HEALTH INSURANCE PROGRAM

Health Insurance Program Overview

Self-Insured (claims processed by Third-Party Administrator, currently BCBS)

Separately Maintained Health Insurance Fund Employee Clinic High-Deductible Health Plan and Co-Pay Plan Stop-Loss Insurance

Protects against large claims above $125,000

Action Items

Stop-Loss Insurance Change carrier from SunLife to Blue Cross Blue Shield

Change in deductible from $125,000 to $150,000

Stop-Loss Insurance

Limits City’s financial claims liability

Currently with SunLifeSought quotes from alternate providers

At the $125,000 deductible level, both carriers propose an increase

Current SUNLIFE RENEWAL$125,000 Ded.

BCBS PROPOSED$125,000 Ded.

Quote Change Quote Change

$288,935

$407,597

$118,662

41.1%

$387,781 $98,84634.2%

Stop-Loss Insurance Quotes -- $125,000 Level

Current SUNLIFE RENEWAL$150,000

BCBS PROPOSED$150,000

Quote Change Quote Change

$288,935

$339,281

$50,34617.4%

$318,201 $29,26710.1%

Stop-Loss Insurance Quotes -- $150,000 Level

Large-Claim History

Stop-Loss Insurance Quotes

YEAR CLAIM 1

CLAIM 2

CLAIM 3

CLAIM 4

Add’l cost if

at $150k

2012 $283,938

$400,790

$327,662

$75,000

2013 137,208 $136,252

$265,585

$48,460

2014 136,976 $11,976

2015 $462,606

$175,637

$169,363

$151,260

$100,000

$235,436

Average Per Year: $58,589

Stop-Loss Insurance Quotes

BLUE CROSS125K

BLUE CROSS150K

$387,781 $318,201

Savings between $125k and $150k Deductible $69,580Historical Average Cost of Claim Increase $58,589

Recommendations

Change to Blue Cross Blue Shield/HM Life for Stop Loss Coverage

Increase Deductible from $125,000 to $150,000

QUESTIONS???