Proposed 2011 Medical Plan
Design
June 8, 2010
Presentation Outline
 Background
 Recommended
Strategy
 Summary
 Next Steps
 Action Requested
Presentation Outline
 Background
 Recommended
Strategy
 Summary
 Next Steps
 Action Requested
Background
 BCC
 Comptroller
8,344
Covered Employees
 Tax Collector
 Supervisor of Elections
 Expressway Authority
 Housing Finance Authority
 OBT Development Board
Total Plan Members:
18,536
 Metroplan Orlando
 Property Appraiser
 Lynx
 Clerk of Courts
 Research and Development
 I-Ride Trolley
Background
 Claim and administrative expenses
for 2010 are expected to reach
$96 million
 Overall cost of claims is trending
at 10.4% and is expected to
increase without major plan
design changes
 Unable to sustain funding for large
increases year after year
 Need to address total cost of plan
and increase share of cost paid by
employees
Background
Keep
Current
Plan
Major Plan
Restructure
Background
If current plan is kept…
Millions
Revenues /
Expenditures
$107.8M
$17.3
Million Deficit
$90.5M
Background
If current plan is kept…
 Premiums will increase by at
least 50%
 Bi-weekly premium increase as
much as $100 for family
coverage
 Coinsurance and deductibles
would need to be added
 Financial challenges will
continue to compound
Background
Implementing a Major Plan Restructure will…
 Lessen premium
increases
 Focus on Wellness and
Preventive care
 Create informed
consumers
 Begin to reverse the
trend
Presentation Outline
 Background
 Recommended
Strategy
 Summary
 Next Steps
 Action Requested
Recommended Strategy
Implement a Consumer
Driven Health Plan for 2011
 Preventive Care at 100%
 Preventive Medications
outside of deductible
 Individual Health Savings
Account (HSA)
 High-Deductible Health Plan
Recommended Strategy
 Nationally there are over 9 million
individuals participating in Consumer
Driven Health Care
 Within the first year, the trend generally
decreases 4-5%
 Savings after the first year indicates
trend rates lower than traditional plans
by 3-5%
 Cost savings are not generated by
avoidance of appropriate care
Recommended Strategy
A recent survey of HSA account holders
by Buck Consultants found:
 52% of respondents more closely monitor their
health care costs since becoming HSA account
holders
 46% better understand costs before using
services, and 25% choose less costly services
 20% are better monitoring their diet and
engaging in fitness and exercise
 83% completed doctor recommended surgeries
at the same rate as before, and 6% completed
surgeries more than before
Recommended Strategy
Two Major Plan Components
 HSA Account

Funding Vehicle/Partially
Funded

$750/$1,250 County
contribution
 High Deductible Health Plan

Deductible: $1,500/$3,000

20% Coinsurance

Out of Pocket Max:
$3,000/$6,000
Recommended Strategy
Deductible
 $1,500 Employee Only
 $3,000 Family
 Amount paid by covered
member before plan begins
 Member pays full cost of the
negotiated rate, until
deductible
 Can be paid from the HSA
Recommended Strategy
20% Co-Insurance
 Starts after deductible is
met
 20% to be paid by member
each time a medical service
is accessed
 80% remaining is paid by
the Medical Plan
 Can be paid from the HSA
Recommended Strategy
Out of Pocket Maximum
 $3,000 for Employee only
 $6,000 for Family
 Designed to protect member in the
event of a catastrophic illness (safety
net)
 Once the out of pocket max is met, all
services are covered at 100% by the
Plan
Recommended Strategy
Premium Schedule
Proposed 2011 Premium Schedule
Total
$
Orange
County
$
Employee
$
Bi-Weekly
Employee
$
5,490
5,490
0
0
Employee +
Child(ren)
11,290
9,470
1,820
70
Employee +
Spouse
12,246
10,244
2,002
77
Full Family
16,739
12,709
4,030
155
Coverage
Employee
Only
Recommended Strategy
Premium Comparison
Percent of Premium Paid by Employer
Agency
Employee Only
Full Family
Broward County
95%
80%
Orange County Sheriff’s Office
100%
79%
Pinellas County
97%
78%
Orange County (Proposed)
100%
100%
100%
100%
76%
73%
55%
48%
City of Orlando
Orange County Public Schools
Miami-Dade County
Recommended Strategy
Premium Comparison
Bi-Weekly Premiums Paid by Employee
Agency
Employee Only
Full Family
Miami-Dade County
$0
$245.80
City of Orlando
$0
$236.11
Orange County Public Schools
$0
$216.69
Orange County (Proposed)
$0
$155.00
Pinellas County
$5.90
$128.18
Broward County
$10.15
$126.00
Orange County Sheriff’s Office
$0
$122.10
Presentation Outline
 Background
 Recommended
Strategy
 Summary
 Next Steps
 Action Requested
Summary
 10.4% annual increase in healthcare
cost is not sustainable
 Fundamental changes to the health plan
are needed
 Recommend fully funding employee
only coverage
 Recommend transitioning to a
Consumer Driven Health Plan to control
costs, change behavior, and begin to
reverse the trend
Presentation Outline
 Background
 Recommended
Strategy
 Summary
 Next Steps
 Action Requested
Next Steps
 Communication campaign beginning
in June
 Open Enrollment in October 2010
 Implement health plan changes and
fund HSA accounts in January 2011
 Evaluate plan success going forward
and make further adjustments
annually
Presentation Outline
 Background
 Recommended
Strategy
 Summary
 Next Steps
 Action Requested
Action Requested
Approval of the 2011 Employee Health
Plan and Premium Schedule as outlined
in the staff report to include:
 Consumer Driven High-Deductible
Health Plan
 Health Savings Accounts
 Bi-Weekly Premium Schedule
Proposed 2011 Medical Plan
Design
June 8, 2010