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AUG 2 0 1991'' <br />BOOK 84 PAGE 6 <br />staff in various specialties with admitting privileges at IRMH <br />and Humana Hospital/Sebastian. As a result of the discounts that <br />were negotiated with Doctors Clinic, we are able to implement a <br />90o benefit for most of the services at Doctors Clinic. A <br />special program has been implemented so that if you use the <br />physicians at Doctors Clinic, there is a $20 office co -payment <br />with the plan paying 1000 of the remaining charge instead of the <br />employee having to meet the annual deductible before the 800/200 <br />begins. So, it is an encouragement to the employees; an <br />improvement in benefits from the standpoint of no deductible; and <br />also a cost containment mechanism. The employee will have to pay <br />$20 at the time of the visit which is enough to make them aware <br />of the cost, but not enough to deter them from going to the <br />doctor when necessary. <br />Commissioner Wheeler asked if you would have to pay 600 of <br />the costs if you were out of the state and had to have an <br />emergency appendectomy, and Mrs. Stanford advised there is no <br />penalty if you are unable to get to a PPO in an emergency <br />situation. If you are unable to access the PPO in certain <br />situations, you still get the PPO benefits listed under the <br />Humana Hospital/FL Health Network PPO. That would apply also to <br />.individuals who are permanent residents out of state or students <br />away at college. There is no penalty if you are unable to get to <br />the PPO for those reasons. <br />Commissioner Scurlock asked the amount of the reserve fund, <br />and Mrs. Stanford stated that the reserve fund normally is 2-1/2 <br />to 3 months of expected paid claims. Due to the extraordinary <br />increases in recent years, especially this past year, the <br />County's current plan was underfunded, and in order to become <br />fully funded, we arranged with Anthem to have a contract which <br />would not only fund for this year but pick up the underfunding <br />for last year so that throughout the course of this year the <br />County would be made whole in terms of being adequately funded. <br />34 <br />