healthcare costs at below 2010 levels? · the results 2010 2014 2012 2011 2013 $8,729 $9,473 $9,934...
TRANSCRIPT
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Healthcare Costs at BELOW 2010 Levels? How Did Palm Coast do THAT?
FCCMA Annual 2015 Conference
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A Conversationabout yourHealth Insurance
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Before we get started, a few basic facts about our traditional healthcare insurance . . .
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Claims = Costs +++
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Employees are Users
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No incentive to save your organization
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The Results
2010
2014
2012
2011
2013
$8,729
$9,473$9,934
$10,266
$10,717$11,3042015
Per EmployeeNationwide Healthcare Insurance Costs
Source: Aon Hewitt
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A New Approach
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A New Approach
• Formed a Team
• Focused on Fixing or Containing Costs
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Broker Organization Employees
A New Approach
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Your Broker
Flat Fee $75,000 versus2015 Projected 5% Fee $115,000
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Your Organization
Fully Insured
• Premiums (including Administrative Fee) Paid to Insurance Provider• If Claims < Premiums, Insurance
Provider Keeps $
• If Claims > Premiums, Insurance Provider Pays + Raises Rates Following Year
Self Insured
• Administrative Fee Paid to Insurance Administrator
• Premiums Paid to Yourself• If Claims < Premiums, Your
Organization Keeps $
• If Claims > Premiums, Your Organization Pays
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Your Organization
Palm Coast goes Self-Insured
• Fixed Costs• Broker Fee
• Administrative Fee
• Stop Loss Insurance - Claims over $125,000
• Premium Costs Paid to Yourself• Actuary Determines
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Your Employees
Do your employees spend more time comparing yogurt (type, brand, price) than healthcare options?
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Your Employees
Palm Coast High Deductible Health Care Plan with HSA
• High Deductible - $1,500 Single• 80/20 After Deductible is Met
• Maximum Out of Pocket - $3,000 Single
• After that…• City Health Insurance Fund up to $125,000 per claim
• Stop Gap after $125,000
Helped Fix Costs to Palm Coast
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Your Employees
Provided Incentives to Get Employees to Think Differently
• Provided HSA Funding
• Dis-incentivized Non-HDP Plans
• Offered Employee Clinic
• Wellness Programs
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Let’s go back…
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Now we can talk about the Clinic
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Request for Proposals
• Management Company
• Local ARNP – No Medical Doctor On-Site
• Insurance Company with Clinic
• Local Family Practice
• Local Urgent Care Facility
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Our Medical Clinic
• Benefits• Urgent Care Services
• New Facility• With Equipment, Staff, and Confidentiality Protocols
• Offered Flat-Rate Per Hour of Services
• No Capital Outlay
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Results
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Plan Costs
Average Cost to Plan
TOTAL
Diagnostic/Minor Surgical 24 $150 $ 3,600
Injections 117 $80 $ 9,360
Lab Tests (Metlyte 8, Lipid, Liver & CBC)
1246 $52 $64,792
Office Visits 659 $117 $77,103
X-rays 39 $35 $ 1,365
TOTAL $156,220
Clinic Cost -$ 111,876
Estimated Cost Savings $44,344
Clinic Analysis by DetailMay 1, 2014 – April 30, 2015
Based upon average of Reasonable & Customary Plan Charges on BCBSF website
Medical Clinic Results
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• Emergency Room usage decreased 30%
• Prescription Costs decreased 13.8%
• Brand Name Drug usage decreased 8%
• Ambulatory Visits decreased 5.0%
• Clinic Usage by 72% of eligible members
Employees as Consumers
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Plan Costs
*Projected Costs Based on Aon Hewitt Health Value Initiative 2015
$7,835 $9,278 $9,508 $9,022$8,601
PerEmployee
Health Plan All-In Costs
$11,304
2015National Average
$-
$1,000,000
$2,000,000
$3,000,000
$4,000,000
2010 2011 2012 2013 2014
$3,174,000$2,804,901 $2,941,128 $3,118,929 $2,986,383
$3,556,372$3,254,322 $3,515,176
$3,741,624
Actual Costs Projected Fully Insured
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Flagler Schools just completed firstyear, no increased costs to employeesand health insurance fund is almostfully funded!
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By the Numbers – A RecapBroker Commission Based Estimated 2014 at 5% $115,000
Broker Flat Fee Actual 2014 $75,000
SAVINGS $40,000
Clinic Estimated Claims 2014 $156,200
Clinic Fixed Expense $111,876
SAVINGS $44,324
Per EE/Year (331 EEs) Nat’l Avg. $11,304 $3,741,624
Per EE/Year (331 EEs) City of Palm Coast $9,022 $2,986,383
TOTAL SAVINGS (inc. Broker & Clinic Savings) $755,241
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FCCMA Annual 2015 Conference
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Contact Information
Jim Landon
City Manager
(386) 986-3710
Wendy Cullen
HR Manager
(386) 986-3720
Julie Freidus
Senior Vice President
(386) 252-9601
Ann Shaw
Practice Administrator
(386) 447-6615