HomeMy WebLinkAbout20013334 CTSI
Serving Colorado's Counties
_ The County Health Pool
The county-owned alternative for employee benefits
Double-digit health insurance rate increases are here, leaving employers at the
mercy of the volatile insurance market. Counties throughout the state are finding
out that the promise of guaranteed rates often evaporates before the ink has dried
_ on a new health benefit plan.
Counties do have an alternative. In 1984 county commissioners had the foresight
to create their own health benefits program. The County Health Pool has offered
counties the best value available in employee benefits for more than a decade.
Since the pool is owned by counties and managed on behalf of counties, CHP
members can step off the roller coaster ride of continuously changing plans and the
confusion switching health care benefits brings to your employees. Imagine a
.`n health care alternative that eliminates the constant hassle of bids and contracts, and
negotiating your coverage through a corporate health benefit provider.
Since CHP is county-owned, counties reap the benefits of ownership. Over the
life of the pool, more than $5.2 million has been returned to county members,
while maintaining competitive rates. Because county commissioners and county
staff oversee the pool. you can rest assured your money is hard at work, where
it belongs.
The success of CHP depends on support from County Commissioners. Since CHP
doesn't pay commissions to insurance brokers, it's up to county officials to make
sure their county takes a closer look at the county-owned alternative.
Who would you rather have your county employees talking to? A health insurance
corporation or a staff of professionals that answers to a board of directors made up
entirely of county commissioners and their staff?
Contact County Technical Services, Inc. today for a quote or for more information
on the County Health Pool. Step off the health insurance roller coaster. Become
part of the long-term solution to employee benefits.
For more information, contact Cindy Downey at:
CTSI • 1700 Broadway, Suite 1512 • Denver, CO 80290
303.861.0507; Fax 303.861.2832
www.ctsi.org
email: ctsi@ctsi.org
Onse/7 l� a 2r/ -
/07- 3-V 2001-3334
Introduction
The County Health Pool was founded to provide counties in
Colorado with an economical health benefit program for
employees and their families. While the cost of health benefits
is rapidly rising, CHP is attempting to curb those costs by
combining a non-profit, county-owned pool with cost
containment and patient access to quality health care. This
controlled privatization brings public entities the competitive
benefits of the private sector while maintaining public sector
control.
CHP is owned by Colorado's counties and is governed by
representatives from each Member county. The Board of
Directors, comprised of representatives from member counties,
must approve changes to benefits, rates, policies, etc.
Membership to non-county governmental entities is also
available. Non-counties can access the same benefits, but will
not have a seat on the Board of Directors.
A key to CHP's success has been our low overhead and low
fixed costs. Our administration and pooling charges are less
than those of typical insurance companies. Because of these
reduced costs, and the self-government of the pool by Members,
entities are able to become part of a long-term solution to their
health benefit needs.
CHIP offers your group the opportunity to join a statewide
organization that stays abreast of the issues that affect your
health care future. We also have access to medical data and
statistics on health care trends nationwide. Our network of
physicians and health care facilities allows your employees
access to effective, economical health care, a critical facet of
employee relations in today's workplace. With over 30 years of
_ combined experience in health benefits for governmental
entities, we are well versed in the issues facing you.
CHP allows Members to share the risks of health benefit costs
while providing them with group purchasing power. CHP uses
the pool layer to fund the first$100,000 per year of an
individual's claims. Stop loss coverage insulates pool Members
from claims over$100,000, ensuring coverage up to $2 million
per lifetime per individual.
CHP is one of three county-owned pools administered by
County Technical Services, Inc., along with the County
— Workers' Compensation Pool and the Casualty and Property
Pool. CTSI is the premier service provider for Colorado's
county governments.
1
Advantages of Membership _
$5.2 million returned to Members -
CHP has returned$5.2 million to Members in the form of surplus, _
equalization distribution and deposit holidays since its inception.
County ownership of the pool, combined with effective management,
has made CHP the best alternative for funding health benefits for public _
entity employees. When comparing health benefits alternatives, don't
forget that the bottom line is county ownership—the ability to control
your health benefit destiny while reaping the financial rewards of your _
health benefits investment.
Cost Containment -
CRP's commitment to top quality employee benefits and cost —
containment has paid off. The advantage of pooling resources to
meet health benefit needs has become even more important as
health care costs soar. —
One of the major advantages of joining CHP is that members reap
the rewards of strong fiscal years. Unlike the private sector, profits
are not drained out of the pool. Instead, surplus is returned to CHP
Members through equity and deposit holidays.
2
Fixed Cost
—
A significant portion of the monthly rate you are currently being
charged probably includes:
—
• Pooling Cost
• Administrative Cost
• State Premium Tax
• Commissions
— Virtually all of these cost elements are based upon the size of your
group. Typically, the fewer employees, the higher the pooling and
administrative charges, cutting into the money available to pay claims.
At CHP, these costs are minimized because they are based upon our
entire Membership, and the fund is not required to pay premium tax or
— commissions.
The net result is a lower cost for our Members.
Health Care Rate Trends Since 1994*
am 'Source:Employee Benefits Plan Review
100%
50% - 47.8%
— 30.2%
20.8%
10.8%
._ 0%
0%
0% 0% 5.0%
-1 -10%
—
-20%
-50% - p3
—
1 ^ ^ i ,�cP
—
-Non-HMO,single coverage - -CHP Rates
3
Employer Cost -
CHP is making substantial progress in cost containment. Some key
elements in our approach are: —
• Participation costs are set by Board Members, repre-
senting Member counties. —
• Providing the opportunity to earn credits for good
loss experience.
• Providing the leverage of large numbers for the —
lowest possible cost.
• Creating a benefit design which encourages wise
consumer(patient) decisions. —
• Employing health care professionals to assist and
reassure the family.
• Maintaining rate stability through Membership in a —
larger group.
Additional Highlights
• Organ and Bone Marrow Transplant Coverage
• COBRA & HIPAA Administration (included in rates). —
• Monthly "wellness"newsletter(included in rates).
• Itemized billing each month.
• A commitment to service, guaranteed by our staff and the
fact that CHP's owners are public entities.
• Commitment to remain proactive on issues that
affect the pool, to ensure improvement.
• CHP handles initial enrollment and provides orientation for
your employees, ensuring a smooth transition.
• Vision, dental and supplemental life benefits available.
4
Summary of the General
Policies of CHP
All Members of CHP must conform to the following general policies.
An exception from these policies may be made if approved by six
Members of the Board of Directors.
• Each Member must have no fewer than 10 active and
covered employees.
• Each employee must be a full time employee of the Mem-
ber who works a minimum of 30 hours per week.
No temporary employees are eligible.
• A Member may choose to allow part-time employees to
participate (subject to CHP parameters).
Contributions
Each Member will contribute on behalf of each employee a
minimum portion of 75 percent of the monthly employee rates
established for each of the self-funded health programs.
Participation levels
Non-contributory entities:
Each Member must have 100 percent of its eligible employees and
dependents participate.
Contributory entities:
If the Member offers dependent coverage, at least 50 percent of
-' those eligible dependents not covered by other insurance must enroll.
Waiting Period
_ The length of the period between the date that
the employee first meets the definition of an
eligible employee and the date that the coverage
commences is left to the discretion of each
Member. The Member must notify CHP of its
waiting period.
5
New Members -
Each new Member entity must adopt the CHP Plan Documents, —
Bylaws and General Policies (including any amendments) in
force at the time of entry. Subject to the minimum terms
established in the general policies, the specific provisions for —
employee eligibility, contributions and the waiting period are at
the discretion of each Member.
Each new Member must also purchase group life insurance
coverage in an amount and schedule that is satisfactory to the
group life underwriter(minimum of$10,000). —
Claims will be considered for payment only if they were
incurred on or after the effective date of coverage. —
6
Coverage Criteria
Coverage is based on compliance with the Bylaws and General
Policies of CUP, and is valid until December 31, 2002. For more
detailed information, please consult the actual policy. The summary
is meant for informational purposes only. The policy itself will
dictate terms and conditions of coverage.
• Rates are subject to enrollment. Final rates will be based on
final enrollment and required claims information.
• Coverage is based upon the current benefits offered by
the County Health Pool (CHP).
• $100,000 specific stop loss insurance is included in this
proposal.
• Application to GP includes a 24-month commitment.
This will enhance long-term pool participation and lower costs.
• Pre-existing exclusion provision applies to future employees and
will be applicable to present employees on a no loss/no gain basis,
subject to HIPAA.
• We will "grandfather"current retirees, no future retirees will be
covered.
Benefit Philosophy
Some benefit designs are structured in a way that carries a message to
— employees that employers don't care where they receive medical attention,
nor how expensive the bill might be.
At CHIP, we know that "where" you receive medical attention is a critical
cost factor. So we have constructed a benefit design that encourages the
most appropriate care at the lowest possible cost. The net result is a
combination of lower costs to our Members, and high quality health care for
your employees.
7
Managed Care/Medical
Review Program
All employees and dependents covered under the CHP health benefits
plan must comply with the provisions of the Specific Procedure Review
and the Pre-Certification/Certification Programs in order to receive
maximum benefits available under the plan.
The key points to remember are:
• Call the Medical Review Company when your doctor
recommends hospitalization, or within 48 hours after an
emergency hospitalization.
• Call the Medical Review Company when you receive
confirmation that you are expecting a baby.
• Call the Medical Review Company when home health
care, skilled nursing care, or hospice care is medically necessary.
• Call the Medical Review Company when your doctor
recommends one of the designated specific procedures listed.
• Call the Medical Review Company when your doctor
recommends Durable Medical Equipment.
• Call the Medical Review Company weekdays 8 a.m.
to 5 p.m.
8
Benefits Summary
Employee must have coverage for dependents to be covered.
Medical Benefits
CHP offers Members flexible benefit packages for employees. Employers
may select their own tailored benefits package under one of three options:
• Offer either the PPO, EPO or Basic plan to all of their employees.
• Offer a dual option program that includes EPO and PPO options, and
allow their employees to select one of the two plans. Employees could
change their election at the next annual enrollment (or sooner under
HIPAA Special Enrollment provisions).
• Offer a triple option program that includes all three plans. Employees
could enroll in their choice of one plan. Employees could change to a
different plan at the next annual enrollment.
Dental Benefits
Two dental plans, A and B, are offered. Members may choose to offer
dental coverage under one of the following options:
• Offer Dental Plan A
• Offer Dental Plan B
• Offer a dual option, allowing employees to choose between A and B.
Employees can't switch between plans for two years.
• Offer no dental coverage.
Members may require dental as pan of a "package"or offer dental as an
employee's choice. Employees and dependents who select dental must
participate for a minimum of two years.
Vision Benefits
Members may offer vision coverage or not.
Members may require vision as pan of a "package"or offer vision as an
employee's choice. Employees and dependents who select vision must
participate for a minimum of two years.
9
CHP Medical Benefits Summary
Pre-certification for certain care is required on all plans.
Fk Preferred Provider'- cluslve Provider "II": ''''''<:"41311.154'4.7s"3
e rganization(PPO) Organization(EPO)'
s '5
r • '$300 (2 per family) $150 (2 per family) $1200-(2 per fami y
i ym f< " f' - YFsrr, ' „
Co-Insurance Subject to deductible, Subject to deductible, Subject to deductible,
then 80/20 in network, then 90/10. then 80/20.
60/40 out of network. _
„; r m r ¶000(2 per family) in 500 (2 per family). ^ $ 200"('f'" 'er lam 1
Y2 x-' Ni - i NF'.i� r ' .�ifWork. Co-payments.., 0-payments do not � � Co paymentsY i�a . s.
,-i*s x •o not apply to this 3 apply to this maximum apply to this maxim
%� � u •maximum. •
` yvsu ^ No max out of '.
sort , network :,
.r'A,+";} pi. ]ra krrvezra'�M '..a:. •
In-Hospital Subject to deductible, $100 co-payment per Subject to deductible,
then 80/20 in network, admission (2x per then 80/20.
60/40 out of network. person annual —
maximum).
Subject to deductible,
then 90/10. _
nonErfrergelnc ubject to deouotible,f'; t0�co-payment per fSubiect'f de u tiblb
® t rt° osp a then 80/20 in network, visit. then 80/20 Mt
aw ^
0/40 out of network 2): 'bect to deductible —
� k+g . ;thin-00/10.
4 41,4
,-.
Office Visits $30 co-payment in and $30 co-payment. $35 co-payment.
out of network. Out of —
network also subject to
deductible, then 60/40.
1 u �1 ubject todeuctible i. ibiect to deductibler"Subiec"f o Bed fc i. -
• ', , : 7en`80/20 in network, "`, � then 90/10. ₹ a than a0l2b`
bac '� t •o/40 out 0>'network .4,4. 2ra; '�fxk
—
.<
Wellness Benefits $325 each (for $325 each (for $325 each (for
employee and spouse). employee and spouse). employee and spouse).
Ages 0-1: $125 Ages 0-1: $125 Ages 0-1: $125
Ages 1-2: $150 Ages 1-2: $150 Ages 1-2: $150
Ages 2+: $50 every 3 Ages 2+: $50 every 3 Ages 2+: $50 every 3
years. years. years.
s d' • ,-;,..,,,t,,,:::"•;,, ":2"`$65 at 100% $65 at 100% $85 of 100°
•`s'# (r•tne ; (age limitations) 17, (age limitations) • ;,(age limitations)~
tz^F"�'�L� k*izbR hG PL Y„Pkkss✓�' hrj3wM..�.. . �. �vu. . .A
10
PPO (cont J EP ont) 67 g A
, 44 c �
Physical Therapy Subject to deductible, �a Subject to deductible, Subject to deductible,
then 80/20 in network, then 90/10. then 80/20.
60/40 out of network. Pre-cert. No annual Pre-cert. No annual
Pre-cert. No annual maximum. ` maximum.
maximum.
Chirc praetor 'Subjept to deducbble _t Subbectto eeduCt' r �t
-,
�� << then 80/20n„�e�nrorK ;� � en 90�'�j �+,4
T'tRT rN 'tl FA of n p {.@$5 .t fijt . Sfy
r 3y'a3 z. • x$500 annual maximum XR"sr ! air , 4
x .'
ae. „ ..21, . ...uaw:X''u'%<.w. .� � + `di
Emergency Care Subject to deductible, $50 co-payment. Subject to deductible,
then 80/20 in network, Waived if admitted. then 80/20.
60/40 out of network. Subject to deductible,
then 90/10.
I `tt axlmum ix t 2 million ' . $2 million , ',* 2 illion
Fhb « ✓ + y
aa£
Mental/Nervous
In-hospital Subject to deductible, $100 co-payment per Subject to deductible,
then 80/20 in network, confinement (2x per then 80/20.
60/40 out of network. person maximum). 30-day annual
30 day annual Subject to deductible, maximum.
maximum. then 90/10.
30 day annual
maximum.
Outpatient Subject to deductible, $30 co-payment. Subject to deductible,
then 50/50 in or out of 30 visits annual then 50/50.
network. maximum. 30 visits annual
30 visits annual maximum.
maximum.
ro IcatTo71:4n'" >' s'iv,P 1n d b441 .4 y.;j • a S r� y -. rt
K r'% t£a 4 ;14: �. t¢ n '3 i.a v-. d.. s s „y, . Ek. i'-vtitir'Ow `For EPO and BASIC Plans, out of network care
only eligible in emergency care situations. No
limit on out-of-pocket for out of network care for
_ EPO and Basic Plans, except in emergency care
situations.
Life
A'F } iYf ,z'i� P ? 3A4 � � Gx hy.£
0 ee °` s �ti. 'sR� 1011% I • • • t
Fa, fie' r : P •zr.
Inatesu••� aA 1ft vm 3 �o
_ n.4,'_11,
� ft '
.� 'n a°�� •`
Suppleinentalapttor.DjRendeotLlfaQP_ttox ..,
AD&D
an
kEe�
mployee c rt
— Benefit terminates upR{l, e i.fl e
11
CHP Prescription Card Service (AdvancePCS) —
Benefits Summary*
■ •uct(Se EPO and PPO=$50 per Individual
V` $ASIC=$200 Ind./$400 Fam. # —
"
Co-Payment $8 minimum co-payment.
Participating pharmacy: 10% of discounted —
wholesale for generic; 20%for Preferred
brand; 40%for Non-Preferred brand.
Non-participating pharmacy: Participant —
pays and submits claim for reimbursement
at a lower level.
■ 'Legend'drugs`:see Exclusions list "„#.;t7Arsl
tsstimsinsulin141:41 . +
°, r "ig , fi ' Disposable insulin • ' '
, needles/syringes `
� # 4,1 S i- ; ',,` Disposable blood/urine,
� —
{{ (���itt f" - glucose/acetone testing agents, (e g t/ �t,
Y S A ? it
g" 3 s5 t 6 2 kR p Z•
�' � ti� °'Chemstrlps,Acetest tablets, Clinitest 'v'7#1# 3
0
tablets, Diastix Strips and TesTape) '_ a —
�€ 4'4' :Lancets 1,t4;„
-? , p + • " Tretinoin, non-oral dosage forms (e g
" Retin-A),for individuals up to age 25
,S{r trim /ears `. >t
., Compounded medication of which at
"is `least one ingredient is a legend drug + u �.,
`';':4%.,Any other drug which under applicable ,°
a f state law may only be dispensed upon, --
'r 7-the written prescription of a physician or:° r.
� , rr •
'stt 4L1-' s'other lawful prescriber
Exclusions • Contraceptives, oral and other, whether
medication or device
• Levonorgestrel (Norplant)
• Anorectics (any drug used for the
purpose of weight loss)
• Dietary supplements
• Growth hormones _
• Immunization agents, biological sera,
blood or blood plasma
• Infertility medications
• Minoxidil (Rogaine) for the treatment of —
alopecia
• Non-legend drugs other than those
listed as covered
• Smoking Deterrent Medications
containing nicotine or any other
smoking cessation aids, all dosage
forms (e.g. Nicorette, Nicoderm, etc.)
12
Prescription Card Benefits Summary, cont.
(AdvancePCS)
• Tretinoin, non-oral dosage forms (e.g.
Retin-A),for individuals 26 years of age
or older
• Therapeutic devices or appliances,
including needles, syringes, support
garments and other non-medicinal
substances, regardless of intended use,
except those listed as covered
• Charges for the administration or
injection of any drug
• Drugs labeled"Caution—limited by
federal law to investigational use,"or
experimental drugs, even though a
charge is made to the individual
_ • Medication which is to be taken by or
administered to an individual, in whole
or in part, while he or she is a patient in
a hospital, rest home, sanitarium,
extended care facility, convalescent
hospital, nursing home or similar
institution which operates on its
premises, or allows to be operated on
its premises, a facility for dispensing
pharmaceuticals
• Any prescription refilled in excess of the
number specified by the physician or
any refill dispense after one year from
the physician's original order
Dlspe��ln tf 1 U n •gays .�i •Igoi r .1 s°�
s -a4
°'EY4'>rT ,. s. 9 j : v ,sv s gr'a�yx ae �3
M r* fr E �.`�"6, k a e
� T5�� Wf irtyc ' „ n sJQnYk 'ucr s f.-�' K�
"� s� ,��fi�s,,.b��^46'kKk$.
'Expenses do not apply to the out-of-pocket or deductible expenses under the
medical benefits plan.
13
CHP Mail Order Prescription Service (AdvancePCS)
Benefits Summary* —
uctifihe EPO and PPO=$5O per Individual —
,� BASIO=$200 Ind./$400 Fam.
Co-Payment $8 minimum co-payment.
EPO and PPO:
$16.00 for generic.
$40.00 for Preferred brand.
$70.00 for Non-Preferred brand.
BASIC:
40%for generic. If participant takes brand,
he or she will pay the difference.
• 'Legend drugs:see Exclusions list
} ; .( nj • Insulin x
x• ,„ «• ��• , Disposable Insulin needles/syringes
w Disposable blood/unne,
S S -
.`t `"glucose/acetone testing
Y" Chemstrips,Acetest tablets Climtest
aftetr.k. ',Pif ;tablets; Diastix Strips and TesTape)
"ir > k' {t . t_aLancets "`" mac� y.� , : —
r e • -Tretinoin,non-oral dosage forms (e
4.. Retina),for individuals up to age 25 .
rate
� 'rc.,t, , '-. t
y,�, r rK � ' Years , ,Y
t v*' 4-jn w- ,� s Y "Compounded medication o• fwhich at<.. e` —
'gyp,,F FY east one ingredient is a legend dry
: 't a4kr'tZ [ any other drug which under appl)cab
r; zzn."4 1, 3 t estate law may only be dispensed upon
the written prescription of a'physician
" rir3#g p"° other lawful prescriber ,
Exclusions •
EContraceptives, oral and other, whether
medication or device
• Levonorgestrel (Norplant)
• Anorectics (any drug used for the
purpose of weight loss) —
• Dietary supplements
• Growth hormones
• Immunization agents, biological sera,
b• lood or blood plasma
• Infertility medications
• Minoxidil (Rogaine)for the treatment of
a• lopecia
• Non-legend drugs other than those
listed as covered
• Smoking Deterrent Medications —
containing nicotine or any other
smoking cessation aids, all dosage
forms (e.g. Nicorette, Nicoderm, etc.)
14
Prescription Mail Benefits Summary, cont.
Order
(AdvancePCS) • Tretinoin, non-oral dosage forms (e.g.
Retin-A), for individuals 26 years of age
or older
• Therapeutic devices or appliances,
including needles, syringes, support
garments and other non-medicinal
substances, regardless of intended use,
except those listed as covered
• Charges for the administration or
injection of any drug
• Drugs labeled"Caution—limited by
federal law to investigational use," or
experimental drugs, even though a
charge is made to the individual
• Medication which is to be taken by or
administered to an individual, in whole
or in part, while he or she is a patient in
a hospital, rest home, sanitarium,
extended care facility, convalescent
hospital, nursing home or similar
institution which operates on its
premises, or allows to be operated on
its premises, a facility for dispensing
pharmaceuticals
• Any prescription refilled in excess of the
number specified by the physician or
any refill dispense after one year from
the physician's original order
Dispensing i� a ku '1161 • �". } sMS' f `
ti` 5ne� p Y "m g z .x' S.. .5...
*Expenses do not apply to the out-of-pocket or deductible expenses under the
medical benefits plan.
15
CHP Dental Benefits Summary —
,..1,4,--al, x .
u��x u i
l•e 0 per calendar year: $50 per calendar year.
,i ;4%.:
artiily Maximum 3 Family Maximum a
ah. jndiwdual deductibles per i individual deductibles per —
, � teat year
Maximum $1,000 per individual per $1,000 per individual per
Benefit year year —
4isnt tl . ae"d�i i 7e t t .,t‘. duc�lble,' i� j
a !r dl�Covered "43 00%Covered ' a _
}u = i. biagnostic ora , °"s ,1 lagnostib Drat eitams
V .�@ y, 'M, l' 44,‘,1,4, ,,,, k
s `.y",w Rays'. 5 � , Rays,, ,.Q.-,t,
.Q . :
r a :: ,tt : '"Emergency treat k'#it ` t Emergency treatment
,a �;r .t a k ah, reventive teeth �` �, reventive teeth r ,- —
, , ; w cleaning t, xj r '.f cleaning= x
-�s`' }::„. yr. �� , > -U ';�fit��Eluonde treattl en1 '� �"' n `•Fide treatments
1♦p4!y#Jf ^yr a�. tl."::::-"r..
+ wf#,'k� , ;' "s n `t'µr,M'' r F: 'sl` ", • z_. _
Basic Subject to deductible Subject to deductible
80% Covered 80%Covered
• Anesthesia • Anesthesia
• Fillings • Fillings —
• Root canal therapy •
_Root canal therapy
• Repair of dentures • Repair of dentures
• Oral surgery • Oral surgery _
• Extractions Extractions
• Treatment of gum • Treatment of gum
disease disease
��fiv sd '4,2,',
.tibject'tt deductible ` 9f�.a overed .1. 'if ^9t^ wtt`m,..t
1a o . .i< u 7.l°�+COVeted �,�ma = t' �"* _k k,,,,.;„
b # '��r1Ia e '• �Y4° a
B s ` i
a-i , Ntx�'t -„,,.,,i4 Crow S t , 1„1".:1,4„.,..,,r,'
iax rti 4 '� •.,c,1,414,',nstallatlon n r ate
* y� "', c ,' ' Y"'BndgeHiork& Der ttdrres tit .',
�x#'" ':t`.,r-, .., y+ $;i. iwds" x , i .,:r - P`"" , —•Orthodontic Subject to deductible Not Covered
—
50% Covered
$1,000 per individual
maximum lifetime benefit
• Diagnostic studies
• Teeth straightening
• (Age limitations—no —
adult orthodontic)
"'
`Expenses do not apply to the out-of-pocket or deductible expenses under
the health benefits plan.
—
16
CHP Vision (VSP) Benefits Summary*
Examination , Mx $15 Deductible aw w -
144.0p7,991112,61- Mee e. 2: and
Materials $15 Deductible
Necessary lenses once every 24 months and
frames once every 24 months.
Frame allowance:
Approx. $39 wholesale, an $88 retail value.
Contact Lenses Qncp @very 24 P1 th �eu f t
a ,
INecessernwM+,1a , ,ti 4' ri
Contact Lenses Once every 24 months in lieu of materials
(Elective) $100 maximum
(Out of network benefits also available).
`Expenses do not apply to the out-of-pocket or deductible expenses under
the health benefits plan.
17
CHP 2002 Life and AD&D Rates
Life -
Employee Match current benefit level. -
Benefit terminates upon retirement
Monthly: $.20 per$1,000 -
Dependent life: Option 1 Option 2
Spouse $2,000 $5,000 Children $1,000 $2,000
Monthly: $.78 per $.92 per
unit unit
AD&D -
Employee Match current benefit level.
Benefit terminates upon retirement
Monthly: $.04 per $1,000
Rates as of January 1, 2002 are effective through December
31, 2002. At that time, rates will be underwritten and
renewed with the Pool.
18
CHP 2002 Medical Rates
Health Benefits for members covering between 10-100
employees (based on the previous 12 months).
(Rate structure must be maintained for at least 3 years).
Stand Alone PPO EPO Basic
Two-Tier Rate Structure
is Employee $329.45 $318.65 $247.10
Employee plus dependent(s) $856.40 $828.30 $642.30
Three Tier Rate Structure
Employee $356.85 $345.25 $267.70
Employee plus one $713.80 $690.45 $535.30
Employee plus two or more $927.90 $897.60 $695.95
Dual Option PPO EPO
Two-Tier Rate Structure
Employee $329.45 $318.65
Employee plus dependent(s) $856.40 $828.30
Three Tier Rate Structure.
Employee $356.85 $345.25
Employee plus one $713.80 $690.45
Employee plus two or more $927.90 $897.60
Triple Option PPO EPO Basic
Two-Tier Rate Structure
Employee $329.45 $334.50 $247.10
Employee plus dependent(s) $856.40 $869.80 $642.30
Three Tier Rate Structure
Employee $356.85 $362.55 $267.70
Employee plus one $713.80 $725.00 $535.30
Employee plus two or more $927.90 $942.50 $695.95
*COBRA
Benefits: same as those for active participants.
Rates: add 2%to those for active participants.
Rates as of January 1, 2002 are effective through
December 31, 2002. At that time, rates will be
underwritten and renewed with the Pool.
19
CHP 2002 Medical Rates
Health Benefits for members covering 101+ employees
(based on the previous 12 months).
(Rate structure must be maintained for at least 3 years).
Stand Alone PPO EPO Basic -
Two-Tier Rate Structure
Employee $298.55 $289.30 $223.95
Employee plus dependent(s) $776.10 $752.15 $582.10
Three Tier Rate Structure
Employee $323.55 $313.45 $242.60 —
Employee plus one $646.90 $626.95 $485.20
Employee plus two or more $840.90 $815.10 $630.70
Dual Option PPO EPO
Two-Tier Rate Structure —
Employee $298.55 $289.30
Employee plus dependent(s) $776.10 $752.15
Three Tier Rate Structure
Employee $323.55 $313.45
Employee plus one $646.90 $626.95 —
Employee plus two or more $840.90 $815.10
Triple Option PPO EPO Basic
Two-Tier Rate Structure
Employee $298.55 $303.80 $223.95 —
Employee plus dependent(s) $776.10 $789.75 $582.10
Three Tier Rate Structure
Employee $323.55 $329.20 $242.60
Employee plus one $646.90 $658.30 $485.20
Employee plus two or more $840.90 $855.90 $630.70
*COBRA _
Benefits: same as those for active participants.
Rates: add 2%to those for active participants.
Rates as of January 1, 2002 are effective through December
31, 2002. At that time, rates will be underwritten and
renewed with the Pool.
20
CHP 2002 Dental Rates
(Rate structure must be maintained for at least 3 years).
Stand Alone Plan A Plan B
., Two-Tier Rate Structure
Employee $21.85 $12.80
Employee plus dependent(s) $56.75 $33.20
Three Tier Rate Structure
Employee $23.60 $13.80
Employee plus one $47.20 $27.60
Employee plus two or more $61.35 $35.85
Dual Option Plan A Plan B
Two-Tier Rate Structure
Employee $23.15 $12.05
Employee plus dependent(s) $60.15 $31.15
Three Tier Rate Structure
Employee $25.05 $12.95
Employee plus one $50.05 $25.95
Employee plus two or more $65.00 $33.75
*COBRA
Benefits: same as those for active participants.
Rates: add 2%to those for active participants.
Rates as of January 1, 2002 are effective through
December 31, 2002. At that time, rates will be
underwritten and renewed with the Pool.
21
CHP 2002 Vision Rates
(Rate structure must be maintained for at least 3 years).
Two-Tier Rate Structure
Employee $5.70
Employee plus dependent(s) $14.75
Three Tier Rate Structure
Employee $5.70
Employee plus one $11.35
Employee plus two or more $14.75
*COBRA —
Benefits: same as those for active participants.
Rates: add 2%to those for active participants.
Rates as of January 1, 2002 are effective through December
31, 2002. At that time, rates will be underwritten and renewed —
with the Pool.
22
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