2/14/1995 - Laserfiche WebLink

Home Browse Search

BOOK 9 PAGE -348 opposed to spending dollars on office visits, which is a service that more of the employees would be needing. Physicians' co -payments have been reduced by 25% from last year, from a $20 co -pay to a $15 co -pay. It was felt this was a better pl4ce to focus the dollars as almost everyone is going to have at least one office visit during the year, whereas only 40 out of the entire covered force would be affected by the out-of-pocket cap. There was a 2.5% increase in the home health allowance, increased from $1,000 to $2,500, with 2 primary advantages as most employees would rather recuperate at home from a surgery than the hospital if they can get adequate medical attention at home to do that. Secondly, permitting them to recover at home is much more cost effective than to have them spend several more days in the hospital,. Commissioner Eggert questioned whether there is anything that home health does not cover, such as aides, and Director Price responded that he was not aware of anything not covered but that a reasonable and customary cap is applied to all charges, which prevents gouging by the providers. Director Price went on to cover the prescription drug plan which permits employees and dependents to either purchase the drugs and file a claim; order through a mail order plan which is primarily beneficial to those requiring on-going medication who can obtain a 90 day supply of a brand name prescription for $10; or purchase the drugs from a local provider. Director Price explained that the mental health coverage has been increased from a $1,000 cap on out-patient expenses to $25,000. They had found in the mental health area that the $1,000 only provided for initial control of the problem, rather than treatment during recovery. A similar circumstance occurred with the alcoholism and drug dependency coverage with the cap being increased from $2,000 to $10,000 as the plan's experience was that $2,000 only pays for detoxification and not for therapy. Acordia also added an on-site claims person 2 days a week, in addition to the toll free telephone number. Also added were several optional features; additional life insurance for employees and dependents; a long-term disability plan; and a 125 plan. The County avoided having to ask employees to pay more for their coverage, which is really significant as few other employers have free employee coverage and dependent coverage for $150 per year. The City of Vero Beach, by comparison, has a good plan but FEBRUARY 14, 1995 18 M M M