HomeMy WebLinkAboutMINUTES - 05231989 - 1.77 7
BOARD OF SUPERVISORS
FRCM:, Harry D. Cisterman, Director of Personnel Contra
Costa`
DATE'. May 23, 1989 Coup,},,
SUBJECT: 1st Choice Health Plan i Ili/
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
Authorize the Director of Personnel to work with the employee organi-
zations to implement the following changes and additions to the 1st Choice
Health Plan:
1. Increase the annual deductible over a two year period beginning January,
1990; the first year being $150 per person per year to a maximum of $450 per
family; the following year (beginning January, 1991) being $200 per person
per year to a maximum of $600 per family.
2. Increase the annual out-of-pocket maximum to $1,000 per member for non-
preferred providers (beginning January, 1990).
3. Institute a mandatory generic drug program and increase the co-payment to $8
for brand name drugs that have a generic equivalent when substitution of a
generic has been approved by the member's physician.
4. Expand the preferred pharmacy network.
5. Institute a hospital audit program through Pacific Peer Review for hospital
billings of $10,000 or greater.
6. Institute a case management program with Pacific Peer Review.
7. Initiate discussions with the Retirement Board on the future funding of
retiree health care coverage.
8. Provide coverage for allergy shots/office visits up to $5 per person per
visit.
9. Provide coverage for required school physicals up to age 18 in accordance
with the current preferred/non-preferred plan provisions.
10. Provide coverage for adult disease immunizations in accordance with the
current preferred/non-preferred plan provisions.
CONTINUED ON ATTACHMENT; X YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEN A N OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON MAY 9. 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: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
originating dept: Personnel - Benefits Division ATTESTED MAY 2 3 1989
CC: County Administrator
County Counsel PHIL BATCHELOR, CLERK OF THE BOARD OF
Auditor-Controller SUPERVISORS AND COUNTY ADMINISTRATOR
BY (.' ,DEPUTY
M382/7-83
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11. Increase the County and employee contribution as follows:
Employee Contribution County Contribution
Employee only $ 6.79 Employee only $158.30
Employee/Family $43.24 Employee/Family $368.17
Should any employee organization not agree to one or all of the above proposed
plan improvements, no changes or additions to the 1st Choice Health Plan will be
made with the exception of cost containment provisions as specified in sub-
paragraphs 3-7 above. In the event agreement is not reached on the above propo-
sal , the County will contribute no more than $6.00 per month of the 1st Choice
increased premium for a single subscriber and $14.00 per month of the 1st Choice
increased premium for a subscriber with dependents, as outlined in the current
Memorandums of Understanding.
BACKGROUND:
Through recent discussions with the employee organizations, both indi-
vidually and as a coalition, the recommended changes and additions to the 1st
Choice Health Plan were developed. The increases in premiums are necessary to
cover the rising costs of medical care generally. The other changes and addi-
tions are necessary to both better manage the lst Choice Health Plan and ensure
its viability and high quality of care.
FISCAL IMPACT:
The above changes and additions to the 1st Choice Health Plan will
produce a cost savings estimated to be in excess of $100,000.
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