The URL can be used to link to this page

Home My WebLink About09/18/2015BAKERSFIELD Staff: Steven Teglia Assistant City Manager l. ROLL CALL Committee Members: Councilmember, Ken Weir - CI Councilmember, Terry Maxwe Vice Mayor, Harold Hanson SPECIAL MEETING NOTICE PERSONNEL COMMITTEE of the City Council - City of Bakersfield September 9, 2015 12:00 p.m. City Hall North - Conference Room A 1600 Truxtun Avenue, First Floor Bakersfield, California 93301 AGENDA 2. ADOPT AUGUST 18, 2015 AGENDA SUMMARY REPORT 3. PUBLIC STATEMENTS 4. DEFERRED BUSINESS A. Continued Discussion and Recommendation regarding 2016 HE Care Plan renewals - Teglia 5. COMMITTEE COMMENTS 6. ADJOURNMENT /�-/ ste�ve� Te��;a� Staff: Steven Teglia Assistant City Manager � BAKERSFIELD Committee Member Councilmember, Ker Councilmember, Ter� Vice Mayor, Harold F SPECIAL MEETING OF THE PERSONNEL COMMITTEE Wednesday, August 18, 2015 12:00 p.m. City Hall North - Conference Room A 1600 Truxtun Avenue Bakersfield, CA 93301 AGENDA SUMMARY REPORT Meeting called to order at 12:00 p.m. 1. ROLL CALL Committee members: Councilmember, Ken Weir, Chair Councilmember, Terry Maxwell Vice Mayor, Harold Hanson City staff: Alan Tandy, City Manager Steven Teglia, Assistant City Manager Chris Huot, Assistant City Manager Chris Gerry, Administrative Analyst III - City Manag Caleb Blaschke, Management Asst. - City Manag Nelson Smith, Finance Director Virginia Gennaro, City Attorney Christi Tenter, Human Resources Manager Mari Blowers, Benefits Technician Retired employees and BCARE: Florn Core, Fred Baugher and Margaret Ursin 2. ADOPTION OF OCTOBER 1, 2014 AGENDA SUMMARY REPORT The Report was adopted as submitted. 3. PUBLIC STATEMENTS There were no public statements. 4. NEW BUSINESS A. Discussion reaardinq 2016 Health Care Plan Renewals Assistant City Manager Teglia reported that the Segal Company has with the various plan providers to obtain an understanding of the ratE plan year, which begins in January. Segal representatives and staff Insurance Committee earlier this same day to present the same infc turned the meeting over to Tom Morrison and John Lu with the Segal present their report by way of a handout and PowerPoint. Mr. Morrison reported that the proposed rate increases for the AnthE PPO (21�) and HMO (9�0) plans for active employees are significantl has been seen before as a result of higher than normal usage of including high-cost specialty medications, and less than necessa premiums to cover those costs. It should be noted that some of medications did not exist before, but are making significantly more difference than what had previously been prescribed. He added th health condition of the participants in the PPO plan is declining wh against the Anthem Blue Cross book of business. To address this, inf provided about a possible wellness initiative, or a disease managerr that could potentially improve that. The proposed rate changes for active employees for the remaining as follows: • Kaiser HMO - 3.6�o increase; • Kaiser High Deductible Plan - 3.6� increase; • MetLife Dental - 2.7�o increase; • PUD Dental - 4.O�o increase (Imperial 1000) and 4.1 �o (Napa 80� • MES Vision - No change. The cumulative total for all proposed rate increases for active emplo� The proposed rate changes for retirees are as follows: • Anthem PPO - 14�o increase; • Anthem Secure Horizon - 16.7� increase; • Kaiser HMO - 15�o increase; The cumulative total for all proposed increases for retirees is 13.4�, w double what has been seen in all previous years, according to Mr. Mc Efforts to reduce the proposed rate increases might include a low� and/or higher co-payments for office visits and/or medications. ThE option of adding a formulary in the drug plan that excludes some dr there is a competing brand, identical value and property, which cc rate increase from 9�o to b.l b�o, and still provide brand and generic a Committee member Maxwell asked about the formulary, specificall� the decision on what drugs are available and are not. Mr. Morrison said that the decision is made by a panel from management company that Anthem Blue Cross subcontracts with, E: Mr. Morrison stated that because of the Affordable Care Act (ACA), only be reduced so far before a plan becomes invalid and the emplc to penalties for not offering a qualifying medical plan. The ACA als� increase or cost sharing for certain preventative services and medic City staff is always looking for ideas to offset healthcare premium in must be mindful of these federal law provisions. An analysis was performed that compared benefit modifications to c strategy that revises the current City/Employee 80/20 premium pay one that is 75/25 for the purpose of lowering the proposed rate incre< Based on this information and the alternatives, it is believed that botr the employees would achieve a greater benefit if the cost rati realigned. It would save the City money and not strongly impa< because it is deducted from the paycheck on a pre-tax basis. H alternatives will be considered and discussed by the Insurance a Committees. The Segal Company will be recommending to City Insurance and Personnel Committees to consider the modification to costs. The Segal Company released a Request for Information (RFI) for tr investigating the current insurance market, and responses are comi submittals have been received from United Healthcare, Blue Shiel< Once all of the information has been compiled, another mee� Insurance and Personnel Committees will take place. Committee member Maxwell asked what the reason might be employees' contribution by the figure of 5%. Mr. Morrison replied � Mr. Morrison reported that the City's contribution towards retiree hec is based on the individual formulas for each retiree. For those enrollE plan, the City contributes 42� of the cost of that plan. He r� Committee that increases in retiree healthcare costs translate into c the OPEB liability. Mr. Morrison provided an overview of the remainder of the report tr presented. He did emphasize a graph that reflected the benefits pa Blue Cross PPO versus the amounts of the premiums that had beer substantiated the data used by the provider to determine the p �r�t.Tt�•:�� Assistant City Manager Teglia reported that the meeting with t Committee earlier in the day went well. There was good dialog, a informed of all of the information and options. The Committee ir increases in out-of-pocket costs and reductions in benefits can be m than an increase in premiums. The proposed revision to the cost sK year, and it will be necessary to modify the Memoranda of Understar different labor groups through the labor negotiation process, should Committee reach approval. The Committee members requestE information, which will be provided at their next meeting on Septemk Committee member Hanson said that he is concerned about City en earn the lower wages. Mr. Morrison said that the majority of these individuals are already E Kaiser plan, which is the lowest cost plan with the lowest proposed ra Committee member Maxwell noted that the City can only do so r� only way to make this work is if the employees are willing to increasE they contribute. Mr. Morrison said that it is his belief that the City of Bakersfield has on cooperative labor group/management relationships that he has public entity. Assistant City Manager Teglia added that the Segal Company has p role in the success of the process as they communicate well with c provide full disclosure. It is they who developed the option of chan split option. Committee member Maxwell said that the City cannot absorb � increase in our payments for that insurance, and that fact was conf Assistant City Manager Teglia said that the Segal Company will ana from the responses to the RFI, after which it will be presented to 1 Committee, along with the information the Committee members h� from City staff. When there is a consensus, City staff and the Segal � return to the Personnel Committee for continued discussion. City Manager Tandy indicated that it is unlikely that any plans providers in response to the RFI will be identical to those currently in � City. Mr. Morrison agreed that it is probable that there will be differer City Manager Tandy added that employees are sensitive to the issu will be considerable study and discussion before the item returns to Committee with a recommendation from the Insurance Committee. Committee Chair Weir asked if the analysis would be ready by Septe and Mr. Morrison indicated that it would. 3. COMMITTEE COMMENTS None 4. ADJOURNMENT The meeting was adjourned at 12:44 p.m. The following presentation was distributed at the Special Meeting of the Personnel Committee on Tuesday, September 18, 2015 City of Bakersfield Presentation to the Personnel Committee Tom Morrison September 18, 2015 Executive Summa rY > Companies that received the Request for Information (RFI) • Aetna • Anthem • Blue Shield • United Healthcare (UHC) • HealthNet >Anthem, Blue Shield, and UHC responded by the deadline > HealthNet declined due to its assessment that its rates would no� financially competitive > Aetna submitted its responses late and its proposal is not financi competitive compared to the other vendors Executive Summa rY >Blue Shield and UHC submitted proposals with rates lower Anthem renewal • Anthem did not revise its proposed rates from the renewal. The overal approximately 17.8% for active employees and 14.1 % for retirees • Blue Shield's proposed rates are 5.1 % higher than current rates for ac employees and 7.0% higher than current for retirees • UHC proposed rates that are 2.2% higher for active employees (-3.9°/ alternative narrow HMO network proposal) and a decrease of 14.7% c current rates for retirees >Blue Shield proposed a narrow and a full network HMO to side by side • The full network has both Bakersfield Family Medical Center and Inde IPA which are in Anthem's network and adds GEMCare IPA which is r Anthem network • It excludes California Desert Medical Group and Hispanic Physician IF �nihir_h arP r_i irrPntiv in AnthPm'� nPt�ninrk Executive Summa rY >Blue Shield PPO • The Hospital network in Kern County matches exactly to Anthem's ne1 Bakersfield Heart Hospital is not in the Blue Shield PPO Network • The proposal matches the current benefits to the largest extent > UHC proposed a full network HMO or a narrow network H� • Full and narrow network physician group has only one match which is Family Medical Center. Many members would have to be assigned to groups or select PPO plan • The full network also has GEMCare IPA • Hospital network has several hospitals excluded that are in the curren — Full network does not have Good Samaritan and Kern Medical Cent — Narrow network has only Dignity Hospitals and no other Kern Count • Proposed benefits differ significantly from the current plan, for exampl� — Proposed out-of-pocket maximum is $2,500/$5,000 compared to cui $3, 000/$6, 000 Executive Summa rY >UHC PPO • Hospital network does not have Kern Medical Center or Ridgec • Proposed benefits are an improvement to the current in many • Proposed a Medicare plan for Medicare eligible retirees — Benefit reduction to the current design where you will have to visit copays after you reach Part B deductible > Second-Year Rate Cap • Segal requested a second year rate cap to prevent vendors fro bidding in the first year • Blue Shield proposed 2nd year rate cap at 7.5% for the narrow � HMO, 9.9% for the full network HMO, and 9.9% for both active PPO • UHC was only willing to propose a 9.9% 2nd year rate cap for a Executive Summa rY >Segal presented RFI results to the Insurance Committee o September 1, 2015 >The Insurance Committee has reviewed the results and un recommended awarding the contract to Blue Shield for the reasons: • Network strength, • benefit design comparability, • and rate stability for both active and retiree >With the addition of GEMCare network in the HMO networl members who switched to PPO when GEMCare dropped c Anthem network may switch to the Narrow Network HMO � considerable City and Employee savings and higher benef > Segal's recommendation is consistent with the I nsurance Append ix Act i ve H M O Rates Blue Shield � Blue Shield' Uni1 Enrollment Current Rates Anthem �Full Network) (Narrow Health Network) (Full Ne Sin le 66 $ 479.35 $ 522.48 $ 527.03 $ 441.83 $ Proposed Rates Two-Party 51 963.41 1,050.11 1,059.24 887.99 Famil 149 1,408.42 1,535.19 1,548.52 1,298.17 1, Percent Change from g 0% 9.9% -7.8% 0.0 Current nd Year Rate Cap None 9.9°/o 7.5% 9.9 ' Blue Shield requires offering both full and narrow network HMOs to the employees. Active P PO Rates roposed Rates rcent Change from rrent Year Rate Cap Enrollment I Current Rates Single 155 Two-Party 138 Familv 387 506.78 1,015.30 1.525.64 Anthem 613.19 1,228.52 1,846.02 21.0% None Blue Shield Un Heali 554.19 $ 1,110.28 1,668.37 9.4% 3. 9.9% 9. Reti ree P PO Rates United U Enrollment Current Rates Anthem Blue Shield Healthcare � (Non-Medicare) Single 266 $ 935.86 $ 1,067.17 $ 1,006.76 $ 1,005.85 : Proposed Rates Two-Party 144 1,871.60 2,134.19 2,013.39 2,011.70 Famil 10 2,807.42 3,201.28 3,020.11 3,027.61 Percent Change from 14.0% 7.6% 7.5% Current nd Year Rate Cap None 9.9% None ' United HealthCare proposed rates split between the Medicare and Non-Medicare. Medicare Advanta e HMO Rates g roposed Rates ercent Change from urrent Enrollment Current Rates nrollee 15 $ 598.68 $ Anthem . • : . �a 16.7% Blue Shield Unit Health 419.38 $ -30.6% -9.3 HMO Ph sician Groups y HMO Physician Groups BAKERSFIELD FAMILY MEDICAL CENTER LIFORNIA DESERT MEDICAL GROUP HISPANIC PHYSICIAN IPA KERN INDEPENDENCE MEDICAL GROUP COASTAL COMMUNITIES PHYSICIAN NETWORK GEMCARE MEDICAL GROUP DELANO GEMCARE MEDICAL GROUP OF KERN COUNTY HEMET COMMUNITY MEDICAL GROUP HERITAGE PHYSICIAN NETWORK HERITAGE VICTOR VALLEY MEDICAL GROUP HIGH DESERT MEDICAL GROUP Anthem Blue Cross (Full Network) X � X X Blue Shield =ull NetworE X X 1� � Blue Shield United HealthCai Narrow Network) (Full Network) � e X X X X X X X X H MO Hospital Network MO Hospitals AKERSFIELD HEART HOSPITAL AKERSFIELD MEMORIAL HOSPITAL IERCY HOSPITAL OF BAKERSFIELD AN JOAQUIN COMMUNITY HOSPITAL ELANO REGIONAL MEDICAL CENTER �OOD SAMARITAN HOSPITAL ERN MEDICAL CENTER ERN VALLEY HEALTHCARE DISTRICT IDGECREST REGIONAL HOSPITAL EHACHAPI HOSPITAL EALTHSOUTH BAKERSFIELD REHAB OSPITAL Anthem Blue Cross (Full Network) X x X X X X X X X X Blue Shield =ull Network i � i � i � i � i � i � i � i � i � i ■ Blue Shield irrow Netwc Q ■ United HealthCare (Full Network) X x X X X � � PPO Hospital Network PO Hospitals AKERSFIELD HEART HOSPITAL AKERSFIELD MEMORIAL HOSPITAL IERCY HOSPITAL OF BAKERSFIELD AN JOAQUIN COMMUNITY HOSPITAL ELANO REGIONAL MEDICAL CENTER �OOD SAMARITAN HOSPITAL ERN MEDICAL CENTER ERN VALLEY HEALTHCARE DISTRICT IDGECREST REGIONAL HOSPITAL EHACHAPI HOSPITAL EALTHSOUTH BAKERSFIELD REHAB OSPITAL ENTRE FOR NEURO SKILLS nthem Blue Cross X X X X X X X X X X Blue Shield X X X X X X X X X X X United HealthCar X X X X X X X X Blue Shield HMO Benefit Deviations ACTIVES ONLY Deductible Single Family Annual Out-of-Pocket Maximum Single Family Hospital Inpatient Outpatient Primary Care Visits Specialty Care Visits Diagnotic X-Ray and Lab Preventive Care Ambulance Durable Medical Equipment Chiropractic services (60 day max) Emergency Room Prescription Drugs Retail (30-day supply) Generic Brand (Formulary) Brand (Non-Formulary) List any benefit deviations from current plan design Current HMO Proposed Plan $0 $0 $3,000 $6,000 $250/day, up to 3 day max $125/admit $20 $40 $0 $o $100 trip 50% $20 $150 deductible (waived if admitted) $10 $25 $45 20°/a up to $150 $0 $0 $3,000 $6,000 $250/day, up to 3 day max $125/admit $20 $40 $0 $o $100 trip 50% $15 / 60 visits $150 deductible (waived if admitted) $10 $25 $45 N/A Mail Order (90-day supply) C�anarir �1 fl �1 fl Access + Specialist This is the highest amoun can offer at this time. Only Mail order Specialty dr Blue Shield Active PPO Benefit Deviations uctible Single Family ual Out-of-Pocket Maximum Single Family Inpatient Outpatient rimary Care Visits pecialty Care Visits iagnotic X-Ray and Lab reventive Care mbulance urable Medical Equipment nergency Room �escription Drugs etail (30-day supply) Generic Brand (Formulary) Brand (Non-Formulary) Specialty ail Order (90-day supply) List any benefit deviations from current plan de; P In network Out of Network In network Out of Network In network $750 $1,000 $750 $1,000 $2,250 $3,000 $2,250 $3,000 $2,000 $10,000 $6,000 $20,000 Hospital Inpatient ded: $250 Non-participating hospital penalty: $500 Non-certification penalty: 25%+$250/admit Ambulatory surgical center ded: $500 for non- participating provider 10°/a 10°/a 10% 10% 10% $0 10% 10% $100 ded+10% ($100 ded waived if admitted) $10 $20 $20 $20 50% 50% 50% 50% 50% 50% 10% 50% $100 ded+10% ($100 ded waived if admitted) Must Submit Paper Form. Expense varies based on the cost of the medication $2,000 $7,000 $6,000 $21,000 Hospital Inpatient ded: $250 - BSC does not call it a deductible, but a Non-participating hospital penalty: $500 - The Blue Cross/Blue Shield Ass from sanctioning a member for no prior authoriz; Non-certification penalty: 25%+$250/admit - The Blue Cross/Blue Shield A: from sanctioning a member for no prior authoriz, Ambulatory surgical center ded: $500 for non-participating provider - BS� facility Copayment + coinsurance. BSC OON maximum appli $250 per admission + 10% 10% 10% 10% 10% No Charge 10°/a 10% $100 per visit + 10% (waived if admitted) $10 $20 $20 N/A 50°/o - see above 50% - see above 50% 50% 50% 50% - Follows the plan coinsurance OON. 10% 50% $100 per visit + 10% (waived if admitted) Must Submit Paper Form. Expense varies based on the cost of the medication Blue Shield Retiree PPO Benefit Deviations RETIREES me Maximum Single Family nual Out-of-Pocket Maximum Single Family Inpatient Outpatient iary Care Visits :ialty Care Visits nostic X-Ray and Lab entive Care List any benefit deviations from current plan des $5,000,000 None - Per PPACA mandate In network Out of Network In network Out of Network $750 $1,000 $750 $1,000 $2,250 $3,000 $2,250 $3,000 $2,000 $10,000 $6,000 $20,000 Hospital Inpatient ded: $250 Non-participating hospital penalty: $500 Non-certification penalty: 25%+$250/admit Ambulatory surgical center ded: $500 for non- participating provider 10% 10% 10°/a 10% 10% (ded waived) 50% 50% 50% 50% 50% (ded waived) In network $2,000 $7,000 Both INN and OON ( $6,000 $21,000 same = 2x's or 3 Hospital Inpatient ded: $250 - BSC does not call it a deductible, but a c Non-participating hospital penalty: $500 - The Blue Cross/Blue Shield Assc from sanctioning a member for no prior authoriza Non-certification penalty: 25%+$250/admit - The Blue Cross/Blue Shield i plan from sanctioning a member for no prior authori Ambulatory surgical center ded: $500 for non-participating provider - BSC facility Copayment + coinsurance. BSC OON maximum applie $250 per admission + 50% - see above 10% 10% 50% - see above No Charge (ded waived) 50% - Follows the plan Must comply v� coinsurance OON. ulance 10% 10% 10% 10% ble Medical Equipment 10°/o 50% 10°/o 50°/o >practic services 10% 50% 10% 50% �gency Room $100 ded+10% ($100 ded $100 ded+10% ($100 ded $100 per visit + 10% $100 per visit + 10% waived if admitted) waived if admitted) (waived if admitted) (waived if admitted) �scription Drugs tail (30-day supply) Generic Brand (Formulary) Brand (Non-Formulary) Specialty il Order (90-day supply) GPnPrir. $10 $20 $20 $20 �20 Must Submit Paper Form. Expense varies based on the cost of the medication $10 $20 Must Submit Paper Form. $20 Expense varies based on the cost of the medication N/A $20 U n ited HealthCare H MO Benefit Deviations Deductible Single Family Annual Out-of-Pocket Maximum Single Family Hospital Inpatient Outpatient Primary Care Visits Specialty Care Visits Diagnotic X-Ray and Lab Preventive Care Ambulance Durable Medical Eauipment Chiropractic services (60 day max Emergency Room Prescription Drugs Retail (30-day supply) Generic Brand (Formulary) Brand (Non-Formulary) Specialty Mail Order (90-day supply) Generic Brand (Formularvl Current HMO $0 $0 $3,000 $6,000 $250/day, up to 3 day max $125/admit $20 $40 $0 $0 $100 trip 50% $150 deductible (waived if admitted) $10 $25 $45 20% up to $150 $10 $50 List any benefit deviations from currE qlan desian Proposed Plan $2,500 $5,000 $200 $25 20% $15 ovc / 30 visits annually $50 30% up to $150 covered under medical $20 U n ited HealthCare Active PPO Benefit Deviatic uctible Single Family ual Out-of-Pocket Maximum Single Familv Inpatient Outpatient rimary Care Visits pecialty Care Visits iagnotic X-Ray and Lab reventive Care mbulance urable Medical Equipment mergency Room rescription Drugs etail (30-day supply) Generic Brand (Formulary) Brand (Non-Formulary) Specialty lail Order (90-day supply) Generic Rranrl /Fnrmi ilarvl Current PPO In network Out of Network $750 $1,000 $2,250 $3,000 $2,000 $10,000 $6,000 $20,000 Hospital Inpatient ded: $250 Non-participating hospital penalty: $500 Non-certification penalty: 25%+$250/admit Ambulatory surgical center ded: $500 for non-participating provider 10% 50% 10% 50% 10°/a 50°/a 10% 50% 10% 50% $0 50% 10% 10% 10% 50% $100 ded+10% ($100 ded $100 ded+10% ($100 ded waived if admitted) waived if admitted) $10 $20 $20 $20 $20 ��n Must Submit Paper Form. Expense varies based on the cost of the medication List any benefit deviations from current plan d� Proaosed Plan In network $500 $1,000 $2,500 $5,000 Hospital IP ded: $100 per occurrence 90% after $100 per occurrence deductible 100% after $15 copay 100% after $15 copay 100% deductible does not apply $25 $45 available via mail order only ��n Out of Neb $1,OOC $2,OOC $S,OOC $10,001 Hospital IP ded: $100 Prior Auth required or k reducei 40% 40% 40% 40% 40% Not-Network Benefits < 40% $25 $45 available via mail ��n United HealthCare Retiree PPO Benefit Deviati RETIREES (Early and Over 65 �time Maximum iuctible Single Family �ual Out-of-Pocket Maximum Single Familv Inpatient Outpatient rimary Care Visits pecialty Care Visits iagnostic X-Ray and Lab reventive Care mbulance urable Medical Equipmei hiropractic services rergency Room �escription Drugs etail (30-day supply) Generic Brand (Formulary) Brand (Non-Formulary) Specialty ail Order (90-day supply) Generic Q.n..r� /C..rm�dor..\ Current PPO $5,000,000 In network Out of Network $750 $1, 000 $2,250 $3,000 $2,000 $10,000 $6,000 $20,000 Hospital Inpatient ded: $250 Non-participating hospital penalty: $500 Non-certification penalty: 25%+$250/admit Ambulatory surgical center ded: $500 for non-participating provider 10% 50% 10% 50% 10% 50% 10% 50% 10% 50% $50 (ded waived) $50 (ded waived) 10% 10% 10% 50% 10% 50% $100 ded+10% ($100 ded waived if $100 ded+10% ($100 ded waived if admitted) admitted) $10 $20 $zo $zo $20 Q�n Must Submit Paper Form. Expense varies based on the cost of the medication List any benefit deviations from current plan de: Proposed Plan In network $500 $1,000 Out of Netwc $1,000 $2,000 $2,500 $5,000 $5,000 $10,000 Hospital IP ded: $100 per occurrence Hospital IP ded: $100 pE Prior Auth required or ber reduced 90% after $100 per occurrence 40% deductible 100% after $15 copay 40% 100% after $15 copay 40% 100% deductible does not apply 40% 100°/o deductible does not apply Non-Network Benefits are 100% after $15 copay $25 $45 available via mail order only Q�n 40% 40% $25 $45 available via mail oi x�n Active Costs � > � v a � HMO Annual Premium Amount Change from Current Percent Change from Current PPO Annual Premium Amount Change from Current Percent Change from Current Total Active Annual Premium Amount Change from Current Percent Change from Current 2nd Year Rate Cap Enrollment 266 680 Cu rre nt Premium (Anthem) '� �:: �� ,, $ 9, 709, 000 $ � $ 13,197, 000 $ $ Anthe m 3, 801, 000 $ 313, 000 $ 9.0°/a 11, 748, 000 $ 2, 039, 000 $ 21.0% 15, 549, 000 $ 2, 352, 000 $ 17.8% None Blue Shield � United Healthcare (Full Networ HMO) 3, 252, 000 $ 3, 488, ( (236,000) $ -6.8% 0.0% 10, 617, 000 $ 10, 000, ( 908, 000 $ 291, ( 9.4% 3.0% 13, 869, 000 $ 13, 488, I 672, 000 $ 291, I 5.1 % 2.2% Narrow Network HMO: 7.5% Full Network 9.9% before A HMO and PPO: 9.9% Reti ree Costs PPO Annual Premium � � � Amount Change from Current � Percent Change from Current L � � Medicare Annual Premium v � � � � � Amount Change from Current � � � � Q Percent Change from Current Total Retiree Annual Premium Amount Change from Current Percent Change from Current 2nd Year Rate Cap Enrollment Current Premium (Anthem) 420 $ 6, 558, 000 $ $ 15 $ 108, 000 $ $ $ 6, 666, 000 $ $ Anthem � Blue Shield � 7,478,000 $ 7,055,000 $ 920,000 $ 497,000 $ 14.0% 7.6% 126, 000 $ 75, 000 $ 18,000 $ (33,000) $ 16. 7% -30.6°/a 7, 604, 000 $ 7,130, 000 $ 938, 000 $ 464, 000 $ 14.1% 7.0% None Retiree PPO: 9.9°/ United Healthcare (Full Network (I HMO) 5, 587, 000 $ (971,000) $ -14.8°/a 98, 000 $ (10,000) $ -9.3% 5, 685, 000 � (981, 000) $ -14.7% None Tota I P re m i u m $ 19, 863, 000 $ 23,153, 000 $ 20, 999, 000 $ 19,173, 000 $ � 0 Amount Change from Current $ 3,290,000 $ 1,136,000 $ (690,000) $ H Percent Chanae from Current 16_6% 5_7% -3_5%,