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<br />2008 Employee Benefit Plan <br />Review and Recommendations <br />February 13,2008 <br /> <br />MEDICAL PLAN <br /> <br />OPTIONS PROPOSED <br /> <br />Brown & Brown is the City's insurance broker for both medical and dental insurance. In <br />preparation for this renewal, Brown & Brown requested medical renewal proposals from <br />the following insurers in addition to United Healthcare: <br /> <br />. Aetna <br />. A vMed <br />. Blue Cross Blue Shield Florida <br />. CIGNA <br />. Humana <br /> <br />A vMed and Blue Cross Blue Shield Florida did not provide proposals to Brown & Brown <br />within the requested timeframe. The proposals from CIGNA were higher priced than the <br />comparable United Healthcare plan. Aetna provided a proposal for both the HMO and <br />POS options, however, the cost savings for the HMO is about 6.8% compared to the <br />United Healthcare renewal proposal. It is understood from discussions with City staff <br />that Aetna was the previous City's insurer prior to United Healthcare and the City <br />experienced service problems, particularly regarding prescription and claim issues. <br /> <br />The H umana proposal is competitively priced with a cost savings of about 16.6% <br />compared to the United Healthcare renewal proposal, however, it includes the following <br />benefit reductions: <br /> <br />. Prescription plan differences - The proposed Humana prescnptlon plan <br />includes a fourth tier which applies to injectable specialty drugs. The plan <br />member is responsible for 25% of the cost, with no maximum, for these <br />specialty drugs. Under the current and proposed United Healthcare plan, <br />these drugs are covered with a $40 copayment. Some examples of the drugs <br />which would be subject to the increased copayment are growth hormones, <br />treatment for hemophilia and some chemotherapy drugs. <br /> <br />In a typical year, this increased cost to members will affect only a few <br />employee families, however, the affect could be significantly costly. For <br />example, we recently saw an example of a growth hormone drug which was <br />about $16,848 per month. In this example, the City employee would be <br />responsible for over $4,212 per month. <br /> <br />· Lifetime maximum - The proposed Humana HMO plan includes a lifetime <br />maximum of $5,000,000. The current United Healthcare HMO plan does not <br />have a lifetime maximum, the benefits are unlimited, While we would not <br />expect this benefit difference to have a significant effeet on any employees, it <br /> <br />Page 3 <br />