HEALTH INSURANCE PROGRAM. Health Insurance Program Overview  Self-Insured (claims processed by Third-Party Administrator, currently BCBS)  Separately.

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Presentation transcript:

HEALTH INSURANCE PROGRAM

Health Insurance Program Overview  Self-Insured (claims processed by Third-Party Administrator, currently BCBS)  Separately Maintained Health Insurance Fund  Employee Clinic  High-Deductible Health Plan and Co-Pay Plan  Stop-Loss Insurance Protects against large claims above $125,000

Action Items  Stop-Loss Insurance  Change carrier from SunLife to Blue Cross Blue Shield  Change in deductible from $125,000 to $150,000

Stop-Loss Insurance  Limits City’s financial claims liability  Currently with SunLife  Sought quotes from alternate providers

 At the $125,000 deductible level, both carriers propose an increase CurrentSUNLIFE RENEWAL $125,000 Ded. BCBS PROPOSED $125,000 Ded. QuoteChangeQuoteChange $288,935$407,597$118, % $387,781$98, % Stop-Loss Insurance Quotes -- $125,000 Level

CurrentSUNLIFE RENEWAL $150,000 BCBS PROPOSED $150,000 QuoteChangeQuoteChange $288,935$339,281$50, % $318,201$29, % Stop-Loss Insurance Quotes -- $150,000 Level

Large-Claim History Stop-Loss Insurance Quotes YEARCLAIM 1CLAIM 2CLAIM 3CLAIM 4Add’l cost if at $150k 2012$283,938$400,790$327,662$75, ,208$136,252$265,585$48, ,976$11, $462,606$175,637$169,363$151,260$100,000 $235,436 Average Per Year: $58,589

Stop-Loss Insurance Quotes BLUE CROSS 125K BLUE CROSS 150K $387,781$318,201 Savings between $125k and $150k Deductible $69,580 Historical Average Cost of Claim Increase $58,589

Recommendations  Change to Blue Cross Blue Shield/HM Life for Stop Loss Coverage  Increase Deductible from $125,000 to $150,000

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