HomeMy WebLinkAbout08/21/2012 07 2011 Year-End Medical Insurance Report BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No. 7
For Meeting of: August 21, 2012
ITEM TITLE: 2011 Year -End Medical Insurance Report
SUBMITTED BY: Cheryl Ann Mattia, Deputy HR Manager
Randy Tabert, Chair, Employee Welfare Benefit Program
Board
CONTACT Cheryl Ann Mattia X6868
PERSON /TELEPHONE:
SUMMARY EXPLANATION:
Attached is the 2011 Year -End Report for the City of Yakima's Self- Insured Health Care
Plan. In reviewing this report, it is important to note that Employee Benefit Management
Services, Inc. utilizes a paid claims system of reporting expenditures. This differs from
Generally Accepted Accounting Principles (GAAP), used by the City of Yakima for its
records. The City recognizes expenditures on a claims incurred basis. Further, the report
does not include any revenues or expenditures for City personnel and administrative costs,
which are attributable to the City's Health Benefit Reserve Fund.
Resolution Ordinance Other Report
(specify)
Contract: Mail to:
Contract Term: . Amount: Expiration Date:
Insurance Required? No
Funding
Source: Phone:
APPROVED FOR
SUBMITTAL: _ City Manager
STAFF RECOMMENDATION:
Accept report as submitted.
BOARD /COMMISSION RECOMMENDATION:
ATTACHMENTS:
Click to download
❑ 2012 report to council
❑ report #1
❑ report #2
❑ Report #3
❑ report #4
❑ report #5
❑ report #6
❑ report #7
❑ report #8
EMSPRI NG
August 16, 2012
City Council Members
CITY OF YAKIMA
129 North 2nd Street
Yakima, WA 98901
Re: Year 2011 Health Care Plan Report
2012 Renewal and Current Status of Plan
Dear Council Members:
Attached are the Financial Summaries and related reports of the City's Employee
Health Plan for calendar year 2011 and mid -year 2012. The 2011 reports were
produced by Healthcare Management Administrators, Inc. (HMA) of Bellevue,
Washington, and subsequent reports are provided by the new claims administrator -
EBMS of Billings, Montana. These reports record actual claims and direct plan
expenses on a cash basis of accounting. Though costs continue to rise, this Plan is in
compliance with current law and regulations and continues to be well monitored and
managed by a cooperative relationship between the City Manager's Office, the Human
Resource and Finance Divisions and a voluntary Board representing all employees and
bargaining units.
Executive Summary
Health care costs too much and, therefore, so does health insurance. Since the
adoption of Medicare and Medicaid programs in the 1960's, the prevailing "fee for
service" method of paying for health care incentivizes providers to do more in order
to get paid more. Insurance companies made it possible to finance the ever increasing
cost of care, and the fragmented employer -based health plan system forces
employers to rely on insurers, preferred provider networks and third party
administrators to keep competitive health benefit plans afloat. On top of this,
dramatic demographic changes in the United States - not the least of which is the
aging of the baby boomers - puts additional pressure on our health care system and
costs. Of course, this system has advanced medical technology and patient care so far
forward that life expectancies are at record highs and Americans now expect the
extraordinary from their doctors, hospitals and pharmacies. Unfortunately, the cost is
now equally extraordinary. Health care spending exceeds 17% of our nation's GDP, the
highest by both percentage and dollar amount in the world. Federal health care
reform has passed and is on its way to full implementation by January 1, 2014. Few
people expect reform laws and regulations to slow health care costs and some,
including me, expect it to escalate them even further. There is also the real
Health Care Plan Report
August 16, 2012
Page 2
possibility that we may be nearing the end of the employer -based health care system
as we know it.
The City of Yakima's Employee Health Care Plan cost $10.6 million last year. Despite
legitimate methods and material changes to the Plan in the last two years designed to
control costs, the Plan is projected to reach $11.4 million in 2012. With costs rising,
the City no longer holds enough cash in its health benefits trust to meet the full State
of Washington requirements for single employer self - funded plan reserves. This is a
claims versus funding issue, not a trust management problem, and there are specific
and attainable proposals to correct the reserve shortfall included in this report. It is
also important to note that this report does not factor in the City's LEOFF 1 liability
beyond their eligible non - Medicare expenses.
Despite the chaos of our American health care system, there are many positive
attributes of the City's Plan. First and foremost, the schedule of benefits is still
considerably stronger than most benchmark employer plans while at the same time
per capita costs are in line with national averages:
Exhibit 1.10
Distribution of Annual Premiums for Covered Workers with
Family Coverage, 2011
Percentage of Covered Workers: YPPA: $15,
sow. City Regular: $15,266*
40°%°
Average: ;15,073
30%
24%
20% 173/ 18%
11%
10%
10%
6% II 5% 5%
0% Ill III 1 IIII MI
5 r oc � ce 4 ti y ' , 4 /� ' 4 e t 4 'e p
Source. Ka ser /HRET Survey of Employer- Sponsored Health Benefits, 2011
•Raom
City of Yakima July 201,1 Trend Accruals effective January 1, 2012
EttSPRING
Health Care Plan Report
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I find this truly astounding given the average age of our group and the extremely high
dependent ratio. An active Employee Benefits Board, proactive Human Resource and
Finance staff, and careful selection of vendors have a lot to do with the success of
this Plan. In my opinion, however, the greatest advantage we've enjoyed is a
competitive stop -loss insurance market that, regardless of the number and magnitude
of large claims our Plan generates, still offers reasonable individual and aggregate
insurance premiums to protect the City from unexpected and excessive Plan losses in
any one year. We all hope this continues.
With state -based health insurance exchanges expected to go online in 2013 and a
crucial pay -or -play decision all employers will be faced with in 2014, the future of the
City's Health Plan will depend on the choices made in the next two years. This report
summarizes the current Plan and explores options for keeping it viable.
Health Care Reform
The Patient Protection and Affordable Care Act (PPACA) was signed into law on March
23, 2010 and referred to as the Affordable Care Act, federal health care reform or
PPACA. Since passage, there have been new regulations continuously published by
Health and Human Services, the Department of Labor, the IRS and each state that we
are monitoring closely. While there are only a few requirements affecting the City's
Plan in 2012, it is a safe assumption that the Plan and the City's role as the Plan
Sponsor will change dramatically in the next few years. Please see the attached
Health Reform Timeline. There are more articles, analysis and legislative briefs found
on our website (www.emspring.com) and many other non - partisan and credible
sources like the Kaiser Foundation (www.healthreform.kff.org).
This report is not intended to offer a political discussion of health care reform nor
predict the outcome of the next election. We are focused exclusively on protecting
the current and future interests of the City and the Plan participants. Our first and
foremost attention is given to the status of the Plan today and the significant fiscal
challenges faced by the City and its employees for the rest of 2012 and beyond.
Overview: What is the Plan?
The current City of Yakima Employees' Welfare Benefit Program (the "Plan ") became
effective April 1, 1994 when the seven separate benefit programs for each
collectively bargained group consolidated into one Plan Document. A Board with
representatives from all employee groups was formed and became responsible for
defining eligibility and covered benefits, monitoring vendors, monthly financial
reports and the annual renewal, and making Plan recommendations to the City
ugh
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August 16, 2012
Page 4
Manager. This Board meets every month and is currently chaired by AFSCME
representative Randy Tabert. Employee and employer premium contribution levels
are subject to bargaining and outside of this Board's responsibilities which,
unfortunately, has created a major obstacle for keeping the Plan current with the
latest cost containment and cost sharing strategies like incentivized wellness and
multi - tiered dependent rates (premiums).
There are two sets of benefits and two separate benefit booklets. The City of Yakima
Police Patrolman's Association rejected benefit changes approved by the Board and
City Manager and thus created the YPPA Health Care Plan in February 2010. The
purpose of these two Plans is to attract and retain a healthy and productive workforce
by financing the collective health needs of City employees and their eligible
dependents. The Plan has been self - funded with stop -loss insurance since the early
1980's. In recent years, the Plan has expanded its scope to include voluntary wellness
services designed to encourage healthy lifestyles with very modest quantifiable
results.
On January 2012, the City of Yakima amended their Regular Employee health plan to
increase Deductibles and Out of Pocket Maximums. The Police Patrolman's
Association plan followed with their own changes effective July of 2012. Both groups
recognized the need to amend the health plan in order to keep it solvent, though
most expect more will need to be done.
Administration: What is a Self- Funded Health Plan?
The City of Yakima assumes the financial risk for providing covered medical,
prescription, dental and vision benefits to eligible and participating employees and
their dependents. Rather than paying a monthly premium to an insurance company, a
self - funded employer pays claims as they are incurred out of general assets. The City
of Yakima must also maintain adequate reserves which, by Washington State taw
requires 8 to 16 weeks of projected claim expenses be held in cash. The City Finance
Department oversees these reserves.
HMA (the third party administrator, or TPA - not the owner of Yakima Regional
Hospital) managed the Plan and processed medical claims from 1994 until December
2011. In January 2012, the plan moved TPA services to EBMS. Washington Dental
Service (WDS) and Vision Service Plan (VSP), though insurers, act only as third party
administrators for the City's dental and vision claims. As TPAs, these vendors are paid
a flat monthly fee per employee and assume no financial risk for claims. It is the
City's money combined with employee payroll contributions that pay for all Plan
claims and expenses.
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Financing: Employer and Employee Contributions
In 2011, 15% of the net Plan costs were paid with employee contributions through
payroll deductions. Per the City Finance Department, this has dropped to 13.8% in
2012 due to bargaining with AFSCME, a freeze on accrual rates in 2010, and the
effects of a static cost sharing formula for Fire and Police dependent premiums. Only
a few years ago, City employee contributions matched the then current AON /Hewitt
Health Initiative benchmark of 22 %.
These employee payroll contributions vary by bargaining unit and are outlined below:
AFSCME 0 25.75%
AFSCME - 17b $50.00 30.51%
AFSCME Transit 0 12.17%
IAFF Firefighters LEOFF I 0 9.69%
IAFF Firefighters LEOFF 11 0 11.00%
IAFF Battalion Chiefs LEOFF I 0 24.08%
IAFF Battalion Chiefs LEOFF 11 0 27.34%
IAFF Fire PERS 0 12.10%
IAFF Communications 0 12.10%
YPPA LEOFF I 0 5.98%
YPPA LEOFF 11 0 7.27%
City Management $50.00 30.51%
Teamsters #760 Captains Et Lieutenants LEOFF I 0 0%
Teamsters #760 Captains Et Lieutenants LEOFF 11 0 0%
Teamsters #760 Deputy Fire Chiefs LEOFF I 0 24.08%
Teamsters #760 Deputy Fire Chiefs LEOFF 11 0 27.34%
Teamsters #760 Public Works Division Manager 0 30.51%
Teamsters #760 Public Works Supervisors 0 30.51%
The Dependent Contribution Requirement shown above reflects aggregate deductions
by group divided by current Plan accrual rates (or premium equivalents). It does not
reflect actual current costs, which have increased as projected since the dependent
accrual rates were set last year.
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August 16, 2012
Page 6
Financing: Stop -Loss Insurance
To fund very large claims, the City purchases stop -loss insurance. This policy
reimburses only for catastrophic claims that exceed a certain amount. That amount,
called a stop -loss deductible, was renewed with Sun Life at $225,000 effective
January 1, 2012. Since this policy reimburses the City and not the plan participant,
this is not considered health insurance under Washington State or Federal (ERISA) law.
The City self -funds this Plan for several reasons. First, there are no prepayment
requirements as claims are not paid with a monthly premium. The City also maintains
its own Plan reserves and keeps any investment income. In addition to having more
control over cash flow, the City has ultimate control over the Plan's benefits and can
negotiate more favorable administrative fees. For example, administrative and
consulting expenses for the Plan in 2011 were 4% of Plan costs; a comparable fully -
insured employer can easily pay from four to five times as much in their premium for
administration and brokerage. With full PPACA implementation looming in 2014,
there has been a substantial resurgence in the interest from employers in self - funded
health plans.
Actuaries typically analyze three components of health care plans to project future
costs: census (who is covered), benefits (what is covered) and administration (how is
it funded). Of the three components, who is covered is by far the biggest factor in
determining the cost of any healthcare plan. As such, the census has been a major
focus for the last year.
Census: Who is on the Plan?
For the first time in many years, the Plan census has changed dramatically. In July
2011, the City removed 100 LEOFF 1 Medicare Eligible participants from the Plan and
placed them on Medicare Supplemental plans. The City now pays their Medicare
premiums plus eligible non - Medicare covered expenses which are far more
controllable costs.
As of July 1, 2012, the Plan covers 784 current and retired employees: 45 are LEOFF
1, 27 are non -LEOFF 1 retirees, and the remaining are active employees, Council
Members and self -pay COBRA participants. Counting all dependents, the Plan covers
1,887 total participants. Of the 784 employees, 543 are men and 241 are women.
Due to the LEOFF 1 carve -out, over age of 60 (160) employees now represent 3.5
times the number of under age 30 (45) - a far more favorable age mix than the 5 to 1
ratio in previous years.
l iIIR.�,
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August 16, 2012
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Benefits: What is covered under the Plan?
All terms, conditions and benefits are detailed in the Plan Document (also called a
Summary Plan Description). The Plan Document was rewritten by EBMS and reviewed
by your Benefits Board to include all amendments and facilitate compliance with the
latest federal and State regulations. Compliance has been a priority.
Effective January 1, 2012, the City Benefits Board elected to relinquish Grandfathered
Status in order to amend the health plan to help offset the rising cost of care. The
Police employee plan bargained their own compromise effective July 1, 2012. The
following is a summary of the benefit changes that were implemented:
Effective January 1, 2012. City of Yakima Employee Health Plan amended:
• Deductible increased to $400 /Individual (was $200 /Individual).
• Out of Pocket Maximum increased to $4,000 /Individual (was
$1,200 /Individual)
• Office Visits Copay increased to $25 (was $20 Copay)
• Emergency Room Copay increased to $200 (was $100 Copay)
• Preventive Care benefit expanded to 100% Coinsurance (was $20 copay with
limitations)
• Implemented Generic Medication incentives
Effective July 1, 2012. City of Yakima Patrolman's Association Plan amended:
• Deductible increased to $200 /Individual (was $100 /Individual)
• Out of Pocket Maximum increased to $1,200 /Individual (was
$600 /Individual)
• Coinsurance reduced to 60% for out of network providers (was 80 %)
• Office Visits Copay increased to $20 (was free for first 5 visits, then $15
copay)
• Emergency Room Copay increased to $200 (was $25 Copay)
• Preventive Care benefit expanded to 100% Coinsurance (was $15 Copay with
limitations)
• Implemented Generic Medication incentives
It is still too early to determine the financial savings of each of these changes, though
year to date reports indicate the results are positive.
There continues to be a free choice of providers, though the City's Plan includes First
Choice Health network - a preferred network of physicians and hospitals that offers
discounts and direct billing.
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August 16, 2012
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How much did the Plan cost in 2011?
_Medical Paid Claims
57,201,390
67%
Stop -Loss
Reimbursement
-52 5,001
0%
Stop -Loss Premium
5391,483
4%
Dental Paid Claims
Administrative Fees Prescription Paid Claims 5765,809
5467,735 Vision Paid Claims
4% 51,762,692 5116,243 7%
17% 1%
Total 2011 Plan Cost: $10,680,351
Total 2011 Plan cost, as shown on the pie chart above, was $10,680,351 versus
$10,116,444 in 2010. This represents a 5.5% increase. Like most employer plans, a
disproportionate share of the Plan's money is spent on individuals with the highest
claims. $3,256,914 of the total cost above was incurred by 32 individuals. The
attached Benefit Analysis Report for 2011 provides detail by diagnostic category and
shows how every dollar was spent.
The Plan includes coordinated disease management, case management, utilization
review procedures, PPO network discounts for medical, dental (WDS) and vision (VSP),
and aggressive hospital bill audits.
As in previous years, we continue to recommend additional benefit design changes,
retiree eligibility restrictions and the formal adoption of financial incentives to
promote wellness. In fact, I believe that neither the City Plan nor the Police Plan will
survive as is beyond 2013 without additional and significant changes and a return to
adequate reserve levels.
If we divide total annual plan costs by the number of employee participants (which
include retirees, 6 months of full LEOFF 1 participation, and COBRA participants), and
SPRh G
Health Care Plan Report
August 16, 2012
Page 9
divide again by 12 months, we get the Total Average Monthly Cost per Employee of
$1,067.50 for 2011. Currently, we are negotiating a reimbursement of $404,273.65
that is pended and waiting for itemized bills and a case management audit. We
anticipate this reimbursement from the stop -loss insurer is forthcoming, but do not
reflect it in our reports until the money is received by the City. If taken into account,
it would make the 2012 per capita cost in the bar chart below roughly equivalent to
2011. In other words, we are holding even this year.
Average Monthly Cost of Coverage per Employee:
2012 - 7 Months Data 51,135.48
2011 .,. -- _
0,06750
201 943 ze
2008 5839.50
2007 .�
rn. :
• •
C.
Through the first seven months of 2012, we have nine individuals considered a large
claimant with a total of $1,028,468 already paid by the Plan. There are 17 individuals
on EBMS claims management reports. Due to these substantial large claims, our
outlook for 2012 is higher than expected. The positive savings from the schedule of
benefit changes made in 2011 and again earlier this year are being overwhelmed by
these very large individual claims.
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August 16, 2012
Page 10
Benchmarking: How do our costs compare to others?
Over the last few years, national and regional surveys by Watson Wyatt and Hewitt
Associates report average annual increases as shown:
Annual Health Care Cost Increases, National Averages 20042012
10.0%
9.2%
9.0%
8.0% 7. °
7.5/0
7.0%
6.9% 7.0%
6.0% 6.0%
6.0%
5.3%
5.0 °!0
4.0%
3.0%
2.0%
1.0%
0.0%
2004 -05 2005 -06 2006 -07 2007 -08 2008 -09 2009 -10 2010 -11 2011 -12
(pro). )
The City's Plan has averaged a per capita increase just under 7% over the last 5 years, in line
with the benchmarks. In addition, annual accrual rates (averaged from all the bargaining units
and management rates) for the City's Plan are also tracking very closely with the national
averages shown on the following chart:
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August 16, 2012
Page 11
Exhibit 1.11
Average Annual Premiums for Single and Family
Coverage, 1999 -2011
1999 ■ 52196
1 55,791 •Siogle Coverage
2000 = $2.471
56,a38
- $2.689•
• Family Coverage 1 2001
$7,061•
2002.3 • 58,003•
2003 lIMMIMMIMMIIMI 53,383*
59,068•
2004 1 53.695•
59,950•
2005 $ 4 . 024•
1 $10,880'
2006 54.242•
511,480•
2007 !4.479 •
1 $12,106•
2008 $4.704`
512,680•
S4,824
2009 513,375•
2010 $5,049•
513,770'
2011 1 $5,429• 515,073•
50 52,000 $4,000 56,000 $8,000 $10,000 $12,000 514,000 516,000
• Estimate is statistically different from estimate for the prevous year shown (p <. 05)
Source Kaiser/HRET Survey of Empbyer- Sponsored Heath Benefits, 1999.2011.
What changed in the last Plan renewal?
The 2012 Renewal was presented to the City Manager and Benefits Board on
December 15, 2011. The City's stop -loss deductible with Sun Life was renewed with a
9% increase. Sun Life is one of the largest and highest -rated stop -loss insurers in
North America, and this policy includes a future renewal increase cap and a "no-
laser" agreement (a provision hidden in many contracts that allows the insurer to
exclude, or laser, a high cost individual upon renewal).
What has been done to control costs?
Since the last report to council:
• Effective July 1, 2011 successfully moved 89 Medicare eligible LEOFF 1's to a
Medicare Part D and Medicare Supplement Plan F for primary coverage. The
City of Yakima self - funded plan will reimburse eligible claims resulting in Part
D prescription copays. The projected savings for 2012 from this move is
$490, 000.
EMSPRING
Health Care Plan Report
August 16, 2012
Page 12
• There are currently 3 Medicare Supplemental eligible LEOFF 1 retirees that
rejected the Medicare program. We will continue to work with the individuals
during the next Medicare open enrollment and encourage their participation.
• Terminated our relationship with HMA and moved our TPA services to EBMS.
This resulted in a reduction in fees along with better reporting, disease and
case management programs.
• Performed a full Dependent Audit and a complete re- enrollment into the new
EBMS enrollment system. 181 ineligible dependents were removed from the
health plan!
• Increase deductibles, out of pocket maximums, copays and incentivized generic
prescription utilization.
• EBMS wellness support has increased participation in preventive care with flu
shots, whopping cough vaccinations and healthy heart checks.
• Added a minor waiting period for new hires.
What can be done to control future cost increases to the Plan?
Can be done now - subject to Benefits Board and City Manager approval:
1. Build, open and operate a City of Yakima Employee Health a Wellness Clinic by
March 2013. Estimated partial first year savings could be as high as $300,000.
A detailed proposal is being presented to the Employee Benefits Board and City
Manager this month.
2. Adopt financial incentives to support full participation in wellness and
integrated disease management programs. If the City is to continue sponsoring
a plan of any kind, it is time to start focusing on employee health and not
health care and health insurance. Like consumer driven plan designs, there is
little short term return on investment for wellness, but the long term effects
are significant. Successful incentivized wellness programs can reduce health
plan costs by as much as 10% over the long term in addition to the benefits of a
healthier and more productive workforce.
3. Carve -out transplant coverage and fully- insure the risk for these potential
claims. The savings would be a discount applied by the stop -loss carrier, not
the reduction in the incidence of transplants. I estimate this to save up to
$225,000 if there is a transplant claim.
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Health Care Plan Report
August 16, 2012
Page 13
Likely subject to bargaining:
• Eliminate the composite dependent premium option and adopt a three or four
tiered dependent rate structure for all divisions and bargaining units. This
would reduce the number of participating dependents since employees would
pay separate spouse and child (or children) rates rather than the composite "all
dependent" rate. Management is currently the only group with multiple tiered
dependent rates.
Rate structure could look something like this:
$576.50 Employee only
$644.93 Spouse
$134.70 1 Child
$248.67 2+ Children)
The full family rate would then be Spouse + 1st Child + 2 Child(ren). A large
family would then pay more than the current composite dependent rate; an
employee covering just one child would pay less.
The savings potential is difficult to calculate as the census change would be
unknown, but with year -to -date dependent claims ($2.2 million) exceeding
employee claims ($1.9 million), I believe it could reduce net Plan expenses by
as much as $500,000 a year.
• If the current composite dependent rate structure is retained, increase
dependent cost sharing across the board to get back to the 22% contribution
benchmark.
• Eliminate the dental plan and save $765,000; eliminate the vision plan and save
$116,000.
• Eliminate early retiree eligibility for a projected net Plan savings of $200,000.
• Eliminate eligibility for retired dependents - including retired LEOFF 1
dependents - for a projected net Plan savings of $75,000.
• Consider consumer - driven programs (HRAs and HSAs) as alternatives to the
current plan. This should not be considered without an integrated and
incentivized wellness program. The savings would be determined by the
number of employees electing the new HSA /HRA and the amount bargained for
City contributions. First and second year savings might be minimal, but the long
term potential could be as high as 8 -10 %, or $1 million, of total Plan costs per
year.
• The City could save more by terminating the current Plan, defining (or fixing)
its health care contribution based on current rates using a Health
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August 16, 2012
Page 14
Reimbursement Arrangement (HRA) and allow employees to go shop for their
own coverage.
• Consider dropping self - funded health plan and adopting a fully insured HMO
Group Health option as a "Base Plan" with "Buy up" options through a
commercial insurer. While this would likely cost more in total premiums, it
would force more aggressive cost containment and cost shifting as both the
City and the bargaining groups would be subject to insurer underwriting
requirements.
• Only allow dependent coverage if coverage is not available through another
employer. This can be difficult to administer, but it is an increasingly common
cost containment tactic that employers take to reduce the dependent coverage
ratio (dependents /employees) and offset the "coverage shift" effect from
other area employers who do not offer affordable health plans to their
employees.
• Add a waiting period of 60 to 90 days for new hire eligibility. Savings are
minimal, though waiting periods are necessary to reduce administrative errors
and control adverse selection.
Conclusion
The extended slow economy has brought unprecedented financial pressure on the City
of Yakima, its employees and local taxpayers. The Health Plan faces additional cost
pressures and legislative uncertainty. Employers are taking more drastic measures to
enable them to offer affordable health coverage to their workforce. I calculate that
the City would pay a penalty of roughly $1.5 million should the Employee Health Plan
be terminated without an alternative plan in place in 2014. That's the "pay" in the
"pay or play" decision. The "play" would be an estimated Health Plan cost of roughly
$12 million in 2014. While I don't believe the City is a candidate for early Plan
termination, it has to be at least considered if bargaining or other factors prevent the
adoption of additional changes to control future Plan costs.
The time has come to focus on employee health and not just health care and health
benefits. According to the latest National Survey of Employer- Sponsored Health Plans
conducted by Mercer, 92% of employers plan to add or strengthen programs to
encourage health conscious behavior. The only way for these programs to work is to
apply material financial incentives to participate. The City's Employee Benefits Board
has considered such incentives in the past, but bargaining has become the road block.
Since it is in every employee's interest to keep this Plan viable and affordable, we
must overcome these objections and fully adopt and embrace wellness. There are
excellent programs and many effective vendors from which to choose. A City
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August 16, 2012
Page 15
sponsored onsite health clinic should also be given immediate and serious
consideration, as well as reducing the spending on dependent coverage in relation to
employee coverage. We can do these things if we work together.
"Culture trumps strategy every time." I don't know who to credit for the quote, but
I've heard it several times this past year while attending conferences on health care
reform and human resource strategies. In context, it means that even if we adopt
wellness programs and strategies to incentivize healthier lifestyles, the culture at the
City of Yakima needs to change to allow it to flourish and produce positive and
profound results. Changing the culture requires leadership, and EmSpring fully
supports your efforts and the efforts of the City Manager, Human Resource and
Finance Divisions, and all employees and dependents that rely on this Health Plan to
maintain their health and lead productive lives.
I take great pride in being the advisor to this Plan, and I look forward to any questions
or instructions you may have.
Sincerely,
Dan Fisher, CEO
Attachments
Health Care Reform: 2012 Compliance Checklist
2011 HMA Financial Summary (Jan -Dec)
2011 -2012 HMA Benefit Analysis Report (Jan -Jun)
2012 HMA Financial Summary Run Out Claims (Jan -July)
2012 EBMS Executive /Financial Summary (Jan -July)
2012 Delta Dental WDS Dental Claims (Jan -July)
2012 VSP Vision Claims (Jan -July)
Plan Census: Age Matrix as of 7/31/2012
i .
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"ir HealthCareReform
ai m
►r► LEGISLATIVE BRIEF
Brought to you by EmSpring
2012 Compliance Checklist
Health care reform brings a number of changes for employers and health plans in 2012. As employers prepare to
comply with new requirements, they need to be aware of how health care reform will affect them in the coming year.
This EmSpring Legislative Brief provides a compliance checklist for employers for 2012. Please contact your EmSpring
representative for assistance or if you have questions about changes that were required in previous years.
GRANDFATHERED PLAN STATUS
A grandfathered health plan is one that was in existence when health care reform was enacted on March 23, 2010.
Grandfathered plans are exempt from some of the health care reform requirements. A plan's grandfathered status will
continue to affect its compliance obligations from year to year.
❑ Determine if you have a grandfathered plan. Contact your EmSpring representative if you have questions
about whether your plan is grandfathered or not.
❑ Determine whether your plan will maintain its grandfathered status. If you make certain changes to your
plan that go beyond permitted guidelines, your plan is no longer grandfathered. Contact your EmSpring
representative if you have questions about changes you have made, or are considering making, to your plat
❑ If you move to a non - grandfathered plan, make sure the plan includes all the additional participant rights
and benefits required by health care reform. These rules include first- dollar coverage of preventive care
services, an enhanced claim and appeal process, and non - discrimination requirements for insured plans.
ANNUAL LIMITS
Beginning Jan. 1, 2014, group health plans will no longer be able to impose annual limits on the value of essential
health benefits. However, until then, certain minimum annual limits are permitted. Unless your plan received a waiver
of the annual limit requirements, you should confirm that any annual limit included in your plan is set at least as high
as the following amounts for each applicable plan year:
❑ $750,000 for plan years beginning on or after Sept. 23, 2010, but before Sept. 23, 2011;
❑ $1.25 million for plan years beginning on or after Sept. 23, 2011, but before Sept. 23, 2012; and
❑ $2 million for plan years beginning on or after Sept. 23, 2012, but before Jan. 1, 2014.
SUMMARY OF BENEFITS AND COVERAGE
El Plans and insurance issuers must provide a Summary of Benefits and Coverage (SBC) to participants and
beneficiaries.
• The SBC is a concise document - no more than four double -sided pages - providing simple and
consistent information about health plan benefits and coverage in plain language.
EMSPRING
1
2012 Compliance Checklist
• A template for the SBC is available, along with instructions and examples for completing the template
and a uniform glossary of terms.
❑ The final SBC regulations provide that plans and issuers must start providing the SBC as follows:
• Issuers must provide the SBC to health plans effective Sept. 23, 2012.
• Plans and issuers must provide the SBC to participants and beneficiaries who enroll or re- enroll during
an open enrollment period beginning with the first day of the first open enrollment period that
begins on or after Sept. 23, 2012.
• For participants who enroll in coverage other than through an open enrollment period (for example,
newly eligible individuals and special enrollees), plans and issuers must provide the SBC beginning on
the first day of the first plan year that begins on or after Sept. 23, 2012.
60 -DAY NOTICE OF PLAN CHANGES
El Plans and issuers must provide 60 days' notice of any material modifications to the plan that are not
related to renewals of coverage. Notice can be provided in an updated SBC or a separate summary of material
modifications.
WOMEN'S PREVENTIVE CARE GUIDELINES
❑ Effective for plan years starting on or after Aug. 1, 2012, non - grandfathered plans must cover specific
preventive health services for women with no cost sharing. These services include well -woman visits, STD
screening and contraceptives. Exceptions to contraceptive requirements apply to religious employers.
._DICAL LOSS RATIO (MLR) REBATES
❑ Fully insured plans may receive rebates in August 2012 if they qualify for a rebate from their issuers due to
the medical loss ratio (MLR) rules requiring insurance companies to spend a certain percentage of premium
dollars on health care. The rebates must be used for the benefit of the plan's enrollees, which may include
reducing enrollees' premium payments.
W -2 REPORTING
❑ Beginning with the 2012 tax year, employers that are required to issue 250 or more W -2 Forms must report
the aggregate cost of employer- sponsored group health coverage on employees' W -2 Forms.
• The cost must be reported beginning with the 2012 W -2 Forms, which are issued in January 2013.
• This requirement is optional for smaller employers for the 2012 tax year - and until further guidance
is issued.
• Reporting is for informational purposes only - it does not affect the taxability of benefits.
'"' EmSpring Legislative Brief is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice
lers should contact legal counsel for legal advice
2011 -2012 Zywave, Inc. Ali rights reserved.
•
11/11, KP 2/12
2
2012 Compliance Checklist
TAX CHANGES FOR AGE 26 COVERAGE
❑ If your state previously required you to impute income for covering dependents up to age 26, check on
changes to your state's tax code. All states that impose an income tax should now be in conformity with
federal tax law, which permits this coverage to be provided on a tax -free basis.
COMPARATIVE EFFECTIVENESS RESEARCH FEES
❑ Self- funded plans must pay a $1 per covered life fee for comparative effectiveness research. Fees are
effective with the first renewal after Oct. 1, 2012. Fees increase to $2 the next year and will be indexed for
inflation after that.
SMALL BUSINESS TAX CREDIT
❑ Small employers that qualify for the tax credit provided by the health care reform law can claim the tax credit
by filing Form 8941 (Credit for Small Employer Health Insurance Premiums) with their annual tax filings.
• To qualify, employers must have fewer than 25 employees and pay average annual wages of less than
$50,000.
If you need more information on any of the health care reform topics addressed above, please contact your EmSpring
representative.
This EmSpring Legislative Brief is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice
Readers should contact legal counsel for legal advice.
c 2011 -2012 Zywave, Inc All rights reserved
11 /11: KP 2/12
3
Group Name: City of Yakima Experience Report Carrier: Sun Life
Group Number: BO101 Contract Period: 1/1/2011 - 12/31/2011
Excess Medical Pd Rx Pd Vision Pd Dental Pd Total Paid Avg Cost Single Family Single Family Total Aggregate Current
Month Loss Prem Admin Fees Claims Claims Claims Claims Claims Total Cost Per Emp Medical Medical Dental Dental Med Emp Deductible Accrual Balance
Jan -11 $33,914 $41,536 $963,438 $149,321 $14,045 $63,360 $1.190,164 $1,265,614 $1,437 362 519 248 476 881 $1,056,997 $860,388 - 8405,225
Feb -11 833,845 $41,042 $527,680 8140426 810,124 874.116 $752,347 $827,234 $944 357 519 246 477 876 $1,050,999 $858,104 $30,871
Mar -11 $33,636 $40,875 8491,873 $219,492 $10.444 $84.828 $806,637 $881,148 $1,009 356 517 256 476 873 $1,047,399 $853.376 427,772
Apr -11 $33,883 $41,308 $442,518 8162,889 $7,154 S68,323 $680,884 $756,076 $865 357 517 257 474 874 $1,048.599 $859,204 8103.128
May -11 $34,059 $41,926 $650,088 $148,394 $6,793 $65.927 $871,202 $947,188 $1,079 364 514 259 472 878 $1,053,398 $864,343 482,845
Jun -11 $33,781 $41,354 $631,690 $146,083 810,996 669 151 $857,920 $933,055 $1.063 364 514 256 471 878 $1,053,398 $857.203 475,853
Jul -11 $31.685 $35,943 $591,300 $148,333 $10,532 845.655 $795,820 $863,447 $1,093 281 509 253 467 790 $947,818 $849,369 - 814,078
Aug -11 $29,447 533,638 $461,434 $90,187 $11,978 $60.862 $624,461 $687,547 $873 279 509 254 466 788 $945,419 8706,520 $18,974
Sep -11 $31,872 $37,601 $629,167 $207.296 $6.830 $65,007 $908,299 $977,773 $1,238 280 510 252 466 790 $947,818 $787,561 - 5190,211
Oct -11 $31.639 $38.689 $783,429 $119,036 $9,057 $43,913 8955,435 $1,025,763 $1,295 283 509 253 468 792 $950,218 $748,834 - 5276,929
Nov -11 $31,886 $37,893 $438,314 $83,240 $7,579 $54.712 $583,845 $653,624 $825 284 508 255 470 792 $950,218 $779,664 $126,040
Dec -11 $31,836 $35,929 5590,458 $147,995 $10,711 $69.954 $819,119 $886,883 51,118 284 509 256 466 793 $951,418 $778,769 - 5108,114
Total YTD 5391,483 $467,735 $7,201,390 51,762,692 8116,243 5765,809 59,846,134 510,705,351 $1,070 3,851 6,154 3,045 5,649 10,005 $12,003,699 59,803,336 - 8902,016
Less Stop Loss Claims $10,680,351
PEPM Current Contract YTD $719 78 $176 18 $11 62 $76.54 $984 12 $1,067.50 $1,070
PEPM Prior Contract Year $622 80 $168 20 $10 89 $81.94 $883.83 $943 26 8981 20
Percentage Change 15.6% 4 7% 6 7% -6 6% 11 3% 13.2% 11.3%
Individual Excess Loss Coverage Aggregate Excess Loss Coverage Aggregate Calculation Optional Data /Rates
Deductible $225,000 Aggregate Attachment Factors: YTD Deductible: $12,003,699
Annual Maximum $1,000.000 Single $1,199 77 Covered Claims: Accrual Rates
Aggregating Specific' NA Family $1,199.77 Medical $7,201.390 Med /Den Employee $575 45
Contract Basis Paid Minimum Attachment 511,545,147 Rx $1.762.692 All dependents $614 68
. Pre - Funding Yes Annual Maximum $1,000,000 Vision $116.243
Covered Benefits: Contract Basis Paid Dental $765.809 LEOFF I
Medical Yes Premium (PEPM) $2 60 Total 59,846,134 Med Employee 5807 31
Rx Yes Covered Benefits: Specific Claim Adjustment All Dependents $614 68
Vision NA Medical Yes Claims Above Ind Ded. 525.001
Dental NA Rx Yes Less Agg Spec NA Rx Rebates'?
Rates: Vision Yes Net Specific Claims $25.001 Q1 $31,892 32
Single $18 03 Dental Yes Net Total Claims' $9,821.133 Q2 $35.864 40
Family $48 71 Monthly Accomodation NA Aggregate Ded Loss Ratio 81 8% Q3
Lasers: NA Q4
'Terminal Liability NAI
+•IMA .
Information on this Experience Report is for illustrative purposes only Actual claims and enrollnment figures covered by the excess loss contract may be different.
HEALTHCARE MANAGEMENT ADM
Date: 08/08/2012 B e n e f i t A n a l y s i s Page: 1
Wednesday August 08, 2012 rbal
Group: BO101 CITY OF YAKIMA
Period: 01/2011- 06/2012
Mem Total copay * - -- Deductibles - - -* C.O.B. Inel Total
Code Description Type Days Charge Amount Co -ins Benefit Savings Amount Paid
ABOR ABORTION SERVICES (VOLUNTARY 36.00 1855.00 0.00 0.00 0.00 0.00 1855.00 0.00
ACUP ACUPUNCTURE 106.00 5291.01 0.00 0.00 0.00 0.00 5291.01 0.00
ALLI ALLERGY INJECTIONS 1427.00 29272.50 0.00 2002.64 0.00 250.04 6977.69 17418.73
ALLT ALLERGY TESTING 984.00 11324.20 0.00 571.61 0.00 0.00 4780.79 5064.07
AMB AMBULANCE 1274.00 96120.26 0.00 73.32 0.00 11654.83 45046.54 36876.73
ANES ANESTHESIA SERVICES 19320.00 352987.55 0.00 619.42 0.00 12072.15 154502.94 167301.89
ASST ASSISTANT SURGEON 107.00 188994.53 0.00 84.07 0.00 177.55 162595.34 24964.06
AUDR BILL AUDIT REVENUE 0.00 5704.96 0.00 0.00 0.00 0.00 0.00 5704.96
CHEM CHEMOTHERAPY 1672.00 128589.63 0.00 70.70 0.00 24003.71 52162.97 52172.86
CHIM CHIROPRACTIC - MULT SERVICES 865.00 34078.96 748.99 741.35 0.00 1144.25 10873.77 19542.58
CHIR CHIROPRACTIC SERVICES 2471.00 126365.05 28601.02 3153.62 0.00 3404.70 42215.85 46041.86
CNR MEDICAL- INELIGIBLE SERVICES 299.00 578046.27 0.00 0.00 0.00 0.00 578046.27 0.00
COLO COLONOSCOPY 139.00 144043.31 1255.00 0.00 0.00 3718.30 82836.88 56233.13
CONS CONTRACEPTIVE MGMT SURGERY 9.00 3143.00 0.00 0.00 0.00 0.00 3143.00 0.00
COSM COSMETIC INEL SERVICES 1.00 172.38 0.00 0.00 0.00 0.00 172.38 0.00
D&A DRUG /ALCOHOL INPT R &B PREAUT 132.00 92379.89 0.00 388.59 0.00 18077.07 22288.95 46211.70
D&A1 6TH &+ DRUG & ALCOHOL OUTPT 94.00 7069.00 1170.00 0.00 0.00 1366.00 1723.26 2809.74
D&AO DRUG & ALCOHOL OUTPT 424.00 25249.91 4080.00 269.22 0.00 279.00 7622.41 12122.51
DIA1 KIDNEY DIALYSIS (1ST 42) 12.00 418576.01 0.00 0.00 0.00 19219.62 394542.34 4814.05
DIA2 KIDNEY DIALYSIS (43 +) 2.00 77303.09 0.00 0.00 0.00 4468.15 73765.53 838.19
DIAL KIDNEY DIALYSIS 4.00 12355.30 0.00 0.00 0.00 813.10 11345.85 196.35
DIET DIETARY EDUCATION 102.00 3732.00 340.00 0.00 0.00 319.37 936.61 2136.02
DME DURABLE MEDICAL EQUIPMENT 3196.00 265142.90 0.00 4823.51 0.00 9709.24 143542.28 98914.60
DOMS DOCTORS OFFICE MISCELLANEOUS 173.00 37640.48 0.00 33.47 0.00 6722.22 20967.90 9729.58
DORX DOCTORS OFFICE PRESCRIPTION 52.00 108.00 0.00 0.06 0.00 0.00 87.02 20.89
DOSG DOCTORS OFFICE SURGERY 1093.00 225362.38 0.00 2378.35 0.00 15467.56 82743.57 118733.01
DOSP DOCTORS OFFICE SUPPLY 237.00 20818.95 0.00 0.64 0.00 1053.18 13405.02 6277.89
DOV DOCTORS OFFICE VISIT 8510.00 1126872.81 107153.50 5939.81 0.00 59899.34 294345.03 654230.48
DOV1 DOCTORS OFFICE VISIT 481.00 65494.69 6645.00 0.00 0.00 2692.33 14217.29 41940.07
DOVP ROUTINE GYNECOLOGICAL EXAM 181.00 30423.72 3235.00 0.00 0.00 959.61 5562.34 20493.51
DXT DIAGNOSTIC TESTING 2315.00 487851.86 0.00 21700.67 0.00 13688.17 244165.24 184302.53
EMER EMERGENCY ROOM SERVICES 568.00 1031256.19 36088.00 12255.47 0.00 28630.58 597078.68 308196.07
FLU FLU SHOTS 165.00 2490.94 0.00 0.00 0.00 10.26 696.22 1784.46
HEAR ROUTINE HEARING SERV INEL 31.00 961.00 0.00 0.00 0.00 0.00 961.00 0.00
HH NURSING VISITS IN HOME 100.00 23248.95 0.00 0.00 0.00 83.30 13099.74 10065.91
HH1 NURSING VISITS IN HOME 3.00 864.30 0.00 0.00 0.00 0.00 0.00 864.30
HMAU BILL AUDIT SAVINGS 0.00 33192.65 0.00 0.00 0.00 0.00 33192.65 0.00
HOME HOME HEALTH MISC SERVICES 22281.00 121389.33 0.00 4204.12 0.00 6265.60 55015.55 50745.03
HRB HOSPITAL ROOM & BOARD PREAUT 868.00 1087354.51 0.00 1896.94 0.00 88813.97 348031.37 624128.52
HSPC HOSPICE CARE /TERMINAL ILLNES 40.00 8201.00 0.00 0.00 0.00 0.00 3117.79 4671.55
ICU INTENSIVE CARE UNIT PREAUTH 107.00 244595.31 0.00 0.00 0.00 26667.26 72829.27 142642.40
IMX IMMUNIZATION SERVICES 1721.00 65653.89 0.00 79.34 0.00 968.69 10940.98 53083.84
INEL MEDICAL- INELIGIBLE SERVICES 1241.00 133684.57 0.00 0.00 0.00 0.00 133684.57 0.00
INFR INFERTILITY INELIGIBLE 61.00 4083.12 0.00 0.00 0.00 0.00 4083.12 0.00
INFT INFUSION THERAPY 903.00 94813.26 0.00 332.14 0.00 181.64 45227.64 47771.70
INJT INJECTIONS 9178.00 89165.52 0.00 334.73 0.00 7422.21 40984.29 40041.18
IPD1 INPATIENT DOCTORS VISIT 4.00 790.00 0.00 0.00 0.00 0.00 216.00 574.00
IPDV INPATIENT DOCTORS VISIT 853.00 173996.76 6420.00 51.31 0.00 19804.77 76068.85 70708.70
IPMM MENT /NERV INPT MISC PREAUTH 5.00 3564.92 0.00 0.00 0.00 24.58 3228.20 250.94
HEALTHCARE MANAGEMENT
;ate: 08/08/2012 B e n e f i t A n a l}, s Page: 2
Wednesday August 08, 2012 rbal
Group: BO101 CITY OF YAKIMA
Period: 01/2011- 06/2012
Mem Total copay * - -- Deductibles - - -* C.O.B. Inel Total
Code Description Type Days Charge Amount Co -ins Benefit Savings Amount Paid
IPMN MENT /NERV INPT R &B PREAUTH 39.00 49149.00 0.00 0.00 0.00 0.00 42413.00 6462.53
IPMS INPATIENT MISC PREAUTH 1221.00 5224554.17 0.00 0.00 0.00 198751.36 2926726.73 2085646.55
IPNP INPATIENT MISC NO PREAUTH 14.00 122999.95 1245.00 0.00 0.00 5793.56 112048.92 2345.86
IPRH INPATIENT REHABILITATION 34.00 16170.40 0.00 0.00 0.00 0.00 859.44 15310.96
IPSG INPATIENT SURGERY 287.00 630196.12 0.00 854.46 0.00 10095.75 343697.49 261439.62
LAB LABORATORY 14521.00 667827.01 0.00 49542.96 0.00 12202.04 378154.08 197162.12
MAM ROUTINE MAMMOGRAMS AGE 0 -35 695.00 43181.51 3020.00 0.00 0.00 825.72 19139.48 20196.31
MASS MASSAGE THERAPY 71.00 2135.00 0.00 0.00 0.00 0.00 2135.00 0.00
MATD MATERNITY DEPENDENTS 117.00 32352.20 0.00 0.00 0.00 0.00 32352.20 0.00
MED MEDICAL SERVICES 526.00 509875.05 0.00 0.00 0.00 45821.23 425532.16 38521.66
MRCT MRI OR CT -SCAN 425.00 474667.35 0.00 6154.08 0.00 14289.20 329671.46 104512.02
MRX PRESCRIPTION INVOICES 0.00 1868627.11 0.00 0.00 0.00 0.00 20.00 1868607.11
NEUR NEURODEVELOPMENTAL THERAPY 202.00 15485.70 0.00 700.00 0.00 0.00 3914.07 8983.23
NOPM SURGICAL FACILITY - NO PREAU 10.00 21784.24 1500.00 166.24 0.00 0.00 12803.82 6877.83
NOTC NOT COVERED 64.00 12959.97 0.00 0.00 0.00 0.00 12959.97 0.00
OBES OBESITY 159.00 31004.68 0.00 346.34 0.00 0.00 10462.21 18584.48
OONS OUT OF NETWORK SAVINGS 0.00 27423.08 0.00 0.00 0.00 0.00 0.00 27423.08
OPDV OUTPATIENT DOCTORS VISIT 597.00 219600.65 0.00 7954.91 0.00 7132.06 116655.60 71446.09
OPM1 6TH &+ OP MENTAL /NERVOUS 285.00 38740.96 4035.00 0.00 0.00 1382.34 9447.20 23876.42
OPMN OUTPATIENT MENTAL & NERVOUS 1256.00 164201.70 12260.00 1374.66 0.00 6778.92 62257.24 77006.69
OPMS OUTPATIENT MISCELLANEOUS 15191.00 3359526.08 0.00 10385.73 0.00 219961.01 1460394.57 1599572.08
OPRH OUTPATIENT REHABILITATION 9240.00 546178.41 0.00 9267.89 0.00 25977.10 267300.13 214479.81
OPRM OUTPATIENT REHAB - MULT SVCS 2.00 84.00- 0.00 0.00 0.00 0.00 27.20- 56.80 -
OPSG OUTPATIENT SURGERY 808.00 772465.44 0.00 5672.09 0.00 22678.00 416751.61 296737.31
PAP ROUTINE PAP SMEAR LAB TEST 224.00 12136.30 0.00 93.75 0.00 323.83 4043.61 7625.43
PROS PROSTHETICS 4.00 300.00 0.00 0.00 0.00 0.00 125.88 124.30
RADT RADIATION THERAPY 91.00 38084.90 0.00 0.00 0.00 24.00 23932.99 13988.61
RX PRESCRIPTIONS 424.00 19918.30 0.00 0.00 0.00 0.00 2987.81 16930.49
SGCT SURGICAL FACILITY FEE PREAUT 279.00 696108.08 0.00 1935.42 0.00 10599.52 371412.80 292442.77
SMOK SMOKING CESSATION 5.00 583.82 0.00 0.00 0.00 0.00 33.01 471.12
SNF SKILLED NURSING FACILITY 45.00 20772.28 0.00 0.00 0.00 7659.44 0.00 13112.84
SPEC OUT OF PLAN PAYMENT 0.00 99606.00 0.00 0.00 0.00 0.00 54783.30 44822.70
SUP MEDICAL SUPPLY 66.00 9692.77 0.00 14.21 0.00 0.00 2768.06 6945.79
TERM TERMED GROUP 0.00 309266.01 0.00 0.00 0.00 0.00 309266.01 0.00
TMJ MEDICAL TMJ SERVICES 1.00 111.80 0.00 0.00 0.00 0.00 111.80 0.00
TRAN TRANSPLANTS 9.00 867.00 0.00 0.00 0.00 80.85 289.38 437.14
VEXM ROUTINE VISION EXAM 101.00 11074.37 0.00 0.00 0.00 0.00 11074.37 0.00
VHDW VISION HARDWARE 5.00 10583.95 0.00 0.00 0.00 0.00 10583.95 0.00
VINL VISION - INELIGIBLE SERVICES 29.00 1009.00 0.00 0.00 0.00 0.00 1009.00 0.00
WELC PREVENTIVE WELLNESS - COPAY 655.00 95244.16 10355.00 396.96 0.00 949.37 22840.11 60577.80
WELL ROUTINE /WELLNESS SERVICES 907.00 69079.94 0.00 105.75 0.00 2073.72 25205.69 41644.24
WELO ROUTINE /WELLNESS OFFICE VISI 20.00 3492.39 0.00 0.00 0.00 122.73 700.17 2669.49
WORK WORKMANS COMPENSATION CLAIMS 8.00 10384.94 0.00 0.00 0.00 0.00 10384.94 0.00
XRAY X -RAY SERVICES 2747.00 698300.82 0.00 23916.52 0.00 15422.65 514949.71 123227.89
cobr not on file 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1399.02
*Totals 94 Benefit codes 135231.00 228151.51 0.00 12272388.76
24679314.43 180887.07 998976.75 10562175.18
Group Name: City of Yakima (exc. Ret Medicare) Experience Report
Group Number: BO101 RUN OUT 1/1/2012 - 12/31/2012
Medical Pd Vision Pd Dental Pd Total Paid
Month Claims Rx Pd Claims Claims -NA Claims -NA Claims Total Cost
Jan -12 $801,767 $62,421 $864,189 $864,189
Feb -12 $248,001 $0 $248,001 $248,001
Mar -12 $164,744 $115 $164,859 $164,859
Apr -12 $142,713 $15 $142,728 $142,728
May -12 $57,554 $0 $57,554 $57,554
Jun -12 $11,872 $0 $11,872 $11,872
Jul-12 $7,798 $10 $7,808 $7,808
Aug -12 $0 $0
Sep -12 $0 $0
Oct -12 $0 $0
Nov -12 $0 $0
Dec -12 $0 $0
Total YTD $1,434,449 $62,561 $1,497,011 $1,497,011
1 I
Information on this Experience Report is for illustrative purposes only. Actual claims and enrollnment figures covered by the
excess loss contract may be different.
Executiv am mar y E i
CITY Or fAK1MA l-'„/' ro ve• &merit%tcnarmimt
■, n,y 1'1 7r,17 i:, n3lr)uI, Group:0000218
Benefit Analysis Benefit Analysis Summary Disallowed Charges by Category
Count Charges Disallowed Allowed Ded Copay Cob Savings Paid %Paid Charges 7,811,575 Amount % of Gross
ALLERGY CARE 153 16,682 6265 10,418 2,392 958 7,068 0.2 Additional Info not Provided 393,997 5.0%
ALTERNATE MED 72 4,016 1,423 2,592 1,210 7 1,376 0.0 less Disallowed 2,696,433
AMBULANCE 81 46,900 30,258 16,642 3,454 494 12,694 0 3 Duplicate Charges 894,057 11.4%
Allowed 5,115,142
ANESTHESIA 127 101,794 27,675 74,119 14,351 5,701 54,066 1.3 Employee Ineligible 8,473 0 1%
AUDITORY 30 1,228 1,228 0 0 0 0 0.0 less Deductible 667,374 Dependent Ineligible 1,419 0.0%
CHIROPRACTIC 1290 62,150 21,305 40,845 17,478 559 22,808 0 5 Eligible Benefits 4,447,767
DENTAL 134 18,896 14,496 4,400 880 1,634 1,886 0 0 Managed Care 0 0 0%
DME /APPLIANCE 163 31,209 15,088 16,121 5,655 140 10,326 0.2 less COB Reductions 189,562 Not Medically Necessary 6,139 0 1%
EMERG ROOM CHRGS 1571 613,361 262,459 350,902 87,778 16,039 247,085 5.8 Paid Benefit 4,258,206 Out of Network 0 0 0%
HOME HEALTH CARE 50 39,910 29,606 10,304 714 0 9,590 0 2
INELIGIBLE 210 16,280 16,280 0 0 0 0 0.0 plus Manual Checks 594,783 Plan Limitations 40.152 0.5
INPATIENT PHYS 253 78,291 27,431 50,860 5,589 2,312 42,959 1 0 Total Checks 4,852,988 PPO Savings 1,291.000 16 5%
IP HOSP CHARGES 223 1,847,351 660,799 1,186,551 76,627 49,164 1,060,760 24.9 Preexisting Conditions 1,643 0 0%
MATERNITY 148 90,730 18,471 72,259 12,203 22,303 37,753 0 9 Number of Claims 14,869 9
MEDICAL MISC 385 29,208 6,926 22,282 3,150 48 19,085 0 4 UCR Reductions 3.034 0 0%
OFFICE VISIT 3410 429,547 97,483 332,064 64,740 13,649 253,674 6 0 XC Negotiated Discounts 10,299 0 1%
OP PHYSICIAN 655 144,276 62,221 82,055 2,574 1,920 77,560 1 8
OTHER 68 1,088 1,088 0 0 0 0 00 Other 46,222 0.6%
OUTPAT HOSP 481 353,744 110,908 242,837 37,617 2.910 202,310 4 8 Totals: $2,696,433 34 5%
PEER REVIEW 10 2,482 0 2,482 0 0 2,482 0 1
PRESCRIPTION 7270 768,803 28,148 740,655 966 451 739,239 17.4 Claims Paid by Month Estimate of Incurred but not reported
PSYCHIATRIC 831 230,279 86,363 143,917 14,533 707 128,676 3.0 February 12 504.644 Avg $ /day X avg lag = Est incurred but not reported
RADIATION /CHEMO 186 116,930 33,156 83,774 900 0 82,874 1 9 March 12 465.710
SLEEP DISORDER 339 51,334 35,210 16,124 3,287 218 12,620 0 3 April 12 712,475 $26,285 X38.50 = $1,011,981
SUBS ABUSE 179 63,333 44,954 18,379 3,180 0 15,199 0.4 May 12 905.167
SURG FACILITY 178 1,000,372 518,472 481,900 70,176 22,568 389,157 9.1 Number of days in sample: 162
SURGERY 326 116,005 20,907 95,098 3,656 1,866 89,576 2.1 June 12 745.237
SURGERY IP 39 66,815 26,739 40.075 6,565 2,020 31,491 0.7 July 12 745.233 Average Cost
SURGERY OP 268 196,261 62,182 134,079 22,861 8,975 102,244 2 4 Totals 4,258,206 Average cost per claim: 286.38
THERAPY 3078 241,841 112,688 129,153 33,004 11,502 84,646 2 0 Claim Type Total Paid Per
URGENT CARE 11 865 111 754 241 0 513 0 0 EE /Mo
VISION 73 5,268 3,894 1,374 806 0 569 0.0 Dental 783 015
WELLNESS 1629 119,098 25,142 93,956 1,408 1,888 90,659 21 Medical 3,518,094 636.99
XRAY/ LAB 6972 905,229 287,058 618,171 169,380 21,529 427,262 10 0
Totals: 7,811,575 2,696,433 5,115,142 667,374 189,562 4,258,206 100.0 Prescriptions 739,329 133 86
Vision 0 0
Census(Age Matrix) Plan Payment by Age, & Clmt Type Top Providers
Census Date Male Female Male Female Male Female Total Total Total Age Category Employee Spouse Dependant Name Paid
7/31/2012 Emp Emp Spouse Spouse Dep Dep Med Dent Vision 0 to 19 0 0 989,358 EBMS RX /CVS CAREMARK MGD 735.501
0 to 1 • 0 0 0 0 289 290 579 579 579 20 to 23 10.537 1.201 47.472 YAKIMA VALLEY MEMORIAL HO 717.032
20 to 2 , 0 3 1 1 64 50 119 118 119 24 to 2• 41.901 25,610 13,790 YAKIMA HMA INC 584.780
• • . , 32 13 1 23 14 17 100 100 100 30 to 3'' 209.719 204,639 4,109 SEATTLE CHILDRENS HOSPITA 572.753
30 to 3• 128 40 13 95 1 0 277 277 277 40 to 4' 536,819 333,397 0 MEMORIAL PHYSICIANS PLLC 177.733
40 to 4', 130 61 19 93 0 0 303 301 303 50 to 5' 648.344 325,551 0 VIRGINIA MASON MEDICAL CE 102.369
50 to 59 154 63 20 70 0 0 307 293 307 60 to . 475,019 130.980 0 ORTHOPEDICS NORTHWEST PLL 95.428
60 to 64 81 53 13 18 0 0 165 108 165 65 and Olde 53.465 203,009 0 LAPALOMA TREATMENT CENTER CANCER INSTITUTES OF WASH 81.713
65 and Olde 18 8 3 8 0 0 37 27 37 Vendors_ 3,285 0 0 81,022
Total 543 241 70 308 368 357 1,887 1,803 1,887 Total - 1,979,090 1,224,386 1,054,729 YAKIMA UROLOGY ASSOCIATES 57.701
Average Ag • 47 9 49.5 50.0 44.6 12.7 13.1 34.2 31.4 34. ' Claims cost paid to vendors YAKIMA PHYSICIAN ANNEE T STHH ESES IA A ASSOSSO AA 46.645
Version° 3 0 Run Date Thursday, August 02, 2012 5 42 PM Page 1 of 1
Group Utilization Washington Dental Service
Washington Dental Service is a member of the
Delta Dental Plans Association
Group Number: 00564
Group Name: City of Yakima
Reporting Month: 07/31/2012
Benefit Period: 01/01/2012 - 12/31/2012
Subscriber Spouse Dependent Total
Mouth Mouth YTD Moufi, Mouth YTD
Number of Claims 95 91 60 53' 143 1972 2 298 2,421
Number of Patients 84 49 51 26' 124 2 259 1,232
Submitted $ 36,322 34 $ 347,577.9 $ 15,196 06 $ 192.429 9' $ 33,500 49 $ 270.65 $ 85,018.89 $ 810,674 20
Less Over Fees -$ 7,237.00 -$ 57,857.1 -$ 3,319 00 -$ 42,013 01 -$ 8,042.50 -$ 43,4 -$ 18,598.50 -$ 143,290.16
Gross S 29.085.34 $ 289.720 8 $ 11,877 06 $ 150,416 9' $ 25,457 99 $ 227.25 $ 66.420 39 $ 667,384 04
Less Elective Care -S 24 00 -$ 5.518.0 -$ 394.00 -$ 2.386.01 -$ 420.00 -$ 5,4 -$ 838.00 -$ 13.373 00
Less Benefit Exclusions -S 3,938.00 -$ 39,249.5 -$ 849.00 -$ 23,153 81 -$ 2,976.05 -5 31,7 -5 7,763 05 -$ 94,1 17.04
Allowed 5 25,123.34 $ 244,953.2 5 10,634.06 5 124,877.1; $ 22,061 94 $ 190,05 $ 57,819 34 5 559.894.00
Less Co- Payment -S 5,222.70 -$ 59,299.3 -$ 1.245 15 -$ 26,864 9' -$ 730 70 -$ 48,1 -$ 7.198.55 -$ 134.279.10
Net S 19.900.64 5 185.653.9 $ 9.388.91 $ 98.012.21 5 21.331 24 $ 141,9 $ 50.620.79 5 425.614.90
Lcss Deductible 5 0.00 $ 0.0 $ 0.00 $ 0 01 $ 0 00 $ $ 0 00 $ 0.00
Persons Affected 0 0 1 0 0 0 0
Less COB -S 989 40 -$ 1,577 8 -$ 389.05 -$ 17,061.01 -$ 1,051.30 -$ 5.6 -$ 2,429 75 -$ 24.329 20
Persons Affected I 12 6 7 5 20 100
Less Over -Max -S 1,847.90 -S 15,532.3 -$ 191.70 -$ 3.981 41 -$ 1,627.70 -S 7,8 -$ 3.667 30 -S 27 314 78
Persons Affected 8 3 3 1 2 13 68
Less Ortho Over -Max S 0.00 $ 0 0 $ 0.00 $ 0 01 $ 0.00 $ $ 0.00 $ 0 00
Persons Affected 0 0 1 0 0 0
Paid S 17,063.34 $ 168.543.6 $ 8.808 16 $ 76.969 81 $ 18,652 24 $ 128.4 $ 44.523.74 $ 373,970.92
Paid Non Member S 1,607.90 $ 1 1,021.8 $ 228.00 $ 1,962.1 ' $ 391 54 $ 7,9 $ 2.227.44 5 20.888 99
*AVERAGES*
Allow /Claim S 264.46 $ 268.59 $ 177.23 $ 231.68 $ 154.28 $ 195.54 $ 194.02 $ 231.07
Paid/Claim S 179 61 $ 184.81 $ 146 80 5 142.8C $ 130.44 $ 132.16 $ 149.41 $ 154.34
Allow/Person S 299.09 $ 494 86 $ 208.51 $ 471 23 $ 177 92 $ 402.68 $ 223 24 $ 454 46
Paid /Person 5 203.14 $ 340 45 $ 172.71 $ 290 45 $ 150.42 $ 272.16 $ 171.91 5 303 55
*BENEFIT BREAKDOWN*
1 Prevent/Diagnost Allowed S 5.930.00 $ 67,000.01 $ 4,697 00 $ 37,387.98 $ 13.521 00 $ 77,353.85 $ 24.148 00 $ 181,741.81
Prevent/Diagnost Net S 5.930 00 $ 67,000.01 $ 4,697.00 $ 37,387.9€ $ 13,521.00 $ 77.552.25 5 24.148.00 5 181,940.23
Prevent/Diagnost Persons 57 461 40 245 88 449 185 1.159
Prevent/Diagnost Claims 59 607 42 355 96 583 197 1,545
Basic Services Allowed $ 10,526 00 $ 77,404.32 5 3,652.00 $ 39,826 31 $ 6.969 00 $ 47.680.00 $ 21.147.00 $ 164.910.63
Basic Services Net S 9,595.30 $ 70,132 18 $ 3,421.60 $ 35,994 96 $ 6.253 80 $ 41,920.70 5 19.270.70 S 148.047 84
Basic Services Pcrsons 44 251 18 122 19 122 81 495
Basic Services Claims 49 395 21 196 21 156 91 751
Special Rest Allowed S 8.189.00 5 61.293.01 $ 2,029.50 $ 34,923 00 $ 155 00 $ 3.321.00 $ 10.373.50 5 99.537.00
Special Rest Net S 4,094 50 $ 30,827.01 $ 1,014.75 $ 17.497.91 $ 139.50 $ 2.037 30 5 5.248 75 $ 50.362 20
Special Rest Persons 10 7C 3 37 3 10 16 117
Special Rest Claims 10 81 3 45 3 11 16 136
Prosthodontics Allowed S 349.00 $ 28,862 01 $ 0.00 $ 6.867.00 $ 0 00 $ 343.00 $ 349 00 $ 36.072.00
Prosthodontics Net S 174 50 $ 14.431.0C $ 0.00 $ 3.433.50 $ 0.00 $ 171.50 5 174 50 $ 18.036 00
Prosthodontics Per 2 16 0 8 0 1 2 25
The inforn stained in this report is privileged. confidential and protected from disclosure This report is a rr the sole use of the individual and entity to which it is addressed !/:you are not the inter, pient
. any dissen ,i, distribution or copying is strictly prohibited. If you have received this report in error, please n,.. - ie sender and destroy the original.
Groff Utilization
Washington Dental S
Washington Dental Service is a membc..,. the
Delta Dental Plans Association
Group Number: 00564
Group Name: City of Yakima
Reporting Month: 07/31/2012
Benefit Period: 01/01/2012 - 12/31/2012
Subscriber . Slime IlltpelMeat t
Moab YID Moab Ma DINA YID YTD
Prosthodontics Claims 3 21 0 17 0 1 3 39
Ortho Allowed S 129.34 $ 10,393 97 $ 255.56 $ 5,872,87 $ 1,416.94 $ 61,365 70 $ 1 $ 77.632.54
Ortho Net $ 106 34 $ 3,263.72 $ 255.56 $ 3.697 87 $ 1,416 94 $ 20.267.04 $ 1,778 84 $ 27,228.63
Ortho Persons 3 S 4 7 32 46 39 62
Ortho Claims 3 36 4 33 33 280 40 349
July 2012 Premium: $50,704.94 Employees: 803 YTD Premium: $ 417,812.41 Average YTD Employees: 810
The information contained to this report is privileged, confidential and protected from disclosure This report is intended for the sole use of the individual and entity to which it is addressed. If you are not the intended recipient
. any dissemination, distribution or copying is strictly prohibited. If you have received this report in error. please notify the sender and destroy the original
vsp Client Utilization Report
For: CITY OF YAKIMA
•
Client ID 12328220 Summary Page 1
Contract Type. ASP Run Date 08/14/12
Client Type Individually Rated
NBR GAIN/ AVG CLM #CLMS PAID REV/
PERIOD COVERED GROSS $ RETENTION $ RETN % NET $ CLAIM $ LOSS $ PLR % COST PAID FREQ MBR
2009 10,881 $126,710 $28,624 22 6 $98,087 $98,087 $0 100 $145 10 676 62 $2 63
2010 10,745 $145,182 $28,339 19 5 $116,843 $116,843 $0 100 $144 43 809 75 $2 64
2011 10,286 $143,949 $27,708 19.2 $116,242 $116,242 $0 100 $132 85 875 85 $2 69
AUG 873 $14,243 $2,266 15.9 $11,978 $11,978 $0 100 $130.19 92 105 $260
SEP 792 $9,140 $2,310 25 3 $6,830 $6,830 $0 100 $119.82 57 72 $2 92
OCT 794 $11,346 $2,289 202 $9,057 $9,057 $0 100 $141.51 64 81 $2.88
NOV 796 $9,893 $2,314 23 4 $7,579 $7,579 $0 100 $126.32 60 75 $2 91
DEC 881 $13,015 $2,304 17 7 $10,711 $10,711 $0 100 $120 35 89 101 $2 62
JAN 805 $23,711 $2,123 9 0 $21,588 $21,588 $0 100 $168.66 128 159 $2 64
FEB 824 $13,434 $2,161 16.1 $11,273 $11,273 $0 100 $161 04 70 85 $2 62
MAR 809 $14,824 $2,135 14.4 $12,689 $12,689 $0 100 $156 66 81 100 $2 64
APR 825 $13,022 $2,135 16.4 $10,888 $10,888 $0 100 $149 15 73 88 $2 59
MAY 808 $8,331 $2,109 25.3 $6,222 $6,222 $0 100 $141 40 44 54 $2 61
JUN 785 $9,292 $2,077 22.4 $7,214 $7,214 $0 100 $126 57 57 73 $2 65
JUL 788 $9,960 * $2,071 20.8 $7,890 $7,890 $0 100 $125 23 63 80 $2 63
LTM 9,780 $150,212 * $26,294 17 5 $123,918 $123,918 $0 100 $141 14 878 90 $2.69
CC 15,930 $236,524 * $42,519 18 0 $194,005 $194,005 $0 100 $139 47 1,391 87 $2.67
YTD 5,644 $92,575 * $14,811 16.0 $77,764 $77,764 $0 100 $150 71 516 91 $2 62
MEMBERSHIP AVERAGES MEMBERS SPOUSE DEPENDENTS
REV/ CLM IND PNL CLMS # AVG MBR CLMS # AVG SP CLMS # AVG DEP SP+
PERIOD MBR $ RATE % PERIOD $ CLMS COST % $ CLMS COST % $ CLMS COST % DEP
2009 $2.63 $9 01 $11 64 81 AUG $5,801 44 $131.83 48 $3,446 25 $137.84 27 $2,731 23 $118.74 25 52
2010 $2.64 $10 87 $13 51 81 SEP $2,559 20 $127.97 35 $1,785 12 $148.71 21 $2,486 25 $99.44 44 65
2011 $2.69 $11.30 $13.99 81 OCT $4,887 30 $162.91 47 $2,058 16 $128.61 25 $2,112 18 $117 32 28 53
Q1 $2.63 $18.68 $21.31 76 NOV $3,020 26 $116.14 43 $1,911 16 $119.46 27 $2,648 18 $14712 30 57
Q2 $2.61 $10.06 $12.67 82 DEC $6,041 47 $128.52 53 $2,336 18 $129.77 20 $2,334 24 $97.27 27 47
Q3 $2.63 $10.01 $12 64 81 JAN $9,208 57 $161.54 45 $5,935 33 $179.85 26 $6,445 38 $169.61 30 55
LTM $2 69 $12 67 $15 35 79 FEB $5,261 30 $175.37 43 $3,539 20 $176.94 29 $2,473 20 $123.65 29 57
CC $2.67 $12 18 $14 84 80 MAR $5,203 34 $153.02 42 $3,331 20 $166.53 25 $4,156 27 $153.92 33 58
YTD $2 62 $13 78 $16 40 79 APR $5,558 36 $154.38 49 $2,558 17 $150.48 23 $2,772 20 $138 60 27 51
MAY $3,049 20 $152.44 45 $1,779 11 $161.74 25 $1,394 13 $10721 30 55
JUN $3,843 31 $123.96 54 $866 9 $96 26 16 $2,505 17 $147 36 30 46
JUL $4,709 36 $130.79 57 $1,353 10 $135.31 16 $1,828 17 $10753 27 43
ADJ - Adjustments TOT $59,137 411 $143.89 47 $30,897 207 $149 26 24 $33,884 260 $130 32 30 53
CC - Current Contract
LTM - Last Twelve Months
YTD - Ye T^ Date This report is solely intended for the '' `the contract holder and is not to be shared
' - Aste vte Estimates Due to Non or Partial Payment EIS /UTIL002
EBMS
Fmp/ '... nenc / ?l Managrenen:t SeeVICes, Inc
Age Matrix
CITY OF YAKIMA
Group. 0000218
As of . 7/31/2012
Emp & Family
Medical: Male Female Male Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Medical
0 to 29 10 1 0 13 290 248 562
30 to 34 27 5 5 32 0 0 69
35 to 39 40 8 5 51 0 0 104
40 to 44 41 9 6 38 0 0 94
44 to 49 29 8 9 24 0 0 71
50 to 54 20 1 5 13 0 0 39
55 to 59 11 2 2 6 0 0 21
60to64 1 0 1 0 0 0 2
Totals: 179 34 33 177 290 248 962
Emp Only
Medical: Male Female Male Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Meaical
0 to 29 15 7 0 0 0 0 22
30 to 34 15 8 0 0 0 0 23
35 to 39 19 8 0 0 0 0 27
40 to 44 13 15 0 0 0 0 28
44 to 49 14 11 0 0 0 0 25
50 to 54 20 18 0 0 0 0 38
55 to 59 38 18 0 0 0 0 56
60 to 64 47 45 0 0 0 0 92
65 to 69 9 6 0 0 0 0 15
70 and Over 4 2 0 0 0 0 6
Totals: 194 138 0 0 0 0 332
Emp, Spouse, 1 Dep
Medical: Male Female Male Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Medical
0 to 29 1 2 2 3 28 34 70
30 to 34 4 2 0 5 0 0 11
35 to 39 9 1 3 7 0 0 20
40to44 6 2 1 8 0 0 17
44 to 49 6 4 2 12 0 0 24
50to54 8 4 4 5 0 0 21
55 to 59 8 0 2 2 0 0 12
60 to 64 2 2 2 1 0 0 7
65 to 69 0 0 1 1 0 0 2
Totals: 44 17 17 44 28 34 184
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Emp & Spouse
Medical: Male Female Male Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Medical
01o29 5 0 0 8 0 0 13
30 to 34 3 0 0 0 0 0 3
35 to 39 0 2 0 0 0 0 2
40 to 44 0 0 1 1 0 0 2
44 to 49 6 1 0 9 0 0 16
50 to 54 14 4 2 17 0 0 38
55 to 59 23 8 5 26 0 0 62
60 to 64 31 5 10 17 0 0 63
65 to 69 4 0 1 6 0 0 11
70 and Over 1 0 1 1 0 0 3
Totals: 87 20 20 85 0 0 213
Emp & 1 Dep
Medical: Male Female Male Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Medical
0 to 29 1 3 0 0 14 16 34
30to34 3 1 0 0 1 0 5
35 to 39 3 2 0 0 0 0 5
40 to 44 1 1 0 0 0 0 2
44 to 49 2 3 0 0 0 0 5
50 to 54 1 2 0 0 0 0 3
55 to 59 5 2 0 0 0 0 7
60 to 64 0 1 0 0 0 0 1
Totals 16 15 0 0 15 16 62
Emp & Children
Medical: Male Female Mate Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Medical
0 to 29 0 3 0 0 35 59 97
30to34 1 0 0 0 0 0 1
35 to 39 4 3 0 0 0 0 7
40 to 44 5 6 0 0 0 0 11
44 to 49 7 1 0 0 0 0 8
50 to 54 4 3 0 0 0 0 7
55 to 59 2 1 0 0 0 0 3
Totals: 23 17 0 0 35 59 134
Totals: Medical
Male Female Male Female Male Female Total
Age Category Emp Emp Spouse Spouse Dep Dep Medical
0 to 29 32 16 2 24 367 357 798
30 to 34 53 16 5 37 1 0 112
35 to 39 75 24 8 58 0 0 165
40 to 44 66 33 8 47 0 0 154
44 to 49 64 28 11 45 0 0 149
50 to 54 67 32 11 35 0 0 146
55 to 59 87 31 9 34 0 0 161
60 to 64 81 53 13 18 0 0 165
65 to 69 13 6 2 7 0 0 28
70 and Over 5 2 1 1 0 0 9
Totals: 543 241 70 306 368 357 1,887
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