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2008 Employee Benefit Plan Review and Recommendations February 13,2008 We have reviewed the contributions paid by many Florida municipalities and, in our opinion, the City/Employee sharing of the medical premiums is consistent with the average Florida municipality. However, we caution that over the next year, we will not be surprised if budget constraints, particularly for Florida governments which are dependent upon ad valorem taxes, force changes for many. Addition o/Neighborhood Health Plan GTJfion We are recommending that the City allow an additional option through Neighborhood Health Plan to be offered to employees. The monthly premiums for this plan are: Employee Employee + Spouse Employee + Children Family $305.56 $678.35 $571.41 $892.26 These premiums, particularly for employees with dependents, are a significant reduction. However, the premium reduction is associated with comparable changes in benefits. Some of the more significant benefit reductions include: . Increased copayments for physician visits; . $500 per member, $1,000 per family deductible applying to many services; . Increased prescription copayments and the addition of a fourth prescription tier for injectible type drugs covered at only 80%; . Specific limitations on many benefits, such as chiropractic, dermatology, substance abuse, mental health, and durable medical equipment; · Deductible plus $100 copayment applying to many diagnostic tests such as MRIs and CAT scans; and · Increased pre-authorization requirements for many services. Due to the significant benefit reductions, we strongly recommend that in-person enrollment meetings with Neighborhood Health Care representatives be scheduled to clearly explain the changes to employees for their review prior to enrollment changes. Page 7