The URL can be used to link to this page

R2006-144 09-05-06RESOLUTION NO. R2006-144 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS, APPROVING EMPLOYEE INSURANCE RENEWAL RATES. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS: Section 1. That the City received renewal rates, attached hereto as Exhibit "A", for employee insurance benefits and such rates have been evaluated. Section 2. That the City Council hereby adopts the renewal rate for employee insurance benefits in the amount described in exhibit "A", attached hereto and incorporated for all purposes. PASSED, APPROVED and ADOPTED this the 5th day of September, A.D., 2006. Mt) at T M REID MAYOR ATTEST: APPROVED AS TO FORM: DARRIN M. COKER CITY ATTORNEY Exhibit "A" POS-OPEN ACCESS POS-OPEN ACCESS OPEN ACCESS PLUS OPEN ACCESS PLUS HMO HRA $750/$1500 HRA HRA CURRENT RATES RENEWAL RATES $10001$2000 $1250/$2500 EE ONLY $ 324.39 $ 409.38 $ 356.83 $ 374.99 $ 379.54 $ 317.90 $ 322.35 ; $ 327.75 EE+ SPOUSE $ 681.19 $ 858.44 $ 749.31 $ 787.46 $ 796.99 $ 667.57 $ 676.92 $ 688.26 iE+CHILDREN $ 583.88 $ 735.80 $ _ 642.27 $ 674.97 $ 683.14 $ 572.20 $ 580.21 $ 589.94 EE+FAMILY $ 908.26 $ 1,144.59 $ 999.09 $ 1,049.95 $ 1,062.66 $ 890.99 $ 902.55 $ 917.68 PCP Office Visit $ 20.00 Same $ 20.00 $ 20.00 $ 20.00 Plan Ded/20% Coinsurance SAME HRA SAME HRA Specialist Visit $ 40.00 $ 40.00 $ 40.00 $ 40.00 Plan Ded/20% Coinsurance In -Patient Hospital 20% _ 20% 20% 20% Plan Ded/20% Coinsurance Out -Patient Facility 20% 20% 20% 20% Plan Ded/20% Coinsurance MRI, CAT SCAN $ 75.00 Plan Ded/Coinsurance Plan Ded/Coinsurance $ - Plan Ded/20% Coinsurance Lab & X-Ray Out Patient Facility 20% Plan Ded/Coinsurance Plan Ded/Coinsurance Coinsurance Plan Ded/20% Coinsurance Lab & X-Ray Independent Facility No Charge No Charge _ Plan Ded/Coinsurance Coinsurance Plan Ded/20% Coinsurance Therapy & Chiropractic $40/60 Chiro Visits $40/20 days max. $40/20 days max. $20/ with 20 days max. 20% Coinsurance/20 days max Prescription Drugs Generic $ 10.00 $ 15.00 $ 15.00 $ 15.00 30% Preferred Brand Name $ 20.00 $ 30.00 $ 30.00 $ 30.00 40% Non -Preferred Brand Name $ 40.00 $ 50.00 $ 50.00 $ 50.00 50% Mail Order Generic (2X) $ 20.00 $ 30.00 $ 30.00 $ 30.00 30% Mail Order Preferred Brand Name $ 40.00 $ 60.00 $ 60.00 $ 60.00 40% Mail Order Non -Preferred Brand $ 80.00 $ 100.00 $ 100.00 $ 100.00 50% Emergency Room Visit $ 100.00 $ 100.00 $ 100.00 $ 100.00 Plan Ded/20% Coinsurance Urgent Care $ 50.00 $ 50.00 $ 50.00 $ 50.00 Plan Ded/20% Coinsurance Maternity Office Visit $20/$40 _ $20/$40 $20/$40 $20/$40 Plan Ded/20% Coinsurance Maternity Inpatient 20% Plan Ded/Coinsurance Plan Ded/Coinsurance 20% Plan Ded/20% Coinsurance In -Patient Services Other Facilities 20%/ 60 days max. 20%/60 days max. 20%/60 days max. 20% w/ 60 days Max Plan Ded/20% Coinsurance Home Health Services $ - _ Deductible then 20% Deductible then 20% $0.00 with 60 days max. Plan Ded/20% Coinsurance Family Planning Services $20/$40 $20/$40 $20/$40 $20/$40 Plan Ded/20% Coinsurance amily Planning Inpatient 20% Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/20% Coinsurance Family Planning Outpatient 20% Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/20% Coinsurance Infertility Services Office Visit $20/$40 Excluded Excluded $20/$40 Excluded 1 Infertility Treatment/Surgery 50% Excluded Excluded 20% Excluded Infertility Inpatient Facility 20% Excluded Excluded 20% Excluded Infertility Out -Patient Facility 20% Excluded Excluded 20% Excluded Mental Health Inpatient $100 per day/8 day max Plan Ded/Coinsurance Plan Ded/Coinsurance $75 per day/20 day max. Plan Ded/20% Coinsurance Outpatient Individual Therapy $ 40.00 $ 30.00 $ 30.00 $ 35.00 Plan Ded/20% Coinsurance Outpatient Group Therapy $20/45 days max. $ 30.00 $ 30.00 $ 35.00 Plan Ded/20% Coinsurance Serious Mental Illness Inpatient 20% Plan Ded/Coinsurance 20% Plan Ded/Coinsurance Plan Ded/20% Coinsurance Outpatient Individual/Group Therapy $ 40.00 $ 50.00 $ 50.00 $15/$35 Plan DedI20% Coinsurance Substance Abuse Inpatient 20% Plan Ded/Coinsurance _ Plan Ded/Coinsurance 20% Plan Ded/20% Coinsurance Substance Abuse Individual/Group $ 40.00 Plan Ded/Coinsurance Plan Ded/Coinsurance $15/$35 Plan Ded/20% Coinsurance Diabetic Office Visit $20/$40 $20/$40 $20/$40 $20/$40 Plan Ded/20% Coinsurance Diabetic Equipment No Charge See Prescriptions See Precriptions See Precriptions See Prescriptions Diabetic Supplies See Prescription See Prescriptions See Precriptions See Precriptions See Prescriptions Durable Medical Equipment No Charge/Max Benefit $3500 Plan Ded/Coinsurance No Charge/Max Benefit $700 No Charge/Max Benefit $3500 20% Coinsurance/$700 max benefit External Prosthetic $200 Deductible/$1000 Max. $200 Deductible/$1000 Max. $200 Deductible/$1000 Max. $200 Deductible/$1000 Max. 20% Coinsurance/$1000 max benefit Annual Deductible -Individual None $ 1,000.00 $ 500.00 None $ 2,000.00 Annual Deductible -Family None $ 2,000.00 $ 1,000.00 None $ 4,000.00 Annual OOP -Individual $ 3,000.00 $ 3,000.00 $ 3,000.00 $ 2,500.00 $ 3,000.00 Annual OOP -Family $ 6,000.00 $ 6,000.00 $ 6,000.00 $ 5,000.00 $ 6,000.00 °recertification Handled by physician Handled by physician Handled by physician Handled by physician Handled by physician ,fetime Maximum Unlimited $ 5,000,000.00 $ 5,000,000.00 Unlimited Unlimited Pre-existing Condition Limitation No Yes, 1 year waiting w/no prior Yes, 1 year waiting w/no prior No Yes, 1 year waiting w/no prior coverage coverage MEMORANDUM TO: Mayor and Council Bill Eisen, City Manager FROM: Mary Hickling, Director of Human Resocesi Yesenia Garza, Benefits Coordinator ta. DATE: August 29, 2006 SUBJECT: Cigna's Proposal to Renew Medical Insurance Contract For the past two (2) years, we have been able to maintain our current premium rates; this year, Cigna has proposed a 29.88% increase. We negotiated with Cigna and they could only offer us a new rate of 26% with our current plan. We looked at plan options with City -County Benefits Service (C-CBS); a consortium of cities in the area that had also gone out for bid; and their proposal would result in an increase of 25% (SeeAttached). We went back to Cigna to negotiate further and Cigna proposed seven (7) plans from which to choose. After careful and diligent review we are recommending that we accept two (2) of Cigna's proposals and offer a dual option to our employees with only a 10% increase (See Exhibit ` A" to Resolution R2006-144). The plans that we will offer our employees are an Open Access Plus Plan and a Health Reimbursement Arrangement (HRA) Plan. The Open Access Plus Plan is very similar to the current plan with the exception that prescription co -payment is higher and there will be a $1000 individual and $2000 family deductible that the employee will need to meet. The HRA Plan is an employer -funded health reimbursement arrangement. The City would contribute $750 for individual coverage and $1500 for family coverage to go towards a $2000 individual and $4000 family deductible. After the deductible is met, Cigna's medical plan takes over and the employee will be responsible for a co-insurance payment of 20%, excluding prescription. For prescriptions, the employee will have a co-insurance of 30% for generic drugs, 40% preferred brand name drugs, and 50% for non -preferred brand names drugs with a cap of $75. If employees participate in this plan the City will save $40 per employee per month, and the City in return would give $20 back to the employee. 3519 LIBERTY DRIVE • PEARLAND, TEXAS 77581-5416 • 281-652-1600 • www.ci.pearland.tx.us r:i Printed on Recycled Paper Exhibit POS-OPEN ACCESS POS-OPEN ACCESS OPEN ACCESS PLUS OPEN ACCESS PLUS HMO HRA HRA HRA CURRENT RATES RENEWAL RATES $750/$1500 $1000/$2000 $1250/$2500 EE ONLY $ 324 39 $ 409.38 $ 356.83 $ 374.99 $ 379.54 $ 317.90 $ 322 35 $ 327 75 EE+ SPOUSE $ 681.19 $ 858.44 $ 749.31 $ 787.46 $ 796.99 $ 667.57 $ 676.92 $ 688 26 iE+CHILDREN $ 583.88 $ 735.80 $ 642 27 $ 674.97 $ 683.14 $ 572 20 $ 580 21 $ 589.94 EE+FAMILY $ 908.26 $ 1,144.59 $ 999.09 $ 1,049.95 $ 1,062.66 $ 890.99 $ 902.55 $ 917.68 PCP Office Visit $ 20 00 Same $ 20 00 $ 20 00 $ 20 00 Plan Ded/20% Coinsurance SAME HRA SAME HRA _ _ Specialist Visit $ 40.00 $ 40.00 $ 40.00 $ 40.00 Plan Ded/20% Coinsurance In -Patient Hospital 20% 20% 20% 20% Plan Ded/20% Coinsurance Out -Patient Facility 20% 20% 20% 20% Plan Ded/20% Coinsurance M RI, CAT SCAN $ 75.00 Plan Ded/Coinsurance Plan Ded/Coinsurance $ - Plan Ded/20% Coinsurance Lab & X-Ray Out Patient Facility 20% Plan Ded/Coinsurance Ded/Coinsurance Plan Coinsurance Plan Ded/20% Coinsurance Lab & X-Ray Independent Facility No Charge No Charge Plan Ded/Coinsurance Coinsurance Plan Ded/20% Coinsurance Therapy & Chiropractic $40/60 Chiro Visits $40/20 days max. $40/20 days max. $20/ 20 days 20% with max. Coinsurance/20 days max Prescription Drugs Generic $ 10.00 $ 15.00 $ 15.00 $ 15.00 30% Preferred _ Brand Name $ 20.00 $ 30.00 $ 30.00 $ 30.00 40% Non - -Preferred Brand Name $ 40.00 $ 50.00 $ 50.00 $ 50.00 50% Mail Order Generic $ 20 00 (2X) $ 30.00 $ 30.00 $ 30.00 30% Mail Order Preferred Brand Name $ 40.00 $ $ 60.00 $ 60.00 $ 60.00 40% Mail Order Non -Preferred Brand $ 80.00 $ 100.00 $ 100.00 $ 100.00 50% Emergency Room Visit $ 100.00 $ 100.00 $ 100.00 $ 100.00 Plan Ded/20% Coinsurance Urgent Care $ 50.00 $ 50.00 $ 50.00 $ 50.00 Plan Ded/20% Coinsurance Maternity Office Visit $20/$40 $20/$40 $20/$40 $20/$40 Plan Ded/20% Coinsurance Maternity Inpatient 20% Plan Ded/Coinsurance Plan Ded/Coinsurance 20% Plan Ded/20% Coinsurance In Services -Patient Other Facilities 20%/ 60 days max. 20%/60 days max. 20%/60 days max. 20% 60 days Max Plan w/ Ded/20% Coinsurance _ Home Health Services $ Deductible then 20% - Deductible then 20% $0.00 60 days Plan with max. Ded/20% Coinsurance Family Planning Services $20/$40 $20/$40 $20/$40 Plan Ded/20% Coinsurance _$20/$40 Planning Inpatient amily 20% Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/20% Coinsurance Family Planning Outpatient 20% Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/Coinsurance Plan Ded/20% Coinsurance Infertility Services Office Visit $20/$40 Excluded Excluded $20/$40 Excluded Infertility Treatment/Surgery 50% Excluded Excluded 20% Excluded Infertility Inpatient Facility 20% Excluded Excluded 20% Excluded Infertility Out -Patient Facility 20% Excluded . Excluded 20% Excluded _ Mental Health Inpatient $100 day/8 day Plan Ded/Coinsurance max Plan Ded/Coinsurance per $75 day/20 day max. Plan Ded/20% Coinsurance per Outpatient Individual Therapy $ 40.00 $ 30.00 $ 30.00 $ 35.00 Plan Ded/20% Coinsurance Outpatient Group Therapy $20/45 days $ max. 30.00 $ 30.00 $ 35.00 Plan Ded/20% Coinsurance Serious Mental Illness Inpatient 20% Plan Ded/Coinsurance 20% Plan Ded/Coinsurance Plan Ded/20% Coinsurance Outpatient Individual/Group Therapy $ 40.00 $ 50.00 $ 50.00 $15/$35 Plan Ded/20% Coinsurance Substance Abuse Inpatient 20% Plan Ded/Coinsurance Plan Ded/Coinsurance 20% Plan Ded/20% Coinsurance Substance Abuse Individual/Group $ 40.00 Plan Ded/Coinsurance Plan Ded/Coinsurance $15/$35 Plan Ded/20% Coinsurance Diabetic Office Visit $20/$40 $20/$40 $20/$40 $20/$40 Plan Ded/20% Coinsurance Diabetic Equipment No Charge See Prescriptions See Precriptions See Precriptions See Prescriptions Diabetic Supplies See Prescription See Prescriptions See Precriptions See Precriptions See Prescriptions Durable Medical Equipment No Charge/Max Benefit $3500 Plan Ded/Coinsurance No Charge/Max Benefit $700 No Charge/Max Benefit $3500 20% Coinsurance/$700 benefit max External Prosthetic $200 Deductible/$1000 Max. $200 Deductible/$1000 Max. $200 Deductible/$1000 Max. $200 Deductible/$1000 Max. 20% Coinsurance/$1000 benefit max Annual Deductible None $ -Individual 1,000.00 $ 500.00 None $ 2,000.00 Annual Deductible -Family None $ 2,000.00 $ 1,000.00 None $ 4,000.00 Annual OOP -Individual $ 3,000.00 $ 3,000.00 $ 3,000.00 $ 2,500.00 $ 3,000.00 Annual OOP -Family $ 6,000.00 $ 6,000.00 $ 6,000.00 $ 5,000.00 $ 6,000.00 °recertification Handled by Handled by physician Handled by Handled physician physician by Handled by physician physician 1fetime Maximum Unlimited $ 5,000,000.00 $ 5,000,000.00 Unlimited Unlimited Pre-existing Condition No Limitation Yes, 1 Yes, 1 year waiting w/no prior waiting w/no No Yes, 1 year prior year waiting w/no prior coverage coverage