84 $40.00 $91.45 $0 $162.39 Annual Cont ributions (Per year) Single $2,496 $1,563 $0 $1,543 $320 $732 $0 $1,299 Double $5,990 $3,751 $0 $3,703 $768 $1,756 $0 $3,118 Family $7,488 $4,689 $0 $4,628 $960 $2,195 $0 $3,897 Notes : • Rates have been re-configured so that family contributions are higher than double • Contributions are under the hard cap contributions • Figures in blue represent costs that fell below the re-tiered annual hard cap amt of either $4,933.63 (S), $11,840.72 (D), or • If you elect not to enroll in medical insurance through Allegan County you will receive an opt- $14,800.90 (F) out credit of $3,000 • Rates shown in the "Financials" section are 2013 rates • New Traditional U&C applies out-of-network • Out-of-Network benefit for all options are located on Sharepoint • Option 8 assumes $0 ER contribution

Plan Comparison - Assumptions  Assumes a single employee utilizing in-network services  Assumes brand formulary prescriptions were filled  Assumes office visits cost $120 each  Assumes generic drugs cost $40 each and brand name drugs cost $100 each