06/04/2019 (2) - Laserfiche WebLink

Home Browse Search

active employees. For retired employees and their eligible dependents, the cost of continued participation may be paid by the employer or by the retirees..." The County subsidizes retiree coverage for eligible retirees who elect to continue coverage under our group plan. The subsidized cost for retiree insurance ranges from $254.00 per month for single coverage to $700 per month for family coverage. Retirees who continue coverage and are not eligible for the County subsidy, pay the employer portion of $635.00 for single coverage to $875.00 for family coverage. This subsidy is in addition to Florida Retirement System health insurance subsidy that is provided through FRS ($5 for each year of service up to a maximum of $150.00 per month). The County does not receive any subsidy payment from the FRS. The FRS subsidy is paid directly to the retiree in the monthly retirement payment. Currently, Indian River County retiree premiums are calculated based on a reduced monthly premium (employer only portion) rather than the full monthly premium. The County provides additional funding for the cost of providing retiree coverage through OPEB funding. Many County retirees remain on the County's insurance beyond Medicare eligibility due to the low cost, pharmacy benefits and the ability to continue insurance for dependents. For the plan year ending October 2018, retirees account for 18% of the group health insurance population and 23.6% of the medical plan spend. As we review the plan's overall performance, we continue to look for opportunities to mitigate rising medical and pharmacy costs and deliver high quality, affordable and competitive benefits to members. Our plan reflects the following: • Approximately 3,600 individuals are insured under the group medical plan. • Full time employees and eligible dependents account for 82% of the group enrollment. The average age of employees = 49.8, Spouses = 50.1 and Dependents = 14.8 years. • Retirees and their dependents account for 18% of the group enrollment with covered members/dependents ranging in age from 2 years to 94 years. • Top 5 diagnostic conditions by spend are Cancer, Circulatory, Rare Conditions, Gastrointestinal, and Musculoskeletal • Diabetes and CAD (Coronary Artery Disease) account for 29.2% of the medical plan spend • Core Chronic Conditions have increased over last year (Coronary Artery Disease, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease and Diabetes) • Obesity, smoking, and other lifestyle factors place individuals in higher risk of developing chronic health conditions. • 48 high cost medical claimants represent L3% of the group population and account for $5.2M spend for the plan year through 9/30/18 incurred (34.6% of the spend). • Current medical and pharmacy claims experience combined is exceeding the budget allocation by $667,419 as projected for the 18/19 plan year. • It is expected that medical and pharmacy costs will increase by 8%. Maintaining a competitive health benefit is critical to recruitment and retention. Health plans vary significantly between employers. Some employers offer multiple plans with employees paying premiums based on the level of benefit provided. Plans offering lower benefit levels, typically have lower monthly premiums, and the employee pays a higher cost share when 183