Web & Social Media Analytics Previous Year Question Paper.pdf
Health plan update 7 26-10
1. City of Dania Beach Self-Funded Group Health Plan Update July 2010
2. Current Health Plan Enrollment Summary June 2010 Active Employees Retirees Under 65 Retirees Over 65 COBRA Adult Dependents Total Employee Only 45 13 14 0 2 74 Employee + Family 99 28 13 0 0 140 Total 144 41 27 0 2 214 Percentage of Enrollees 67.29% 19.16% 12.62% 0.00% 0.93% 100%
6. Health Plan Components October 2008 through September 2009 % of Total October 2009 through June 2010 % of Total Revenue $2,068,648 $1,863,396 Gross Medical Claims $1,451,317 $1,187,683 Rx Claims $557,161 24.09% $449,116 23.94% Capitation $7,329 0.32% $5,499 0.29% ASO Fee $126,386 5.46% $82,997 4.42% Reinsurance Premium $297,877 12.88% $273,360 14.57% Expected Reinsurance Reimbursements $126,933 $122,514 Net Medical Claims $1,324,384 57.25% 1,065,169 56.77% Total Claims & Fees $2,313,136 100% $1,876,141 100%
7. Employee Contribution Comparison Dependent health premium does not include employee amounts. Dania Beach General Employees Dania Beach Firefighters Miramar General Employees HMO Miramar General Employees POS Employee Health Premium $463.15 $463.15 $379.97 $704.46 Contribution % 0% 0% 0% 0% Dependent Health Premium $764.21 $764.21 $765.15 $1,206.96 Contribution % 5% 2% 50% 50% Aventura POS Fort Lauderdale General Employees POS Lauderhill General Employees HMO Lauderhill General Employees POS Employee Health Premium $588.96 $825.93 $447.68 $585.39 Contribution % 0% 23% 0% 24% Dependent Health Premium $1,076.59 $1,093.86 $670.94 $948.33 Contribution % 50% 32% 31% 51%
8. Market Benefit Comparison - Pharmacy City of Dania Beach AvMed City of Fort Lauderdale AvMed City of Miramar Humana City of Lauderhill Humana City of Aventura United Retail Prescriptions (30 days) Tier 1, Generic $5 $10 $5 $10 $7 Tier 2, Preferred Brand $10 $20 $10 $25 $20 Tier 3, Non-Preferred Brand $25 $35 $25 $40 $50 Mail Order Prescriptions (90 days) $10/$20/$50 $20/$40/$70 $10/ $15 /$50 $20/$50/$80 $17.50/$50/$125 Red indicates a lesser benefit. Blue indicates an improved benefit.
9. Market Benefit Comparison – POS In Network Hospital Services CYD = Calendar Year Deductible. Red indicates a lesser benefit. Blue indicates an improved benefit. City of Dania Beach AvMed City of Fort Lauderdale AvMed City of Miramar Humana City of Aventura United City of Lauderhill Humana Calendar Year Deductible (CYD) $150 per person, $300 family None $250 per person, $500 family None $150 per person, $300 family Hospital - Inpatient CYD only $100 per day 1st 3 days + 10% CYD only $250 per admission CYD + 20% Hospital - Outpatient CYD only $150 CYD only No charge CYD + 20% Outpatient Advanced Diagnostic Testing (MRI/CT Scans, etc.) No charge 10% CYD only No charge No charge
10. South Florida Health Plan Trend Factors AvMed Aetna Blue Cross Blue Shield CIGNA Humana United HMO 10.5% 13.5% 17.7% 12.0% 11.2% 12.5% POS 14.8% PPO 15.2% Rx 8% - 11.2%