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Item B2M C ounty of f Monroe ELj » °o � BOARD OF COUNTY COMMISSIONERS /� r i � �� Mayor George Neugent, District 2 The Florida. Ke Se y I 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.2 Agenda Item Summary #3302 BULK ITEM: Yes DEPARTMENT: Employee Services TIME APPROXIMATE: STAFF CONTACT: Maria Fernandez - Gonzalez (305) 292 -4448 n/a AGENDA ITEM WORDING: Approval of a Resolution establishing the procedure for distribution of $250 subsidy to Medicare - eligible Rule of 70 retirees. 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 #4A changed the County subsidy provided to Medicare eligible Rule of 70 retirees who will now have two options to choose from: 1. Retiree Leaves the Monroe Countv Health Plan to purchase Medicare Supplement: If the retiree decides to enroll in a Medicare Supplemental Plan effective 1 /l /18, the retiree would terminate their coverage under the Monroe County Group Health Plan during the Annual Open Enrollment and beginning 1/1/18 the Medicare Supplemental Plan would become their Secondary Insurance. The County will provide a $250 subsidy to the retiree and the HIS that was being deducted for their coverage with Monroe County will be stopped The retiree who terminates their coverage under the Monroe County Health Plan will waive the right to re- enroll and the spouse of the retiree that elects to use the $250 subsidy to purchase a Medicare supplement will be ineligible to stay on the Monroe County Health Plan. 2. Retiree Remains enrolled on the Monroe County Health Plan: A Medicare eligible retiree can use the $250 subsidy plus the retirees FRS Health Insurance Subsidy and make up the difference between the County Insurance health premium and these 2 subsidies. 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). PREVIOUS RELEVANT BOCC ACTION: CONTRACT /AGREEMENT CHANGES: na/ STAFF RECOMMENDATION: Approval. DOCUMENTATION: Resolution Medicare eligible $250 subsidy FINAL Copy of subsidy $250 Medicare eligible all Option 4A background Copy of BOCC Decisions for 7 -25 -17 Final Savings FINAL List of options DESCRIPTIONS approved on 7 -25 -17 Copy of 2018 premium worksheet FINANCIAL IMPACT: Effective Date: January 1, 2018 Expiration Date: N/A Total Dollar Value of Contract: Total Cost to County: This change should save approximately $873,000 in 2017 and then in following years, approximately $1.3 Million annually, along with inflation in future years. Current Year Portion: Budgeted: Source of Funds: Group Insurance Fund 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 4:21 PM Cynthia Hall Completed Budget and Finance Completed Maria Slavik Completed Kathy Peters Completed Board of County Commissioners Pending 08/22/2017 1:48 PM Completed 08/22/2017 4:37 PM 08/22/2017 4:46 PM 08/23/2017 8:19 AM 08/22/2017 4:54 PM 09/05/2017 5:05 PM RESOLUTION NO. -2017 A RESOLUTION BY THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ESTABLISHING THE PROCEDURE FOR DISTRIBUTION OF $250 SUBSIDY TO MEDICARE- ELIGIBLE "RULE OF 70" RETIREES TO OFFSET THE COST OF MEDICARE SUPPLEMENTS; ESTABLISHING AN EFFECTIVE DATE. WHEREAS, prior to 1999, the County offered free health insurance to retirees, and WHEREAS, on March 13, 2001, the Monroe County Board of County Commissioners ( "BOCC "), in its capacity as the Plan Administrator of the Monroe County group insurance health plan ( "Health Plan "), adopted Resolution No. 119 -2001, stating the amount of money retirees must pay, above and beyond the Florida health insurance subsidy outlined in F.S. 112.313, in order to maintain Monroe County health insurance after retirement; and WHEREAS, one of the groups of retirees whose contribution rates were outlined in Resolution No. 119 -2001 were retirees (as defined by Florida Retirement System) with a minimum of 10 years of creditable service hired before 10/1/2001 and whose combined age plus years of service at time of retirement totaled at least seventy (70) ( "Rule of 70 Retirees "); and WHEREAS, Resolution 119 -2001 was subsequently amended by the BOCC, via Resolution Nos. 154 -2003, 354 -2003, and 388 -2013; and WHEREAS, on July 25, 2017, the BOCC adopted numerous changes to contribution rates of active employees, dependent and retirees under the Monroe County Health Plan; and WHEREAS, one of the changes approved by the BOCC at the July 25, 2017 meeting was approval of Option 4A, a $250 /month subsidy to Medicare eligible retirees (defined as Health Plan members who are eligible for Medicare either as a result of (i) age (65 years of age or older), (ii) two years after receipt of Social Security Disability Insurance benefits, or (iii) being diagnosed with end stage renal disease or amyotrophic lateral sclerosis); and WHEREAS, the intent of Option 4A was to provide a monthly supplement for Medicare - eligible Rule of 70 Retirees, to offset excessive claim costs ; and WHEREAS, in Plan Year (calendar year) 2018, the Plan expects to have approximately 344 Medicare eligible Rule of 70 Retirees (313 current retirees, plus an additional 31 members who are currently active employees, but expected to retire and be eligible for the $250 Subsidy during the Plan year); and WHEREAS, forecasted savings as a result of payment of the $250 Subsidy to Rule of 70 Retirees in Year 1 (calendar year 2018) are projected to be approximately $841K (projected savings of $1.873 million as a result of members leaving the Plan in favor of a Medicare supplement, partially offset by cost to the Plan of the distribution of the $250 per month subsidy, which is expected to total approximately $1.032 million in Year 1); and E CL 0 cis a� WHEREAS, under F.S. 112.0801, the BOCC is required to continue to offer membership in the Health Plan to the retirees, whether they continue on the Plan or not, after receiving the $250 Subsidy; and WHEREAS, staff wishes to clarify that the $250 Subsidy will be provided to Medicare - eligible Rule of 70 Retirees, irrespective of whether the members purchase the Medicare supplement or not; and WHEREAS, the BOCC wishes to clarify the process and procedure by which the $250 Subsidy will be distributed to Medicare eligible Rule of 70 retirees. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, Section 1 . Beginning January 1, 2018, Medicare Eligible Retirees will be given a $250 per month supplement which can be used one of two ways as follows: (a) The $250 supplement may be used to offset the annual actuarial cost the County will charge Medicare — eligible Rule of 70 Retirees beginning January 1, 2018; or (b) The $250 supplement may be paid to the Medicare - eligible Rule of 70 Retirees who do not remain on the County Health Plan, for any other purchase. Section 2 . The Monroe County Benefits office will send a mailing to potential retirees in order to confirm eligibility for the $250 Subsidy. In order to be eligible for the $250 Subsidy, the retiree must provide a W -9 to the Benefits office. Section 3 . By no later than January 1, 2018, Monroe County Benefits office will generate and send a hard copy list of Medicare - eligible Rule of 70 retirees and send the list to the Clerk's Office (Finance). For each name on the list, Benefits will forward the retiree's W -9 to Finance. Section 4. The following groups of Medicare - eligible retirees are entitled to the $250 Subsidy: (a) Rule of 70 Retirees who are currently Medicare - eligible, and who are members of the Monroe County Health Plan on 1/1/2018; and (b) Persons who are currently actively employed by Monroe County BOCC or a participating employer in the Monroe County Health Plan, who meet the Rule of 70 criteria, who are members of the Monroe County Health Plan on 1/1/2018, and who retire on or after 1/1/2018. Section 5. Rule of 70 Retirees who are not yet eligible for Medicare shall qualify to receive the $250 Subsidy once they become Medicare - eligible. The obligation is on the Medicare - eligible Rule of 70 Retiree to notify the Benefits office once they become Medicare - eligible. Section 6 . Beginning with the 2018 Plan Year, on a monthly basis, Finance will issue a check to each eligible retiree. Payments will be made in arrears. Checks will be issued on or about the 1s of every month, for the prior month. Section 7. For all subsequent months starting with February 2018, Benefits will send an update to Finance by no later than the second Friday of the month, indicating names of retirees added and deleted from the list. Finance will issue checks to Medicare - eligible Rule of 70 Retirees based on the updated lists. E N a� 2 Section 8. Beginning in December 2018, to maintain eligibility in the program, each retiree must provide a certification to Benefits, in a form designed by Benefits, attesting to the retiree's continued eligibility and providing updated contact information. The certification must be filed by the retiree on an annual basis, in order to maintain eligibility in the program. Section 9. The $250 Subsidy is a taxable fringe benefit. Therefore, on an annual basis, the Clerk's Office shall cause the appropriate forms (Form W -2 or Form 1099) to be issued to the taxpayer, and shall cause the appropriate forms to be filed with and reported to the Internal Revenue Service, in order to report the value of the taxable fringe benefit to the IRS. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida at a regular meeting held on the day of , 2017. Mayor George Neugent Mayor Pro Tem David Rice Commissioner Heather Carruthers Commissioner Danny Kolhage Commissioner Sylvia Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA M . Mayor George Neugent (SEAL) ATTEST: KEVIN MADOK, CPA, CLERK 0 E CL 0 04 a� Deputy Clerk Projected Cost of Providing $250 Monthly Subsidy to Medicare Eligible Retirees Non Rule of 70 Active Employees Rule of 70 Employees /Retirees Includes: Current Rule of 70 Retirees who are Medicare Eligible (65 +) Current Rule of 70 Pre- Medicafer Retirees starting with the year they turn 65 the given year Currently Active Employees eligible for the Rule of 70 subsidy starting in the 10 years of service in the given year year they satsify the Rule of 70 criteria and are 65+ years old Year # Eligible Exposure 2019 43 Current Current $174,000 Current Current 2022 100 $300,000 Retirees Actives Total Retirees Actives Total 2018 313 31 344 $939,000 $93,000 $1,032,000 2019 325 36 361 $975,000 $108,000 $1,083,000 2020 331 44 375 $993,000 $132,000 $1,125,000 2021 337 54 391 $1,011,000 $162,000 $1,173,000 2022 347 63 410 $1,041,000 $189,000 $1,230,000 2023 354 76 430 $1,062,000 $228,000 $1,290,000 2024 361 88 449 $1,083,000 $264,000 $1,347,000 2025 368 100 468 $1,104,000 $300,000 $1,404,000 2026 375 109 484 $1,125,000 $327,000 $1,452,000 2027 382 119 501 $1,146,000 1 $357,000 1 $1,503,000 "Exposure" is the cost of providing $250 monthly subsidy to all eligible employees. This does not include expected mortality. Expect that the current retirees will experience some mortality that will keep the total lives closer to 450 over this period Non Rule of 70 Active Employees Currently Active Employees who: Are not eligible for rule of 70 Will be 65 years of age or older in the given year Satisfy FRS Normal retirement and have at least 10 years of service in the given year Year # Eligible Exposure 2018 37 $111,000 2019 43 $129,000 2020 58 $174,000 2021 75 $225,000 2022 100 $300,000 2023 118 $354,000 2024 148 $444,000 2025 180 $540,000 2026 222 $666,000 2027 256 $768,000 "Exposure" is the cost of providing $250 monthly subsidy to all eligible employees a� E a� LO as ca a� to August 16, 2017 Christine Hurley, AICP Assistant County Manager Monroe County Board of County Commissioners Marathon Government Center 2798 Overseas Highway Marathon, FL 33050 Re: 2018 Health Plan Changes — Option 4A Dear Christine: As you requested, I am writing to document what I believe was the intent of Option 4A approved by the Commission at its July 25, 2018 meeting. I understand that the presentations that Gallagher made to the Board may not have expressly identified all of the pertinent details, although I do believe the Board's understanding is consistent with the way the Option was valued by Gallagher. Option 4A was a variation of Option 4 that was presented in earlier discussions with the Board and the HPAC. Option 4 was labeled "Charge Full Annual Amount of Health Insurance to Medicare Eligible Retirees ". Our estimate of the value to the County of this Option assumed that it applied only to Rule of 70 Retirees who were currently, or would eventually become, Medicare eligible. Retirees who do not meet the Rule of 70 already pay a rate that is comparable (though not exactly equal) to the actuarial rate so we felt there was no need to include them in this Option. Option 4A provides for a flat $250 monthly subsidy from the County for Medicare eligible retirees, and again we assumed this would only apply to Rule of 70 Medicare eligible retirees. Our understanding of the intent of this Option was that it would provide more efficient coverage for Medicare Eligible Rule of 70 Retirees. While we apparently did not ever directly tell the Commission that the $250 monthly supplement payable under this option was limited to Rule of 70 retirees, we believe that was understood by the Commissioners given that the goal of these discussions was to reduce County cost. Extending the $250 Supplement to non Rule of 70 retirees would be a new cost for the County and we certainly did not intend to advocate for that. Subsequent to concerns being raised about the intent of Option 4A, we reviewed the County health plan census to estimate the impact of extending the $250 monthly subsidy to non Rule of 70 Medicare eligible retirees who meet the normal retirement age and years of service requirements under FRS but with a minimum of 10 years of service. The attached exhibit shows the number of retirees that would be eligible to retire at the start of each year for the next 10 years, assuming no turnover or mortality. For comparative purposes, we also show a projection of the Rule of 70 Medicare eligible retirees. For both tables we show the maximum annual exposure to the County each year, assuming all eligible employees retire and collect the subsidy for the full year. The cost for Rule of 70 Retirees would start at $1 million and rise to $1.5 million, but the offset in claim costs (or the additional premium collected from retirees who stay on the County plan) would be far more than that and the County would see significant savings. For non Rule of 70 Retirees, the maximum cost is smaller, ranging from $111,000 in 2018 to $768,000 in 2027, but this would represent pure cost to the County. Given the history of the Option 4A development, the context of the discussions, and the results in the table, I don't believe it was ever the intent of the Board to extend the subsidy to non Rule of 70 retirees. Please let me know if you have any questions or would like to discuss this further. Arthur J. Gallagher & Co. Healthcare Analytics Consulting 2255 Glades Rd., Ste 200E, Boca Raton FL 33431 Phone: 561.998.6755 Fax: 561.998.6731 as E as CL �a Ln �a �a ©2017 GALLAGHER BENEFIT SERVICES, INC www.AJG.COM Sincerely, Glen R. Volk, FSA, MAAA Consulting Actuary E .2 CL CD m N 6 as 0 L - CD CL 0 r- 0 E 0 8.2.d Packef Pg. 27 '. d co J m m m Q N N N 0 Contribution Changes Approved on July 25, 2017 �o 4 ET co < m rn o p N l l lrL LL $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 D BY BO CC ON 7 4A. Provide a Flat $250 Subsidy to Medicare El Retirees ($697 - $250=$447) $873,000: $1,330,000 $1,507,000 $1,696,000 $1,$990,000 i $1,326,116 7A. Reduce subsidy for Rule of 70 Pre-65 Retirees by 204. 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 32. 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 41. Establish Acturial 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 Employee/Retiree Funding Changes $1,640,000 $2,391,000 $2,700,000 $3,030,000' $3,384,000 Combined Impact of All Benefit and Revenue Changes $2,775,000 $3,976,000 $4,396,000 $4,845,000' $5,328,000 $559,116 Impact of Prejcted Claim Reductions on 6- Montjh Surplus Target $567,500 $792,500 $848,000 $907,500 $971,000 $8,384 Combined 1 pact of All Benefit and Revenue Changes plus benefit of increased impact on surplus $3,342,500 $4,768,500 $5,244,000 $5,752,500 $6,297,000 ($8,384) 8.2.d Packef Pg. 27 '. 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. Io ,em,E.te,p,ise,o,l.te,..IFunds Add$958,558f,om Ad Valorem, Non- AdValo,em,E.te,p,iw,o,lnternal F..dsto Health Fund N29 PCP, Mental / bah .vio ,,lhe.ltho,substa.ce.buse..d Pre /Post Natal Care Yo ... op .yme.tfo,..officevkitwlth.Primary Care Physicians(PCP), Mental / bah.vio,, the .kho,subst...e.b.wofficevkits..d Pre /Post Natal Care Co a e.t $30 office visits W i l l i ... ease f,om $25 to $30 effective FALL . Currently a 111. b work done th rough 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 Clinical 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.yme.tyo.— cu „e.tly payi.gfo, Generic Dmgs will i.c,e.sefrom$10 to $15 effective 1 /1/18. No ch..geswe,em.detotheFo,mulary,No.- g paymen Fo,mula ors eclalt Du. c e.ts. Effective 1/1/18 maintenance medi,.tio.s(fo,ex.mple, medi,.tio.,fo, You c ue.tly h.vethe choieto refill..yofyo., medications monthly o,geta 90- day ,efill(physicla.mustw,ite p,esc,iptio.fo,. 90- d.ysupply)at N35 diabetes, high blood pressure) will require. 90-d.y supply at retail. Wa lg,ee.s is most retail pharmacies. Effective 1 /1 /18ifyou a re prescribed any medicatio.sth,t a re considered m, i, te ... ce( fo , example, diabetes, hypertension bethe exclusive retail ph.,m.cyyou must uwfo,the 90-d.y maintenance medications) you, physician must w,iteyou a prescription for a 90 -day supply that you ca n only fill at Walgreens Pharmacies. mediation prescriptions. Active employees hired ad-to 5/1/12 are w„e.tly paying $25 monthly for their cove ,,ge. This premium will increase to $50 monthly effective 1/1/18. N9 Active Emp loyees Pay $50/75 for Emp loyee Cove,. go Activeem Ployees hfired after 5/1/12 a re currently pay in g$ 50 m oath H for th ei, cove ,, go. This pre, ium willi, crease to$ 75 effective 1/1/18. These re to stay in the t ,,dltio..I msu,,.ce plan and not elect the High Deductible /Health Savings Acco. 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 yeti red fte,1/1/15. Effective 1/1/18 the N28 $100 per month smokers.,charge moke, surcharge will increase to $100 for ALL employees, regardless of hire date and ALL retirees o. the plan. D.,i.gthkye. is Ope.E.rollme.t ALL plan participants (actives, retirees, spouses and dependents over the age of 18) must complete, sign and ,etu r. a Non - Tobacco Attest atio. Ceaificatio. N7A over S years The County so bsidy p rovided to R. le of 70 retirees who a re n of yet eligible for Media re will be changed over the next 5 years a.d will vary depending o. the years of service with the County. The Media re Part D p,og ,,m offers employers, who keep retirees o. their health plan after they a re Media re eligible,. Retiree Dmg Subsidy (RDS). The subsidyfrom RDSbythe County is approximately$ 150,000 per ca lend., yea r, but the Co. my does not receive th is susidy for over one yea r. The Contribution as Percenls a of Annual Utuarial Rate Em ploye, Group Waiver P,og ,,m (EGWP) was introduced seve ,,I years ago and has become the way em ployers who offer retiree prescription be—fitsare N15 Change Media re Retiree Dmg Su bsidy Do. BUS to EGWP going. The EGWP is expected to gene ,,te over $ 200,00 of so bsidy for the County an d so bsid ies th rough the EGWP a re received at time of service. BUS 2024 1019 limits reimbursement to 28 % ..... Ily. 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) coed icatio.s will be excluded from being covered under the prescription plan. If you have bee. getting any OTC N36 Over - the -Cou.te,(OTC) ned iatio.s will no longer be a v.i la ble through the coed icatio.s t h cough the prescription pla n an d just paying the copayment, effective 1/1/18 she. Id your physician give you a prescription for coed icatio.s 26;o prescription pla n for just a copayment. that are avaiI. ble OTC, it will be de. ied. 20% 34% The Select Fo,mu 1. y is the list of coed icatio.s that will be covered under our prescription plan effective 1/1/18. Should you happen to betaking any N34 Adopt E.visio. Select Formulary mediation that is not cove,edu.derthe Select Fo— I.,y,you will be notiied p,io,to 1/1/18 so th.tyoua. discuss a. alternative mediation with your 2022 HIS physician. If a coed ic.tio. is not co e,ed u.de,the Select Fo,mu la ry, there will be at least (2) two .Iterative coed ic.tio.s that your physicla n ca n M% Effective 1/1/18 spouses /Domestic Pa rtners of em ployees.nd retirees who are eligible for hea hh fins.,, nce cove ,agethuo.gh his /he,employe ... o not Spousesofen,ployees o „eti,eeswho h.ve.ccesstocove „geth,ough his /her eligible for cove,. go as.depe.de.to. the Monroe Cou. tyG, ou p Health Pla..A.yen,ployee o„etimewhoelects cove „gefo,.. employed N18A ow. employe,.,e meligiblefo, cove „ge u.de,the Monroe County G,oup spouse /Domestic Part.erwill be req,i,edto have ..attest.tio.fo,.completed..d signed bythespouse or Domestic Partner's employer i.diati.g they Health Pl... offer no health i.su,,.ce cove „geto their employees. Seff— ployed spouses /Domestic Partners will h.veto complete and sign attesti.gth.t they have employe,spo.so,ed health are. The Cou.tywill hire ..outsidefi,m to perfo,m .... dlt of.Ilthe depe.de.tso. the Monroe County Group Health Ph. and e.su,eth.t they a re eligible N19 Conduct an audit to ens. rethat dependents on the plan are eligible for cove „ge or ,,ge. Effective 1 /1 /18the depe. de. t subsidy provided bythe Cou.tywill be reduced Employees hired 1 /1 /18who willwa.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 afte, 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.- Medicre eligible "Rule of70 Retirees' will change depending o. yourye.rs of servicewith the FRS. Retirees with 25+ YOSwill continueto pay cu „e.t HIS ate. Retireswith 20- 24YOSwill uki —ely pay 25 % ofthe "act ..rial ate” phased over5 years and retirees with 10 -19 YOS pay 50 % ofthe "act uarial ate" phased over5 years. (PLEASE REFERTO THE ATTACHED RATE SHEET FOR 2018) N7A over S years The County so bsidy p rovided to R. le of 70 retirees who a re n of yet eligible for Media re will be changed over the next 5 years a.d will vary depending o. the years of service with the County. Contribution as Percenls a of Annual Utuarial Rate Plain Year years of SeM. tsilh ]lonroe 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...e R the retiree decides toe. roll I. a Medicare Supplemental Pla. effective 1/1/18, the retiree wou Id termi.atetheir cove „ge aderthe Monroe County Group Health Plaa during the A ... aI Open Earollmeat and beginning 1/1/18 the Medicare Supplemental Pla. would become thei,Seco.da ry I.su,,.ce. The County will p,ovidea $250 subsidy to the retiree and the HIS that was being deducted fo,thei, cove „ge with Monroe County will be stopped. The retiree who terminates their cove „ge u.de,the Monroe The county will begin p,o vidi.g Tule of 70 Retirees' who are eligible for County Heath Pla. willwaive the right to re- enroll and the spouse ofthe, etim ethat 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 o. the Monroe County Health Plaa. d ltfe,e.t ways: Retiree Remains enrolled .. the Monroe County Health Plan: A medicare eligible retiree can usethe $250 susidy plus the retirees FRS Health I.su „nce Subsidy and make upthe difference between the County l.su „nce health premium and these 2 subsidys. To,example,fo,2018, the monthly actuarial ,ate is $677. The retiree would use the $250 subsidyfrom the County, plusthe HIS (a 30 year employee would HISwould be $150) toward the $677. The ,eti,eewould pay the dltfe,e.ceto the County ($677- $250 -$150= $277). Employeeshwi d10 /01 /01 or later are not con sidered ” Rule of70 Retimes"a.d are not eligiblefo,the subsidized premium that the "Rule of70 Retirees” N41 Establish Acturial Rate ( premium) for employees hired 10/1/01 o, late,a.d retire have. Ifyou were h red o. or afte, l0 /O1 /Oland reti,ewfh Mon roe Cou.tyyou have bee.payi.gthe Department Rate of$1035 for 2017. Effective with Monroe County 1/1/18 the rate paid by these retirees will be the acturial rate. (PLEASE REFER TO THE ATTACHED RATE SHEET FOR 2018) I. add itio. to the County's7,aditio.al "i.su ance cove „ge pla n, employees, TheT „ditio.al Pla. mcludes a$ 400. dividualdeductible ;$800familydeductible; Pays 75 %coi.su „.ce I. Network; Pays 45 %coi.su „nce Out of depe.de.ts,a.d retirees nayelecta High Deductible Health Pla.(HD /HP)wltha Network; Max out of pocket is $7,150 i.dividual; Max out of pocket is $14,300 family. N13 Health Savings ACcou.t(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) mcludesa $2000 individual deductible; $4000 family deductible (which must be net p,io,to i.su ,,nce paying o. A HEALTH SAVINGS ACCOUNT WILL BE PROVIDED AT OPEN ENROLLMENT). co f su ,,nce Pays 80 %coi.su nce I. Network; Pays 50 %coi.su nce Out of Network; Max out of pocket is $6,650 individual; Max out of pocket is 13 fa mi ,, ,, *Co payments are fixed dollar amounts (for example, $30) you pay covered health care, usually when you receive the service. E QD CL 0 04 * Coins. ,,nce is the percentage of the Allowed Amount forcoveredservices. I.- Network covered services are paid at 75% ofthe allowed amounta.d your *coi.su ,,nce k25% ofthe allowed amount. (Example: H- networkproviderbills Florida Bl.e$1000foraproced.re. Whentheclaimisprocessedthe .!lowed— o.ntbythepl -ii $800. Florida Blue will paythe provider $600 which is 75% ofthe allowed amo.ot. The Ica - network provider can o.ly bill you $200 which is your coius.raace of25 %. The difference between the billed and allowed mo.nt, in this case $200 thaz was not allowed, can not be billed to yo.. O.t- of- network providers are paid .45 % ofthe .!lowed —o.nt and yo. are responsible for a coins.rance of 55%. H addition, O.t -of- network providers can bill you for the diff rence between the billed arno.ot and the allowed arno.ot. Monroe County B..m & County Commissioners Employee ..d Retiree Contributions Effective January 1, 2018 ® ® ® ® ® ® ® ® ®® ® ® ® ® ® ® ® ® ®® - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - -- - ---- - - - - --