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PRM Health Trust FY 19-20 One Boca Place 561-995-6708 2255 Glades Road I Suite 200E www.ajg.com Boca Raton,FL 33431 Gallagher USA Insurance Risk Management I Consulting July 26,2019 India Riedel Finance Director City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 Re: Group Health Rates for Plan Year 2019-2020 Dear India, We are pleased to provide you with your Group Health rates for the new plan year beginning October 1, 2019. The rates illustrated below represent an increase of 6.7% over your current medical rates. The increase in the medical rate is 2%higher than the pool average due to a loss ratio of 110.3%. There was a decrease in the Dental rates and no change to the Vision, Life or Disability rates. We believe that you will find this renewal very reasonable in light of current market conditions. Medical—PRM Plan PPO 0727 Funding Rates Coverage Medical Medical COBRA Medical Reduced Retiree Employee $850.70 $867.71 $647.32 Additional for Spouse $1,273.11 $1,298.57 $891.16 Additional for Child $847.55 $864.50 N/A Additional for Family $1,858.25 $1,895.42 N/A Medical—PRM BlueOptions 05901 Funding Rates Coverage Medical Medical COBRA Medical Reduced Retiree Employee $669.40 $682.79 $509.28 Additional for Spouse $1,001.76 $1,021.80 $701.18 Additional for Child $666.85 $680.19 N/A Additional for Family $1,462.17 $1,491.41 N/A Dental High PPO Low PPO Coverage Funding Rate Funding Rate Employee $33.99 $27.19 Employee Family $88.70 $70.97 Page 2 Vision NVA,Voluntary Coverage Funding Rate Employee $5.24 Employee Spouse $9.83 Employee Child(ren) $8.18 Employee Family $16.19 Basic Life Coverage Funding Rate Basic Life per$1,000 $0.32 Basic AD&D per$1,000 $0.02 Voluntary Life Coverage Funding Rate Voluntary Life per$1,000 Age Rated Voluntary Spouse Life per$1,000 Age Rated Voluntary AD&D per$1,000 $0.03 Voluntary Child Life $2.00 Disability Coverage Funding Rate: Short Term Disability-Voluntary $0.37 Long Term Disability—Non-Contributory $0.61 We appreciate the opportunity to serve you and your employees and look forward to working with you over the new plan year. Should you have any questions, please contact Yvonne Blackford or me at 561-995-6706, Sincer , Paul Hebert Area Senior Vice President PH/cm v. . F cf,„_ Exhibit 4 1 •!24' �y °et City of Okeechobee July 16, 2019 T 1” LL i Memo Date: for July 16 meeting TO: Mayor and City Council FR: Admin Marco Montes De Oca and India Riedel, Finance Dept RE: PRM Group Health Insurance The City's current premium structure for plan 0727: Employee Only $ 797.29 Empl & Spouse $1,990.46 Empl & child(ren) $1,591.62 Empl Family $2,538.86 The City has had another year of large payout of benefits for our employees and dependents. ($110.00 paid out for every $100.00 premium (apprx $67,000), based on the months used for renewal rates. As per the bylaws of the PRM group the maximum premiums will increase is 6% over the Group. The Group (PRM members) experience base rating is @ a 4.7% increase effective 10/01/2019. PRM and the broker Arthur J. Gallagher have provided an additional 1% decreased (already included in percentages) based on the Board of directors (us), approval to renegotiate contracts with Pharmaceuticals. This is one of the strong points of being within a pool the members have control of. The city's claims experience rating is higher than the groups average of 4.7%, therefore the current PPO 0727 plan premium increase for this fiscal year is at 6.7%, or a $41,670 increase. The city is continuing to take a long term approach regarding the health of its employees by continuing the current benefits including the Clinic. (Currently a 2 year contract without an increase for 2019/2020 FY) 1I PPIFPF- City of Okeechobee Memo Current plan, 0727 City Cost Deduction Premium Per Employee per per Month Employee Pay Check Employee Only $850.70 $850.7 $0.00 Add'l for Spouse $1,273.11 $150.00 $518.35 Add'I for Child (ern) $847.55 $150.00 $321.94 Add'l for Family $1858.25 $150.00 $788.42 Affordable Care Act required option, 05901 City Cost Deduction Premium Per Employee per per Month Employee Pay Check Employee Only $669.40 $669.40 $0.00 Add'I for Spouse $1,001.76 $150.00 $393.12 Add'l for Child (ern) $666.85 $150.00 $238.54 Add'I for Family $1,462.17 $150.00 $605.61 2 . . . . .. /4- * FLORIDA * Faueided 1415 PRM Health Trust and City of Okeechobee Paul Hebert and Katrina Bouthot I July 16, 2019 cts - , . p z DR ' �M Gallagher ' PLO9 - Insurance , Risk Management ( Consulting ... ,_,,:;,.7n ,,,,ti,,,k l[i?S,,..0 j ',it,:,:' 'a (7) About PRM Health Trust Gallagher Insurance Risk Management Consulting The City of Okeechobee joined effective August 1 , 2010 • Health Trust established in December 1989 • Has grown from 7 members to 55 member as of July 2019 • Formed pursuant to an Interlocal Governmental Cooperative Agreement under Florida Statute §112.08 • Each Health Trust Member names a Board Member who has 1 vote on the Health Trust Board • The PRM Health Trust has a surplus of approximately $21 million as of September 30, 2018 PSX Ah:gC li s _ 8,,FIH11k r;?.LL,4G1-1FR. () I !=.J(_;(;Gig,': - :- ; r -' 2 F u n d i n g Status Gallagher V Insurance I Risk Management Consulting Low Administrative Expenses allow for richer benefits The PRM Health Trust is self-insured. Funding is used to pay the administrative costs of operating the Health Trust and to pay the claims incurred by the participating employees and their family members, with no profit margin. 0% 1% 1% 0% 4% �l. 0% 6% W Net Paid Claims m Blue Cross Medical Administration u Specific Premium @$300,000 w Aggregate Premium LA Consortium u Businessolver o Reinsurance Tax(Healthcare Reform)1 PCORI Fee(Healthcare Reform)1 m 1 171 Rm FIOR\O 88% k 1 kat 1 Medical Rates Gallagher Insurance Risk Management Consulting PRM's renewal methodology provides for rate caps • Gallagher is the broker/consultant for the Health Trust and sets "premium equivalent" rates each year for each member The premium rates are fixed for the full plan year so the program feels like a fully insured program The City would never be asked for additional dollars to make up for a funding shortfall • Gallagher determines a Pool Average — which is the average increase needed to meet projected claims and expenses for the upcoming plan year For employers that have been in the Health Trust 3 years or more, the renewal is based on a deviation schedule tied to the Pool Average, with a maximum deviation (up or down) of 6% Q\SKMANCF �C �zR M �FFLOPOP n 'laNUFI ",ILL-‘4,- . . City of Okeechobee tar) Medical Renewal History Gallagher Insurance Risk Management Consulting The City has received significantly lower renewals each year than it would have in the fully insured market Year Loss Ratio PRM Gallagher Projected Renewal Fully Insured Increase 2019/2020 110.3% 7.7% 25%+ 2018/2019 108.6% 10.0% 25%+ 2017/2018 176.7% 11 .0% 25%+ 2016/2017 132.2% 14. 1 % 25%+ 2015/2016 113.4% 8.3% 25%+ f;!tom ; . 2014/2015 185.2% 10.0% 25%+ 2013/2014 134.6% 11 .6% ._ =`-"` }.h 25%+ ti } x` w,l 2012/2013 172.5% 9.4% 25%+ r;.x r .�.,TV.rx,. ,,, + �."s�.. �, I, w ,.:vim 4cT.-' ,.�,. ,:^ r . .._ .:._S„w y �1 i u - `P\SKMA"46. 2011/2012 146 9%-, 7.5% .- 25%+ *6 PR nn ,m8 ART'I IR J Al_ I At Mt r.C(J ! AJ('COM tar) Gallagher The C i ty s Other Coverages Insurance Risk Management Consulting Rates for the City's Ancillary Benefits have remained unchanged - and even reduced in some cases - through the years Dental Insurance: High and Low Plans Florida Combined Life Rates have not increased in years. 5% rate reduction effective October 1 , 2019. Vision Insurance: National Vision Administrators Rates have not increased in years. Remain the same for October 1 , 2019 with no increase. Life, Short and Long Term Disability: The Standard Basic Life and AD&D, and Short Term Disability reduced effective October 1 , 2018. Rates remain the same for October 1 , 2019 with no increase. ``�`SK MArygCfi 171111i 3z M OFFLOR�OP' ::,r.IlifriRfl-IURJ AUA(,IIIt A.I(;cOM *4.) Other Value-Added Benefits Gallagher Insurance Risk Management Consulting At No Additional Cost to the City • Customer Service: Multiple layers of dedicated support through: — PRM Administrative staff, with 2 dedicated professionals to the PRM members Florida Blue, with 2 dedicated professionals to the PRM members — Gallagher, with 2 dedicated professionals to the PRM members Benefits Administration System • COBRA Administration • Compliance Support @\5 MANgcF \R kr) Advantages of PRM Gallagher <J Insurance I Risk Management Consulting PRM stand Alone Program Predictable/Stable Renewals 0 ❑ National Account Status 0 0 Offer Employees 1-10 Plans 0 0 Dedicated Customer Service 0 0 Two Tiered Prescription Drug Program` 0 0 Customized Benefits 0 0 Determine Plan Benefits 0 0 Annual Educational Conference n r+ n Electronic Enrollment&Bill 0 Reconciliation Actuarial Support 0 .> Legal/Compliance Support 0 'Avalable with the PPO Plan 0702,0727 and HMO 55 osy..mAN4G / �' P tZ M 8 Thank you ! Paul Heb- 561 .998.6746 paul_hebert@ajg.com 2255 Glades Road, Suite 200E Gallagher Boca Raton, FL 33431 Insurance I Risk Management I Consulting AFn HOP.,! G/1I AL-E]R;i.Cn ,-.