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HomeMy WebLinkAboutInsurance Committee Minutes 06.08.2005Present: Guests: MINUTES ]2qSURANCE COMMITTEE June 8, 2005 5:00 pm Council Chambers Guy Kolisor~ Chairman Bud Arnold Cheryll Lund Mary Embleton Dave Allen, Western States Mike Zuhoski Kurt Markegard Jason Wells (arrived approx. 6:00 pm) Sheliy Wherley, BCBS Dave Allen ~and Shelly Wherley spoke to the gronp in regards to a Blue Choice Plan with 80/20 benefits. Dave and Sh~lly explained that the Blue Choice 80/20 plan is a drop in benefits, but it also has a lower price. The main advantages with going to this plan would be that the employee can keep his Primary Care Physician and the co-pay would be only $10 each visit; and, if you stay within the network of doctors no referral is necessary and every doctor visit has a $10 co-pay· A disadvantage to the Blue Choice 80/20 plan is the higher cost of a hospital stay. At this time each hospital stay is $500. With the Blue Choice 80/20 Plan A if an employee were to be hospitalized they would have to pay 20% of the cost of the hospital. Il'the doctors that are treating the employee in the hospital were network doctors then the employee would only pay $10 for each doctor visit. Dave and Shelly both stated that the plan the city employees have now, Blue Select, is the Cadillac of health insurance plans. After Dave and Shelly reviewed the quote for the Blue Choice 80/20 plan they discovered that the prescription benefit had been quoted with a $100 deductible with co-pays of $8/$25/$50, which is not what was asked for. With the current policy there is $0 deductible and the co-pays are $10/$20/$40. Shelly stated that she thought the new quote, with the correct deductibles could come back as much as 3.1% higher. She will get the quote with the correct figures and send it to the committee on June 9, 2005. Dave pointed out to the committee that the quote for Blue Select is just for the health insurance portion of the policy; the vision and dental were quoted separately. (attached) After a discussion by the committee, a motion was made by Mike Zuhoski, and seconded by Bud Arnold that the committee recommends remaining with the current Blue Select Plan, with the option of going with the Blue Choice 80/20 Plan depending on union negotiations. Motion carried. The committee discussed employee complaints regarding having difficulties getting any information from the Western States representative. After a lengthy discussion a motion was made by Mike Zuhoski, seconded by Bud Arnold, to request and recommend that Miak Difronzo, ofDifronzo & Co, take Dave Allen' s place as contact. IfMick is unavailable to take the job then it is recommended that the contact be MMIA or Legacy directly. Motion carried. The committee discussed the "caps" that the City put on the employees health insurance plans. The committee suggested that the caps be .spread out more evenly throughout all of the categories (4) of the plan. The meeting was adjourned at 6:15 pm. Respectfully submitted,' Cheryl1 Lund, Secretary: 2 Renewal Confirmation for: . Medical Benefit Plan: Renewal Date: City of Laurel Blue Select July 1, 2005 3alendar Year Deductible(s) N/A Annual Out-of-Pocket Maximum $2,000 ~ $4,000 Lifetime Maxihmm Room, Board & support Services (pdor authorization required) Inpatient Hospital Ambulatory Surgery Center Emergency Room Accident Benefit urgeon & Anesthetist Office Visits Physician Services Children's Preventative Care $5,000,000 100% - $500 Copay $30 Copay $75 Copay Not listed $30 Copay $25 Copay $25 Copay $25 Copay Routine Exam Employee & Spouse $25 Copay Diagnostic X-Ray & Lab 100% Durable Medical Equipment Ambulance 100% up to $4,000 Substance .Abase Inpatient Hospital $50 Copay Home Health Care (prior authorization required) 100% ~ 180 visits Chiropractic Services $25 Copay -- 30 visits Infertility Services Not Covered $500 Copay - 21 days Inpatient/Ou~atient Professional ~ Mental $30 - 40 visits Inpatient/Outpatient Professional ~ Substance Abuse Retail Genedc Rx Co-pay Retail Brand Formulary Rx Co-pay $20 Retail Non Formulary Brand Co-pay $40 $30 Copay $10 Drugs fortreatmenl Not Covered Rates nployee $414.55 mployee& Spouse Employee & Child Employee & Family $1,054.79 Medicare Single $234.29 2Pady Medicare $468.58 Prepared by ~rMZ4 ... P.~v: 3/31/2005 Renewal Confirmation for: City of Laurel Benefit Plan: Blue Select Dental Renewal Date: July 1, 2005 This Document is a Summary of Coverage Only. The BCBSMT Plan Document ruu~t be referenced for details of all coverages. Diagnostic & Preventive - no deductible 80% Basic Restorations 80% Major Restoration 50% Orthodontic ~ Child (ran) under 19 50% Calendar Year - Individual $25 Calendar Year ~ Family $50 Calendar Year ~ }ndivdiual $1.500 Orthodontic- Lifetime $1.000 Employee $22.77 Employee & Spouse $45.54 Employee & Child(ran) $40.17 Employee & Family $66.12 Non-Participating Provider Coinsurance is 10% Prior Authorization may be required. It is important to call BCBSMT to determine which services require prior au~horiziafion. Prepared by MMIA - Rev. 3/3112005 Renewal Confirmation for: City of Laurel Benefit Pla'n: BCBS Vision Plan Renewal Date: July 1, 2005 This Document is a Summary of Coverage Only. The BCBSMT P!an document must be referenced for details of all coverages. Examination $48 Frames $50 Single Vison Lenses $72 Lined Bifocial Lenses $136 Lined Tdfocial Lenses $92 Lenticular $320 Contacts $98 Contracts when Acuity cannot be $320 made 20/70 or better with lenses Coinsurance 100% Exams 12 Months Lenses/Contact Lenses 12 Months Frames 12 Months Employee $6.60 Employee & Spouse $14,85 Employee & Child(ren) $13.32 Employee & Family $21.48 Prepared by MMIA - Rev. 3/31/2005