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HomeMy WebLinkAboutMINUTES - 10101989 - 1.38 x; 1-®38 TO BOARD OF SUPERVISORS Mark Finucane FAContra °"' Health Services Director Costa `0ctober1"r0 `;, 1989 DATE; Coi '•J Approval of projected revenue requirement for SUBJECT: Contra Costa Health Plan for 1989-90 and Authorization to use the revenue requirement to develop rates. . SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION 1. RECOMMENDED ACTION Adopt the actuarially determined projected revenue requirement per month of $79.84 for Fiscal Year 1989-90. Authorize the Executive Director, Contra Costa Health Plan, to increase the revenue requirement on a quarterly basis as appropriate by an amount not to exceed 4% (four percent) per quarter. Authorize the Executive Director, Contra Costa Health Plan, to use the Board approved revenue requirement to develop and establish specific premium rates required by commercial groups and individuals. Included will be two, three and four tier basic community rates, composite rates, adjusted community rates, and rates for special Health Plan programs such as For Rids Only and SeniorHealth. Small group and individual rates will include additional administrative overhead costs for handling these contracts. Premium rates will also be affected by the level of benefits in each package. Authorize the Executive Director, Contra Costa Health Plan, to utilize the community rating by class ( "CRC" ) rate determination 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. II. FINANCIAL IMPACT Gross premium revenue is expected to increase. The level of the net revenue increase will vary depending upon total enrollment, membership mix, and service utilization in the affected groups. CONTINUED ON ATTACHMENT: _ YES SIGNATURE: r �✓i✓i _ RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE I S : ACTION OF BOARD ON OCT to 1M APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS 1 HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES. AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTA 1 NOF SUPERV 1 SORS ON THE DATE SHOWN. CC,. ATTESTED 0 C T 10 1989 PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY ,DEPUTY M3B2/7-83 III. REASON FOR RECOMMENDATIONS/BACKGROUND The Contra Costa Health Plan, as do all Federally Qualified HMO's, bases its premium rates on a basic revenue requirement per member per month. The projected revenue requirement is used as the base for premium rate development, and adjusted for membership mix, family size and the anticipated impact of competition. The revenue requirement as well as the adjustment factors are ( developed by contracted actuaries to ensure accuracy. This year the projected revenue requirement is $79 .84 which represents an increase of 13% over current realized revenue of $70.57. The ' 13% increase in revenue requirement will result in a like increase in premium rates. This increase compares favorably with anticipated increases of 15% to 30% or more among other Bay Area health care insurers. Through the recommended action, the Board adopts the- revenue requirement of $79 .84 referenced above. The Board also authorizes the Executive Director, Contra Costa Health Plan, to increase the basic revenue requirement no more than 4% (four percent) a quarter in developing the various premium rates required by groups and individuals to keep pace with inflation, competition, and expense trends. F5:borates RTH:fw ccs: Health Services Director CCHP, Attn. Rich Harrison