1.1 FY 2016-17 MEDICAL PLANS EXHIBIT A PLAN CHANGESFINAL.DOCX

Exhibit A
Medical Plans
Proposed changes to the Cigna HMO are as follows:
 Reduce the Convenience Care copay from $20 to $10.
 Limit coverage for a newborn to the first 96 hours following birth, unless employee adds
newborn to coverage under employee’s benefit plans.
 Eliminate the non-smoker discount for COBRA participants.
 Move administration of the Diabetes Management Program from the County Benefits
Office to the healthplans – Cigna and UnitedHealthcare.
Proposed changes to the UnitedHealthcare PPO are as follows:
 Reduce the Convenience Care copay from $30 to $20.
 Limit coverage for a newborn to the first 96 hours following birth, unless employee adds
newborn to coverage under employee’s benefit plans.
 Eliminate the non-smoker discount for COBRA participants.
 Move administration of the Diabetes Management Program from the County Benefits
Office to the healthplans – Cigna and UnitedHealthcare.
 Increase the In-Network Deductibles.
o Individual: from $350 to $750
o Family: from $700 to $1,500
 Increase the Out-of-Network Deductibles.
o Individual: from $700 to $1,500
o Family: from $1,400 to $3,000
 Increase the In-Network Out-of-Pocket Maximums.
o Individual: from $3,000 to $3,500
o Family: from $6,000 to $7,000
 Increase the Out-of-Network Out-of-Pocket Maximums.
o Individual: from $6,000 to $7,000
o Family: from $12,000 from $14,000
Proposed changes to the UnitedHealthcare HDHP with H.S.A. are as follows:
 Limit coverage for a newborn to the first 96 hours following birth, unless employee adds
newborn to coverage under employees’ benefit plans.
 Eliminate the non-smoker discount for COBRA participants.
 Increase the In-Network Out-of-Pocket Maximums.
o Individual: from $3,000 to $3,275

o Family: from $6,000 to $6,550
 Increase the Out-of-Network Out-of-Pocket Maximums.
o Individual: from $6,000 to $6,550
o Family: from $12,000 to $13,100
 Increase the In-Network member coinsurance percentage from 10% to 15%.
 Increase the annual H.S.A. contribution limit for Family coverage from $6,650 to $6,750
(the limit for Individual coverage will remain unchanged at $3,350).
 Set the annual, minimum contribution to an H.S.A. at $240.
Prescription Plans
Proposed changes to the Catamaran Co-Insurance Prescription Plan are as follows:
 Increase the tier maximums.
Generic - No Change
Preferred Brand
o Retail 30-day: from $60 to $80
o Retail 90-day: from $180 to $240
o Mail Order 90-day: from $105 to $160
Non-Preferred Brand
o Retail 30-day: from $110 to $120
o Retail 90-day: from $330 to $360
o Mail Order 90-day: from $275 to $300
Specialty Preferred
o Specialty 30-day: from $105 to $125
Specialty Non-Preferred
o Specialty 30-day: from $275 to $300
 Move to a partially closed formulary that excludes coverage for certain Brand name
drugs that offer no clear clinical advantage over less costly Brand or Generic
alternatives.
 Eliminate mail order pricing for retail 90-day supply prescriptions purchased at the
Walgreens Onsite Pharmacy located in the Administration Building, 301 W. Jefferson St.
Proposed changes to the OptumRx Prescription Plan are as follows:
 Implement “Medical Necessity” reviews to ensure prescribed specialty drugs are
medically necessary.
 Eliminate 30-day fills at a retail pharmacy for specialty drugs, and instead require use of
the mail order OptumRx Specialty Pharmacy.