HomeMy WebLinkAboutOpen Enrollment 2024Open Enrollment
2024
Pacific Source Health Insurance Experience
2022
Medical/Rx Loss Ratio with Admin included 129.1%
20 large claimants accounted for 65% of claims cost
Medical Claims increased 53% over prior year
Rx Claims decreased 15% over prior year
Brand Name prescriptions account for 7.2% of scripts, but 93% of cost
2023 January to September
Medical/Rx Loss Ratio with Admin included 158.99%
Significant increase in large claims
Increase in Mental Health claims
Health Insurance
Pacific Source Renewal
$1,018,563 increase annually (34.81%)
Increase of 16% employer and 33% employee average to break even
Decided to shop options
III-A Self Funded Group declined to bid
Reinsurance provided parameters that made it unaffordable to bid at this time
Select Health
$234,848 increase annually (8.03%)
Recommend Increase of 8% Employer/6% employee avg. to save $500,000 for savings account
Similar benefits with minimal changes
Urgent care copay $20 (Will re-evaluate at $40 in 2025 renewal)
Prescription Same Deductible ($500), but no Prescription Drug Out-of-Pocket Limit of $2,000 individual/ $4,000 family
Rate cap in 2025 of 12%
Will run disruption report and seek to add missing local providers if any. Find a Doctor-Select Health Select Health Network
Dental Insurance
No Change in Premium offered from Blue Cross for current
plan, even though experience down
Decided to shop options
Recommendation to switch to MetLife Dental
Similar benefits but adds adult orthodontia with no waiting period
and reduces the individual benefit max down from $2500 to $2000
Savings of $85,279 annually
Vision, Life-Employer Paid and Voluntary, Long-
Term Disability (LTD), Accidental Death &
Dismemberment (AD&D), and Accident Insurance
Offered a package deal with Dental Plan from MetLife
New Vision Plan with MetLife to offer savings of over $29,440
annually
Similar benefits to current VSP Plan
Similar rates would be provided for Life, LTD, and AD&D, and
possibly Accident Insurance with MetLife
Employee to cover 15% and Employer 85% of total cost of Plan for all
Benefits Include-Health, Dental, HRA, Vision, EAP, Wellness, Tele-Health
COLA vs Insurance Premium
Increase Example
Employee $50,000 Annual Salary
With 6.28% COLA increase in Annual Pay of $3,140
New Annual Salary $53,140
Family Insurance Coverage 2024 = 5.53% increase in
premium
Increase Monthly $34.92 Annual $419
Increase in pay annually after premium increase applied $2,721
What the future may hold for City
of Rexburg Insurance Plan
Hope to go Self Funded in Future
Will consider III-A Self Funded Plan again, but may be a few years before they can bid
Give us more flexibility in customized plans
May consider going to a membership base on standard office visits and Rx
Savings Account will increase to close to $2 Million
Department of Insurance requires you to have at least 33% of your insurance plan in savings
to go self funded (Current Total Plan Cost is approximately $3.9 Million-would have been
closer to $4.8 Million had we renewed with current plan options with only $1.5 Million in
savings)
We have to be diligent in watching our medical expenditures. There are
definitely things that cannot be prevented……but in the times we have
choices, we must choose wisely.
Motion From City Council Requested
Move Forward with recommended plan changes and rates
Make Budget Adjustment to move 7% increase back from benefit budgets to contingency in respective funds
$189,900 back into contingency with $99,000 to General Fund
Hold Open Enrollment meetings on the following dates:
November 14, 2023 10AM or 2PM
November 16, 2023 10AM or 2PM
City Hall Council Chamber
Employees will be encouraged to determine providers in new network and plan for any changes
OPEN ENROLLMENT PERIOD TBD-Tentative-November 20-27, 2023