Manatee County Government Administrative Center Commission Chambers, First Floor 9:00 a.m. - September 27, 2016
September 27, 2016 - Regular Meeting
Agenda Item #21

2017 Medical and Dental Premium Rates - Active and Retiree


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

Action Requested
Approval of the 2017 Plan Year premium rates for self-funded Medical and Dental plans for active employees and retirees.

Enabling/Regulating Authority


Background Discussion
Medical and Dental Plan
Annually, in conjunction with the new budget, the County Commission establishes medical and dental premium rates for the self-funded health plan.  The medical plan has performed exceedingly well over the last 6-7 years, in comparison to the national trend, and the Commission has not been required to shift costs to the employees via high premiums, high deductibles, or reduced coverage.  However, as has been described to the Board  in previous discussions, the aging population of our employee base, inflation, and several catastrophic claimants this current plan year have created a trend increase and the Administration recommended a 4% increase in the medical premiums.  The Administration is cognizant of the pay compression issue that is present with our employees and, therefore, made the recommendation in the Board's approved budget that the increase be absorbed by the employer, not the employee.  

The dental plan is funded by the employee with no employer cost sharing of the premium.  Due to increased utilization and escalating costs, a slight increase in the dental premium is recommended.  

Exhibit A outlines the medical/dental rates for 2017

Prescription Plan
Specialty prescriptions continue to absorb 30% of our $6M drug spend for less than 150 members.  The industry continues to look for ways to manage these rising costs and manage the utilization in the most effective manner.  EHB engaged in an RFP to assess opportunities to mange prescription costs and elected to continue with the current Pharmacy Benefit Administrator (OptumRx) due to an aggressive rate proposal as well as significantly higher rebates for high cost brand medications.  Last year the Board approved a $5 copay for generic medications at preferred pharmacies which has helped control some of the cost increases.  The Administration is recommending that the benefit structure for the prescription plan remain the same for the 2017 plan year. 
Exhibit B outlines the Benefit structure for 2017 for Pharmacy.
Retiree Medical Options
Under 65 retirees are eligible for the county self-funded health plan.  Due to the increase in the self-funded plan as described above, the retirees enrolled in this plan will see an increase as well.  The County subsidy will remain the same as the current year.
Retirees over 65 have 3 plan options:  The self-funded health plan, Group Medicare Supplement with Part D Prescription coverage, and Private Medicare Exchange with a Health Reimbursement Account. Retirees enrolled in the Transamerica/Aetna Part D prescription plan will see a stable premium rate for the 2017 year due to increases in those fully-insured products. Retirees enrolled in Bankers Medicare Supplement will experience a slight increase due to a possible increase in premium for that product.  The County will increase its subsidy slightly for the Private Medicare Exchange in order to provide an incentive for retirees to use that more affordable and individualized option.
Exhibit C outlines the proposal for the Retiree premiums for 2017.

County Attorney Review
Not Reviewed (No apparent legal issues)

Explanation of Other

Reviewing Attorney

Instructions to Board Records
Please email a copy of the approved agenda item to Kim Stroud:  kim.stroud@mymanatee.org

Cost and Funds Source Account Number and Name

Amount and Frequency of Recurring Costs

Attachment:  2017 Med Dental Fees .pdf
Attachment:  2017 Prescription Benefit .pdf
Attachment:  2017 Retiree Medicalx.pdf