1. CITY OF PALM COAST GROUP HEALTH & DENTAL PROPOSAL 2009

2. Blue Cross Blue Shield Coverage provided by Blue Cross Coverage provided by Blue Cross Renewal quote provided for 15.1% increase over current to maintain current policy elections Renewal quote provided for 15.1% increase over current to maintain current policy elections

3. Quote Process Received competitive bids from other Insurance Providers; Aetna, Florida Healthcare Plans and United Healthcare Received competitive bids from other Insurance Providers; Aetna, Florida Healthcare Plans and United Healthcare Florida Healthcare removed from consideration due to network and concerns regarding purchase by BCBS Florida Healthcare removed from consideration due to network and concerns regarding purchase by BCBS Considered carriers provide a comprehensive network of providers Considered carriers provide a comprehensive network of providers Remaining plans offered similar designs with only marginal differences in out-of-pocket costs to employees in few components Remaining plans offered similar designs with only marginal differences in out-of-pocket costs to employees in few components Significant savings over Blue Cross offering Significant savings over Blue Cross offering

4. Quote Process Competitive pricing shared with Blue Cross Blue Shield Competitive pricing shared with Blue Cross Blue Shield Initial discussions with BC/BS did not result in rate reductions comparable with competition Initial discussions with BC/BS did not result in rate reductions comparable with competition Rate reduction achieved through reducing plan options from three to two, increasing some out-of-pocket costs, and only after BC/BS realized that pricing was non- competitive Rate reduction achieved through reducing plan options from three to two, increasing some out-of-pocket costs, and only after BC/BS realized that pricing was non- competitive

5. Why Change Now? All carriers offered excellent plan designs with affordable premiums All carriers offered excellent plan designs with affordable premiums Blue Cross Blue Shield did not willingly provide options comparable in price to competition Blue Cross Blue Shield did not willingly provide options comparable in price to competition Need to protect the process for 2010 Need to protect the process for 2010 Dental bundles provide additional savings Dental bundles provide additional savings

6. RECOMMENDATION Change carrier to Aetna Healthcare Change carrier to Aetna Healthcare Comparable coverage Comparable coverage Lower cost Lower cost

7. SAVINGS 2008 Blue Cross 2009Aetna Cost per Employee per Month $713$619 Total Cost: $3,071,604$2,666,652 Based upon current enrollment