employee benefits renewal january 1, 2014 - december 31, 2014€¦ · 2014 employee benefits...

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Employee Benefits Renewal

January 1, 2014 - December 31, 2014

Comprehensive strategies.Individual attention.

Presented by:Laurence MarxJonathan Krass

August 21, 2013

Thbe of ContentsExecutive Summary . 1

Medical Plan Performance ............................................................................2

BOBSMedical Renewal ................................................................................3

Medical Marketing Summary .........................................................................4

Alternative Funding Analysis .........................................................................5

BenchmarkAnalysis............................................................ .......................... 6

County of Kane2014 Employee Benefits RenewalAugust21, 2013

Comprehensive strategies. -Individual. attention.

4

Executive SummaryGlobal Group, Inc. is pleased to present this initial renewal proposal for health and welfare benefits to theCounty of Kane. Global harnesses our years of expertise to comprehensively review Kane's benefit plans toensure that optimal renewal terms are identified every year.

Medical Analysis HighlightsThe Blue Cross Blue Shield renewal terms for the 2014 plan year initially called for a 9.3% increase to

current rates. As the 2014 renewal is the first to reflect the major cost impacts due to the Affordable CareAct, the plan is also being assessed the required estimated Premium Tax and Reinsurance Fee ($5.25 per

covered member per month) totaling 4.5% of premium. These fees yielded a total overall increase to theplan of 13.8%. After negotiation with BCBS, we were able to make them comfortable by lowering theincrease to the plan to .6%, which resulted in the ACA fees equaling 3.6% of premium, for an overall 9.2%

increase.Our fully-insured review of the marketplace yielded quotes from Humana and United Healthcare, bothoffering double-digit increases to current rates. We also are showing an Alternative Funding Strategy withBCBS, for both the HMO and PPO programs. As Global is committed to finding the optimal fundingmethodology for the County, we will explore all options fully.

Dental and Vision HighlightsOur review of the Dental and Vision programs are still pending, as Delta Dental has yet to release the 2014renewal rates for both lines.

SummaryWe are confident that our marketing efforts will provide the best options that the market has to offer. Wewish to thank Kane County for allowing Global to serve the benefits needs of your employees and theirfamilies, and we look forward to being your partner for many years to come.

Comprehemive strategies.County of Kane Individual attention2014 Employee Benefits Renewal August 2l,2013

4r

County of KaneMeffleal Plan Performance

PPO/HMO CotnedEXPERIENCE PERIOD FOR JANUARY 1, 2013 RENEWAL

Claims Loss

Month Enrolled Premium incl. Cap Ratio

APR-11 1172 $1,237,768 $859,543 69.44%

MAY - il 1176 $1240266 $914448 73.73%

JUNE-11 1177 81,236,314 $1,063,419 86.02%

JULY-11 1172 81,230,372 $1,092,457 88.79%

AUG-11 1168 81,228,308 81,122,610 91.39%

SEPT-11 1165 $1,227,756 $1,087,042 88.54%

OCT-11 1170 $1,233,925 $949,555 76.95%

NOV- 11 1163 $1230546 $1,041,577 84.64%

DEC-11 1159 $1,228,222 $1,123,908 91.51%

JAN-12 1151 $1,190,441 $1,096,448 92.10%

FEB-12 1143 $1,182,951 $1,186,674 100.31%

MAR-12 1140 $1,179,026 81.296,898 110.00%

Total 13,956 $14,645,895 $12,834,579 87.63%

Average 1,163 $1,220,491 $1,069,548

PPO/HMO CombinedEXPERIENCE PERIOD FOR JANUARY 1, 2014 RENEWAL

Claims Loss

Month Enrolled Premium Incl. Cap Ratio

APR-12 1,143 $1,183,241 $1,014,682 85.75%

MAY-12 1,148 $1,188,292 $1,016,854 85.57%

JUNE - 12 1,142 81,184,840 81,415,259 119.45%

JULY-12 1,138 $1,180,604 . $965,119 81.75%

AUG-12 1,132 81,176,432 81,052,025 89.43%

SEPT-12 1,130 $1,174,502 $913,416 77.77%

OCT-12 1,131 81,175,066 81.287,205 109.54%

NOV- 12 1,135 $1,171,058 $983,600 83.99%

DEC-12 1,144 $1,180,449 $933,130 79.05%

JAN - 13 1,147 $1,194,526 $1,153,376 97.39%

FEB - 13 1,140 $1,195,977 $908,218 75.94%

MAR-13 1,142 $1,188,733 $1,399,023 117.69%

Total 13,672 $14,193,720 $13,051,907 91.96%

Average 1,139 $1,182,810 $1,087,659

County of Kane Comprehensive strategies. -

2014 Employee Benefits Renewal Individual attention.

th^zv PAAAugust2l,2013 -.V

County of KaneMedical Pan Performance

April 1, 2011 through March 31, 2012January 1 2013 Penewa!

HMO FF0

MonthAPR - liMAY -11

JUNE - 11JULY -11AUG - ilSEPT-11

OCT - li

NOV- 11DEC - ilJAN - 12FEB - 12

MAR - 12

MonthAPR - 12

MAY - 12JUNE - 12

JULY -12

AUG - 12

SEPT - 12OCT-12NOV- 12DEC - 12

JAN - 13FEB-13MAR-13

Enrolled576577

580580579

578

578

577

574

581575

575

Enrolled579

582

579

578

575

574

582587

597595599

Premium$495,522$495,519

$497,223$494,722$493,357

$492,461

$496,485$496,845

$494,875

$457,771$482,249$483,537

$5,910,566

$492,547

HMO

Premium$486,541

$487,304$488.097

$488,190

$486,879$486,824

$487,713$489,303

$497,412$513,760$517,150$512,480

$5,941,653

$495,138

ClaimsIncl. Cap$342,481

$404,481

$457,706$486,049

$511,184$475,775

$439,678

$405.331

$414,198W8,544

$450,834

$633,201

$5,489,462

$457,455

ClaimsIncl. Cap$439033$460,321$461,000$484,254

$459,528

$378,339$579,016$508,021$456,717

$454,057$413,177$816,961

$5,910,454

$492,538

LossRatio69.12%81.63%

92.05%98.25%

103.61%96.61%

88.56%81.58%

83.70%

96.06%93.49%

130.95%

92.88%


94.45%

99.20%

94.38%77.72%116.72%103.83%91.82%88.38%

79.90%159,41%

99.47%

MonthAPR - ilMAY - 11

JUNE - ilJULY -11

AUG - ilSEPT- 11

OCT - ilNOV- 11

DEC-11

JAN - 12FEB - 12

MAR - 12

MonthAPR - 12

MAY - 12JUNE - 12

JULY -12

AUG - 12

SEPT-12OCT-12

NO\'- 12DEC - 12JAN-13

FEB-13

MAR - l

Enrolled596

599

597

592589

587

592586

585570

568

565

Enrolled564

566563

560557

556bbb553557

550545

543

Premium Claims$742,246 $517,062

$744,747 $509,967

$739,091 $605,713

$735,650 $606,408

$734,951 $611,426

$735,295 $611,267

$737,440 $509,877

$733,701 $636,246

$733,347 $709,710

$702,670 $627,904

$700,702 $735,840

$695,489 $663,697

$8,735,329 $7,345,117

$727,944 $612,093

Premium Claims$696,700 $575,649

$700,988 $556,533

$696,743 $954,259

$692,414 $480,835

$589.553 $592,497

$687,678 $535,077

$687,353 $708,189

$681,755 $475,579

$683,037 $476,413

$680,766 $709,319

$678,827 $4957041

$676,253 $582,062

$8 7 252,067 $7,141,453

$687,672 $595,121

Ratio69.66%68.48%

81.95%82.43%

83.19%63.13%

69.14%

86.72%96,78%

89.36%105.01%

95.43%

84.09%


136.96%

69.44%85.92%

77.81%103.031%

69.76%

69.75%104.19%

72.93%86.07%

86.54%

Total 6,930

Average 578

Total 7,002

Average 554

Total 7,026

Average 586

Total 6,670

Average 556

April 1, 2012 through March 31, 2013Ja'nuary_1_2014Rewal

FF0

County of Kane2014 Employee Benefits RenewalAugust 21, 2013

Comprehensive strategies.: Individual \ 40,4'..,


Comprehensive svategies.Individual attention.

,-

County of KaneMedical Large Camants

I.]

HMO

ignostc .,aegcyRestricted Diagnosis $402159C i rcu la tory 1$115,548Circulatory $107467Conditions in the Perinatal Period $87,751Infectious and Parasitic $67,880Rx $61,902Mental Health $55,293Rx $53,541



County of KaneMedca Pan UtUzaeonPPO Cost Sharing

Deductible Satisfaction:

2011 Calendar Year ($300 Single/$9D0 Family)

2012 Calendar Year ($500 Single/$1,500 Family)

Out-of-Pocket Satisfaction:

2011 Calendar Year ($750 Single/$2,250 Family)

2012 Calendar Year ($1,000 Single/$3,000 Family)

1,440 members enrolled373 Satisfied (26%)


1,440 members enrolled132 Satisfied (91/6)


PPO and HMO Utilization

PPO Emergency Room AdmissionsBCBS PPO Benchmark

HMO Emergency Room AdmissionsBCBS HMO Benchmark

PPO Inpatient Admissions:BCBS PPO Benchmark

HMO inpatient Admissions:BCBS HMO Benchmark

PPO Outpatient Cases:BOBS PPO Benchmark

HMO Outpatient Cases:BCBS HMO Benchmark

Pharmacy Utilization

Total Pharmacy Paid

Generic Dispensing RateBCBS Benchmark

Paid per PrescriptionBCBS Benchmark

2O1 N-.1 Y021

Se'ices1.000 CosL'Servic170 $1,146209 $825

157 $790196 $847

64 $18,03971 $13,505

67 $11,65069 $12,294

1,575 $7681,660 $672

514 $1,308616 $1,171

PPO HMO$1,449,429 $959,207

74% 79%76% 78%$78 $78$70 $79

$6,941,553$953,873 (13.

$7,382,472$1,663,140 (22.

212SeMces1i,C

187204

200206

6273

7471

1,5981,645

576592

PPO$1,489,688

67%71%$77$71

PPO Claims Cost (Copays, Deductible, Out-of-Pocket, etc)

2011 Calendar Year

2012 Calendar Year

CosziSorvice

$793

$761$824

$14,749$12,680

$11,202$12,093

$710$640

$1,154$1, 159

HMO$821,953

77%74%$69$77



:' 4

County of KaneMedical Pan Performance = Retiree Section

April 1, 2012 through March 31, 2013

HMO IF O

Claims Loss Loss

Month Premium Ind. Cap Fee Ratio Month Premium Claims Ratio

APR-12 $13,946 $26,305 188.63% APR-12 $22,603 $51,394 227.38%a -.

ivA - s,u ,uo o io - u, i

JUNE - 12 $13,025 $12,051 92.53% JUNE - 12 $23,852 $17,287 72.47%

JULY-12 $12,169 $11,102 91.23% JULY-12 $24,476 $28,114 114.86%

AUG - 12 $12,596 $19,978 158.60% AUG - 12 $24,476 $23,546 96.20%

SEPT-12 $12,596 $11,569 91.84% SEPT-12 $24,778 $47,052 189.90%

OCT-12 $12,596 $132,828 1054.52% OCT-12 $25,079 $31,087 123.95%

NOV- 12 $12,596 $17,766 141.04% NOV- 12 $25,683 $18,597 72.41%

DEC-12 $11,676 $10,524 90.13% DEC-12 $25,683 $36,881 143.60%

JAN - 13 $13,171 $15,281 116.02% JAN - 13 $28,922 $55,803 192.94%

FEB-13 $13,171 $17,341 131,66% FEB-13 $28,290 $35,205 124.44%

MAR-13 $13,171 $114,888 872.28% MAR-13 $28,290 $36,013 127.30%

Total $153,737 $400,678 260.63% 0 Total $305,983 $401,701 131.28%

Average $33,475$12,811 $33,390 M Average $25,499

Medicare Primary PPOLoss

Month Premium Claims Ratio

APR - 12 $3,620 $6,897 190.52%

MAY - 12 $3,620 $4,426 122.25%

JUNE - 12 $3,620 $3,524 97.34%

JULY-12 $3,620 $5,846 155.97%

AUG-12 $3,620 $7,788 215.12%

SEPT-12 $3,922 $5,905 150.57%

OCT-12 $4,224 $8,313 196.84%

NOV- 12 $4,827 $6,723 139.28%

DEC - 12 $4,827 $16,850 349.08%

JAN - 13 $5,249 $5,645 107.53%

FEB - 13 $5,249 $17,605 335.40%

MAR - 13 $57249 $7,479 142.48%

Total $51,647 $96,801 187.43%

Average $4,304 $8,067

County of KaneMedical Pan Performance = Retiree Section

pgs!HMo CombinedEXPERIENCE PERIOD FOR JANUARY 1, 2014 RENEWAL

Caims Loss

Month

Premium Incl. Cap Fee Ratio

APR - 12

$40,169

$84,597

210. 60%

MAY - 12

$40,498

$36,195

89.38%

JUNE - 12

$40,498

$32,862

81.15%

JULY -12

$40,265

$44,862

111.42%

AUG - 12

$40,692

$51,311

126.10%

SEPT-12

$41,295

$64,525

156.25%

DOT- 12

$41,899

$172,228

411.06%

NOV- 12

$43,106

$43,085

99.95%

DEC - 12

$42,185

$64,254

152.31%

JAN - 13

$47,342

$76,728

162.07%

FEB -13

$46,710

$70,152

150.19%

MAR-13

$46,710

$158,380

339.07%

Total $511,368

$899,181

175.84%

Average $42,614

$74,932


Comprehensive strategies. IfIndividual attention.

V4

I,

IIII!

Kane CountyProspective Prenriurn Projection

Januery 1,2014-December 31, 201401101/2014 Premium ProspectiveProspective Renewal

CLAIM PROJECTION

Net Paid ClaimsRemove Large ClaimsNumber of Large ClaimsIBNR AdjustmentAdjusted Net Paid ClaimsExposuresAverage Claim Value (ACV) Per Contract Per Moutir (FCFM)Annual Trend RateTreed Mo,rths (midpoint method)Treed FactorTreaded ACV PCPMHistorical Plarr Change AdjustmentDependent Ratio AdjustmentAdjusted ACV PCPMNon-Pooled Large Claims PCPMProjected ACV PCPM by PeriortExperience Period Weigtrtirrq

Blended Experience ACV PCPMManual ACV PCPMCredibilityTotal Projected ACV PCPMProjected Plan Clrorrge ArtjustrrrelrtTotal Projected ACV PCPM with Projected Plan ChangesStop Loss Alternate Level AdjustrnerrtAdjusted Projected ACV PCPM with Projected PIes ChangesProjected EnrollmentNumber or Morr(trs lrr Policy PeriodProjected Net Paid ClaimsProjected Illinois Facility Network SavingsProjected Illinois Physician SavingsTotal Projected Illinois SavingsProjected Other Network SavingsTotal Projected Network SavingsProjected Network Senlrrgs % or Total Gross Medical Clansp rojected Gross Medical F Rn,Ctrrims

01/0112012 Hist. 2012 Plarr Changen01101/2013 Hist. 2013 Ptarr Cha,rgns01I0112013 HIst. Worrrerrs Preventive CareTotal Historical Benefit Adjustments01101/2014 Proj. OPX Li,rrlls trrr El-IllsTotal Projected BenefitBerretlt Adjristrrrerrts

ML) I L [)RIJG - _TOTAsL

Friar Current Prior Current Prior Current01/1 1-03/12 04/12-03/13 04/11-03/12 04/12-03/13 04111-03/12 01/12-03/13

15.777.663 85,608.511 $1,567,454 $1,532,943 $7,345.117 $7,14 1, 1154

$292,052 $866,419 8292,052 $866,419

1 3 1 3

$3,859 ($2,531) $54 ($20) $3,913 ($2,551)85.489.470 $4,739,561 $1,567,508 $1,532,923 $7,059,978 86,272,41)4

7,027 6,670 9,9j7 6,530 7,027 6.670

$781.20 $710.58 $226.62 $234.70 $1,007.82 894533

6.7% 7.4% 6.1% 6.0%

33.0 21.0 33.0 21.0

19.5% 13.3% 17.7% 10.7%

$933.53 $805.09 $266.73 $259.87 $1,200.26 81,004.116

-0.27% -2.24% -4.06% 0.47%

0,16% -0.27% 0.75% -0.07%

$876.40 $784.93 $257.82 $260.91 $1,134.22 $1,045,114

$29.17 $92.20 $0.00 $0.00 $29.17 892.70

$905.57 $877.13 $257.82 $260.91 $1,163.39 $1,138.01

0% 100% 0% 100% 0% 1017%

$877.13 $290.91 $1,139,114

$837.48 $193.08 81.030.56

1001/1 100% 00%

$877.13 $260.91 $1,138,111

1,34% 0.00%

$888.88 $260.91 $1,149.79

1.0000 1.0000

$888.68 $290.91 $t,t49.:'S

539 525 539

12 12 12

$5,749,276 $1,643,733 $7,393,009

($5,203,724) ($5,203,724)

($2,923,598) (82,923.598)

($8,127,322) ($8,127,322)

($111,908) ($11 1,9011)

($8,239,230) ($8,239,230)

(58.9%) (52.7%)

$13,986,506 $15,632,239

-3.43% 0.00% .469% 0.00%

-3.40% -2.60%

0.48% 0.37% 0,63% 0.47%

-8.27% -2.24% -4.06% 0.47%1.34%

1.34% 0.00%

Gorrrprvherr.rir:e ntrurtcgiroc.County of Kane Jpditridrutlaitetr(ion.

2014 Employee Benefits Renewa.

S v jAugust 21, 2013


,r'": Individual affention.

Ir

Kane CountyProspective Premium Projection

January 1, 2014- December 31, 201401101/2014 Premium ProspectiveProspective Renewal

CLAIM PROJECTION

TL

Prior Current Prior Current Prior -Current

04/11-03/12 04/12-03/13 04/11-03112 04/12-03/13 04/11-03/12 04112-03/13

Net Paid Claims

Remove Large Claims

Number of Large Claims

Adjusted Net Paid Claims

Exposures

Average Claim Value (ACV) Per Contract Per Month (PCPM)

Annual Trend Rate

Trend Months (midpoint method)

Trend Factor

Trended ACV PCPM

Historical Plan Change Adjustment

Dependent Ratio Adjustment

Adjusted ACV PCPM

Non-Pooled Large Claims PCPM

Projected ACV PCPM by Period

Experience Period Weighting

$375,460 $219,613 $178,094 $200,981 $551,554 $420,594

$0 $0 ,$0 $0

0 0 0 0

$375,460 $219,613 $176,094 $200,981 $55i,54 $420,594

1,006 971 1,006 971 1006 971

$373.22 $226.17 $175.04 $2136.98 $548.26 $433.15

4.0% 4.0% 6.1% 13.0%

33.0 21.0 33.0 21.0

11.4% 7.1% 17.7% 10.7%

$415.77 $242.23 $206.02 $229.13 $621.79 $471.36

-1.28% 0.00% -13.04% -4.84%

-3.71% -2.39% -3.25% -2.03%

$395.22 $236.44 $173.33 $213.61 $568.55 $450.05

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$395.22 $236.44 $173.33 $213.61 $568.55 $450.05

0% 100% 0% 100% 0% 100%

Blended Experience ACV PCPM

Manual ACV PCPM

Credibility

Total Projected ACV PCPM

Projected Plan Change Adjustment

Total Projected ACV PCPM with Projected Plan Changes

Stop Loss Alternate Level Adjustment

Adjusted Projected ACV PCPM with Projected Plarr Changes

Projected Enrollment

Number of Months in Policy Period

Projected Net Paid Claims

01101/2012 Hist. 2012 Plan Changes

0/01/2013 I-list. 2013 Plan Changes

01/01/2013 F-list. Womens Preventive Care

Total 1-listo0cal Benefit Adjustments

$236.44

$213.61

$450.05

$354.16

$148.78

$502.94

100%

100%

100%

$236.44

$213.61

$450.05

0.00%

0.00%

$236.44

$213.61

$450.05

1.0000

1.0000

$236.44

$213.61

$450.05

75

75

75

12

12

12

$212,796

$192,249

$405,045

-1.28% 0.00% -7.06% 0.00%

-6.90% -5.20%

0.50% 0.38%

-1.28% 0.00% -13.04% -4.84%


January 1, 2014 December 31, 20140110112014 Premium Prospective Renewal

CLAIM PROJECTION

- MEDlAL DUG TOTAL

Prior Current Prior Current Prior Current

Net Paid ClaimsRemove Large Claims

Number of Large Claims

Adjusted Net Paid Claims

ExposuresAverage Claim Value (ACV) Per Contract Per Month (PCPM)

Annual Trend Rate

Trend Months (midpoint method)

Trend Factor

Treaded ACV PCPMHistorical Plan Change Adjustment

Dependent Ratio Adjustment

Adjusted ACV PCPM

Non-Pooled Large Claims PCPM

Projected ACV PCPM by PeriodFvnerience Period Weiahtinu

Blended Experience ACV PCPM

Manual ACV PCPM

Credibility

Total Projected ACV PCPMProjected Plea Change Adjustment

Total Projected ACV PCPM with Projected Plan Changes

Stop Loss Alternate Level Adjustment

Adjusted Projected ACV PCPM with Projected Plan Changes

Projected Enrollment

Number of Months in Policy Period

Projected Net Paid Claims --

01/01/2012 I-list. 2012 Plan Changes

01/01/2013 Hist. 2013 Plarr Changes

01/01/2013 Hist. Womens Preventive Care

Total Historical Benefit Adjustments

04/11-03112 04/12-03/13 04/11-03112 04/12-03/13 04111-03/12 04/12-03/13

$2,362,887 $2,653,181 $643,538 $758,227 $3,006,425 $3,411,408

$324,541 $402,737 $324,541 $402,737

I 1 1 I

$2,038,346 $2,250,444 $643,538 $758,227 $2,681,884 $3,008,671

5,927 6,041 5,927 6,041 5,927 6,041

$343.91 $372.53 $108.58 $125.51 $452.49 $498.04

4.0% 4.0% 6.1% 6.0%

33.0 21.0 33.0 21.0

11.4% 7.1% 17.7% 10.7%

$383.12 $398.98 $127.80 $138.94 $510.92 $537.92

-0.79% 0.38% -13.47% -5.20%

1.23% 0.65% 1.10% 0.64%

$384.77 $403.10 $111.80 $132.56 $496.57 $535.66

$34.59 $33.93 $0.00 $0.00 $34.59 $33.91

$419.36 $437.03 $111.80 $132.56 $531.16 $569.5y

0% 100% 0% 100% 0% 100°%

$437.03

$132.56

$569.59

$399.81

$165.46

$565.27

100%

100%

100%

$437.03

$132.56

$569.59

0.00%

0.00%

$437.03

$132.56

$569.59

1.0000

1-0000

$437.03

$132.56

$569.59

520

520

520

12

12

12

727,067

$827,174

554.241

-1.28% 0.00% -7.06% 000%

-6.90% -5.20%

0.50% 0.35%

-0.79% 0.38% -13.47% -5.20% -



January 1, 2014- December 31, 201401101/2014 Premium Prospective Renewal

TOTAL PROJECTED COST

RENEWAL

______ ____ P14425 H/1442S TOTAL

Projected Enrollment 639 696 1 1,134

Tetal Projected Net Claims $7,393,009 S3.959286 $11,352,295

illinois Facility Access Fee{% of ADPn 0639-S $34,768 $34,756

Physician Seivice Fees $2,263,457 $2,293,457Poolina S205,00D Level .) $316,912 3162.939 3491,651

Rick

HMO Managed Core Fee $63.760 $63,790

Total Benefit Charges $7M97,303 $6.5747897 314,472,200

Desired Lose Ratio (IJLR

9312% 91127, 93.12%

Requited Premhsin $8.480.761 37.060.671 $15,541,452

Premium at Current Rates $8.049.744 3671697929 $14,219,673

.eqthra[1FernmurnfPremIurn at irm ant ate

Allocated Taxes & Fees 3943,467

Total Required Premium 316,164,919

Total Required Premium / Premium at Current Rates 1380%

Corrpitrensir' .t,ulCgi'$.

County of Kane

Individual allen//air

2014 Employee Benefits RenewalAugust 21, 2013

''.H,-


for the periodJanuary 1. 2014 December 31. 2014

0110112014 Premium Prospective Renewal

RATE DEVELOPMENTPlease refer to the ACA Disclaimer regarding benefits and final pricing,.

P144:25 H14425 614425

Premium at Current Rates $8,049,744 $741,505 $5,428,424

Rate Action 13.80% 13.80 is 13.130

Requested Premium at Renewal Rates* 89.160.609 $843.833 $6,177,547

Livcjs Cunont eiwai

irr'ent___________

HCSC Primary

Single 185 $631.90 $719.10

38 $465.58 $529.83

192 $433.00 $492.75

Single + 1

138 $'1,26128 $1,441.03

15 $933.00 $1,061.75

119 $867.69 $987.43

Family 201 $1,857.20 $2,113.69

22 $1,368.41 $1,557.25

209 81,272.02 $1,448.24

Medicare Primary

Single 11 $308.77 $351.38

0 $470.18 $535.00

O $437.27 $497.61

Family 4 $017.54 $702.76

o $940.30 $1,070.12

0 $874.53 $995.22

HCSC & Medicare Total

539

75

520

Cfmirprrhensive s1rategis.

County of Kane Individual a/ lention,

2014 Employee Benefits RenewalAugust 21, 2013 . L...JL.j

Lao

po"Tk

r$t^ H V9 9 9 8

Medca Marketng SummaryCurrent Renewal Negotiated Renewal Alternative Alternative

PPO BCSS of IL BCBS of IL tiL OT IL

Deductible (Single/EE±1/Family)

In-Network $600/$1.200/$1 1800 5600/61 200/Si 800 $600/$1,2C 800 5500/51 .000/StOOD $6001$1,200/$1,800

Out-of-Network $1,200/$2,400/$3,600 Si ,200/$2,400/$3,600 $1,200/$2,4 51,500/53, 000153,000 $1 ,200/$2,400/53,600

0t of Pocket ;(SinglefEE+ 1/Family) -

In-Network S1,500/$3,000/$4,500 $1, 500/53,000/54,500 Si ,5001$3,000/54,500 52,000/54, 000/54,000 Si 500/53,000/54 500

Out-of-Network 53,000156, 000/59,000 53,000/56, 000/59,000 $3,0001$6,000/$9,000 $6,000/s1 2,000/512,000 53,000156,000159,000

'Physician Off ce'Vidits . .- . . ______________________

Primary Care $25 $25 $25 $25 $25

Specialist $45 $45 $45 $40 $45

Emirgéncy-Room

In-Network $250 copay $250 copaI $250 copay $250 copay $250 copay

Out-of-Network Same Same Same Same Same

P.rescñptionDrug

Generic $10 $10 $10 $10 $10

Formulary Brand $40 $40 $40 $40 $35

Non-Formulary Brand $60 $60 $60 $70 $60

Rates, Enrollment

Employee 185$631.90 $719.10 $690.03 $648.17 $573.77

Employee + 1 138 $1,266.28 $1,441.03 $1,362.78 $1,296.34 $1,149.78

Employee + Family 201 $1,857.20 $2,113.49 $2,028.06 $2,009.33 $1,686.35

Current Renewal Negotiated Renewal Alternative Alternative

HMO BCBS of IL SOBS 01 IL OL..00 or IL

Physician pffibe Visits 1Primary Care $25 $25 $25 $25 $25

Specialist $45 $45 $45 $45 $45

Inpatierit.Hopital Ser'Aces$250 $250 $250 $250 $250

Emergency Room

In-Network $250 copay $250 copay $250 copay $150 copey $200 copay

Out-of-Network Same Same Same Same Same

Prescription Drug

Generic $10 $10 $10 $10 $10

Formulary Brand $25 $25 $25 $45 $25

Non-Formulary Brand $40 $40 $40 $70 $50

Rates -HMO IL Enrollment

Employee ' 38 $465.58 $529.83 $50841 $545.34 $581.70

Employee + 1 15 $93300 $1,061.75 $1,018.64 $1,096.68 $1,365.06

Employee + Family 22 $1,368.41 $1,557.25 $1,494.30 $1,699.83 $2,003.57

Rate& -.l-IMO .BA Enrollment]

Employee 192 $433.00 $492.75 $472.84 $548.34 $681.70

Employee + 1 119 $867.69 $967.43 $947.52 $1,096.68 $1,366.06

Employee + Family 209 $1,272.62 $1,448.24 $1,389.70 $1,699.63 $2,003.57

Total Active Premium $13,611,789 J $15,490,216 $14,664,092

Tote! Retiree Premium $607.863 $691,748 $663,786

Total Annual Premium $14,219,652 $16,181,954 $15,627,878 $16,364,334 $16,816,301

Difference From Current (5) $1,962,312 1 $2,308,226 $2,144,682 $2,596,649

Difference From Current (%) 13.80% I 9.20% 15.08% 16.26%

Comprehensive strategies. Al!County of Kane Individual attentzon eu y 42014 Employee Benefits Renewal

'fTL.August 21, 20134

County of KaneAlternative, Funding Anayss = HMO Cost Pus

Reinsurance Data CURRENT RENEWAL OPTION OPTIONReinsurance Carrier BCBS of IL BCBS of IL BCBS HMO BCBS HMOSpecific Deductible $105,000 $105,000Specific Coverage Medicai/Rx MedicallRxAggregate Coverage MedicaVRx MedicaVRx

Mature

Immature ll!ustration

Employee CensusEmployee Only 232 232 232 232

Family 366 366 366 366

Total Employees: 598 598 598 598

Fixed CostsAdministration Fee $31.92 $32.72

Specific Premium $45.03 $49.35

Physician Service FeesEmployee Only $151.81 $151.81

Family $421.11 $421.11

Aggregate Premium $0.63 $0.63

ACA Taxesand Fees $19.35 $19.35

Tota!Month!y Fixed Costs: $247,310.32 $250,372.08

Total Annual Costs: $2,967,723.84 $3,004,464.96

Aggregate LiabilityExpected Claims Rate Per Member $470.23 $515.28

Maximum Claims Rate Per Member $587.79 $644.11

HMO Managed Care Fee $8.81 $8.81

Expected Plan Exposure $6,169,923 $6,737,570 $6,405,315 $6,765,335

Maximum Plan Exposure $6,169,923 $6,737,570 $7,248,925 $7,689,819

County of Kane Comprehensive strategies.

2014 Employee Benefits Renewal Individual attention. 4 1August 21, 2013

F v4

Atemathie Funding Analysis = P1 :0 SBf=FLmded (ASO)

Reinsurance Data CURRENT RENEWAL OPTION OPTIONReinsurance Carrier BCBS of IL BCBS of IL BCBS PPO BCBS PPOSpecific Deductible $135000 $135000

Specific Coverage MedicaVRx MedicaVRxAggregate Coverage Medical/Rx Medical/Rx

Mature

LImmature Illustration

Employee CensusEmp loyee Only184 184 184 184

Family 345 345 345 345

Total Employees: 529 529 529 529

Fixed CostsAdministration Fee $42.32 $43.67

Specific Premium $82.58 $88.01

Aggregate Premium $0.89 $0.89Illinois Access Fee $12.19 $12.19ACA Reinsurance Fee $10.64 .$1064

Total Monthly Fixed Costs: $78,619.98 $82,206.60Total Annual Costs: $943,439.76 $986,479.20

Aggregate LiabilityExpected Claims Rate Per Member $1,052.04 $1,120.83

Maximum Claims Rate Per Member $1,315.05 $1,401.04

[Expected Plan Exposure $8,049,728 $8,790,307 $7,621,790 $8,101,508

Maximum Plan Exposure $8,049,728 $8,790,307 $9,291,377 $9,880,281]


2014 Employee Benefits Renewalindividual aitention

August 21, 2013 he.. 47 ^--- 4

Alternative Funding Analysis Summary


2014 Employee Benefits Renewal Individual attention.

August 21, 2013 b4̂'MPA4 :tv



Alternative Funding Anayss • Cams Analysis

p'po

r LAN .. •. -SO PPO

r Pre urn Paid* Clams O1rns± Fixed Costs

2012 $8,315,082 $7,382,472 $8,046,689

2011

$8,115,202 $6,231,843

HMO

FuF!v-nsured CO5t:Pi5HMC

Year rern urn Pa& Clams* Cairns ^ Fixed Costs2012 $5,851,820 $3,679,846 $6,235,281

$5,440,636 $3,092,044

$5,957,653$6,975,605

2011

2010

$8,330,337 $6,638,282

$7,552,247 2010

$5,392,322 $2,996,008

$5,457,911

2009

$8,648,356 $7,065,787

$7,821,064 2009

$4,493,796 $2,837,854

$5,703,463

SUMMARY' Self-Funded p201:

Fully-nsuied'' CôstPlusHMO

Year Premium Paid C laims* Claims +FixedCosts Net Gain/L,22012 $14,166,902 $11,062,318 $14,281,970 ($115,068)

2011 $13,555,838 $9,323,887

$12,933,258

$622,580

2010 $13,722,659 $9,634,290

$13,010,158

$712,501

2009 $13,142,152 $9,903,642

$13,524,528

($382, 376)

$837,637

*premiums and claims are represented on a calendar-year basis. Large claimants have beenpooled out of the totals based on the $135,000 and $105,000 pooling levels for the PPO andHMO, respectively, used in the ASO and Cost Plus calculations.

County of KaneCollar County Benchmark Analysis

ppo loon OnKoIb' .. Du'1yu ',, ..'.., .'Ki6oi. ,L8I18° il' 1 •''.' MnH&nry' ., , WillCOOOt. 00W' 1,. 1' - :- .. ':,fl. .!..,- .i.00nt6-,. . .. . '. County . . '': ,., ". . . Cnoty

C BIllS 0085 0085 BCBS BCBS BCBS00115Dodnolible (In flolwnrk( (ring/Inn,) 0600/51.800 0750/01.500 0750 0200/0600 0450/5900 0750/0600 0250/0000 0300/5600 0350/5700Dedunliblo (00101 Nnln,nrk) (ring/Ion,) 51,700/03,600 01.500/03.000 0750 5500/51500 $1,100/S2,200 5425/01,125 S2so/0500 $30010600 5350/5701JCoin,o,nnnn (in/nor) 80%/60% 080/660 8001160% 9001/70% 8001/605. 8531/7501 9031/60% 90%/60% 9001160%Our of Podrer MIn (to) )ling/Ionr) 01,900/03,500 01,500/53000 $2,000 0500/51,900 $1,200/02,400 $1.20052,M10 $1,005/03,000 01.500103.000 $u,500/$3,0011Our of Pookor Mn, (Our) (hug/lan',) 03.000/09.000 $3.000/06,000 $10000 01500/04,500 04,000/08000 52,400157,200 $3,500/07.000 $3,500/57,000 $3,900157,005Or(r VIII) (l',In,n,y) $25 $25 Dod/Coin, $10 $30 Sod/Coinu Dod/Color Oeil/Cuinr Ded/Colus01)1,0 0311 (SynninIlul) 045 $35 Oed/Coinr $10 $30 Dad/C.1-Dod/Co1n1 Dnd/Coiiiu Ded/ColuuR. Cu/,y

Deunilu $10 $5 $15 010 $10 $5 $10 SIR $10- B,nud ' $40 $40 $30 520 530 529 $20 $20 $70- Ron tornulsuy 8—d $60 060 $50 $35 $45 $35 $35 $35 $35- Specialty $70

Pren,in,osICusrSiogle Eurploynd Co,rI,Ibulron 09% 25% 20% 10% 9% 10% Sal.,l,rodISgln loIn) P,eoduni $532 0696 $794 $857 0695 $950 0552Inrollu Eu9llnyoo Coul,ibi,Iluu 19% 25% 27% 31% 13% 21)16 Solnry boredfe,r,ilo 00141 P-1""' 51,857 $2,073 02,536 $2,052 01,842 $7,256 $1,726

8M0 ', I/lOu , . . , Delrnlb , . ' - , , . .1 .,DIrPne-,.-, ..., .. 110111101 1600 ' . . . ' . MoHerrey '"' WillCl"ltd '- .County ... I . " . .', -..cnoRty..

C I N su 6 lIMO 11(1 I Dl Ad t B HMO Ii)) I Dl Ad a #1M051111 I Dl Ady I UMO 1111 I DI Ad 8 DI Add 1 Dl Ad I S

Iupnrieol Cal)"'

$555 .$200 $200 " $256 $0 .. $0 $150 $150 ' 0100 0500

ER Coyly $250 $250 $250 0100 $75 $75 . $126 $125 575 550OlSon V j 111 )P,inrnry)

$25 $25 $25 $15 $15 $15 $25 025 010 $10..co D011 00001111111 . $45 $45 $40 $25 $15 $55 $30 $30 $10 $10Ox Coyly

Geun,11 . $50 $10 NO . $ 55 $55 $10' $60 $10 $10 $5 $7BroIl,) . $25 $25 lIMO $30 $30 $20 , $20 $30 $30 $25 $15Nun-I000ulury Brnrrd $40 $40 0)10,01 $50 , $50 ' $35 . $35 $45 $45 $35 $305600)0)10 . . . . .. . . $70

preorlrr,or/Cnrl .SbrgloEnrylnyne CnoI,llrrrllnu . 5096 6% 35% . . 6% 10% 1099 7% 6% 1091Sioglo roll) PleO0 u,l1 5466. $433 $526 $511 $701 $652 $605 $519 0599 $579

Snurilu Errryl0000 Coolobullno 15% 8% 21% 16% 32% 32% ' 11% 10% 15%Fnnrlly lolnI P,n,lrlrlrn $1,368 $1,273 $1,470 $1,426 $1.842 $1,752 $1.546 ' $1,376 $1.487 $1,497

1-10111' . .' ' . . ' Oeknlln , -'-DrIPoge : '..,, ' ' (lerrdo)I . '' , , Coke '. ' . ' McI-leery " I : wi

Coun.'. ., 7 . . County . . 'county. . ' .'Cnls4ty . . ' . County , ' ' Currrlry7 . County

DerlucliErle (10 ReWork) (Dog/Inrul $2,500/59,000 02,000/54,000 51.900/03,000 03,250/52,900Dednollbln (OrrI of Nnlurk) (sing/fa-) 55,000/010,000 $4,000/08.000 01.500/03,000 00,000/74,200Coiouure000 9001/70% 9001/60% 50091/8094 0031/60%01,301 Pnoknl Mon (In) Irlog/Inrol NO 01.250/50,500 03,000/76.000 03,000106,000 01,500/03,000 No No

On) of Pockor MonO") )dog/Oro( 80111' 02,900/55,000 $6000/012000 $3,000/56,000 $3,000/$6,000 1111111' 110111'

On Coonu Otlnred OIIo,nd UtIe,ed

Gnrre,lc 000uolIlr)e 055 Deduollble Dodoclible

5r,nld & $40 & &

Nnn . fo,00dnry Brand Coln-r0000 $50 Cohn urr—co Culocornoce

Prernrrrn,r/CostSolgle Eorpluuoe Co,rl,IlruIlon 29% 1011. 55% 9%

SIngle loIn) P,e,rriunr $756 $621 0567 0699Feorily En,yluyne ConIrIburlon 25% 18% 31% 13%Inroily 701,1 Pre,ol,,rn $1,744 $3,984 $1,346 S1,n42

County of Kane CullrpFnhrtnniue III-aringier.

2014 Employee Benefits Renewal . !,, ,Iroldr,8t anentlnrl.

August 2l,2013 4pu_rr. ) ,,,,0.,,,,,, " I 6,

employee benefits renewal january 1, 2014 - december 31, 2014€¦ · 2014 employee benefits...

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