Manatee County Government Administrative Center Commission Chambers, First Floor 9:00 a.m. - October 9, 2018
REVISED October 9, 2018 - Regular Meeting
Agenda Item #27

2019 Employer Sponsored Medical and Dental Premiums

Briefing Provided Upon Request

Contact and/or Presenter Information
Kim Stroud-Division Manager-Employee Health Benefits/HR

Action Requested

Approval of 2019 premium rate changes reflected in Exhibit A - Active Medical, Dental and Cobra premium rates; Exhibit B - Prescription Coverage rates; and Exhibit C - Retiree premium rates and subsidies. 

Enabling/Regulating Authority


Background Discussion

Annually, in conjunction with the new budget, the County Commission establishes premium rates for the self-funded health and dental plans and establishes rates and subsidies for the retiree medical programs.  

YourChoice Health Plan-Active Employee Medical

As the Board is aware, the YourChoice Health Plan has been a nationally recognized health plan for its innovation, financial cost containment, and promotion of preventative care since its inception in 2006.  For a period of 8 years, the plan experienced a negative trend while other employers were experiencing double digit cost increases.  The performance of the plan has helped to delay the impact of the rising costs of healthcare and pharmaceuticals.   However, as it has been described to the Commission in previous discussions, the growing costs of specialty medications, more advanced and costly medical interventions, the health issues associated with our aging population, and the increase in chronic conditions in our younger population have created the need to manage these costs via premium rate increases and other strategies.   

We continue to see the desire of our employees to be enrolled in the Ultimate and Best Plan levels which offer the highest level of reimbursement.  To maintain this type of health plan design which helps to provide the very best coverage for our employees and their families and is a significant recruitment and retention tool, a slight medical premium increase is necessary. It is recommended that both the employer (departments and constitutional agencies) as well as the employee experience a 4% increase in their share of the premiums.

Dental Coverage-Active and Retiree

The dental plan offered to employees and retirees is fully funded by the participants of the plan.  Due to the plan’s performance and projections for 2019, the premiums for the dental plan will remain stable for 2019

Exhibit A is reflective of the recommended medical premiums for 2019 which reflect a 4% increase for the employer and the employee share.  Additionally, Exhibit A reflects the employee paid dental premiums as well as the employer paid flexible spending account and administrative fees and COBRA premiums for 2019. 

Prescription Coverage-Active and Retiree

The premium cost for the prescription coverage is part of the overall medical premium.  The increase in the overall medical premium is in large part due to the prescription drug trend that is being felt nationwide.  However, the benefit design (copays and coinsurance levels) for prescriptions will remain consistent for 2019.  Some members of the plan will experience some shifts in the pharmaceuticals they use as more stringent managed care techniques are being applied to help contain some of the pharmacy costs by driving members to lower cost but just as effective equivalent medications.  Additionally, in response to the opioid crisis in the nation, some members and their prescribers will experience tighter controls around the dispensing and justification for controlled substances. 

Exhibit B outlines the prescription benefit design for 2019 (no change from 2018).

Medical Plan Options-Retiree

Eligible Retirees of Manatee County Government and participating constitutional agencies can participate in 3 different plan options based upon their age. 

The YourChoice Health Plan is an option for both under and over 65 Retirees.  It offers the same coverage to retirees as it does for the active members of the plan; however, when in retiree status, the retiree pays a higher portion of the premium.  Due to the increase in the total premium for the YourChoice Health Plan, the retirees too will experience a premium increase for 2019 for their medical and prescription coverage with the average increase being 4.7% across all tiers of coverage. 

Via Benefits is an option for our post 65-year-old retirees where they can elect from a variety of different plan designs through a private exchange for their medical coverage secondary to Medicare.  Retirees who are eligible for a County subsidy enrolled in this plan option will see a reduction in that subsidy offering to align the subsidy with the other retiree plan options offered. 

Transamerica Medicare Supplement is an option for our post 65 retirees and is our plan offering that has the most enrollment.  For many years we offered a group Medicare Part D prescription plan and bundled it with the Medicare supplement plan.  Over the years, we have seen the group prescription plan become more and more expensive for the County and for our retirees and offered less and less coverage.  Effective 1/1/2019, our retirees will experience a premium decrease in their Transamerica and Bankers Group Medicare supplement offering and they will select an individual Medicare Part D prescription plan on their own.  This model is consistent with our surrounding public-sector employers and, for most retirees, is a cost saving opportunity for their prescription coverage.

Exhibit C outlines the recommended 2019 Retiree Medical Premium options.

County Attorney Review
Not Reviewed (No apparent legal issues)

Explanation of Other

Reviewing Attorney

Instructions to Board Records
Send copy of approved agenda item to Kim Stroud-Employee Health Benefits:  kim.stroud@mymanatee.org.

Cost and Funds Source Account Number and Name

Amount and Frequency of Recurring Costs

Attachment:  2019 Exhibit A-Active Med, Dental and COBRA.pdf
Attachment:  2019 Exhibit B-Prescription Coverage.pdf
Attachment:  2019 Exhibit C-Retiree Premiums.pdf