San Francisco Health Service System Health Service Board
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1 San Francisco Health Service System Health Service Board Rates & Benefits 2018 Renewal Vision Service Plan June 8, 2017 Prepared by:
2 May Board Meeting Follow-ups Costco Frame Allowance Variation Explanation (VSP): The Costco Retail Frame Allowance is lower because Costco purchases frames in bulk, and adds very little markup. When comparing the price difference, an $80 frame allowance at Costco is equivalent to a $150 frame allowance elsewhere If the San Francisco Health Service System were to match the allowances, VSP would essentially be almost doubling the frame allowance, which would cause a rate impact. This is outlined below To raise the Costco allowances to the Non-Costco level, premiums would need to increase by: Frame allowance of $150: +4.5% Base/Current Plan Frame allowance of $300: +8.5% Buy-Up Plan HSB Meeting 2018 Renewal VSP June 8,
3 VSP Renewal Status Quo with Costco Allowance VSP s monthly premiums are as follows: Actives (Bargained) / Monthly Premiums Tier Costco Allowance % Change EE Only / RET Only $3.95 $ % EE + 1 / RET + 1 $7.92 $ % EE + Family / RET + Family $11.20 $ % To raise the Costco allowances to the Non-Costco level, premiums would need to increase by: Frame allowance of $150: +4.5% Base/Current Plan HSB Meeting 2018 Renewal VSP June 8,
4 VSP Renewal Buy-Up Option with Costco Allowance VSP s monthly premiums are as follows: Actives (Bargained) / Monthly Premiums Tier % Change EE Only / RET Only $14.81 $ % EE + 1 / RET + 1 $23.46 $ % EE + Family / RET + Family $42.02 $ % Active (Bargained)/ Monthly Cost EE Only / RET Only $10.86 $ % EE + 1 / RET + 1 $15.54 $ % EE + Family / RET + Family $30.82 $ % To raise the Costco allowances to the Non-Costco level, premiums would need to increase by: Frame allowance of $300: +8.5% Buy-Up Plan HSB Meeting 2018 Renewal VSP June 8,
5 Recommendations Aon recommends that the Health Service Board confirm the 2018 VSP plan premiums voted on in the May meeting HSB Meeting 2018 Renewal VSP June 8,
6 Appendix BSC Flex Funded Monthly Rate Card Status Quo HMO Access + With Costco Vision Plan 93 / 93 / 83 Contribution Strategy Only Actives and One Dependent without Early s and Spouse w/o Medical $ $1, $1, $1, $2, $2, Vision $4.13 $8.28 $11.70 $4.13 $8.28 $11.70 Expense 1 $3.00 $3.00 $3.00 $3.00 $3.00 $3.00 Best Doctors 2 $1.40 $1.40 $1.40 $1.40 $1.40 $1.40 Claims Stabilization Amount / Self-Funded Policy $8.42 $16.81 $23.77 $19.43 $28.15 $35.13 Total $ $1, $1, $1, $2, $2, County Amount (Early s and s only) 3 $0.00 $0.00 $0.00 $ $0.00 $0.00 Single Offset 4 $0.00 $0.00 $0.00 $0.00 $ $ "Actuarial Difference" 5 $0.00 $0.00 $0.00 $ $ $ Prop. E Subsidy 6 $0.00 $0.00 $0.00 $29.53 $ $ Subtotal City Contributions $0.00 $0.00 $0.00 $1, $1, $1, Non-Bargained Contribution Rate $ $1, $1, $29.53 $ $ MOU Negotiated Pickup 7 $ $1, $1, Typical Bargained Member / Contribution $49.58 $98.85 $ $29.53 $ $ Final Member Contribution 2017 $52.66 $ $ $73.70 $ $1, Difference -$3.08 -$6.16 -$ $ $ $ NOTE Footnotes 1 7 defined on page HSB Meeting 2018 Renewal VSP June 8,
7 Appendix BSC Flex Funded Monthly Rate Card Status Quo HMO Access + With Costco Vision Plan 100 / 96 / 83 Contribution Strategy Only Actives and One Dependent without Early s and Spouse w/o Medical $ $1, $1, $1, $2, $2, Vision $4.13 $8.28 $11.70 $4.13 $8.28 $11.70 Expense 1 $3.00 $3.00 $3.00 $3.00 $3.00 $3.00 Best Doctors 2 $1.40 $1.40 $1.40 $1.40 $1.40 $1.40 Claims Stabilization Amount / Self-Funded Policy $8.42 $16.81 $23.77 $19.43 $28.15 $35.13 Total $ $1, $1, $1, $2, $2, County Amount (Early s and s only) 3 $0.00 $0.00 $0.00 $ $0.00 $0.00 Single Offset 4 $0.00 $0.00 $0.00 $0.00 $ $ "Actuarial Difference" 5 $0.00 $0.00 $0.00 $ $ $ Prop. E Subsidy 6 $0.00 $0.00 $0.00 $29.53 $ $ Subtotal City Contributions $0.00 $0.00 $0.00 $1, $1, $1, Non-Bargained Contribution Rate $ $1, $1, $29.53 $ $ MOU Negotiated Pickup 7 $ $1, $1, Typical Bargained Member / Contribution $0.00 $56.48 $ $29.53 $ $ Final Member Contribution 2017 $0.00 $60.00 $ $73.70 $ $1, Difference $0.00 -$3.52 -$ $ $ $ NOTE Footnotes 1 7 defined on page HSB Meeting 2018 Renewal VSP June 8,
8 Appendix BSC Flex Funded Monthly Rate Card Trio proposal With Costco Vision Plan 93 / 93 / 83 Contribution Strategy Only Actives and One Dependent without Early s and Spouse w/o Medical $ $1, $2, $1, $2, $3, Vision $4.13 $8.28 $11.70 $4.13 $8.28 $11.70 Expense 1 $3.00 $3.00 $3.00 $3.00 $3.00 $3.00 Best Doctors 2 $1.40 $1.40 $1.40 $1.40 $1.40 $1.40 Claims Stabilization Amount / Self-Funded Policy $8.42 $16.81 $23.77 $19.43 $28.15 $35.13 Total $ $1, $2, $1, $2, $3, County Amount (Early s and s only) 3 $0.00 $0.00 $0.00 $ $0.00 $0.00 Single Offset 4 $0.00 $0.00 $0.00 $0.00 $ $ "Actuarial Difference" 5 $0.00 $0.00 $0.00 $1, $1, $1, Prop. E Subsidy 6 $0.00 $0.00 $0.00 $70.54 $ $ Subtotal City Contributions $0.00 $0.00 $0.00 $1, $2, $2, Non-Bargained Contribution Rate $ $1, $2, $70.53 $ $1, MOU Negotiated Pickup 7 $ $1, $1, Typical Bargained Member / Contribution $55.32 $ $ $70.53 $ $1, Final Member Contribution 2017 $52.66 $ $ $73.70 $ $1, Difference $2.66 $5.32 $ $3.17 $16.60 $48.16 NOTE Footnotes 1 7 defined on page HSB Meeting 2018 Renewal VSP June 8,
9 Appendix BSC Flex Funded Monthly Rate Card Trio proposal With Costco Vision Plan 100 / 96 / 83 Contribution Strategy Only Actives and One Dependent without Early s and Spouse w/o Medical $ $1, $2, $1, $2, $3, Vision $4.13 $8.28 $11.70 $4.13 $8.28 $11.70 Expense 1 $3.00 $3.00 $3.00 $3.00 $3.00 $3.00 Best Doctors 2 $1.40 $1.40 $1.40 $1.40 $1.40 $1.40 Claims Stabilization Amount / Self-Funded Policy $8.42 $16.81 $23.77 $19.43 $28.15 $35.13 Total $ $1, $2, $1, $2, $3, County Amount (Early s and s only) 3 $0.00 $0.00 $0.00 $ $0.00 $0.00 Single Offset 4 $0.00 $0.00 $0.00 $0.00 $ $ "Actuarial Difference" 5 $0.00 $0.00 $0.00 $1, $1, $1, Prop. E Subsidy 6 $0.00 $0.00 $0.00 $70.54 $ $ Subtotal City Contributions $0.00 $0.00 $0.00 $1, $2, $2, Non-Bargained Contribution Rate $ $1, $2, $70.53 $ $1, MOU Negotiated Pickup 7 $ $1, $1, Typical Bargained Member / Contribution $0.00 $63.04 $ $70.53 $ $1, Final Member Contribution 2017 $0.00 $60.00 $ $73.70 $ $1, Difference $0.00 $3.04 $ $3.17 $16.60 $48.16 NOTE Footnotes 1 7 defined on page HSB Meeting 2018 Renewal VSP June 8,
10 Appendix Kaiser Permanente Monthly Rate Card 93 / 93 / 83 Contribution Strategy Only Actives and One Dependent without Early s and Spouse w/o Premium 1 $ $1, $1, $1, $1, $2, Vision $4.13 $8.28 $11.70 $4.13 $8.28 $11.70 Expense $3.00 $3.00 $3.00 $3.00 $3.00 $3.00 Best Doctors $1.40 $1.40 $1.40 $1.40 $1.40 $1.40 Total $ $1, $1, $1, $1, $2, County Amount (Early s and s Only) 3 $0.00 $0.00 $0.00 $ $0.00 $0.00 Single Offset 4 $0.00 $0.00 $0.00 $0.00 $ $ "Actuarial Difference 5 $0.00 $0.00 $0.00 $ $ $ Prop. E Subsidy 6 $0.00 $0.00 $0.00 $0.00 $ $ Subtotal City Contributions $0.00 $0.00 $0.00 $1, $1, $1, Non-Bargained Contribution Rate $ $1, $1, $0.00 $ $ MOU Negotiated Pickup 7 $ $1, $1, Typical Bargained Member Contribution $42.96 $85.61 $ Final Member Contribution 2018 $42.96 $85.61 $ $0.00 $ $ Final Member Contribution 2017 $40.78 $81.25 $ $0.00 $ $ Difference $2.18 $4.36 $14.99 $0.00 $15.58 $41.45 NOTE Footnotes 1 7 defined on page HSB Meeting 2018 Renewal VSP June 8,
11 Appendix Kaiser Permanente Monthly Rate Card 100 / 96 / 83 Contribution Strategy Only Actives and One Dependent without Early s and Spouse w/o Premium 1 $ $1, $1, $1, $1, $2, Vision $4.13 $8.28 $11.70 $4.13 $8.28 $11.70 Expense $3.00 $3.00 $3.00 $3.00 $3.00 $3.00 Best Doctors $1.40 $1.40 $1.40 $1.40 $1.40 $1.40 Total $ $1, $1, $1, $1, $2, County Amount (Early s and s Only) 3 $0.00 $0.00 $0.00 $ $0.00 $0.00 Single Offset 4 $0.00 $0.00 $0.00 $0.00 $ $ "Actuarial Difference 5 $0.00 $0.00 $0.00 $ $ $ Prop. E Subsidy 6 $0.00 $0.00 $0.00 $0.00 $ $ Subtotal City Contributions $0.00 $0.00 $0.00 $1, $1, $1, Non-Bargained Contribution Rate $ $1, $1, $0.00 $ $ MOU Negotiated Pickup 7 $ $1, $1, Typical Bargained Member Contribution $0.00 $48.92 $ Final Member Contribution 2018 $0.00 $48.92 $ $0.00 $ $ Final Member Contribution 2017 $0.00 $46.43 $ $0.00 $ $ Difference $0.00 $2.49 $14.99 $0.00 $15.58 $41.45 NOTE Footnotes 1 7 defined on page HSB Meeting 2018 Renewal VSP June 8,
12 Appendix Contribution Strategy Footnotes 1) Healthcare Sustainability Fee 2) Best Doctors: Second opinion vendor fees of $1.40 PEPM 3) "10-County" City Contribution: Per Charter Section A8.423, employer contribution must equal the average of the employer contribution to health premium of the 10 most populous counties in CA, not including San Francisco. Per the MOU, the 10-County offset does not apply to 93 / 93 / 83 for Actives, and the County amount is $ ) "Single Offset": Per Charter Section A8.428, for Early s = 10-County Amount; for -Eligible s = Premium (because it is the lower than the 10-County Amount) HSB Meeting 2018 Renewal VSP June 8,
13 Appendix Contribution Strategy Footnotes 5) "Actuarial Difference": Per Charter Section A8.428, employer contributes the difference between a single and a single non- cost of premium. Calculated for Non- only 6) Prop. E Subsidy Passed in November 2000 Election: Per Charter A8.428, employer subsidy for (R) and R+1 = 50% x [Total Rate Cost 10-County Actuarial Difference] 7) MOU Negotiated Pickup: The employer pickup at 93% of the BCA EE Only, 93% of BSC EE+1, 83% of BSC EE+2. BSC premium is the second lowest cost plan and is the maximum the City contributes, as outlined in the MOU for applicable bargaining units HSB Meeting 2018 Renewal VSP June 8,
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