1. Workforce Status and Benefits Budget Worksession July 12, 2011

2. Workforce Status Health Insurance Presentation Outline

3. Workforce Status Health Insurance Presentation Outline

4. Note: Excludes Court Related Positions for Comparison Purposes Position Summary

5. Budgeted Salary Increases –FY 2010 – 0% –FY 2011 – 0% –FY 2012 – 0% Bargaining Unit Employees: Wages based on negotiated contracts Building employees were on reduced workweeks from February 2009 to March 2011 Employees are paying significantly more in health insurance costs Wages

6. Newly enacted pension reform including the 3% employee contribution requirement has lowered county’s FRS expense Annual savings is approximately $27 million Florida Retirement System

7. FRS savings being used for: –Health Insurance Plan –Capital Projects –Reserves Most of the savings are being utilized for one- time expenses since FRS rates may increase in future years Florida Retirement System

8. Workforce Status Health Insurance Presentation Outline

9. 2012 Healthcare Plan Budget Worksession July 12, 2011

10.  Background  Recommended Plans  Healthcare Supplement  Wellness Initiatives  Next Steps Presentation Outline

11.  Background  Recommended Plans  Healthcare Supplement  Wellness Initiatives  Next Steps Presentation Outline

12.  BCC  Comptroller  Tax Collector  Supervisor of Elections  Housing Finance Authority  OBT Development Board  Metroplan Orlando  Property Appraiser  Lynx  Clerk of Courts  Research and Development  I-Ride Trolley Background 8,310 Covered Employees Total Plan Members 16,100

13. Background  Lower Plan Costs  Increased Wellness  Increased Member Engagement County moved to a High Deductible Health Plan with Health Savings Accounts in 2011 Intended Results

14. Background  Healthcare Avoidance  Postponement of Treatment  Affordability  Greater Stress County moved to a High Deductible Health Plan with Health Savings Accounts in 2011 Unintended Results

15. Background  Plan Costs  Wellness  Member Engagement  Affordability  Access to Healthcare  Productivity  Improved High Deductible Option  Low Deductible Option  Health Insurance Supplement

16.  Background  Recommended Plans  Healthcare Supplement  Wellness Initiatives  Next Steps Presentation Outline

17. Recommended Plans  Low Deductible Health Plan  Flexible Spending Account  Improved High Deductible Health Plan  Health Savings Account Option 1Option 2

18. Recommended Plans  100% Covered Preventive Care  Deductible Reduced To: $1,200/$2,400 from $1,500/$3,000  20% Coinsurance  Out of Pocket Reduced To: $2,400/$4,800 from $3,000/$6,000  Preventive Rx*  Health Savings Account (HSA)  $750/$1,250 County Contribution  Contribution Limits $3,100/$6,250  Catch Up $1,000/$1,000 Option 1: High Deductible Health Plan * Does not apply to Deductible

19.  Combines elements of HMO & Deductible Plans  100% Covered Preventive Care  Some services subject to $500/$1,000 deductible and $1,500/$3,000 Out-of-Pocket (OOP) Maximum  Preventive/Treatment Rx*  Co-pays for*:  Office Visits - $20  Specialist - $35  Urgent Care - $40  Outpatient Surgery (non-hospital) - $100  Flexible Spending Account (FSA)  No County Contribution  Employee Funded Recommended Plans Option 2: Low Deductible Health Plan * Does not apply to Deductible/OOP

20. Recommended Plans Coverage Category High Deductible Plan Low Deductible Plan EmployeeEmployerEmployeeEmployer Employee Only $0$229.53$10$236.15 Employee + Child(ren) $70$428.30$82.50$434.00 Employee + Spouse $77$395.92$89.50$404.22 Employee + Family $155$531.36$170$538.81 Recommended 2012 Bi-Weekly Premium Structure

21.  Background  Recommended Plans  Healthcare Supplement  Wellness Initiatives  Next Steps Presentation Outline

22. Healthcare Supplement  $1,200 health insurance supplement for all benefits eligible employees to offset health expenses  Additional contribution deposited in either health savings account or medical flexible account  Distribution will occur in October 2011 for eligible employees or in January/February 2012 for remainder

23.  Background  Proposed Options  Healthcare Supplement  Wellness Initiatives  Next Steps Presentation Outline

24. Wellness Initiatives Cost Drivers  Diabetes – 22% of Employees and Spouses  Obesity – 48% of Employees and Spouses

25. Wellness Initiatives Disease Management  Diabetes Management Program – in partnership with Florida Hospital Diabetes Institute  Weight Management Program – in partnership with Orlando Health

26. Wellness Initiatives “Wellness Works!”  Weight Management, Dental Care, Eye Care  Flu shots, Mobile Mammography, On-site Mini Health Checks  Community Involvement, Wellness Challenges  Fruits and Vegetables, Education Classes

27.  Background  Proposed Options  Option Comparisons  Healthcare Supplement  Wellness Initiatives  Next Steps Presentation Outline

28. Next Steps  BCC Approval of Low Deductible and High Deductible Health Plans  Education Education Education  Workshops/Classes  Online Support Tools  Social Media  Printed Materials (Mailers, Packets, Pocket Guide)  Tools to help employees choose between plans  Enhance Wellness Focus  Mandatory Open Enrollment in October

29. Workforce Status and Benefits Budget Worksession July 12, 2011

30. Medical Expenses (in millions) Category2010 2011 – Projected if no change 2011 – Projected with change Medical$73.5$80.1$55.8 Pharmacy$13.7$15.0$13.5 HSAN/A $7.5 Total$87.2$95.1$76.8