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