The group health insurance agreement, based on the proposed plan designs, is estimated to cost $44 million (dependent on claims). The estimated cost is made up of the following components: estimated health claims of $39.1 million, retention (including administrative fees, network access, disease management, wellness, and taxes/fees) of $2.8 million, and stop loss coverage of $2.1 million.
The group pharmacy agreement on a self-insured basis, based on the current plan designs, is estimated to cost $13.6 million, dependent on claims. The total cost for group health and pharmacy is $57.6 million.
Based on employee premiums recommended in this item, the County’s estimated cost for health insurance and pharmacy expenses is $53.5 million of the total $57.6 million premium/plan cost (employee contributions are $4.1 million if there is no shift in enrollment).
In addition, the County’s cost for the incentivized Health Savings Account is estimated to total approximately $8.1 million for 2019, with no shift in enrollment. Also, $2.2 million is estimated for funding for employees who “opt out” of County health insurance (with proof of other group health coverage) at an amount of $3,100 per employee who has opted out. The estimated total cost to the County of the health-related benefits for 2019 is therefore $63.8 million.
Funds are included in the Fiscal Year 2019 recommended budget to support this Agreement and programs.
The funding source for the self-insured health and pharmacy coverage:
Health:
5050 023 8221 4515 - Claims
5050 023 8221 4951 - Admin Fees
Pharmacy:
5050 023 8221 4549 - Prescription Plan Self-Insured
Requisition No. PE12171500000000001; Folder No. 14125304
PeopleSoft requisition No. HRS0000037 |