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Loxahatchee River District

Water Reclamation | Environmental Education | River Restoration

2500 Jupiter Park Drive, Jupiter, Florida 33458-8964

Telephone (561) 747-5700 •Fax (561) 747-9929 • www.loxahatcheeriver.org

D. Albrey Arrington, Ph.D., Executive Director

Gordon M. Boggie Stephen B. Rockoff Dr. Matt H. Rostock Harvey M. Silverman James D. Snyder Board Member Board Member Chairman Board Member Board Member

MEMORANDUM

TO:

GOVERNING BOARD

FROM:

D. ALBREY ARRINGTON, Ph.D.

DATE:

OCTOBER 10, 2014

SUBJECT:

EMPLOYEE HEALTH INSURANCE

The Gehring Group has received renewal quotes for our health insurance, dental insurance, basic life insurance,

and long term disability insurance from the various carriers.

Insurance

Current Premium Renewal Premium

Annual Increase

Annual Increase

Health

$971,244

$1,043,953

$72,709

7.5%

Dental

$44,816

$46,676

$1,860

4.2%

Basic Life

$6,735

$7,339

$604

9.0%

Long Term Disability

$10,208

$11,229

$1,021

10.0%

Total

$1,033,003

$1,109,197

$76,194

7.4%

Lincoln Financial has agreed to lock this rate in for 2 years.

Gehring Group negotiated with the carriers before the release of these renewal offers, so we should consider

these renewal quotes as best and final offers. These renewal quotes are well below anticipated (dreaded) rate

increases, and are within budgeted amounts.

Florida Blue (Health Insurance) would not release our claims data due to the size of our group. The Gehring

Group has compared the renewal quote with the area’s medical inflation/trend, and believes the renewal offer is

reasonable. In addition, this year we are still seeing Healthcare Reform charges being applied (PCORI,

Transitional Reinsurance and Health Insurer Fee). A further 1% increase is due to the launch and potential plan

exposure of new specialty medications. The District’s loss ratio on Dental Insurance is around 100% for the past

12 months, and the proposed rate increase is consistent with general dental trend. The District had one Basic

Life insurance claim paid in 2013 totaling $50,000 and two so far in 2014 at $25,000 each.

The following page provides a general timeline for renewal of our insurance benefits, as well as the details

associated with the renewal quotes.

Staff is interested in hearing your feedback regarding the acceptability of the renewal quotes. If the renewal

quotes are acceptable, the Board can take action at the November meeting. If the renewal quotes are not

acceptable, staff will work with the Gehring Group to putting together materials necessary to go out to RFP.

No action is needed this month. Ideally, the Board would take action in November or December at the latest.

F:\Albrey\Board Memos\2014_Oct_Employee_Health_Insurance.docx

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Medical Insurance Renewal Evaluation

Effective Date: January 1, 2015

SCHEDULE OF BENEFITS

Plan Basics In Network Out of Network In Network Out of Network

Lifetime Maximum Calendar Year Deductible

Single $500 $750 $500 $750

Family $1,500 $2,250 $1,500 $2,250

Out of Pocket CYM

Single $2,500 $5,000 $2,500 $5,000

Family $5,000 $10,000 $5,000 $10,000

Coinsurance (Member Pays) 20% 40% 20% 40%

Physician Services

Primary Care Physician $20 40% after CYD $20 40% after CYD

Specialist $40 40% after CYD $40 40% after CYD

Preventive Care No Charge 40% No Charge 40%

Chiropractic Services $40 40% after CYD $40 40% after CYD

Independent Laboratory Services No Charge 40% after CYD No Charge 40% after CYD

Advanced Imaging $150 40% after CYD $150 40% after CYD

Urgent Care $45 40% after CYD $45 40% after CYD

Hospital Services Tier 1 / Tier 2 Tier 1 / Tier 2

Inpatient Hospital $600 / $1,000 40% after CYD $600 / $1,000 40% after CYD

Outpatient Hospital $200 / $300 40% after CYD $200 / $300 40% after CYD

Emergency Room $100 $100 $100 $100

Mental Health / Substance Abuse

Inpatient Hospital No Charge 40% No Charge 40%

Outpatient No Charge 40% No Charge 40%

Pharmacy Plan

Tier 1 / Generic $10 $10

Tier 2 / Preferred Brand $50 $50

Tier 3 / Non Preferred Brand $80 $80

Tier 4 20% ($200 Max) 20% ($200 Max)

Mail Order Copay 2.5x Retail Copay 2.5x Retail Copay

Rates

Employee 24

Employee + Spouse 16

Employee + Child(ren) 11

Family 23 Monthly Premium Annual Premium $ Increase % Increase 50% Unlimited Renewal $966.54 Florida Blue $1,638.91 50%

BlueOptions Predictable Cost - 03559

Includes Ded, Coins, Copays, & Rx Includes Ded, Coins, Copays, & Rx

$525.29 $80,937.03 $971,244.36 N/A N/A Current

BlueOptions Predictable Cost - 03559 Florida Blue Unlimited $1,250.20 7.5% $86,996.11 $564.62 $1,343.79 $1,038.89 $1,761.60 $1,043,953.32 $72,708.96

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Dental Insurance Renewal Evaluation

Effective Date: January 1, 2015

Deductible In Network Out of Network In Network Out of Network

Annual Benefit Maximum

Single $50 $50 $50 $50

Family Aggregate $150 $150 $150 $150

Ded. Waived for Preventive Srvcs? Yes No Yes No

Benefits

Preventative 100% 100% 100% 100%

Basic 100% 80% 100% 80%

Major 60% 50% 60% 50%

Child Orthodontia 50% 50% 50% 50%

Orthodontia - Lifetime Max Waiting period (Timely Entrants) Periodontics and Endodontics Out of Network Benefits Payable Rate Guarantee

Employee 25

Employee + Spouse 17

Employee + Child(ren) 8

Employee + Family 24

Monthly Premium: Annual Premium: $ Increase:

% Increase: 4.2%

$49.37 $51.52 $84.02

$3,889.68 $46,676.16

$1,860.48

None Basic Fee Schedule

12 Months $24.87

Renewal United Concordia

$1,000

$1,000

Current United Concordia

$1,000

$1,000

Basic None

Fee Schedule Expires 12/31/2014

N/A N/A

$23.88 $47.40 $49.47 $80.67

$44,815.68 $3,734.64

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Basic Life and AD&D Insurance Renewal Evaluation

Effective Date: January 1, 2015

Current Renewal

Lincoln Financial Lincoln Financial

Life & ADD Benefit

1. Employees working a minimum of 30

hours per week $50,000 $50,000

Features

Waiver of Premium Included Included

Accelerated Benefit 75% to $250,000 75% to $250,000

Age Reduction Schedule 65% at Age 6550% at Age 70 65% at Age 6550% at Age 70

Rate Guarantee Period Expires 12/31/2014 24 Months

Basic Term Life Rate / $1,000 $0.140 $0.154

AD&D Rate / $1,000 $0.016 $0.016

Total Rate / $1,000 $0.156 $0.170

Volume $3,597,500 $3,597,500

Monthly Premium $561.21 $611.58

Annual Premium $6,734.52 $7,338.90

$ Increase / Decrease N/A $604.38

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Long Term Disability Insurance Renewal Evaluation

Effective Date: January 1, 2015

Current Renewal

Lincoln Financial Lincoln Financial

Core Benefit

Monthly Benefit 60% 60%

Maximum Monthly Benefit $6,500 $6,500

Elimination Period 90 days 90 days

Own Occupation Period 24 Months 24 Months

Duration of Benefit SSNRA SSNRA

Rate Guarantee Period Expires 12/31/2014 24 months

Rate / $100 $0.300 $0.330

Estimated Volume $283,567 $283,567

Monthly Premium $850.70 $935.77

Annual Premium $10,208.41 $11,229.25

$ Increase / Decrease N/A $1,020.84

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Voluntary Life Insurance Renewal Evaluation

Effective Date: January 1, 2015

Employee Formula

Guarantee Issue

Spouse Formula

Guarantee Issue

Child Formula

Guarantee Issue Minimum Participation

Rate Guarantee

EE Life Rates Age Bracket Rate / $1,000 Age Bracket Rate / $1,000

0-19 $0.070 0-19 $0.070

20-24 $0.070 20-24 $0.070

25-29 $0.070 25-29 $0.070

30-34 $0.080 30-34 $0.080

35-39 $0.100 35-39 $0.100

40-44 $0.160 40-44 $0.160

45-49 $0.260 45-49 $0.260

50-54 $0.500 50-54 $0.500

55-59 $0.800 55-59 $0.800

60-64 $0.930 60-64 $0.930

65-69 $1.680 65-69 $1.680

70-74 $3.290 70-74 $3.290

75-79 $8.880 75-79 $8.880

80-84 $20.150 80-84 $20.150

85+ $20.150 85+ $20.150

Child(ren) $0.200 Child(ren) $0.200

AD&D $0.016 AD&D $0.016

Expires 12/31/14 24 Months

14 days to 6 months: $250 6 months to 19 years: $10,000

14 days to 6 months: $250 6 months to 19 years: $10,000

$10,000 $10,000

Greater of 10 employees or 25% of eligible Greater of 10 employees or 25% of eligible

$100,000 $100,000

Increments of $5,000 up to 50% of EE amount.

Not to exceed or $150,000. Increments of $5,000 up toNot to exceed or $150,000. 50% of EE amount.

$10,000 $10,000

Current Renewal

Lincoln Financial Lincoln Financial

Increments of $10,000, up to 5x Salary. Not to

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11505 Fairchild Gardens Avenue, Suite 202, Palm Beach Gardens, FL 33410 Tel: (561) 626-6797 Fax: (561) 626-6970

Loxahatchee River District

2015 Timeline for Renewals

Insurance Coverage

Renewal Date

Current Carrier

Medical

January 1, 2015

Florida Blue

Dental

January 1, 2015

United Concordia

Life and AD&D

January 1, 2015

Lincoln Financial Group

Long Term Disability

January 1, 2015

Lincoln Financial Group

Proposed Schedule of Activities

Date

Action

10/03/2014

Renewal received by Gehring Group

10/08/2014

Census Requested from District

10/16/2014

Board Meeting – Discuss Renewal Offer

10/20/2014

RFP released to the market (If necessary)

10/31/2014

RFP responses due at Gehring Group

11/03/2014-11/07/2014

RFP Responses evaluated by Gehring Group

11/10/2014

Initial review of RFP analysis with Loxahatchee River District

11/14/2014

Best and Final Offers due

11/17/2014

RFP analysis packet provided to LRD for Board Members

11/20/2014

Board Meeting – Option to Approve Recommendation for

Renewals

11/21/2014 - 11/28/2013

Prepare Open Enrollment Materials

12/18/2014

Board Meeting – if needed

December 2014

Open Enrollment Meetings

1/01/2015

Plan Year begins

References

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