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Offering affordable and competitive benefits is an important part of our recruitment and retention strategy. Medical and pharmacy costs will continue to increase year after year, and it is a challenge for an employer to provide a plan that is affordable for both the employer and employees as well as competitive. The majority of public employers in the surrounding areas offer more than one plan for employees to choose between. Many employers have multiple premium tiers for employee only, employee + spouse, employee + children, employee + family. Each employer's plan design, deductible, copays, coinsurance and out of pocket maximum vary from agency to agency. Plans with a higher deductible, copays, coinsurance, and out of pocket maximums, have lower monthly premiums. Buy up plans offer higher benefit levels and employees pay a higher premium. Cost Saving Options In order to reduce the financial impact to employees and the County and maintain a plan that offers affordable monthly premiums, it is recommended that a Premier Silver Plan be offered as the County's core medical plan. The Premier Silver Plan would have an actuarial value of approximately 80% as an alternative to a Premier Gold Plan that would offer an actuarial value of approximately 88%. The provider network for medical and pharmacy would be the same under both plans. A comparison of the two plans is below: In -Network Benefits Core - Premier Silver Plan Buy Up - Premier Gold Plan Individual/Family Deductible $800/$1,600 $400/$800 Individual/Family OOP Max (includes Deductible) $6,000/$12,000 $3,000/$6,000 Coinsurance 30% 20% Inpatient Hospital Copay (Per Admission) + Deductible & Co-insurance $500 $200 ER Copay (Waived if Admitted) + Deductible & Co-insurance $500 $250 PCP Office Visit/Urgent Care $35 $25 Specialist Office Visit $60 $45 Advancing Imaging (in any setting) 30% $200 R Deductible $100 $0 Rx Retail Generic $5 $10 Formulary Brand $50 $35 Non -Formulary Brand $70 $50 Do Rx Copays Accumulate to OOP Max? Yes Yes Out of Network 40% 30% The Premier Silver Plan would be an affordable option for employees and retirees and still provide a competitive benefit. This plan option is available for Individuals who do not wish to pay higher monthly premiums. The Premier Silver Plan would have lower monthly premiums and continue to cover preventive services at 100%. The plan has a higher deductible, higher out-of- pocket maximums, higher coinsurances, increased copays, and a $100 pharmacy deductible. 186