HomeMy WebLinkAboutInsurance Committee Minutes 02.03.2010HEALTH INSURANCE COMMITTEE
Wednesday, February 3, 2010
2:00 P.M. @ City Hall
Members Present: Bill Sheridan, Chairman Donnie Nelson
Monica Salo H.P. Nuernberger
James Huertas Cathy Gabrian
Others Present: Mick DiFronzo Mary Embleton
Dave Allen Troy Kane
Michelle Harris Holman Mayor Olson
This meeting was called so BCBS can give a presentation on the insurance plans they
submitted. Dave Allen stated there is integrity in the quote from BCBS. They guaranteed
the rates to July 1, 2010 and even though these plans are not an exact duplicate, they offer
some choices and premium relief.
Troy Kane, District Sales Manager, said they are required to file their plans with the
Department of Insurance and therefore was unable to match our current plan exactly.
There was discussion regarding the specifics of the 80/20 plan in regard to deductibles, out
of pocket, provider networks, no referrals required, wellness programs and case managers
on staff. Dave said if you stay within Level A, it works like an HMO. Mick said you
don't need to be sick to use this plan. Many companies require a diagnosis code for injury
or illness before they will pay. With this plan, you can go straight to a specialist and do not
have to use a primary care doctor.
Troy recommended using the web-site for the most current information on the BCBS
provider network. The company has spent decades developing this network and they have
the largest one in the country. When you stay within the network, the doctors have agreed
to accept the allowable amounts and you will not be balance billed. Allegiance does not
have as broad a network and you may have to pay the differential. Mick also went over the
differences between a self-funded plan and a fully insured plan.
The 80/20 plan is $76.00 less than what we are currently paying with a 4% reduction in
benefit. Dave said as employees, you decide whether you would assume the risk; savings
versus out of pocket deductible.
The benefit year is on the calendar year, all deductibles and out of pocket transfer. All
employees who have been continuously covered, either on this job or a previous job are
covered. Any new employees or family members that are added, that have not had
previous coverage, are subject to 1-year on pre-existing conditions. There are qualifying
events which allow additions to the plan such as births, marriage, adoption, etc. It was
clarified that it is up to the employer whether they will cover a domestic partner and if they
do, the specifics must be spelled out in policy.
Page 2, Health Insurance Committee
February 3, 2010
It was stated the BCBS pool that we would be in has 63 groups and is for employers with
between 51-99 employees, for a total of about 4,600 participants. The 3 %2 year average for
increases with BCBS is 10.3%. BCBS does not give mid-year rate increases, they give 60-
day notice for new rates, a group can leave at any time, and they have local agents who
will service the participants.
There was discussion on retirees being on the plan. Mick said the city policy is primary
for them if they are under 65 and secondary if they are over 65. The city has to give them
the option of staying on the plan but it can be very expensive for them. Dave said people
held on to the employer insurance so they could get drug coverage, but since Medicare D,
they can find less expensive policies and get Medicare D coverage for prescriptions.
Michelle spoke about the dental plan. She said our current plan required employees to
choose one plan. BCBS would still be with our current carrier, Delta Dental, but
participants can elect to have orthodontic coverage and only those with children would be
assessed.
Mary expressed appreciation for a company having local agents who will work with the
participants. Dave Allen had previously been our agent and did a good job for our group.
There was discussion regarding increased costs, medical inflation, and the uncertainty of
increases and the effect is it having on employers and employees. Mick said some
employers can't afford the benefit and are giving it up while others are going with lesser
benefits to lower the costs.
Meeting adjourned at 3:50 p.m.
Respectfully Submitted,
Cathy G Arian