Item B1M
C ounty of f Monroe
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BOARD OF COUNTY COMMISSIONERS
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Mayor George Neugent, District 2
The Florida. Ke Se
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Mayor Pro Tern David Rice, District 4
Danny L. Kolhage, District I
Heather Carruthers, District 3
Sylvia J. Murphy, District 5
County Commission Meeting
September 5, 2017
Agenda Item Number: B.1
Agenda Item Summary #3293
BULK ITEM: Yes DEPARTMENT: Employee Services
TIME APPROXIMATE: STAFF CONTACT: Maria Fernandez - Gonzalez (305)
292 -4448
n/a
AGENDA ITEM WORDING: Approval of resolution amending Resolution No. 388 -2013 and
amending rule for collection of health insurance contributions for Group Health Insurance coverage
from Retired Monroe County employees and establishing an effective date.
ITEM BACKGROUND:
On 7/25/17, the Board approved changes to the County Health Plan. Attached is a Final List of
Options with descriptions of each change. Options approved include:
• Adding $958,558 to the Health Fund from Ad Valorem, Non -Ad Valorem, Enterprise, or
Internal Funds
• #2, #2A, #29, #30, #31, #35, #9, #28, #15, #36, #34, #18A, #19, #32, #7A over 5 years, #4A,
#41, and #13.
Option #7 A necessitates an amendment to Resolution 388 -2013. Prior to 7/25/17, the County
subsidized Rule of 70 retirees by allowing them to remain covered under the County Health Plan
as long as they paid the County $5 /month per year of creditable service with the Florida
Retirement System (FRS). This amount was equal to the Health Insurance Subsidy (HIS)
provided to the retiree by FRS. The following table summarizes the changes to Resolution 388-
2013.
n of Resolution 388 2D13 m Hoard of county commis sion
approvals of 7 25 17 so1u1ion 388 2.13
July 23, 2D1] Board of county Comm Fdon App—k:
pF
p e e p w,k clan
hired prform 10 /1 /2001,
defined by
who re (a, fps)
on orakernormal renrem ent date
$5 /month /Vearof credi[abl e service with FRS
A(IJ
Rule of 70 /normal retrem ent date
Also covered'.
($50$150 mazJ
- emplo omer IRS dase,miad pmorm 10/1/2001, em.)
and all other anrees— - of 10/1 /2001 are participating m the
health
becomeseli,blefor
Co y ,—p insuance pmgam at no con"
ethe mtime Medica,ea,aresult of age. receipt of So—1 Security 0isabilrty, or
�anate,enald .the tine -11 ontmbnt 1001 of the annnalamnmal.1. —.$ 0- bt,d
they an m ove off the County Health Plan and receive a $250 m onth subidy.
A(I,)
on Rd. of 70 /norma1 retirement date
5p n ass hired on or after 10 /1 /2001
who retire on Drafter "normal retlrem ent date"
merit R.I.
nnual --.1 Rate
es hired pnorm 10/1/2001
covered by MChealth plan at R.. of renrem ent who re[Ire at an
eas retirement date
p merit Rate
Annual ACtunal Rate
en a or$5 /mon[h/Year of
. �.... t.n...r u..nrr r.r. �............nun.�
cred [ablesery ew FRS ($50$150 mazJ if
B(I)
Ruleof 70 /ea Fy re[rem en[ date
Employ... h prorm 10 /1/2001
covered by MC health at[ f ho re[re a[an
they are regular classand area[least 60 years
'
plan
eadyre[rementdatebutthen h h 60 years of agefor
of age or ft hey are spec al -k classand
least 55 years of age or$5 /m onth/Ye f
- -
r ' r r
rclas or sof age fo k classor who, mmbned
creditable sery ce wth FRS ($50$150 mazJ if
y rs of service plus renreesage equal70
their m m biped years of service with Monroe
Co yand the retiree'sagelotal 70
0 Ihe el,ee becomes elgble for Median asa result of age, receipt of Social Security Disabilrcy, or
-te renal disease, the retiree shall cohl,h— 100% of the annual actunal ate lesa $250 -bsdy -
they an m ove off the County Health Plan and receive a $250 m onth subidy.
B(,,)
on Rde of 70 l retirement date
mployeeshired on oraker 10 /1 /2001
who retire at any "eady retirement date"
men ae
nnual --.1 Rate
s of service/fu lly v ested l n FRS
hi date hire
C
/not retired when [hey,epaatefam MOnae
o
any of
inatefam employment, but do not initially retire
e they retire, retire -enroll X M Cwa, thei r Jas[ FRS em Ioye,
p men[Ra[e
Annual AC[uanal Ra[e
D
< rs of service/fully vestedin FRS/
no[,et0 ed when they sepaate from Monroe
Co y
r s(an ass)
hired any date of hire
erminate from employment, but do not actually retire
Cen maintain my ge MChealI planlf MC was[helr last FRS
p merit Rate
Annual --.1 Rate
Further, Option #4A changed the County subsidy provided to Medicare eligible Rule of 70
retirees who will now have an option to:
1. Leave the Monroe County Health Plan and purchase a Medicare supplement with a $250
county subsidy paid to the retiree or and will now be covered under a separate
resolution.
2. Remain on the Monroe County Health Plan and utilize the $250 county subsidy, along
with the FRS HIS to fund the annual actuarial cost of remaining on the County Health
Plan.
Option #4A changes are being covered under a separate resolution.
PREVIOUS RELEVANT BOCC ACTION: 7/25/17 BOCC approved changes to the Health
Insurance Benefits
CONTRACT /AGREEMENT CHANGES:
n/a
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
REVISED STAMPED Resolution revising Rule of 70 FINAL (8/24/17)
Resolution 388 -2013
Copy of 2018 premium worksheet
Copy of BOCC Decisions for 7 -25 -17 Final Savings
FINAL List of options DESCRIPTIONS approved on 7 -25 -17
FINANCIAL IMPACT:
Effective Date: 9/5/17
Expiration Date: N/A
Total Dollar Value of Contract: N/A
Total Cost to County: Option 4A saves approximately $873,000 for 2018 and approximately
$1.3 Million per year and may increase based on medical claims increases; Option 7A saves
approximately $21,000 for 2018 and $62,000 for 2019.
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
REVIEWED BY:
Bryan Cook
Completed
Assistant County Administrator Christine Hurley
08/22/2017 4:20 PM
Cynthia Hall
Completed
Budget and Finance
Completed
Maria Slavik
Completed
Kathy Peters
Completed
Board of County Commissioners
Pending
08/22/2017 1:40 PM
Completed
08/22/2017 4:35 PM
08/22/2017 4:46 PM
08/23/2017 7:32 AM
08/22/2017 4:56 PM
09/05/2017 5:05 PM
fflm��Z �Zl ��M
1177 LITZ 77wee oecomes engr care as P — IrmXV
Disability, or end stage renal disease, the retiree shall contribute 100% of the annual
actuarial rate.
Contribution as Percentage
of Annual Actuarial Rate'
Plan Year
Years of Service with Monroe County
25+
20-24
10-19
2018
HIS
17%
18%
2019
HIS
18%
26%
2020
HIS
20%
34%
2021
HIS
22%
42%
2022
HIS
25%
50%
1177 LITZ 77wee oecomes engr care as P — IrmXV
Disability, or end stage renal disease, the retiree shall contribute 100% of the annual
actuarial rate.
subsection, i.e., subsection 1. B. (i), will continue to be covered by Monroe
County's group health insurance benefits until they meet the requirements shown in
(a), (b) or (c) below:
(a) Sixty (60) years of age for Regular Masse loees or fifty-five
(55) years of age for Special is Class; or
(b) Qualifications under the Rule of 70 wherein the combined years of
service with Monroe County and the retiree's age equal a total of
seventy (70).
Upon satisfying the conditions in (a), (b) or (c) below, these members will bz�
required to pay the contribution amounts outlined in subsection 1. A. (ii), above.
10
monthly actuarial rate for active employees. Such amount will be payable on the first day
of every month beginning with the first of the month following the month in which the
employee tenninates employment with Monroe County, Employees with less than ten (10)
years of full-time service with the County are not eligible for amount adjustments under
subsection B. (i) of the resolution.
Section 2. The contribution rates shown above are separate and apart from the annual
subsidy for Medicare-eligible Rule of 70 retirees referenced in Resolution No. -2017.
Section 3. The contribution rates set forth in this resolution shall become effective on
January 1, 2018.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe Count
Florida at a regular meeting held on the — day of 2017. 1
Mayor George Neugent
Mayor Pro Tem David Rice
Commissioner Heather Carruthers
•
OF MONROE COUNTY, FLORIDA
M
Mayor George Neu gent
M
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Employee Services
RESOLUTION NO. 388 -2013
A RESOLUTION AMENDING RESOLUTION NO. 354 -2003 AND
AMENDING RULES FOR COLLECTION OF HEALTH INSRUANCE
SUBSIDIES FOR GROUP HEALTH INSURANCE COVERAGE FROM
RETIRED MONROE COUNTY EMPLOYEES.
WHEREAS, group health insurance expenses and claims attributable to the retirees have
been steadily increasing; and
WHEREAS, the number of retired County employees continues to increase dramatically
each year; and
WHEREAS, it is the intent of the Monroe County Board of county Commissioners to
allow County employees, including employees of the Constitutional Officers who meet the
criteria established in this resolution to retire through the Florida Retirement System and
maintain their group health insurance benefits with Monroe County as provided herein, now,
therefore
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA:
Section 1 in Resolution 354 -2003 is amended to read as follows:
Section 1
A. (i) Employees in FRS Regular and Special Risk Classes with a hire date prior
to October 1, 2001, with a minimum of ten (10) years of full -time service
with Monroe County, who retire on, or after, their normal retirement date as
described in Sec. 121.021(29), F.S., and who are covered under the group
health insurance coverage provided by Monroe County upon retirement,
employees in other FRS Classes who complete the number of years of
creditable service required by the Florida Statutes to be eligible for a benefit
under FRS, who retire on, or after, their normal retirement date under Sec.
121.021 (29) F.S., and who are covered under the group health insurance
coverage provided by Monroe County upon retirement, including those who have
retired or will retire in accordance with these insurance programs, and all other
retires who as of October 1, 2001 are participating in the County's group
insurance program at no cost, may maintain their group health insurance benefits
with Monroe County following their retirement provided they contribute a
premium of $5.00 per month for each year of creditable service with the Florida
Retirement System at the time of retirement with Monroe County and will pay at
a minimum $50 per month up to the maximum of $150 per month.
Page 1 of 4
V
Employee Services
Employees hired on or after October 1, 2001, who meet the requirements of
Section 1. A. (i) may maintain their group health insurance benefits with Monroe
County following their termination of employment, provided such retired
employees pay to Monroe County a monthly premium in an amount established
annually by the Board of County Commissioners. The premium will equal, but
not exceed, Monroe County's monthly departmental cost for active employees.
Such premium will be payable on the first day of every month commencing with
the month following the month in which the employee retires.
B. (i) Employees with a hire date prior to October 1, 2001, with ten (10) years of
full- time service with Monroe County who are covered under the group health
insurance coverage provided by Monroe County upon retirement and retire at an
early retirement date, as described in Sec. 121.021(30) F.S., may maintain their
group health benefits with Monroe County following their early retirement,
provided such early retirees pay to Monroe County a monthly premium in an
amount established annually by the Board of County Commissioners. The
premium will equal, but not exceed, Monroe County's monthly departmental cost
for active employees. Such premium will be payable on the first day of every
month commencing with the month following the month in which the employee
retires. Early retirees who pay the premium described in subsection 1. B. (i) will
continue to be covered by Monroe County's group health insurance benefits
provided they contribute a premium of $5.00 per month for each year of
creditable service at the time of retirement with the Florida Retirement System
with Monroe County and will pay at a minimum $50 per month up to the
maximum of $150 per month upon meeting either of the following requirements:
(a) Sixty (60) years of age for Regular Class employees or fifty -five
(55) years of age for Special Risk Class; or
(b) Qualifications under the Rule of 70 wherein the combined years of
service with Monroe County and the retiree's age equal a total of
seventy (70).
(ii) Employees with a hire date on or after October 1, 2001 who meet the
requirements of Section 1. B. (i) above and retire at any early retirement date,
may maintain their group health insurance benefits with Monroe County
following their early retirement, providing such early retirees pay to Monroe
County a monthly premium in an amount established annually by the Board of
County Commissioners. The premium will equal, but not exceed, Monroe
County's monthly departmental cost for the month following the month in which
the employee retires. Notwithstanding anything to the contrary, however,
employees with a hire date on or after October 1, 2001 are not eligible for the
premium adjustment under Section I.B. (i).
Page 2 of 4
Employee Services
C. Employees with at least ten (10) years of full -time service with Monroe County who are
covered under the group health insurance coverage provided by Monroe County upon
termination of employment and are fully vested under FRS who elect not to retire under
FRS upon termination of employment with Monroe County may elect to re- enroll under
the group health insurance coverage provided by Monroe County upon retirement under
FRS, provided that Monroe County was their last FRS employer. Former employees
electing this option, may maintain their group health insurance benefits with Monroe
County following such election, provided such former employees pay to Monroe County
a monthly premium in an amount established annually by the Board of County
Commissioners. The premium will equal, but not exceed, Monroe County's monthly
departmental cost for active employees. Such premium will be payable on the first day of
every month beginning with the first of the month following the month in which the
employee elected to re- enroll under the group health insurance coverage provided by
Monroe County upon retirement from FRS. Employees electing this option must notify
Monroe County of their intent to re- enroll in the County's group health insurance
program. Employees who re- enroll under the group health insurance coverage pursuant
to this paragraph are not eligible for premium adjustments under subsection 1.B.(i) of this
resolution.
D. Employees with less than ten (10) years of full -time service with Monroe County who are
covered under the group health insurance coverage provided by Monroe County upon
termination of employment and are fully vested under FRS, upon retirement under FRS
in accordance with these provisions, and provided that Monroe County was their last FRS
employer, may maintain their group health insurance benefits with Monroe County
following their termination of employment, provided such terminated employees pay to
Monroe County a monthly premium in an amount established annually by the Board of
County Commissioners. The premium will equal, but not exceed, Monroe County's
monthly departmental cost for active employees. Such premium will be payable on the
first day of every month beginning with the first of the month following the month in
which the employee terminates employment with Monroe County. Employees with less
than ten (10) years of full -time service with the County are not eligible for premium
adjustments under subsection B. (i) of the resolution.
Section 2. This resolution shall be effective as of January 1, 2014.
Section 3. This resolution does not affect any requirement of eligibility with the Florida
Retirement System; it affects only eligibility to receive health insurance benefits under the
Monroe County Group Employee Benefit Plan.
Section 4. For purposes of this resolution, full -time service shall have the meaning provided
in the County's policies and procedures governing determination of service. For purposes of this
resolution, the definition of date of hire is the date an employee first beings work for Monroe
County determined in accordance with the county's procedures governing fringe benefits. Any
break in employment of forty -eight (48) hours or more will result in a new date of hire if the
employee returns to County service.
Page 3 of 4
Employee Services
Section 5. The Monroe County Board of County Commissioners formally reserves the right
to any and all future changes and modifications of this resolution, the group insurance contract
providing health benefits described herein and/or the required contribution premiums.
Section 6. In all other respects, Resolution 354 -2003 remains in full force and effect.
PASSED AND ADOPTED by the Board of County Commissioners, Monroe County,
Florida at a regular meeting of said Board held on the 20 day of November 2013.
Mayor Sylvia Murphy Yes
Mayor Pro Tem Danny Kolhage Yes
Commissioner David Rice Yes
Commissioner George Neugent Yes
Commissioner Heather Carruthers Yes
f BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
ar. ow
AMY HEAVILI ,CLERK
By By:
Deputy Cler Mayor /Chairman
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MO ROE COUNTY ATTORNEY
PROVE,p A T F M:
CYNTHIA L. HALL
ASSISTANT COUNTY ATTORNEY
Date _.11 - 1 ' — 2013
Page 4 of 4
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Monroe County Boartl& C ounty Commss oners
EmployeeantlRetree C. -b.ti- Effectve January 1, 2018
Curren Tatl tonal
20'10 Em to ee/Retiree
Rae.
2018Ad...ial Rates
2018 Employ -IRet ree
Actuaral Rates
Rates as °h of
2018 COBRA Rates
10111201]
Department
Rate
f8 [6DB BN
MQOkhly RAG
MQOthly Rafe
TratlRional Plan HDHPIHSA
Monthly Ra[e Monthly Rate
TratlRional Plan
Monthly Rate
HDHPIHSA
Monthly Rate
TratlRional Plan
Monthly Rate
HDHPIHSA
Monthly Rate
Options
Category
Monthly Ra[e
EMPLOYEES
13
Empl. ye ,PFymg$25Rete(Rireaph.rm51v2012)
$25
$50
1 $0
1 $752
1 $629
7%
0%
$756
1 $630
$1,10233
13
Employees Feymg$50Rete(Rirea51v12.rlet�r)
$50
$75
1 $0 = =.
1 $752
1 $629
1 10°0
0%
$756
1 $630
$1,1023a
EMPLOYEE DEPENDENTS ONLY HIRED PRIOR TO 111110
13
Spouse only
$332
Q
$362
'.$299
$1,615
$356
33%
35%
$1,636
$367
13
Spouse +l child
$436
$552
.p-e32 .
$1,467
$1,227
3F%
35%
$1,486
$1,252
13
Sp .uses 2 more ch Idr-
$701
$366
,''
$2,144
$1793
3F%
35%
$2,157
$1,329
13
One child only
$143
$ 170
$
$451
$373
33%
35%
$466
$335
13
Two child -only
$295
$340
$266
$963
$755
33%
35%
$921
$776
13
Three chIdr- nN
$443
$510
. '.$3991. '..
$1,354
$1,133
33%
35%
$1331
$1,155
13
F..rehld -.mv
$591
$6680
),$532.'.
$1,305
$1510
33%
35%
$1341
$1540
13
Five +Chiltlren
$739
$849
$665..
1 $2,257
$1,333
3F%
35%
$2,362
$1,926
EMPLOYEE DEPENDENTS ONLYHIREDON GRAFTER -18
32
Sp ..se only
$332
a
$568
d,r
$425
$1,615
$356
50%
50%
$1,636
$367
32
Sp..ses1 child
$439
$733
$614.
1 $1467
$1227
5o%
5o%
$1496
$1252
32
Sp..se +2 or more ch Idr-
$761
$1,072
$697..
$2,144
$1,793
50%
50%
$2,137
$1,329
32
One child only
$143
$2
$ 169..
$451
$373
50%
50%
$466
$335
32
Two child -only
$295
$451
$376..
$963
$755
50%
50%
$921
$776
32
Three hIdr -.,1
$443
7. $677
7]$566.
$1,x54
$1,1 as
50%
50%
$1 3F1
$1,155
32
F..rehld -.m
$591
$963
.1$755
1 $1305
$1510
5o%
5o%
$1341
$1540
32
Five +Chlltlren
$739
$1,1'
',$944
1 $2257
$1333
50%
50%
$2362
$1926
RULE OF ]B RETIREES QNLY
7A
251YRS- N.f ,, Eligbl
FRSI
FRS
1 , $$56
1 $752
1 $629
1 17% -20%
9%
NIA
NIA
7A
2024YRS- N.f Medare Elglble
FRS
$$1.
$66
$752
$629
17%
10%
NIA
N.
7A
1019YRS- N.f- ,,- Elglble
FRS
$1.37
$76..
1 $752
1 $629
1 1F%
12%
N/A
N/A
RULE OF 70'. RETIREES ONLY MEDICARE ELIGIBLE STAYING ON PLAN
4A
10,YRSMeaiare Elgble Smymg.n C..my Flen
i FRS
$677
1 $566
1 $677
1 $566
1 100%
i00%l
NIA
NIA
4A
10+ YRS Meaiare Eligble St,,g.n C ... y Plan -C...ry S-dy
-$250
-$250
4A
10+ YRSMedareElglbleStayi ng.nC ... tyPlan NetRetreeRate
$427
$316
RULE OF ]O. RETIREES ONLY.MEDICARE ELIGIBLE NOTSTAYING ON PLAN
4A
10 +YRSMetlare Elgble Leaving C...ty Plan C ... ty S- dy(Can be
usetlmpurchas - ,,-Supplement) I M.nthlyt,- ployee
+$250
+$250.
OTHER RETIREES
41
N.nR,1 -70-r- N.fMeaiafa Eligmle
$1035
$752
I I $629
$752
$629
100%
100%
$756
i $630
41
N.nR,1 -70-r- - ,, -E lgbl
$621
$677
,$566
1 $677
1 $566
100%
100%
$679
1 $569
RETIREE DEPENDENTS ONLY:
13
Surviving Sp ..se N.f- ,,- Eligible
$332
Q
$362
$299
$1,915
$359
33%
35%
$1,936
$367
13
S.mrom Sp ..se Medare ei
$559
- -. $$677
?,$566.'.
$677
$566
100%
100%
$679
$566
13
Sp ..se only- N.f Metlare Eligible
$332
$p382
$299
$1,915
$359
33%
35%
$1,936
$367
13
Sp ..se only- N.fMed are Eligible +l child
$439
$$552
$432..
$1,467
$1,227
33%
35%
$1,496
$1,252
13
Sp..se.nly- N.fMed are Eligible +2 or -re chltlren
$701
$606
$631
$2,144
$1,793
33%
35%
$2,137
$1,329
4A X13
Spouse only M tliare Eligible (Ret ree must reman. n C...ty plan for
sp.se m be elgblel
$559
$677
!.$566
$677
$566
100%
100%
$691
$573
13
oneehoa .m
$143
$1.70
G
$451
$373
33%
35%
$460
$335
13
T- ehimren ,Iy
$295
$340
.1$266
1 $903
$755
33%
35%
$921
$770
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Contribution Changes Approved on July 25, 2017
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3,334,116
Value of Benefit Changes Approved (Options 2, 2A, 29, 30, 31,18A, 9, 19, and 35)
$1,135,000
$1,585,000
$1,696,000
$1,815,000
$1,942,000
$2,199,116
ITEMS APPROVED BY BOCC ON 7-25-17
4A. Provide a Flat $250 Subsidy to Medicare Eligible Retirees ($697 - $250 = $447)
$873,000
$1,330,000
$1,507,000
$1,696,000
$1,899,000 i
$1,326,116
7A. Reduce subsidy for Rule of 70 Pre-65 Retirees by 2W. each year, over 5 years
$21,000
$62,000
$103,000
$151,000
$206,000
$1,305,116
13. Dual Option HSA with LOW option
$289,000
$412,000
$441,000
$472,000
$505,000
$1,016,116
15. Change Medicare Retiree Drug Coverage from RDS to EGWP
$250,000
$250,000
$250,000
$250,000
$250,000
$766,116
28. Add $100 per month smoker surcharge
$167,000
$222,000
$222,000
$222,000
$222,000
$599,116
132.. Dependents of employees hired after 1/1/2018 pay 500 of actuarial rate
$44,000
$117,000
$176,000
$235,000
$294,000
$555,116
141. Establish Acturl I Sound Retiree Rate for insurance after retirement instead of retiree paying department rate
($4,000)
($2,000)
$1,000
$4,000
$8,000
$559,116
Subtotal - Impact of Ernployee/Retbee Funding Changes
$1,640,000
$2,391,000
$2,700,000
$3,030,000
$3,384,000
i
Combined Impact of All Benefit and Revenue Changes
$2,775,000
$3,976,000
$4,396,000
$4,845,000
$5,326,000
$559,116
Impact of !roejcted Claim Reductions on 6-Montjh Surplus Target
$567,500
$792,500
$84
$907,500
$971,000
($8,384 )
Com bined
i mp act ; � ofAll Benefit and Revenue Changes plus benefit of increased impact on surplus
$3,342,500
$4,768,500
$5,244,
$5,752,500
$6,297,000
($8,384)
O
-6
OPTIONS I Monroe County Heath Plan Ch..ges.dopted7 /25 /17fo, 1 /1/18 I DESCRIPTION OF CHANGE
N/A Add$958,558 from Ad Valorem, Non- AdV. 10 ,em,E.te,p,ise,o,l.te,..IFunds Add$958,558f,om Ad Valorem, Non -Ad Valo,em,E.te,p,iw,o, Internal F..dsto Health Fund
N29 PCP, Mental / bah .vioalhe.ltho,substa.ce.buse..d Pre /Post Natal Care Yo ... op .yme.tfo,..officevkitwlth.Primary Care Physicians(PCP), Mental / bah.vioa the .kho,subst...e.b.wofficevkits..d Pre /Post Natal Care
Co a e.t$30 office visits Willi... ease from $25 to $30 effective 1118.
Currently a 111. b work done through Quest there is zero opayment. Effective 1/1/18 there will be.$10 opayment on all lab work done through Quest.
N30 $10 Cop.yme.t for Independent Cli.ial Lab (Quest) NOTE: ALL PREVENTIVE LAB WORK DONE THROUGH QUEST WILL REMAIN AT A ZERO COPAYMENT ANY LAB WORK DONE AT AN INDEPENDENT CLINICAL
(ALL lab work must be sent to Quest for the $10 opayment to a pply) LAB, OTHER THAN QUEST, ORTHE OUT - PATIENT HOSPITAL FACILITY YOUR LAB WORK WILL BE SUBJECT TO THE ANNUAL DEDUCTIBLE AND YOU WILL HAVE
A 55% COINSURANCE TO PAY.
N31 Generic D,. Co t$15 The cop.y.e.tyo. are cu „e.tly payi.gfo, Generic Dmgs will increase Do. $10 to $15 effective 1 /1/18. No ch..geswe,em.detotheFo,mulary,No.-
g paymen Fo,mula ors eclalt Dm c e.ts.
Effective 1/1/18 maintenance medi,.tio.s(fo,ex.mple, medi,.tio.,fo, You cu„e.tly h.vethe choieto refill..yofyo., medications monthly o,geta 90- day mfill(physicla.mustw,ite p,esc,iptio.fo,. 90- d.ysupply)at
N35 diabetes, high blood p,essu,e)will require. 90-d.y supply at ,etail. Wa lg,ee.s is most retail pharmacies. Effective 1 /1 /18ifyou are prescribed any medicationsthm are considered —into ... ce (fo, example, diabetes, hypertension
bethe exclusive retail ph.,m.cyyou must uwfo,the 90-d.y ma i .... o medic.tio.$)yo., physician must w,iteyou a prescription for a 90 -day supply that you can only fill at W.Ig,ee.s Pharmacies.
mediation prescriptions.
Active employees hired ad-to 5/1/12 are w„e.tly paying $25 monthly for their coverage. This premium will increase to $50 monthly effective 1/1/18.
N9 Active Emp loyees Pay $50/75 for Emp loyee Cover. go Activeemployees hfired after 5/1/12 are currently pay in g$50 mo.thly for thei, cover, go. This pre enium wiIli. crease to$ 75 effective 1/1/18. These
increases are to stay in the traditional msua.ce plan and not elect the High Deductible /Health Savings Account Plan
The smoker surcharge is cu „ently$50 a n d is charged to Act ive amp loyees hired 1/1/15 or late,.. d Act ives w h o reti red fte,1/1/15. Effective 1/1/18 the
N28 $100 per month smokers.,charge moke, surcharge will increase to $100 for ALL employees, regardless of hire date and ALL retirees on the plan. D.,i.gthkye. is Open Enrollment ALL
plan participants (actives, retirees, spouses and dependents over the age of 18) must complete, sign and return a Non - Tobacco Attest atio n Certi iation
N7A over
S years
The County so bsidy provided to R. le of 70 retirees who are not yet eligible for
Medica re will be changed over the next 5 years and will vary depending on the
years of service with the County.
The Medicare Part D p,ogam offers employers, who keep retirees on their health plan after they are Medicare eligible,. Retiree Dmg Subsidy (RDS). The
subsidyf,om RDSbythe Cou my is a pp, ox imately$1 50, 000 per . lend. , yea r, but the Co. my does not receive th is susidy for over one yea r. The
Cointribulion as Percenls a of Annual utuarial Rate
For ploye, Group Waiver P,ogam (EGWP) was introduced several years ago and has become the way em ployers who offer retiree prescription benefits are
N15
Change Media re Retiree Dmg Su bsidy Do. BUS to EGWP
going. The EGWP is expected to generate over $200,00 of so bsidy for the County an d so bsid ies through the EGWP a re received at time of service. BUS
2024
1019
limits reimbursement to 28 %annually. The EGWP has no rein, burseme.t limit Effective for 2018 a lend., year the County will be switching to the EGWP.
HIS-
17
Effective 1 /1 /180ve,- the -Cou nte,(OTC) med icatio.s will be excluded from being covered under the prescription plan. If you have been getting any OTC
N36
Over - the -Cou.te,(OTC)med iatio.s will no longer be a v,i la ble through the
med icat ions t h cough the prescription pla n an d just paying the copayment, effective 1/1/18 she. Id you r physicia n give you a prescription for med icatio.s
26;o
prescription plan for just a copayment.
that are— I. ble OTC, it will be den ied.
20%
34%
The Select Form. 1. y is the list of med icatio.s that will be covered under our prescription plan effective 1/1/18. Should you happen to betaking any
N34
Adopt Envision Select Formulary
mediation that is not covered.nderthe Select Fo, l.la ,you will be notified p,io,to1 /1/18 so thatyou can discuss an alternative medication with your
2022
HIS
physician. If a med ic.tio. is not cov u nderthe Select Fo,mu la ry, there will be at least (2) two alternative med ic.tio.s that you, physician can
M%
Effective 1/1/18 spouses /Domestic Pa rtners of em ployees.nd retirees who are eligible for hea hh insurance coveageth,o.gh his /he,employe ... o not
Spousesofemployees o „eti,eeswho h.ve.ccesstocoveageth,ough his /her
eligible for cover, go as. dependent — the Monroe Cou. tyG, ou p Health Plan.A.yemployee o„etimewhoelects coveagefo,.. employed
N18A
own employe,.,e meligiblefo,coveage.nderthe Monroe County Group
spouse /Do mestic Pa rt.e, will be req.i,edto have an attest.tio.fo,. completed and signed bythespouse or Domestic Partner's employer indicating they
Health Plan.
offer no health fins.. nce coveageto their employees. Seff— ployed spouses /Domestic Partners will h.veto complete and sign attesti,gth,t they have
employe,spo.somd health care.
The Cou.tywill hire an outsidefi,m to perfo,m .... dlt of.11the dependents on the Monroe County Group Health Plan and ensurethat they are eligible
N19
Conduct an ..ditto ensurethat dependents on the plan are eligible for coverage
for age.
Effective 1 /1 /18the dependent subsidy provided bythe Cou.tywill be reduced
Employees hired 1 /1 /18who willw..t to cover depe.de.tswill not receivethe same subsidized premiums as cu „e.t employee receive. Subsidyfo,
N32
to 50 %fo,employees hired 1/1/18 and after
dependents ofemployees hired after 1 /1 /18will be reduced to 50 %. (PLEASE REFERTO THEATTACHED RATE SHEET FOR2018)
Effective 1/1/18 the monthly .tesfo, no.- Medicare eligible "Role of 70 Retirees' will change depending on you,ye.rs of servicewlth the FRS. Retirees
with 25. YOS will co.ti.ue to pay cu „e.t HIS ate. Reties wlth 20 -24 YOS will u ltimately pay 25% ofthe "act uarial ate” phased over5 years and retirees
with 10 -19 YOS pay 50 %ofthe "actuarial ate” phased over5 years. (PLEASE REFERTO THE ATTACHED RATE SHEET FOR 2018)
N7A over
S years
The County so bsidy provided to R. le of 70 retirees who are not yet eligible for
Medica re will be changed over the next 5 years and will vary depending on the
years of service with the County.
Cointribulion as Percenls a of Annual utuarial Rate
Plain Year
years of SeM. tsilh ]lo.. County
25+
2024
1019
2018
HIS-
17
15;6
2 019
HIS
1BN
26;o
2020
HIS
20%
34%
2021
HIS
41 -1.
2022
HIS
-
M%
Retiree Leaves the Monroe County Health Plen to purch ase Medicare Suppl...n R the retiree decides toe. roll in a Medicare Supplemental Plan
effective 1/1/18, the retiree wou Id terminate their mveage u nderthe Mon roe County G,ou p Health Plan coring the A ... a I Open Enrollment and
beginning 1/1/18 the Medicare Supplemental Plan would become their Secondary I.sua.ce. The County will provide $250 subsidy to the retiree and
the HIS that was being deducted fo,thei, coverage with Monroe County will be stopped. The retiree who terminates their coverage .nderthe Monroe
The county will begin pro viding "Role of 70 Retirees' who are eligible for County Hea th Plan willwaive the right to re- enroll and the spouse ofthe reti,eethat electsto usethe$250 subsidyto purchase a medicare supplement
ILIA Medicare a$250 monthly subsidy. This subsidy can be used by a reti,eetwo will be meligibleto stay on the Monroe County Health Plan.
different ways: Retiree Remains enrolled on the Monroe County Health Plan: A medicare eligible retiree can use the $250 susidy plus the retirees FRS Health Insurance
Subsidy and make u p the d lfference between the County Insurance health premium and these 2 subsidys. For example, for 2018, the monthly actuarial
rate is $677. The retiree would use the $250 subsidy from the County, plus the HIS (a 30 year employee would HIS would be $150) toward the $677. The
retiree would pay the difference to the County ($677- $250 -$150= $277).
Employeeshwi d10 /01 /01 or later are not considered "Role of 70 Retirees" and are not eligible forthe subsidized premium that the "Role of 70 Retirees”
N41 Establish Acturial Rate ( premium) for employees hired 10 /1 /01 or later and retire have. Ifyou were h ired on or afterl0 /O1 /01 and retire with Monroe County you have been paying the Department Rate of $1035 fo r 2017. Effective
with Monroe County 1/1/18 the rate paid by these retirees will be the acturial rate. (PLEASE REFER TO THE ATTACHED RATE SHEET FOR 2018)
Inaddition to the County's ” Traditional" insurance coverage plan, employees, The Traditional Plan includes a$400 ind ividual deductible; $800 fa or ily deductible; Pays 75% coins. a nce in Network;Pays 45% coins. a nce Out of
dependents, and retirees mayelecta High Deductible Health Plan (HD/HP)wfth a Network; Max out of pocket is $7,150 individual; Max out of pocket is $14,300 family.
N13 Health Savings ACcount(HSA) effective 1 /1/18. (A COMPARISON OF THE
CURRENT "TRADITIONAL PLAN" AND THE "HIGH DEDUCTIBLE HEALTH PLAN W ITH The High Deductible Health Plan (HD /HP) includesa $2000 individual deductible; $4000 family deductible (which must be met prior to insurance paying on
A HEALTH SAVINGS ACCOUNT WILL BE PROVIDED AT OPEN ENROLLMENT). 5oisuance) a a ;Pays 80% coins. nce in Network; Pays 50% coins. nce Out of Network; Max out of pocket is $6,650 ind ividua l; Max out of pocket is
13 fa mi
*Co payments are fixed dollar amounts (for example, $30) you pay covered health care, us.a lly when you receive the service.
*Co ins. ance is the percentage of the Allowed Amount for covered services. In- Network covered services are paid at 75% ofthe allowed amount and your *coins.ance k25% ofthe allowed amount.
25%
(Ex.ple: H- vetworkp,ovide,bills Florida Bl.e$1000fo,ap,oced.,e. Wheutheclaimisp,ocessedthe .!lowed— o.utbythepl -ii $800. Florida Blne will paythep,ovide,$600 which is 75% ofthe allowed ar.o.ut.
The In- network provider can only bill yo. $200 which is yon, coins.rance of25 %. The difference between the billed and allowed mo,ut, i. this case $200 thaz was not allowed, can not be billed to yo,.
O.t- of- network providers are paid .45 % ofthe .!lowed —o.ut and yo. are responsible for a coi.s.,..ce of 55%. H addition, O.t -of- network providers can bill yo. for the diff rase between the billed ar.o.ut and the allowed ar.o.ut.