Department
Finance
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval of 2023 premium rates for the Medical and Pharmacy, Dental and Vision Plans effective January 1, 2023.
body
Requirement for Board Action (Cite specific Board policy, statute or code requirement)
In accordance with Board Policy, benefit plan premiums are approved prior to the beginning of each plan year
Strategic Priority Area related to this item (If yes, note strategic priority area below)
Open and Responsible Government
Commission Districts Affected
All Districts ☒
District 1 ☐
District 2 ☐
District 3 ☐
District 4 ☐
District 5 ☐
District 6 ☐
Is this a purchasing item?
No
Summary & Background (First sentence includes Agency recommendation. Provide an executive summary of the action that gives an overview of the relevant details for the item.)
Scope of Work: Fulton County currently provides a combination of self-funded and fully-insured Medical & Pharmacy (Rx), Dental and Vision programs to approximately 4,700 employees, 3,400 retirees/beneficiaries, and their eligible dependents. Under a fully-insured funding arrangement, the insurance carrier pays claims from its own funds and sets premium rates to support expected claim payments. While under the self-funded arrangement, the carrier administers the plan, but claims are funded by the County. The Finance Department worked with Segal Consulting to complete the 2023 health plan renewals and premium rate projections. The 2023 funding projection and premium rates assumes no changes in benefit plan design or cost share for active employees and retirees/beneficiaries.
2023 SELF-FUNDED RATE CHANGES
The funding rates for the self-funded plans require calculation using historical claims and enrollment data, to which actuarially sound methodologies and assumptions are applied, and costs and credits associated with administration of the plan are incorporated. Segal, our benefits consultant performed this exercise for 2023 on behalf of the County. Below are the proposed funding (premium) rate changes for 2022. These rates are set to support the expected costs generated by members enrolled in the plans.
2023 FULLY-INSURED RATE CHANGES
Fully insured plans account for approximately 36% of the total medical and pharmacy costs. Our benefit consultants from Segal, met with each vendor and successfully negotiated lower renewal premium rates for the 2023 plan year. A summary of negotiation outcomes is listed below.
2023 VS 2022 PROJECTED HEALTH PLAN COST COMPARISON
2023 Projected Health Plan Cost
The expected total cost for all health plan offerings (Medical, Rx, Dental, and Vision) for 2023 is $112.3 million as shown below. This incorporates all renewal rate changes outlined above.
2022 Projected Health Plan Cost
Community Impact: None
Project Implications: None
Community Issues/Concerns: None
Department Recommendation: The Finance Department request approval of 2023 health premium rates and funding as presented and summarized below for fully insured and self-insured plans:
Anthem (BCBS):
• 4.0% increase to Active and Pre-65 Retiree rates (HSA, POS, and HMO plans)
• 4.0% increase to Post-65 Retiree rates (Medicare HMO, Indemnity PPO, and PPO Plus plans)
Kaiser:
• 5.4% increase to HMO Active and Pre-65 Retiree rates
• No change to Post-65 Senior Advantage Medicare rates
Aetna:
• No change to the Dental HMO rates
• 4.9% increase for the Dental PPO rates
• 3.7% increase to the Basic Medicare Advantage Plan rates
• 4.7% increase to the Enhanced (Buy-Up) Medicare Advantage Plan rates
EyeMed:
• No change to the Vision PPO rates
These changes were carefully considered, weighing the financial impact to the plan as well as the financial and logistical impact to the member. Approval is needed to begin open enrollment planning including Employee Self-Service (ESS) enrollment system modifications and communications for the upcoming enrollment period scheduled from September 26th through October 14th for active employees, and October 3rd through October 21st for retirees. Employee and retiree information meetings will be held virtually, starting the week of September 26th.
Department Issues/Concerns: None
History of BOC Agenda Item: Has this item previously been before the BOC? Yes.
Contract & Compliance Information (Provide Contractor and Subcontractor details.)
Click or tap here to enter text.
Exhibits Attached (Provide copies of originals, number exhibits consecutively, and label all exhibits in the upper right corner.)
Attachment I: 2023 Proposed Medical Premium Rates
Attachment II: 2023 Proposed Dental Premium Rates
Attachment III: 2023 Proposed Vision Premium Rates
Attachment IV: 2022 vs 2023 Medical Premium Rates Comparison
Attachment V: 2022 vs 2023 Dental Premium Rates Comparison
Attachment VI: 2022 vs 2023 Vision Premium Rates Comparison
Attachment VII: 2023 Medical & Rx Plan Designs Comparison
Contact Information (Type Name, Title, Agency and Phone)
title
Ray Turner, Deputy Finance Director (404) 612-7737
Melissa Barnett, Benefits Manager (404) 612-4243
Fiscal Impact / Funding Source
Funding Line 1:
426-999-P003-1560: Group Insurance Stabilization, General Fund, Administrative