PRESENTATIONOF ANNUAL INSURANCE CONTRACTS October 25, 2011

 Human Resources  Finance  Contracts  Purchasing  Utility  Fire  Insurance Broker  Recreation & Parks  Last, but not least …. YFCM HEALTH INSURANCE TEAM “HIT” MEMBERS

Entered into Flat-Fee contract with insurance broker Brown & Brown Entered into Flat-Fee contract with insurance broker Brown & Brown Converted from fully-insured to self-insured Converted from fully-insured to self-insured Implemented Employee Clinic Implemented Employee Clinic Implemented New Plan Designs Implemented New Plan Designs Added High-Deductible Plan Option Added High-Deductible Plan Option Created Wellness Sub-Committee to promote healthy workforce through enhanced wellness programs Created Wellness Sub-Committee to promote healthy workforce through enhanced wellness programs GROUP HEALTH INSURANCE PROGRAM OVERHAUL 2010 – 2011 ACCOMPLISHMENTS

2012 QUOTES HEALTH INSURANCE 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).

HEALTH INSURANCE QUOTES AETNA CURRENT AETNA RENEWAL UHC BCBSFL Stop Loss Insurance $184,256$235,284$228,851$203,476 Annual Administration Fee $146,893$165,035$133,426$215,784 Creditsn/a - $50,000 NET COST $331,149$400,319$362,277$369,260

2012 RESULTS ANCILLARY INSURANCES MUTUAL OF OMAHA Dental Insurance Employee PaidRate Constant Short Term Disability Employee PaidRate Constant Voluntary Life Insurances Employee PaidRate Constant Long Term Disability $ 3,307Rate Constant AD&D $ 300Rate Constant Employee Life Insurance $ 2,329$ 1,803 Rate Decrease EAP Services 3 visits per family 6 visits per family Rate Constant

HIT RECOMMENDATIONS for 2012 HEALTH INSURANCE ADMINISTRATION & STOP LOSS Change to BLUE CROSS BLUE SHIELD DENTAL and ANCILLARY INSURANCES Stay with MUTUAL OF OMAHA

PHARMACY In current health care plan discrepancies exist between retail and mail order pharmacy pricing Common Cholesterol Medication Common High Blood Pressure Medication 30 Day Retail 30 Day Mail Order 90 Day Retail 90 Day Mail Order $12.74$47.71$34.72$ Day Retail 30 Day Mail Order 90 Day Retail 90 Day Mail Order $ 3.39$ 7.42$ 6.67$ 22.27

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 3 rd party provider is cost effective

2012 ADJUSTMENTS 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)

Questions and Discussion THANK YOU!