HomeMy WebLinkAboutMINUTES - 08251987 - 1.41 TO BOARD OF SUPERVISORS
FROM: Mark R . Finucane , Health Services Director Contra
Costa
DATE: August 11 , 1987 Courty
SUBJECT: Approval of Standard Rates for Contra Costa Health "`�
Plan Contracts and Authorization to Establish Composite
Rates .
SPECIFIC REQUEST(S) OR RECOMMENDATIONS) & BACKGROUND AND JUSTIFICATION
I RECOMMENDED ACTION
Adopt the attached monthly rates for membership in the
Contra Costa Health Plan by commercial employee groups , and
private non -group Medicare and individual subscribers , such
rates to be effective on contract annual renewal dates .
Authorize the Executive Director , Contra Costa Health Plan ,
to establish group-specific composite rates which are based
on the number of single , dual and family employees in a group
and satisfy the revenue requirements established by the
Standard Public and Private Group rates .
Authorize the Executive Director , Contra Costa Health Plan ,
to utilize the Community Rating by Class (CRC ) rate determina-
tion process for groups with 25 or more employees . Rating
factors which may be used include age/sex , family size , industry
and smoking/non-smoking ratios .
Authorize the Executive Director , Contra Costa Health Plan ,
to increase the established rate structure on a quarterly basis
not to exceed three percent per quarter . This will allow
The Plan to continue to maintain a competitive position and
accomodate changes in medical costs in Contra Costa County.
The premium rate in effect at the signing of each contract
will remain constant for the term of the contract which will
continue to be 12 months .
II FINANCIAL IMPACT
Assuming no change in enrollment in the affected groups ,
premium revenue will increase by $92 ,428 annually.
III REASONS FOR RECOMMENDATIONS/BACKGROUND
The Contra Costa Health Plan revises its rates annually based
on its experience with cost , membership mix and family size ,
and by considering the anticipated impact of competition .
Contracted actuarial services continue to be the basis to
ensure the accuracy of the data used in this pro S .
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON APPROVED AS RECOMMENDED A OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
Y_ UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. �f,Q
cc: Health Services (Contracts) ATTESTED C26
County Administrator PHIL BATCH LOR, CLERK OF THE BOARD OF
Auditor-Controller SUPERVISORS AND COUNTY ADMINISTRATOR
M382/7-83 ,DEPUTY
P A G E T W 0
The recommended community rate averages 4. 5% above the
1986/1987 rates and no single rate in the community rate
schedule increased more than 7. 7%. This rate of increase is
consistent with the Bay Area Medical Care C. P . I . , which is
currently increasing at an annual rate of 7.8%.
The Board of Supervisors , in approving these rates , also
authorizes the Health Plan ' s Executive Director to
establish composite rates for those employers who request
them . This is a common practice in the industry and a
composite rate has been provided by The Plan to the
Richmond School District for each of the last four
years .
The Board of Supervisors also authorizes the Health
Plan ' s Executive Director to utilize the newly approved
Community Rating by Class (CRC ) concept in establishing
premium rates for groups that can benefit from this
application and thus assist in minimizing adverse selec-
tion for The Plan . This includes the smoking factor
recently approved by the Health Care Financing Administra-
tion .
The quarterly rate review will allow the Plan to adjust
rates for new contracts every three months instead of
every 12 months . This will assist the Contra Costa Health
Plan in keeping premium rates in line with changing medi -
cal expenses .
The new rates will result in higher revenue and an
improved competitive position for The Plan . For these
reasons we believe the proposed rates serve the County
and The Plan equally well .
IV CONSEQUENCES OF NEGATIVE ACTION
The Plan should communicate the new rate structure to
its contracted employer groups as soon as possible .
The revenue increase will not be realized if Board of
Supervisor action is negative .
Attachment : Proposed 1987 -88 Rates
ccs : Health Services Director
Milton S. Camhi , CCHP
M C 0 N T R A C 0 S T A C 0 U N T Y
C 0 N T R A C 0 S T A H E A L T H P L A N
PROPOSED HEALTH PLAN PREMIUM RATES
G R 0 U P R A T E S :
COMMUNITY RATES
-- -------------
Two Tier
Single $79 . 95
Family 209 . 00
Three Tier
Single $79 .95
Two party 166 . 45
Family 230 . 00
Four Tier
Single $79 .95
Employee with Spouse 177 .00
Employee with Children 134 . 35
Family 235 .00
GROUP MEMBERS WITH MEDICARE
---------------------------
Rates for group members with Medicare and their families with
Medicare are below :
Employee , Spouse or Child with Medicare $66 . 35 each
Employee , Spouse or child without Medicare - Each
at Single Rate ($79 . 95 , 84 . 90 or CRC single rate )
(Note : Family total not to exceed the Family Rate for the
Contract type )
N 0 N - G R O U P R A T E S :
INDIVIDUALS
Four Tier
Single $84 . 90
Employee with Spouse 187 . 95
Employee with Children 142 . 75
Family 249 . 70
SENIORHEALTH $41 . 00
------------
SENIORHEALTH PLUS $66 . 35
-- ---------------
INFORMATION NOTES:
Composite rates and community rating by class will be calculated
on a group specific basis .
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RTH : smp
7/29/87
BORATESI-3#16
ADOPTED :
EFFECTIVE : _