HEALTHCARE 2017
COLUMBUS CONSOLIDATED GOVERNMENT
HUMAN RESOURCES DEPARTMENT
www.columbusga.org/hr
2017 Action Plan
• Expand access to the Health and Wellness Center to all employees
enrolled in CCG medical coverage, regardless of plan selection
• Replace HMO plan due to large capitation fees with Open Access POS
National Network, no referrals
• Replace PPO plan with Open Access POS, National Network, no referrals
• Develop High and Low Open Access POS Plan options – Silver or Gold
• Tie financial rewards to plan cost based on wellness participation
HEALTHCARE SUMMARY 2017
 City’s contribution increased from $5,650 in FY16 to $6,100 in FY17 per
budgeted position totaling $1.2 million.
 Approved Contribution Strategy of 70% Employer / 30% Employee
 Over the last several years, the city has made up the deficit at year
end which equates to approximately 83%/17% contribution split.
 A 2% COLA is recommended to help offset the employee premium
increase of $1.3 million. This COLA covers the employee only premium
increases for the proposed Silver plan at all pay grades.
 Current Enrollment:
 Employee Only = 51.03%
 Employee + Spouse = 8.29%
 Employee + Child(ren) = 25.82%
 Employee + Family = 14.86%
 Current Plans include the Health & Wellness Center Plan (HWC), the
HMO Plan, and the POS/PPO Plan. The proposed plans include access
for all to the HWC with a POS Silver Plan or a POS Gold Plan.
Current-2016
Proposed-2017
Current Health &
Wellness Plan
Current
HMO Plan
Current
Open Access
POS/PPO
Proposed
Open Access
POS
(Silver Plan)
Proposed
Open Access
POS
(Gold Plan)
$500/$1,000
$1,000/$2,000
$1,000/$2,000
$2,000/$4,000
$1,000/$2,000
90%
90%
80%
80%
90%
$1,500/$3,000
$6,350/%12,700
$6,350/$12,700
$6,350/$12,700
$6,350/$12,700
$0
N/A
N/A
$0
$0
$50
$20
$30
$30
$20
$20
$30
$40
$40
$30
Emergency Room
$150
$150
$150
$200
$150
Prescription drug
(Retail/Mail
Order)
Available at
HWC
Tier 1
Tier 2
Tier 3
$0
N/A
N/A
$0
$0
$20/$40
$20/$40
$20/$40
$20/$40
$20/$40
$40/$80
$40/$80
$40/$80
$40/$80
$40/$80
$60/$120
$60/$120
$60/$120
$60/$120
$60/$120
Benefit Design
Deductible
(Single/Family)
Coinsurance
Global out-ofpocket
Medical
copayments
HWC office
visits
PCP office visits
SP office visits
Health and Wellness Center will be available to all employees enrolled in the Silver or Gold plan
No cost for services or prescriptions at HWC
Columbus Consolidated Government
Health Insurance Premium Rates – Effective January 1, 2017
Active Employee Contributions at 30%
2% COLA Increase Effective January 1, 2017
Silver Plan Premium Rate Comparison
2016 Current
HWC Biweekly
Employee
2016 Current
POS/PPO
Biweekly
2016 Current
HMO
Biweekly
2017 Proposed
Silver Plan
Biweekly
$59.65
$65.69
$71.02
$73.03
Employee +Spouse
$112.14
$123.49
$133.51
$137.29
Employee + Child(ren)
$104.39
$114.85
$124.28
$127.82
Employee + Family
$165.23
$181.95
$196.72
$202.31
Gold Plan Premium Rate Comparison
2016 Current
HWC Biweekly
Employee
$59.65
Employee +Spouse
$112.14
Employee + Child(ren)
$104.39
Employee + Family
$165.23
2016 Current
POS/PPO
Biweekly
$65.69
$123.49
$114.85
$181.95
2016 Current
HMO
Biweekly
2017 Proposed
Gold Plan
Biweekly
$71.02
$104.65
$133.51
$196.74
$124.28
$183.16
$196.72
$289.90
Columbus Consolidated Government
Health Insurance Premium Rates – Effective January 1, 2017
Pre-65 Retiree Contributions at 50% Retiree, 20% Dependents
.25% COLA Increase Effective January 1, 2017
Silver Plan Premium Rate Comparison
Employee
$215.40
2016 Current
POS/PPO
Monthly
$228.49
Employee +Spouse
$566.94
$591.52
$613.24
$793.26
Employee + Child(ren)
$527.74
$550.63
$570.85
$738.53
Employee + Family
$838.34
$871.57
$903.56
$1,168.90
2016 Current
HWC Monthly
2016 Current
HMO Monthly
2017 Proposed
Silver Plan
Monthly
$240.04
$263.72
Gold Plan Premium Rate Comparison
2016 Current
HWC Monthly
Employee
$215.40
Employee +Spouse
$566.94
Employee + Child(ren)
$527.74
Employee + Family
$838.34
2016 Current
POS/PPO
Monthly
$228.49
$591.52
$550.63
$871.57
2016 Current
HMO Monthly
2017 Proposed
Gold Plan
Monthly
$240.04
$332.23
$613.24
$922.06
$570.85
$858.42
$903.56
$1,358.67
MEDICAL PLANS COMPARISON
Plan
Provisions
2016 HWC
2016 HMO
2016 POS/PPO
2017 SILVER
2017 GOLD
Coverage Tier
Emp Only $59.65
Emp Only $71.02
Emp Only $65.69
Emp Only $73.03
Emp Only $104.65
Emp/Spouse $112.14
Emp/Spouse $133.51
Emp/Spouse $123.49
Emp/Spouse $137.29
Emp/Spouse $196.74
Emp/Children $104.39
Emp/Children $124.28
Emp/Children $114.95
Emp/Children $127.82
Emp/Children $183.16
Family $165.23
Family $196.72
Family $181.95
Family $202.31
Family $289.90
Lifetime Maximum
Unlimited
Unlimited
Unlimited
Unlimited
Unlimited
Deductible
(individual/family)
Annual Out of
Pocket Maximum
Coinsurance
$500/$1000
$1000/$2000
$1000/$2000
$2000/$4000
$1000/$2000
$1000/$2000
$6350/$12,700
$6350/$12,700
$6350/$12,700
$6350/$12,700
90%
90%
80%
80%
90%
Immunizations
100% (no copay)
100% (no copay)
100% (no copay)
100% (no copay)
100% (no copay)
Primary Care
$50 (free at HWC)
$20
$30
$30
$20
Specialist
$20 (with HWC
referral; $50 with no
HWC referral
$20
$30
$40
$40
$30
$20
$20
$30
$20
10% after deductible
10% after deductible
20% after deductible
20% after deductible
10% after deductible
$150 copay
$150 copay
$150 copay
$200 copay
$150 copay
$20
$30
$30
$40
$40
Travel & Out of the
Area Benefits
Nationwide, no
referral needed
Emergency care only
Nationwide, no referral
needed
Nationwide, no referral
needed
Nationwide, no referral
needed
Chiropractic
20% Coinsurance
20% Coinsurance
20% Coinsurance
10% Coinsurance
Pediatrician Office
Visit
Hospital/Inpatient
Services
Emergency Room
(waived if
admitted)
Urgent Care
(Health & Wellness Center)
outside of GA
Not covered
MEDICAL PLANS COMPARISON
Plan Provisions
2016 HWC (Health &
2016 HMO
2016 POS/PPO
2017 SILVER
2017 GOLD
Wellness Center)
Rehabilitation
Services
20% Coinsurance
$20 Copay/Visit
20% Coinsurance
20% Coinsurance
10% Coinsurance
Skilled Nursing Care
20% Coinsurance
No Charge
20% Coinsurance
20% Coinsurance
10% Coinsurance
Medical Expenses
outside of plan
network
Mental/Behavioral
Health Outpatient
Services
Mental/Behavioral
Health Inpatient
Services
Substance Abuse
Disorder Outpatient
Services
Substance Abuse
Disorder Inpatient
Services
Prenatal and postnatal
care
40% Coinsurance
Not covered
40% Coinsurance
40% Coinsurance
30% Coinsurance
20% Coinsurance
No Charge
20% Coinsurance
20% Coinsurance
10% Coinsurance
20% Coinsurance
10% Coinsurance
20% Coinsurance
20% Coinsurance
10% Coinsurance
20% Coinsurance
No Charge
20% Coinsurance
20% Coinsurance
10% Coinsurance
20% Coinsurance
10% Coinsurance
20% Coinsurance
20% Coinsurance
10% Coinsurance
$100 Copay/ applies to
first visit only
$30 Copay/ applies to
first visit only
$100 Copay/ applies to
first visit only
$100 Copay/ applies to
first visit only
$100 Copay/ applies to
first visit only
Home Health Care
$30/Copay/Visit
No Charge
$30/Copay/Visit
$30/Copay/Visit
$30/Copay/Visit
Durable Medical
Equipment
20% Coinsurance
No Charge
20% Coinsurance
20% Coinsurance
10% Coinsurance
Prescription Drugs (30
day supply)
Free at HWC, $20
Generic, $40 Brand,
$60 Non-formulary
$40 Generic, $80
Brand, $120 NonFormulary
$20 Generic, $40
Brand, $60 Nonformulary
$40 Generic, $80
Brand, $120 NonFormulary
$20 Generic, $40
Brand, $60 Nonformulary
$40 Generic, $80
Brand, $120 NonFormulary
Free at HWC, $20
Generic, $40 Brand,
$60 Non-formulary
$40 Generic, $80
Brand, $120 NonFormulary
Free at HWC, $20
Generic, $40 Brand,
$60 Non-formulary
$40 Generic, $80
Brand, $120 NonFormulary
Prescription Mail
Order (90 day supply)
Wellness Incentive
Incentive Option Recommendation:
• Health Reimbursement Account (HRA) Credits for compliance (or HRA Dollars)
• Receive $500 HRA credit for compliance
• $100 for Health Risk Assessment
• $200 for Biometric Screening
• $200 for Coaching if High Risk, Automatically Received if not High Risk
• Used to offset deductible
Compliance =
• Complete biometric screening
• Complete Health Risk Assessment
• If deemed high risk, must see health coach until released
• For 2017 will only apply to employees, not spouses
Applies to both Silver and Gold Plans
Questions?