2005-06-07 Workshop Health Ins27r,
CITY OF OKEECHOBEE
JUNE 79 2005 CITY COUNCIL
HEALTH CARE COVERAGE WORKSHOP
I. CALL TO ORDER - Mayor:
June 7, 2005 City Council Health Care Coverage Workshop, 5:00 p.m
II. MAYOR, COUNCIL AND STAFF ATTENDANCE - City Clerk.
Mayor James E. Kirk
Council Member Noel A. Chandler
Council Member Lowry Markham
Council Member Dowling R. Watford, Jr.
Council Member Lydia Jean Williams
City Administrator Brian Whitehall
City Attorney John R. Cook
City Clerk Lane Gamiotea
Deputy Clerk Melisa Eddings
Police Chief Denny Davis
Fire Chief Herb Smith
Public Works Director Robertson
111. NEW BUSINESS - Mayor.
A. Discuss Health Care Coverage Options - Scott Harris.
PAGE 10F 2
Mayor Kirk called the June 7, 2005 City Council Health Care Coverage Workshop to order at 5:00 p.m.
City Clerk Gamiotea called the roll:
Present
Present (entered Chambers at 5:18 p.m.)
Present
Present
Present
Present
Absent
Present
Present
Absent (Major Peterson was present in his absence)
Absent
Absent
Mr. Scott Harris of Group Insurance Solutions, Inc., the City's representative to Blue Cross/Blue Shield of Florida, was
present to introduce to the Council this years' alternate coverage options available for the City and employees. Mr.
Harris stated that the current HMO plan is being offered to the City for another year with no premium increase or
decrease of benefits. He also offered a new plan, Blue Options 1748 and 1750. The comparison given was between
the present plan (HMO Plan 4), and Blue Options Alternate 1748. With the HMO Plan 4, employees are limited to
health care services listed in the HMO Network, you must also obtain referrals to visit any doctor other than your
designated primary provider. Blue Options 1748 is basically a PPO (Preferred Provider Option) Plan. A note made by
Mr. Harris was that Dr. Platt and the Okeechobee Surgical Center are not included in the new Blue Options plans.
Under the PPO plans, employees would have to pay out of pocket deductible expenses, however the are no designated
primary providers or referrals to obtain.
17
1
277
III. NEW BUSINESS - Mayor.
A. Discuss Health Care Coverage Options continued.
IV. ADJOURN WORKSHOP - Mayor.
Please take notice and be advised that when a person decides to appeal any decision made by the City Council with
respect to any matter considered at this meeting, he/she may need to insure that a verbatim record of the proceeding
is made, which record includes the testimony and evidence upon which the appeal is to be based. City Clerk tapes
are for the sole purpose of backup for official records of the Clerk.
A
James E. Kirk, Mayor
ATTEST:
Lane Gami a, CMC; City:Clerk
JUNE 7, 2005 - CITY COUNCIL HEALTH CARE COVERAGE WORKSHOP - PAGE 2 OF 2
Mr. Harris offered the suggestion that since the Blue Options Plan is less in overall premiums. The City could then pass
that savings on to the employee's who purchase health insurance coverage for spouse or family plans. Currently there
are only fourteen employee's who participate in this. Mr. Harris also advised that the PPO plans are where Blue
Cross/Blue Shield are wanting to eventually be with all their clients and the HMO plans are being phased out. The City
will need to decide whether they want to continue with the HMO plan another year or change to the PPO plan.
Council Members noted they were pleased with the news that the premiums will not be increasing. The Council
instructed Administrator Whitehall to meet with the Department Heads to promote feedback from the employees on
which option they would prefer. Mr. Harris offered to meet with the Department Heads and employee's to explain the
coverage options. The Council expressed their appreciation to Mr. Harris for the presentation of the coverage options.
No official action was taken at the workshop. Once Administrator Whitehall has the employee feedback, the matter
will be brought back to the City Council for final consideration and contract renewal.
THERE BEING NO FURTHER ITEMS ON THE AGENDA, MAYOR KIRK ADJOURNED THE WORKSHOP AT 5:58
P.M.
0 0
The Okeechobee News
P.O. Box 639, Okeechobee, Florida 34973
(863) 763-3134
Published Daily
STATE OF FLORIDA
COUNTY OF OKEECHOBEE
Before the undersigned authority personally appeared
Judy Kasten, who on oath says she is publisher of the Okeechobee
News, a DAILY Newspaper published at Okeechobee, in
Okeechobee County, Florida; that the attached copy of advertise-
ment, in a
in the matter of
in the 19th Judicial District of the Circuit Court of Okeechobee
County, Florida; was pu lished in said newspaper in the issues
of
30
Affiant further says that the said Okeechobee News is
a newspaper published at Okeechobee, in said Okeechobee
County, Florida, and that said newspaper has heretofore been
published continuously in said Okeechobee County, Florida
each week and has been entered as second class mail matter at
the post office in Okeechobee, in said Okeechobee County,
Florida, for a period of one year next preceding the first
publication of the attached copy of advertisement; and affiant
further says that she has neither paid nor promised any person,
firm or corporation any discount, rebate, commission or refund
for the purpose of securing this advertisement for publication in
the said newspaper.
S%V a sabscribed before me this 7' `"
day of A.D. 20
�xI R. Brown
Notary Public, State of Flo ida at Large Commission #DD2721 I8
=aP Expires: Jan 17, 2008
Bonded Thru
"" Atlantic Bonding Co., Inc.
•
•
Tape 1 side A
CITY OF OKEECHOBEE - June 7, 2005 - HEALTH CARE COVERAGE WORKSHOP.
HANDWRITTEN MINUTES
I. CALL TO ORDER -Mayor: Kirk June 7 2005 City Council Regular Meeting 5:07 p.m.
II. MAYOR, COUNCIL AND STAFF ATTENDANCE - City Clerk.
Present Absent
Mayor James E. Kirk
Council Member Noel A. Chandler
Council Member Lowry Markham
Council Member Dowling R. Watford, Jr.
Council Member Lydia Jean Williams
City Administrator Brian Whitehall
City Attorney John R. Cook
Clerk Lane Gamiotea
Deputy Clerk Melisa Eddings
Police Chief Denny Davis
Fire Chief Herb Smith
Public Works Director Robertson
Page -1-
X
5:18 p.m.
x
X
X
X
X
x
X
X
Major Peterson
x
Cleveland Lamb
III. NEW BUSINESS - Mayor.
A. Discuss Health Care Coverage Options - Scott Harris.
Scott Harris, Veach had asked for them earlier, renewal no in crease in costs or decrease in benefits, alternate
plan introduced statewide, want to consider it.
Page 1 comparison of benefits, HMO Plan 4, to Blue Options Alternates 1748 and 1750 (PPO, different
network)
provider match very good, provider in new plan.
Platt not in nor is the surgical center
Costs rates, budget figures, enrollment figures,
Interest in new plan at all?
DW cost employee to pay fairly similar, but benefit to change, go to Moffett center, you can and you don't have
to ask, huge plus in my opinion.
Good is the flexibility, don't have specific doc assigned, test authorizations no longer, higher co pay, is down
side
just want to show you best options available to city,
decide by July 15, July 1 better, new id cards, no enrollment , application, enrollment summary, employee
education meetings,
tip of the ice burg for the future of insurance plans, you can offer multiple plans for the employees, 3-5 years
down the road you may be interested,
covered if out of state, yes, HMO for emergency & ppo yes,
ask dept heads to ask employee's their plan,
access to medical care
better than expected,
appreciate Scott presenting the options.
ADMINISTRATOR MEET WITH DEPT HEADS 1748-2, -4 AND HMO
IX. MAYOR KIRK ADJOURNED THE WORKSHOP AT 5:58 p. m.
Page -1-
CITY OF OKEECHOBEE - June 7, 2005 - HEALTH CARE COVERAGE WORK
HANDWRITTEN MINUTES SHOP.
I. CALL TO ORDER - Mayor: Kirk June 7 2005 CitY Council Regular Meeting 5;
N.m
If. MAYOR, COUNCIL AND STAFF ATTENDANCE - City Clerk.
Mayor James E. Kirk Present Absent
-
Council Member Noel A. Chandler
Council MF tuber Lowry Markham ✓ -- --T -
Council Ml- mber Dowling R. Watford, Jr.
Council Member Lydia Jean Williams �
City Admi,iistrator Brian Whitehall ✓ ----
City Attorney John R. Cook
Clerk Lane Gamiotea
Deputy Clerk Melisa Eddings
Police Chief Denny Davis &b
Mob orb
Fire Chief Herb Smith
Public Works Director Robertson
III. NEW BUSINESS - Mayor.
A. Discuss Health Care Coverage Options - Scott Harris, -- --'
�hC z�
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IX. MAYOR KIRK ADJOURNED THE WORKSHOP AT =G7�
C/� p. M.
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CITY OF OKEECHOBEE
JUNE 7, 2005 CITY COUNCIL
HEALTH CARE COVERAGE WORKSHOP
OFFICIAL AGENDA
PAGE 1 OF 1
• I. CALL TO ORDER - Mayor: June 7, 2005 City Council Health Care Coverage Workshop, 5:00 p.m.
II. MAYOR, COUNCIL MEMBERS AND STAFF ATTENDANCE - City Clerk.
Mayor James E. Kirk
Council Member Noel A. Chandler
Council Member Lowry Markham
Council Member Dowling R. Watford, Jr.
Council Member Lydia Jean Williams
City Administrator Brian Whitehall
City Attorney John R. Cook
City Clerk Lane Gamiotea
Deputy Clerk Melisa Eddings
Police Chief Denny Davis
. Fire Chief Herb Smith
Public Work Director Donnie Robertson
III. NEW BUSINESS - Mayor.
A. Discuss Health Care Coverage Options - Scott Harris.
IV. ADJOURN WORKSHOP - Mayor.
PLEASE TAKE NOTICE AND BE ADVISED that if any person desires to appeal any decision made by the City Council with respect to any matter considered at this proceeding,
such interested person will need a record of the proceedings, and for such purpose may need to ensure a verbatim record of the proceedings, which record includes the testimony
and evidence upon which the appeal is to be based. City Clerk tapes are for the sole purpose of backup for official records of the Clerk.
Provider Data Report by Member Count
Page 1 of 7
•
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•
•
SPECIALTIES OKEECHOBEE
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•
•
SPECIALTIES
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X
X
SPECIALTIES
OTHER
88388
STEPHENS PETER W
CHIROPRACTOR
OKEECHOBEE
FL
34074
OKEECHOBEE
1
8
$111.86wxx—lx
X
SPECIALTIES
OUTER
81326
GALIN MX:HAEL A
OTORHINOLARYNOOLOGY
927 45TH ST STE 101
BEACH WEST PALM
FL
33407
PALM BEACH
1
1
$108.31
ix
SPECIALTIES
I OTHER
GRIMM ERK: S
RADIOLOGY
4WD LINTON BLVD
BLDG C STE 800
DELRAY BEACH
FL
33448
PALM BEACH
1
3
$170.97
IX
(SPECIALTIES
JO H
42548
eO��iL
SURGERY, GENERAL
OKEECHOBEE
FL
34972
OKEECHOBEE
1
1
us.58
TI`S
OTHER
31830
AAAIN SHAKOOR A
CARDIOVASCULAR DISEASE
1800 SW 2ND AVE Y B
OKEECHOBEE
FL
34974
OKEECHOBEE
1
7
$07.83
X
X
X
ISPECAALTIES
OTHER
20940 ;OLIVOS
WILLJAM A
OPTOMETRIST
OKEECHOBEE
FL
M74
OKEECHOBEE
11
2
$114.09
X
X
ix
;SPECIALTIES
,OTHER
10272
FRANKDAVIDA
ANESTHESIOLOGY
WELLINGTON
FLt
PALM BEACH
1
1
L122a00
X
X
X
%
SPECIALTIES
�OTHER
17806
TIDWELL BTEVEN M
MDKX OGY
STUART
FL
MARTIN
1
2
$75.10
X
X
X
Ix
SPECIALTIE3
OTHER
15001
PICERNE STEVEN D
RADIOLOGY
STUART
FL
MARTIN
1
1
$70.47
Ix
X
SPECIALTIES
OTHER
SPECIALTIES
13893
MILLER HAROLD S
ANESTHESIOLOGY
JUPITER
FL
PALM BEACH
1
1
$380.00
X
IX
SPECIALTIES
08210
I IANNOTTI NICHOLA8 O
ONCOLOGY, MEDICAL
1801 BE HILLMOOR OR
STEB-101
PORT SAINT
LUCIE
349�
SST LUCIE
1
2
t42.83
X
X
%
X
IOTHER
12248
GOMEZ HELDO J
SURGERY, NEUROLOGICAL
BURNS RD STE
200
00
PALM BEACH
GARDENS
33g10
PALM BEACH
1
1
$101.10
X
X
X
X
SPECL4LTIES
IX
OTHER
0047
KUEHL GORY V
PATHOLOGY
WEST PALM PALM
BEACH
FL
W4W
PABEACH
1
2
$785.82
X
X
X
SPECIALTIES
OTHER
08573
AMADO JEFFREY A
ANESTHESIOLOGY
1411 N FLAGLER DR
STE 4000
WEST PALM
BEACH
FL
33401
PALM BEACH
1
1
$210.00
X
X
1 X
X
SPECIALTIES
jOTHER
07173
MARIN CARLOS F
ANESTHESIOLOGY
BELLE GLADE
FL
3343DI
PALM BEACH
1
1
$315.00
X
X
X
X
!SPECIALTIES
HOSPITAL
HOSPITAL
GENERAL ACUTE CARE
OKEECHOBEE
FL
34272
OKEECHOBEE
491
238
11=154.04
X
X
IX
X
286
RAULERSON
HOSPITAL
IHOSPITAL
COLUMBIA HOSPITAL
GENERAL CARE
PALM
FL
33407
PALM BEACH
4
24
i4935.92
X
X
f X
X
283
HOSPITAL
BEACH
BEACH
http://infobank/Analytics/saw.dll?PortalGo 4/11 /2005
Provider Data Report by Member Count
Page S of 7
L�
HOSPITAL W�NGTON
GENERAL ACUTE CARE
WEST PALM
FL
W414
PALM BEACH
3
67
$5647.74
X Ix
i
IX
i
IX
293 REGIONAL MEDICAL
CENTER
HOSPITAL
BEACH
HOSPITAL
JUPITER
MEDICAL
GENERAL ACUTE CARE
JUPITER
FL
334M
PALM BEACH
3
32
$8125.07
X
X
X lX
289
CENTER
HOSPITAL
!HOSPITAL
SHANDS HOSPITAL AT
GENERAL ACUTE CARE
GAINESVILLE
FL
32810
ALACHUA
1
18
$4322.02
X
X
X
X
12b
THE UNIVERSITY OF FL
HOSPITAL
HOSPITAL
TAA ��
GENERAL ACUTE CARE
TALLAHASSEE
F
3M
LEON
1
9
8221.78
X
X
X
I
406
HOSPITAL
HEALTHCARE INC
ANCILLARY
QUEST DIAGNOSTICS
CLINICAL MEDICAL
TAMPA
FL
33817
HILLSBOROUGH
24
90
$143OXA
X
X
X
X
Lam
INC
LABORATORY
ANCILLARY
LAB�AT�Y
CLINICAL MEDICAL
TAMPA
FL
33807
HILLSBOROUGH
20
92
82888.13
X
X
X
Lam
CORPORATION OF
LABORATORY
AMERICA
;
ANCILLARY
JUPITER OPEN
RADIOLOGY
8�6 MILITARY TRL STE
JUPITER
FL
33468
PALM BEACH
6
11
$1366.10
X
X
X
X
V2416
IMAGING
AiNCILLAnir
O4Y
NEW AiriERi%AN
REHABILITATION
OKEECHOBEE
K
!
34SIre
- --- ----
untt�.nwet
3
!
PHYSICAL THERAPY
ANCILLARY
DIAGNOSTIC IMAGING
RADIOLOGY
STUART
FL
34994
MARTIN
3
14
Ni0.00
X
X
X
X
77636
SERVICES
3
$1479.31
X
X
ix
ANCILLARY
OPEN MRI OF
RADIOLOGY
115 NE 3RD ST STE A
OKEECHOBEE
FL
34972
OKEECHODEE
3
IX
OKEECHOBEE. LLC
--I
1ANC. ILLARY
IMAGING
RADIOLOGY
12300SOUTHSHORE
�JNGTON
R
33414
PALM BEACH
2
2
$111.88
X
X
�X
�X
V�
SPECIALISTS
SPECIALISTS
MIDTOWN IMAGING LLC
RADIOLOGYSM
BLVD STE 212
OKEECHOBEE
BLVD STE 101
WEST P�
BEACH
FL
39417
PALM BEACH
2
2
$134.13
X
X
IX
IX
ANCILLARY
Y2448
ANCILLARY
GAINESVILLE OPEN MRI
RADIOLOGY
4340 W NEWBERRY RD
GAINESVILLE
FL
32807
AIACHUA
1
3
$410.70
X
X
X
IX
V2801
CENTER INC
STE 104
ANCILLARY
63A
PALMS WELLINGTON
AMBULATORY SURGICAL
ROYAL PALM
FL
3341t
PALM BEACH
1
3
j1814.96
X
X
X
X
SURGICAL CENTER
X
X
X
IX
ANCILLARY
39W6
FL UNITED RADIOLOGY
MULTI -SPECIALTY
PLANTATION
FL
M17
BROWARD
1
2
$170.94
PLANTATION
ANCILLARY
ORTHOPEDIC FIXATION
DURABLE MEDICAL EOUIPMENT
PALM CITY
R.
34000
MARTIN
1
1
i300.00
X
X
ix
X
R8782
SYSTEMS
& MEDICAL SUPPLIES
' ANCILLARY
INDEPENDENT IMAGING
RADIOLOGY
1 W OKEECHOBEE
PALM
FL
33411
PALM BEACH
1
3
$217.00
X
X
X
X
V2848
LLC
ANCILLARY
V2309
RADIOLOGY IMAGING
RADIOLOGY
FORT PIERCE
FL
34950
SAINT LUCIE
1
1
$111.05
X
X
X
X
{
ABSOCUITES
V2288
ULTRACAREtMA01NG
RADIOLOGY
COCON{ANCILLARY
CREEK
FL
33073
BROWARD
1
3
>j227.84
X
X
X
iX
SERVICES
CORAREHABILITATION
REHABILITATION
HAINES CITY
FL
33844;POLK
1
11
11443.00X
X
X
;X
(ANCILLARY
O81
CLINICS
I I
ANCILLARY
JUPITER PATHOLOGY
4/11/2005
http://infobank/Analytics/saw.dll?PortalGo
Provider Data Report by Member Count
Page 6 of 7
•
0
'ANCILLARY
NM 'ASSOC
PATHOLOGY
JUPITER
FL I33458
1
PALM BEACH
11
2
SM.04
X IX
IX
IX.
206
MARTIN MEMORIAL
STUART
FL
34M
MARTIN
1
8
$2140.76
X
X
X
X
HOSPITAL SOUTH
PRIMARY CARE
11356
MILLER WILLIAM P
FAMILY PRACTICE
TALLAHASSEE
FL
32308
LEON
1
1
S83.03
X
SPECIALIST
I OTHER
22072
PLATT JOHN K
CHIROPRACTOR
OKEECHOBEE
FL
34974
OKEECHOBEE
44
354
$6138.96
X
X
X
SPECIALTIES
OTHER
12910
HUSSAIN MUSHTAO
PATHOLOGY
OKEECHOBEE
FL
34973
OKEECHOBEE
8
8
$718.30
X
X
X
SPECIALTIES
;OTHER
47018
GARCIA TRiNIDAD E
GYNECOLOGY
OKEECHOBEE
FL
34972
OKEECHOBEE
3
4
$591.35
X
X
X
SPECIALTIES
OTHER
80141
DOUGLAS EDWARD W
CHIROPRACTOR
OKEECHOBEE
FL
34972
OKEECHOBEE
3
3
S72.42
X
X
SPECIALTIES
iOTHER
02074
KURESHI ZAFAR U
SURGERY, ORTHOPEDIC
,
2257 HWY 441 NORTH
SUITE B
OKEECHOBEE
FL
34972
OKEECHOBEE
2
3
$200.81
X
X
X
i SPECIALTIES
,OTHER
'SPECIALTIES
07246
PANGILINAN TRISTAN H
UROLOGY
OKEECHOBEE GENITO
URINARY BURG 200 N E
OKEECHOBEE
FL
34972
OKEECHOBEE
2I
15
se93 as
X
X IX
i
19TH DR
!OTHEALT1E3
43037
MACMILLAN DAVID M
SURGERY, NEUROLOGICAL
MART
FL
34M
MARTIN
2
2
$85.18
X
X!SPECI
X
?OTHER
20900
MOLL MARK J
OPTOMETRIST
OKEECHOBEE
FL
34974
OKEECHOBEE
1
2
$79.40
X
X
jSPECAALTIE3
OTHER
12807
LEIBOWK:H SHLOMO
RADIOLOGY
PLANTATION
FL
33324
BROWARD
1,
2
$54.50
X
X
IX
SPECIALTIES
EBRA3KA AVE
1STEE
LUCIE
IF-1
$141 28
X
X
IX
•OTHER
28218
BRIDGES KENNETH G
SURGERY, CARDIOVASCULAR
4
FORT PIERCE
0
SAINT
i 3PECIALTIE9
OTHER
11638
HELLERSTEIN DANIEL K
UROLOGY
1411 N FLAGLER OR
WEST PALM
BEACH•OTHER
1
PALM BEACH
1
1
sw.w
X
X
;SPECIALTIESSTE5100
27570AFSHAR
JOHN K
SURGERY. NEUROLOGICAL
5W S2E�RIVERSIDE DR
STUART
4
MARTIN
1
1
$211.00
X
X
X
SPECIALTIESOTHER
26728
REDDY KAMBAM R
ANESTHESIOLOGY
234514TH AVE STE B
VERO BEACH
INDIAN RIVER
1
2
$414.54
X
X
X
SPECIALTIESjOTHER
14404
GAREN PAUL D
PATHOLOGY
WE8T PALM
BEACHIOTHER
1
RFOKEECHOBEE
PALM BEACH
1
2
571.84
X
X
!SPECIALTIES
00448
WEISS GARY A
PATHOLOGY
B�CH"�'A
1
PALM BEACHi
1
S7e.7s
X
X
IALTIES
05720
SCHNEIDER JOEL A
RADIOLOGY
210 S FEDERAL HWY FL
2
HOLLYWOOD
19ROWARD
1
1
$726.85
X
X
X
SPECIALTIESOTHER
47045
RIAZ MOHAMMAD
CARDIOVASCULAR DISEASE
OKEECHOBEE2
OKEECHOBEE
1
3
$167.73
X
X
X
!SPECIALTIES+—i
03879
FLAXMAN MITCHELL S
GASTROENTEROLOGY
STYE SOLD DIXIE HWY
JUPITER
8
1 PALM BEACH
1
1
$338.13
X
X X
OTMER
4gggg
ENDOCRINOLOGY
8200 JOG RD STE 204
BOYNTON
FL
�33437
PALM BEACH
1
i
554.30
X
'X X
GATCHAIR ROSE
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Provider Data Report by Member Count
Page 7 of 7
SPECIALTIES
ANDREA E
RD
BEACH
IX
OTHER
381
REINOSO HORACIO E
EMERGENCY MEDICINE
toot IVES DAIRY
STE 208
MIAMI
FL
33179
MUW-DADE
1
1
$64.82
X
X
(SPECIALTIESill
OTHER
09602
PARKER PATRK;UI J
PATHOLOGY
PALM BEACH
GARDENS
FL
33410
PALM BEACH
1
5
$215.62
SPECIALTIES
OTHER
10N7
ppgpEg RF.UVEN
RADIOLOGY
PLANTATION
FL
3=17
BROWARD
1
12
$511.38
X
X
X
SPECIALTIES
OTHER
95184
TAUS SHELDON J
GASTROENTEROLOGY
1002 S OLD DIXIE HWY
STE 201
JUPITER
FIL
33458
PALM BEACH
1
1
$170.57
X
X
X
SPECIALTIES
ANCILLARY
87M
SURGERY CENTER OF
AMBULATORY SURGICAL
OKEECHOBEE
FL
34972
OKEECHOBEE
7
22
$14844.74
X
X
X
(ANCILLARY
Z0204
OKEECHOBEE INC
WILLETTEMICHAEL
OCCUPATIONAL THERAPIST
OKEECHOSEE
f
34972
OKEECHOBEE
4
27
$121&00
X
IANCILWiY
40675
MENTAL HEALTH
PSYCHIATRY
12E MORANBLVD
CASSELSERRY
FL
32707SEMINOLE
4
8
$899.40
X
NETWORK
(ANCILLARY
LABORATORY CORP OF
CLINICAL MEDICAL
BIRMINGHAM
AL
35233
JEFFERSON
2
6
$1la93
X
X
X
Law
AMERICA HOLDINGS
LABORATORY
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P3822
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PHARMACY
OKEECHOBEE
Fl
34972
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AX
DISCOUNT DRUGS
ANCILLARY
FLORIDA HOSPITAL
SE13RING
FL
SU72
HIGHLANDS
2
4
$70.00
X
X
j
,22
WAUCHULA
;ANCILLARY
MARTINMEMORUIL
PORT SAINT
FL
Ig4966
SAINTLUGE
1
2
ti629.12
X
X
X
V2300
DIAGNOSTIC SERVICES
RADIOLOGY
LUCIE
AT 3
`ANCILLARY
68U
AMBULATORY SURGICAL
FORT PIERCE
FL
34950
SAINT LUCIE
1
2
$1446.15
X
X
X
CENTER PSURGICAL
ANCILLARY
S
NURSE ANESTMEnsT'
�T PALM
FL
33414
PALM BEACH
1
1
t22&00
X
p1418
POULOS J
CERTIFIED REGISTERED
ANCILLARY
G2393
STINE DIAN£ W
CERTIFIED REGISTERED
JUPITER
FL
39456
PALM BEACH
1
1
ti315 00
X
ANCILLARY
CAMPBELL ELIZABETH
NURSE ANESTHETIST,
JUPITER
FL
33458
PALM BEACH
1
2
$266.50
jX
j
G2473
A
CERTIFIED REGISTERED
;ANCILLARY
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G2878
FEGfT DEMISE M
NURSE ANESTHETIST,
CERTIFIED REGISTERED
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FL
33456
PALM BEACH
1
1
$167.50
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7.
City of Okeechobee
Group Health Insurance
August 1, 2005 Renewal Analysis and Comparison
Prepared by
Scott Harris
May, 2005
18230 RIVER OAKS DRIVE 0 JUPITER, FL 33458 0 PHONE 561-747-5636 • FAx 561-747-3524 • 800-972-0963
�olut�occ, c.cc.
City of Okeechobee 2005 Blue Cross Health Insurance Renewal Comparison
Present Plan
B1ueOptions Alternates
HMO Plan 4
1748 1750
Provider Network
Bluecare
Network Blue
Maximum Benefit
Unlimited
$5,000,000
Basic, Preventive and Diagnostic Care
Open Access to PCP/ Specialist?
No
Yes
Test/Surgery Approval Required?
Yes
No
1M, GP, FP, Ped OV Copay
$10
$10 $15
Specialist OV Copay
$10
$20 $30
Independent Clinical Lab Copay (Quest)
$0
$0
Ind Diagnostic Testing Fac Copay
$0
$50 $100
Prescription Copays
5/15/30
7/20/35 10/25/40
Physician Services Received Outside of the Physicians Office (surgery, IP ER Radiology, Pathology, Anesthesia)
Calendar Year Deductible
$0
$0 in/ $500 out $0 in/ $500 out
Coinsurance C/o you pay, in network)
0%
0% of negotiated fee 10% of
Coinsurance (out of network)
100%
40% +bb in excess of BCBS allowance
Hospital Services
Varies by
Hospital- Option 1 Hospital/ Option 2/ Option 3
Hospital Inpatient Co Pay/admit
$0
$250/500/750 $400/800/1200
Out Patient Surgery/Test Copay
$0
$100/200/300
Emergency Room Services Copay
$50
$50 $ 1 00+ded/coins on Dr
Amb/DME/HHC/Injectable Drug
$0
deductible/coinsurance
Therapy Copay
$0, 60 days
ded/coins, $2500/ year
Maximum Out of Pocket Expense on Covered Charges/ Calendar Year (In Network/Out of Network)
On Ded/Coins/Non-rx Copays
$1500
$1500/$3000 $2500
Blueoptions non -participating provider benefits access the Blue Cross PPO and Traditional networks to access their pre -
negotiated fees and no balance -billing provisions with providers that do not participate in Network Blue. Expenses with
providers who are not under any contract with BCBSFL are subject to the BCBSFL "MAP" (Maximum Allowable Payment),
which is lower than actual charges.
�olut�'ora., c.cc.
City of Okeechobee 2005 Health Insurance Rate Comparison
Blue Cross/Blue Shield
Present Rates
Renewal Rates
Alternate Plans
HMO Plan 4
HMO Plan 4
Plan 1748
Plan 1750
Employee Only (49)
$438.00
$438.00
$407.47
$395.85
Employee/Sp (5)
936.50
936.50
965.19
937.68
Employee/Ch (9)
790.88
790.88
818.71
795.37
Family (1)
1299.38
1299.38
1376.43
1337.19
Annual Total (64)
$415,342
$415,342
$402,441
$390,967
$ Change
$0
($12,901)
($24,375)
% Change
0.0%
(3.1 %)
(5.9%)
Employer Cost*
$348,984
$348,984
$325,537
$316,613
Employer Cost $ Change
$0
($23,447)
($32,371)
Employer Cost % Change
0.0%
(6.7%)
(9.3%)
Weekly Payroll Deductions:
Employee Only
$0
$0
$0
$0
Employee/Spouse
$98.89
$98.89
$112.56
$108.89
Employee/Children
$65.29
$65.29
$78.75
$76.05
Empl/Spo/Children
$182.64
$182.64
$207.47
$201.09
*Employer Cost is based on 100% of the employee premium and $70 of each dependent premium
No adjustment has been made for enrollees the City does not pay for.
�olutlosa., ucc.
Employee Only (49)
Employee/Sp
(5)
Employee/Ch
(9)
Family
(1)
Annual Total
(64)
$ Change
% Change
City of Okeechobee 2005 Health Insurance Rate Comparison
Blue Cross/Blue Shield
Present Rates
Renewal Rates
HMO Plan 4
HMO Plan 4
$438.00
$438.00
936.50
936.50
790.88
1299.38
$415,342
Employer Cost* $348,984
Employer Cost $ Change
Employer Cost % Change
Weekly Payroll Deductions:
790.88
1299.38
$415,342
$0
0.0%
$348,984
$0
0.0%
Alternate Plan Rates
Plan 1748 Plan 1748-2 Plan 1748-3 Plan 1748-4
$407.47 $438.00 $421.99 $425.16
965.19 881.60 920.49 908.20
818.71
1376.43
$402,444
($12,898)
(3.1 %)
$325,537
($23,447)
(6.7%)
Employee Only $0 $0 $0
Employee/Spouse $98.89 $98.89 $112.56
Employee/Children $65.29 $65.29 $78.75
Empl/Spo/Children $182.64 $182.64 $207.47
1748= standard rates, unequal rate changes in each category
1748-2= all savings applied to dependent rates
1748-3= maintain present deductions, balance of savings to the City
1748-4= 3.1 % decrease on all rate categories
741.00 774.87 767.09
998.00 1283.37 1259.83
$402,444
($12,898)
(3.1%)
$348,984
$0
0.0%
$0
$86.22
$53.77
$113.09
$402,444
($12,898)
(3.1%)
$336,688
($12,296)
(3.5%)
$0
$98.89
$65.29
$182.64
$402,444
($12,898)
(3.1%)
$339,123
($9,861)
(3.1%)
$0
$95.32
$62.76
$176.48
*Employer Cost is based on 100% of the employee premium and $70 of each dependent premium. There is no
adjustment for enrollees the City does not pay for.
The benefits provided under 1748, 1748-2, 1748-3 and 1748-4 are identical.
• �'.
C,J*&ezjw4, 4vc.
Notes: Blueoptions benefit disadvantages (compared to the HMO) include: Higher copays than TfreHMO options
for some services, deductible and coinsurance will apply to some expenses. Outpatient diagnostic testing,
for example, will be subject to the outpatient facility copay and the associated will be subject to the
deductible and coinsurance. A maternity claim is another example. Physician expenses will be subject to
the deductible and coinsurance.
Blueoptions benefit advantages (compared to the HMO) include: No "Primary Care Physician"
designation, no referrals required to visit specialists and no authorizations required for tests and surgeries.
Out of (Network Blue) coverage is provided and members can access the BCBSFL Traditional and PPO
networks to secure pre -negotiated fees and no balance -billing.
There are no geographic boundaries to accessing healthcare services. Nationwide coverage is included.
Members can use the PPO networks of out of state Blue Cross plans and receive the in -network benefit
level. Out of state hospital claims are paid at the tier two benefit level. Out of state BCBS plan networks
can be accessed through bebs.com.
Claims with providers that do not participate in any BCBSFL network (Traditional, PPO, Network Blue
or HMO) are subject to the BCBSFL "Maximum Allowable Payment". MAP is significantly lower than
retail charges.
The Florida provider networks can be reviewed by visiting the Blue Cross website at bcbsfl.com. Click on
the link to "Provider Directory", then click on the "Plan" drop down menu and select the network you are
interested in; Bluecare HMO, Bluechoice PPO or Blueoptions/Network Blue. Choose one or more of the
other options to search by County, provider type or name.