05/11/2021 - Laserfiche WebLink

Home Browse Search

Our actual Health Plan experience through March 2021 indicates the following: • Employee & Retiree enrollment averages 1,672 members • Average of 3,675 individuals are insured under the group medical/6n • 23.6% of members are enrolled in the Premier Silver Plan and 76ll d in the Premier Gold Plan • 27 high cost claimants over $50K totaling $3.3M in claims during tths of the plan year • Stop Loss reimbursement of $17,639 resulting in net claims of $ high cost claimaints • The Premier Silver Plan is performing well and the Premier Gold Pat a loss. • Overall plan performance is 91.2% during the first six (6) m plan year. However, the ongoing expenses related to high cost claims ar expected to impact the plan over the next six (6) months and it is anticipated we will ti d the plan year on budget. The Self -Insurance Fund balance through March 2021 indicates` the fund balance history and actual fund balance as of March 31, 2021 as listed below: Fiscal Year 1End Fund (Balance History Septernber 30t, 2018 Septeimber 30, 2019 September 30, 2020 $13,148,724 $12,197,911 $12,807,,209 FA Fund Ralance Change Tihr ugh 2nd Quarter FY 20/21 September 30, 2020 March 31,202Y Inc./Dec. °fo Inc./Dec. $121807,209 1 $13,500,11 $692,903 5.41'°l0 Funding for the health plan is providecjky employer, employee, and retiree contributions to the plan as well as OPEB funding. Whilyf Whileis projected we will end the current plan year on budget, projections indicate additional fun ng of $1,561,000 will be required for the plan year beginning October 1, 2021. This increase is ased on a 5.5% medical trend, a 10% pharmacy trend, increase in stop loss premiums, and in ease administrative costs (ASO) fees. The projections assume $1,830,000 in pharmacy r ates. Funding requirements for FY21/22 are projected at $25,186,000. Medical and Pharmac Administration The County plan has in existing Administrative Services Agreement (ASO) with Florida Blue. This agreement wase Bred into on June 5, 2018 and is for a period of five (5) years expiring on September 30, 3. The curren /Pharmacy Benefit Administrator (PBA) is RXBenefits and the Pharmacy Benefit Manager BM) is Express Scripts. Lockton has completed PBM marketing for the upcoming plan year. ine (9) proposal were reviewed and analyzed. The analysis included comprehensive final ial comparison using Lockton's proprietary repricing model utilizing our claims data, pricing guarantees, bidding terms, clinical programs, formularies, pharmacy networks, mail order and -4