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CONSENT INDIAN RIVER COUNTY MEMORANDUM TO: Jason Brown County Administrator FROM: Suzanne Boyll j714 - Human Resources Director DATE: December 13, 2016 8-E SUBJECT: Approval to Eliminate the Acupuncture Benefit from the Health Plan Effective January 1, 2017 to Offer a Special Enrollment Period in the Health Care Flexible Spending Account BACKGROUND: The Indian River County self-insured health plan has experienced a 391 % increase in acupuncture claims costs since 2013 as reflected below: *Annualized The annualized 2016 acupuncture cost of $1,015,944.35 makes up 7.6% of the total annualized health plan spend. The average number of office visits per person for this benefit in 2016 was 37 with 87 members being seen more than 26 times in the year. The acupuncture benefit is an out of network benefit which is paid at 60% by the health plan. If $123.27 represents 60% of the amount allowed, the member's share at 40% would be $82.18 and the member's cost share would be over $3,000 based on 37 visits. However, Florida Blue does not have any provider agreements with acupuncturists and an acupuncturist may waive the 40% employee paid coinsurance for the office visit which encourages increased utilization. To the member the office visit is free, however, the cost to the health plan remains substantial. Although the health plan is not required to include coverage for acupuncture, if a health plan does cover acupuncture, section 627.6403, Florida Statutes, states the following: "Any policy of individual health insurance that provides coverage for acupuncture shall cover the services of an acupuncturist certified pursuant to chapter 457 under the same conditions that apply to services of a licensed physician. " Staff requested information from Florida Blue and Gehring Group regarding possible options to manage the increased cost of the acupuncture benefit. One of the options discussed was to limit P37