Approve Renewal of Stop Loss Coverage with National Benefit Resources, NBR, for the 2007 FPB Employee Health Plan:
Staff is recommending that FPB renew Stop Loss coverage with NBR beginning January 1st, 2007. The proposal from NBR reflects an increase of approximately 6% in combined Specific and Aggregate premiums.
The following comparison is based on coverage for 60 Single and 155 Families
|
|
2006
|
|
2007
|
| Coverage |
|
Medical & RX |
|
Medical & RX |
| Specific Deductible |
|
$60,000 |
|
$60,000 |
| Single Premium |
|
$ 34.98 |
|
$ 36.88 |
| Family Premium |
|
$ 89.04 |
|
$ 93.87 |
| Aggregate Premium Rate |
|
$ 2.99 |
|
$ 3.44 |
|
|
|
|
|
| Annual Expected Claims |
|
$1,422,736 |
|
$1,307,500 |
| Attachment Point (125% of Claims |
|
$1,778,420 |
|
$1,634,375 |
|
|
|
|
|
| ANNUAL SPECIFIC PREMIUM |
|
$190,800 |
|
$201,152 |
| ANNUAL AGGREGATE PREMIUM |
|
$ 7,714 |
|
$ 8,875 |
| TOTAL ANNUAL PREMIUM |
|
$198,514 |
|
$210,027 |
In 2007, NBR will expand their network of treatment providers and facilities to include kidney dialysis and certain cancer treatments (last year it was for transplants only). Participation in the United Resource Network (URN) is optional to members; but the renewal is contingent upon FPB agreeing to make it available to them. In the event that a covered person would take advantage of the URN program, their specific deductible would be stepped down by 15% (last year it was 25%, but the program only covered transplants).
Claims for the FPB Employee Health Plan for January through September 2006 have decreased by approximately $180,000 compared to the same period for 2005. The most significant decreases have been in hospital and lab/X-ray claims.
CLAIMS AND FIXED COSTS JANUARY THROUGH SEPTEMBER:
|
|
2005
|
|
2006
|
| Claims |
|
$1,009,858 |
|
$ 841,892 |
| Fixed Costs |
|
$ 232,774 |
|
$ 220,109 |
| TOTAL |
|
$1,242,633 |
|
$1,062,000 |
| Plan Cost Per Member |
|
$ 5,700 |
|
$ 4,928 |
The above totals do not include Life and LTD premiums.
The rates for Life, Long Term Disability, and Third Party Administration will not change due to guarantees obtained during the RFP process in 2004. The Prescription Benefits Management vendor will renew in July.
