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the number of visits to 26 in the plan year to equal benefit limitations for chiropractic care. Limiting the benefit to 26 visits would reduce the claims cost of acupuncture to approximately $460K based on 2016 utilization. This limitation would reduce the costs of these services somewhat, but would not be completely effective at cost containment for the purposes of the 'health plan. To put these costs in perspective, the $30 monthly increase in employee premiums for the 2016/2017 plan year will generate approximately $490K in additional funding for the health plan. This premium increase paid by all employees will cover less than half of the cost of 2016 acupuncture claims paid which total over $1M. In order to maintain the financial stability of the health plan and mitigate future premium increases, corrective action is recommended. If changes to the acupuncture benefit are approved, it is also recommended that a midyear special enrollment for the health care flexible spending account (FSA) be offered to allow employees to modify contributions to their FSA. FUNDING: Funding for the self-funded health plan comes from employer paid premiums, employee paid premiums, retiree paid premiums, and OPEB trust contributions. RECOMMENDATION: Staff recommends approval for the acupuncture benefit to be eliminated from the County's health plan effective January 1, 2017 and to offer a special enrollment period for the health care flexible spending account. ATTACHMENTS: None. P38