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Health Insurance Annual Update
Presented by: Carl Vincent, CPA Risk Manager/Benefits Analyst Tina Vincent, MBA Lead Human Resource Specialist
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Wicomico County Public Entities (WCPE) Healthcare Consortium
Wicomico County Govt. & City of Salisbury Established 2001 Plan Year 9/1 to 8/31 How the Consortium Works Same benefit plans & rate structure Differences – premiums, contributions, & eligibility Reduced CareFirst administrative fees
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WCPS Subscribers by Status & Plan
# of Contract Holders Employee PPO 1,584 Employee EPO 422 Retiree EPO & PPO (<65) 130 Retiree Medicare Supplemental (+65) 860 Total 2,996
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WCPS Employee Subscribers by Coverage Level
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WCPS FY 2019 Operating Budget - $194.8 million
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WCPS FY 2019 Operating Budget - $36.1 million Employee Fringe Benefits
Approved FY 19 Budget Health Insurance $19,778,639 FICA $8,538,927 Pension Funding $5,228,641 Other Employee Benefits $1,338,952 Workers Comp $1,008,722 Life Insurance $216,407
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WCPS CareFirst Utilization Paid Claims as a % of Premiums
Year Ending Utilization 8/31/10 81.08% 8/31/11 87.26% 8/31/12 88.62% 8/31/13 86.03% 8/31/14 93.83% 8/31/15 90.21% 8/31/16 91.70% 8/31/17 98.14% 8/31/18 102.94%
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WCPS Health Insurance Annual Premium Increases
5.2%
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HealthCheck Checklist
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Financial Summary
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Cost Sharing Distribution
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Current Co-Pays - WCPE $0 – Preventive Medical Services & Prescription Drugs (Affordable Care Act) $15 – Office Visit (Primary Care Doctor or Specialist) $75 – Emergency Room $75 – Outpatient Surgery $100 – Inpatient Hospitalization
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Non-Preferred Brand Drugs
WCPS Co-Pay History Prescription Drug Medical Co-Pay Generic Preferred Brand Drugs Non-Preferred Brand Drugs Office Visit 2001 $5 $20 $35 $10 2007 $25 $40 $15 2014 to Present $30 $45 Increase since 2001 $0
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PHARMACY STATISTICS Generic Rx Brand Rx Plan Year End Member per Fill
Plan per Fill Average 8/2015 $5 $32 $30/$45 $405 8/2016 $39 $487 8/2017 $43 $575 8/2018 $44 $812 Cost Increase x Annual # of Fills $842,268 (70,189 fills) $4.4 million (10,886 fills) 2% 41%
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“Top 25 Drug Cost Summary” - Excerpt
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Combined Medical & Pharmacy Costs (PMPM) by Relationship Type
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Feedback from wcps employees:
I realized that I couldn't be the mom I wanted to be if I wasn't taking care of myself. So I committed to taking time for myself to exercise multiple times during the week. Being a role model for my two daughters helps me to stay on track. A healthy lifestyle has no ending. The changes that I am making need to become life long habits. I can't reach a goal weight and then go back to making the food choices that I did previously. There is no finish line. The best part [about this program] was that it gave me a lot of options to pick from. I did way more things in this program than I listed because it was fun. Please keep this program and incentives for next year. The incentive was very motivating! I thought about it the whole time as I worked out.. even on bad days! I can’t wait to get a fitness tracking watch for all of the time I have devoted to my fitness this year. My dad had dementia, my wife and I were expecting our 3rd child, there was a lot of work piling up, and we needed repairs to our home which we did not have the money saved up for. Addressing stress and anxiety was my main goal for wellness this year. I am very grateful for this program. As strange as it sounds, having incentives to keep track of my health and being able to see my results all in one place is a wonderful thing to have. My high amounts of stress were directly affecting my ability to feel great physically. I started to adopt meditation and yoga into my lifestyle and divide my work and home life. Now I can manage my stress better and I feel better as well! This program has helped me keep an active and healthy lifestyle. It is encouraging to track your accomplishments and it helps you want to continue to reach fitness goals.
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Questions and Discussion
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