HomeMy WebLinkAboutHealth Benefits Recommendations - 1 -
Memorandum
To: Deschutes County Board of Commissioners
From: Ronda Connor, Benefits Coordinator
Date: June 29, 2009
Subject: 09/10 Health Benefits Renewal
Each year, in advance of the plan renewal the health benefits Renewal Committee and
EBAC meet to analyze our current benefit structure, state and federal requirements,
analyze benefits trends, and requests from employees.
Our health plan insures approximately 2,500 people. We provide a comprehensive
benefit package of Medical, Dental, Vision, Prescription and Alternative Care coverage.
Employees pay $35 per month to insure themselves and their family members. The
departments currently pay $1,201.01 per employee per month. Next year departments
will pay $1,028.41 per employee per month.
Below is a listing of the items that were reviewed by the Renewal committee and EBAC.
Adding coverage for nitrous oxide during dental procedures
Recommended by Renewal and EBAC
This is a current exclusion. Parents have requested this for their children who are overly
anxious about seeking treatment from their dentist.
Estimated Cost: This treatment ranges from about $40-$60 per treatment and is used
sparingly. This would apply to the $2,000 maximum on the dental benefit.
Add Tobacco Cessation benefit
Recommended by Renewal and EBAC
Currently we have a limited prescription benefit for tobacco cessation, but no coverage
for office visits, counseling or over the counter (OTC) medications. This benefit
includes counseling, OTC and prescription medications to assist the person in quitting
tobacco. Through a survey, it was determined that we have approximately 350 tobacco
users on our health plan. Both the renewal committee and EBAC recommend the
addition of this benefit.
Estimated Cost: Year one fixed cost is $6,250 to pre-pay the first ten participants.
Each participant thereafter would cost $375.
Increase allowance for Alternative Care, Massage Therapy and add coverage for
herbal supplements
Not recommended by Renewal and EBAC
Our Alternative Care benefit allows for $1,500 per person per year spent on the
enrollee’s behalf when treating with either a Chiropractor, Massage Therapist,
Acupuncturist, or Naturopath. Numerous requests were received from employees to
increase this amount as well as the $45 allowance to treat with a massage therapist.
Employees also requested the inclusion of recommended herbal supplements to be
allowed in this annual allotment of dollars.
- 2 -
Add infertility diagnosis and treatment
Not recommended by Renewal and EBAC
We currently have a specific exclusion for the diagnosis and treatment of infertility.
While some states do mandate this as a covered benefit, it is not currently mandated in
Oregon.
Match IRS guidelines for dependent enrollment
Not recommended by Renewal and EBAC
Currently our, health plan is more generous in terms of not requiring the child be a full
time student. Should the dependent not meet the terms of an IRS qualifying child, and
the parent wish to retain the dependent on the health plan, the employee would be taxed
on the value of the benefit.
Cover colonoscopies and EBTs at 100%
Recommended by Renewal and EBAC
Currently the colonoscopy and EBT benefit is 80/20 no deductible applies.
Estimated Cost: Had this recommended benefit structure been in place for the current
plan year, the plan would have incurred an additional $60,000 in expenses.
Cover LEEP and colposcopies at 100% as preventive care
Not recommended by Renewal and EBAC
Our benefit for these procedures is 80/20 after the deductible is met. These are not
preventive procedures, but generally done after an abnormal pap smear.
Items to be reviewed by the renewal committee on 07/10/09
• Bariatric surgery
• Dental charge structure
• Foot orthotics