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DEPARTMENTAL MATTERS <br />INDIAN RIVER COUNTY <br />MEMORANDUM <br />To: Jason Brown <br />County Administrator <br />From: Suzanne Boyll <br />Human Resources Director <br />Date: May 3, 2021 <br />Subject: Medical and Pharmacy Benefit Recommendations for Plan Year 2021/2022 <br />Background <br />Indian River County provides employee and retiree group health insurance through a partially <br />self-insured plan. Health insurance is available to full-time employees (budgeted at 30 hours per <br />week or more) and eligible retirees of the Board of County Commissioners and the respective <br />Constitutional Officers (Sheriff, Property Appraiser, Tax Collector, Clerk of Courts, and the <br />Supervisor of Elections) to include their eligible dependents. Medical and pharmacy claims and <br />plan administration expenses are funded from contributions made by employer and <br />employee/retiree contributions. The County purchases stop loss insurance for extraordinary and <br />aggregate claims experience to protect against high cost claims. The current stop loss individual <br />deductible is $300,000 with an aggregate deductible of $100,000. <br />The health insurance plan is an essential part of the employee benefit package and important to <br />recruitment and retention efforts. The County has engaged the services of a professional <br />benefits consultant, Lockton Companies, to review plan experience and provide <br />recommendations to maintain a benefits package that is: ' <br />✓ Affordable <br />✓ Competitive <br />✓ Sustainable <br />The County offers two health insurance plans — the Premier Silver Plan and Premier Gold Plan. <br />The medical benefit is administered by Florida Blue and the pharmacy benefit is administered by <br />RX Benefits using Express Scripts Pharmacy Benefit Manager (PBM). <br />Both plans have the same access to the Blue Options provider network through Florida Blue and <br />access to the same network of pharmacies through Express Scripts. The differences between the <br />two plans are the deductible, copayment, and coinsurance amounts and the monthly premium <br />paid by the employee or retiree for coverage under the plan <br />