HomeMy WebLinkAboutMinutes - July 27, 2004 SSCITY OF LODI
INFORMAL INFORMATIONAL MEETING
"SHIRTSLEEVE" SESSION
CARNEGIE FORUM, 305 WEST PINE STREET
TUESDAY, JULY 27, 2004
An Informal Informational Meeting ("Shirtsleeve" Session) of the Lodi City Council was held Tuesday,
July 27, 2004, commencing at 7:03 a.m.
A. ROLL CALL
Present: Council Members — Beckman, Land, and Mayor Hansen
Absent: Council Members — Hitchcock and Howard
Also Present: Deputy City Manager Keeter, City Attorney Schwabauer, and City Clerk Blackston
B. CITY COUNCIL CALENDAR UPDATE
City Clerk Blackston reviewed the weekly calendar (filed).
C. TOPIC(S)
C-1 "Update regarding potential health insurance changes"
Deputy City Manager Keeter reported that the City Manager had met with department
heads, staff, retirees, and bargaining groups about this matter. Council was briefed at a
Special meeting on July Q and on July 15 the City Manager and staff met with ABD
Insurance & Financial Services and PacifiCare.
Terri Ezaki, representing ABD Insurance, distributed and reviewed a handout entitled "City
of Lodi Active/Retiree 2005 PERS Breakaway Update" (filed). She highlighted the following
information:
➢ Blue Cross has declined to submit a quote;
➢ Health Net would not be an adequate network as it does not contract with Lodi
Memorial Hospital;
➢ Kaiser may adjust the rates it quoted after it receives notification that the City has
withdrawn from CaIPERS; however, Ms. Ezaki stated that its rates would never be
below CalPERS rates;
➢ Late Friday afternoon, a quote was received from Aetna; Ms. Ezaki stated that
work still needs to be done to make sure that the benefit design, eligibility, and
other components are confirmed prior to it being an option for the City to consider;
➢ The overall cost comparison shows a savings of just under $400,000 between the
2005 CalPERS rates and the PacifiCare/Kaiser options; and
➢ PacifiCare has provided guarantees and trend caps, which means that it would take
the City's experience, and in addition to that, project a future amount.
Ms. Ezaki reported that Lodi Firefighters have expressed concern about leaving CalPERS
and have indicated that they would prefer remaining with them for the stability it offers.
There are 44 active firefighter employees on the census, which amount to 10% of the group.
Ms. Ezaki stated that the group rate would be affected if the firefighters were not included.
Ms. Ezaki stated that PacifiCare's average rate increases in California ranged between 12%
to 15% in 2001-03 and its Preferred Provider Organization plan increased 12% to 14% in
the same period.
In answer to Mayor Pro Tempore Beckman, Ms. Ezaki stated that the deadline for Lodi to
withdraw from CalPERS is August 14. A decision on an insurance carrier would need to be
made by September. Open enrollment could then occur in October, with an effective date
of January 1, 2005. She confirmed that if the City switched to PacifiCare it would sustain a
9.45% increase in medical insurance costs and if it stayed with CalPERS the increase
would be 23.71%.
Continued July 27, 2004
Ms. Keeter noted that the Human Resources Department and staff would be meeting
formally with bargaining groups regarding this matter. She commented that many of these
changes would result in an increased cost to retirees as well.
Mayor Hansen pointed out that the Memorandums of Understanding tie the City to a
specific insurance provider, which he believed to be a mistake and suggested that it be
considered in future bargaining sessions. He requested that a CalPERS representative
appear at a future City Council meeting to discuss its medical insurance rate increases and
answer questions.
Council Member Land asked that another attempt be made to obtain the City's utilization
cost information from CalPERS.
D. COMMENTS BY THE PUBLIC ON NON -AGENDA ITEMS
None.
E. ADJOURNMENT
No action was taken by the City Council. The meeting was adjourned at 7:48 a.m.
ATTEST:
Susan J. Blackston
City Clerk
2
Mayor's& Council Members' Weekly Calendar
WEE( O F JULY 27, 2004
Tuesday, July 27, 2004
7:00 a.m. Shirtsleeve Session
Update regarding potential health insurance changes(HR)
Wednesday, July 28, 2004
Reminder Hansen. League of California Cities Mayorsand Council Members
Executive Forum and Academy Advanced Leadership Workshop,
Monterey, CA. July 28 - 31, 2004
Thursday, July 29, 2004
9:00 a.m. San Joaquin County of Public Works Ground breaking Ceremony forthe
start of work on Main Street in Historic Woodbridge, located between
Cactusand Woodbridge Feed and Fuel Restaurants.
Friday, July 30, 2004
Saturday, July 31, 2004
Sunday, August 1, 2004
11:00-2:00 p.m. Lodi Boysand Girls Club, National KdsDay Celebration,
Blakely Park - Corner of Stockton and Poplar Street.
Monday, August 2, 2004
Disclaimer. This calendar contains only information that was provided to the City Clerk's Office.
CADocuments and Settings\jperrin\Local Settings\Temporary Internet Files\OLKC4\Mcalndrl.doc
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City of Lodi
A c t i v e/ Retiree 2 0 0 5 P E R S B r e a k a w a y
U p d a t e
Presented By
Terri Ezaki
July 27, 2004
ABD Insurance & Financial Services
Sacramento Employee Benefits Division
Broker License No. OD58513
HMO Medical Group & Hospital Comparison
-- Stanislaus/San Joaquin Counties --
Aetna Blue Cross Blue Shield Health Net Pacificare
Dameron Hospital (Stockton) - San Joaquin
Yes
Yes
Yes
Yes
Yes
Doctors Hospital (Modesto/Manteca) - Stanislaus
Yes
Yes
Yes
Yes
No
Emanuel Medical Center (Turlock) - Stanislaus
Yes
Yes
Yes
Yes
Yes
Lodi Memorial Hospital (Lodi) - San Joaquin
Yes
Yes
Yes
No
Yes
Los Banos Community Hospital - Merced
No
No
No
No
No
Mark Twain Saint Joseph's Hospital
No
Yes
No
Yes
No
Memorial Hospital of Los Banos
Yes
Yes
Yes
Yes
No
Memorial Medical Ctr (Modesto)
Yes
Yes
Yes
Yes
Yes
Mercy Hospital - Merced
No
Yes
Yes
Yes
Yes
Oak Valley District Hospital (Oakdale) - Stanislaus
Yes
Yes
Yes
Yes
Yes
St. Dominic's Hospital (Manteca) - San Joaquin
No
Yes
Yes
Yes
Yes
St. Joseph's Medical Center - San Joaquin
No
Yes
Yes
Yes
Yes
Sutter Delta Medical Center
Yes
Yes
Yes
Yes
Yes
Sutter Tracy Hospital(Tracy) -San Joa uin
Yes I
Yes
Yes
Yes
Yes
1!lJUr/nduUl7 prUVIUeU IrUM cdrner weosrres eMeMve: JUIy LUUq July LUU4
Prepared By ABD Insurance and Financial Services, License #01358513
Confidential - modification or reproduction is prohibited.
JU/y ZUU4 JUIy IUU4 Jury 2UU4
7/26/2004
1
Kaiser/Aetna Quote Information
Kaiser:
* Preliminary Kaiser Rates
* Rates include Chiropractic Plan (similar to PERS)
Aetna :
* Preliminary Aetna Rates
* Refine Rates and Quote Assumptions
* Rates include Chiropractic Plan (Blue Shield PERS does not)
* Compare Benefit Designs
* Refine Eligibility Guidelines
z
CITY OF LODI
MEDICAL - Cost Comparison (Actives) - Effective January 1, 2005
Participation in the medical plans is based on current medical elections,
Rates above are based on the census data provided by CITY OF LODI.
Final rates are subject to actual emollirmt, plan design(s) selected, underwriting guidelines and approval.
Prepared by ABD Insurance and Financial Services, License #OD58513
Confidential. Modification or reproduction is prohibited.
7/26/2004
KAISER
KAISER
KAISER
MEDICAL
vers ov. a: sans stoclirol
nu ov. � ssns.su �}
tsv ov. aY ssrrs. ��
Employ-
15
$305.42
$354.69
$410.28
Employee +I Dependent
6
$610.84
$709.38
$820.56
Employee + 2 or more Dep.
15
$794.09
$922.19
$1,066.72
MONTHLY PREMIUM
$20,157.69
$2.409.48
$27,078.36
ANNUAL PREMIUM
$241,892
$280,914
$324,940
anal $ Increase over Current
N/A
$39,021
$83,048
% Increase over CurrenkN/A
16.13%
34.33%
.....................................................................................................................................................................................................................................................
BLUE SHIELD
BLUE SHIELD
AETNA
4190v.rr:ssn646)
We 9-V Ric Na
rslsOV, rxssnSMS10Ctamf
Employee
67
$315.22
$389.96
$403.04
Employee + 1 Dependent
78
$630.44
$779.92
$806.08
Employee + 2 or more Dep.
205
$819.57
$1,013.90
$1,047.91
MONTHLYPRI3MIUM
$238,305.91
$294,810.58
$30699.47
ANNUAL PREMIUM
$2,859,671
$3,537,727
$3,656,394
Annual $ Increase over Current
N/A
$678,056
$796,723
% Increase over Currenr:
N/A
23.7196
27.8696
.....................................................................................................................................................................................................................................................
PERSCARE
PERSCARE
AETNA
(PPO)
(PPO)
Open Access Managed Choice
POS (80-60)
Employee
0
$544.77
$619.93
$518.97
Employee +l Dependent
0
$1,089.54
$1,239.86
$1,037.95
Employee+ 2 or more Dep.
0
$1,416.40
$1,611.82
$1,349.32
MONTHLY PREMI UM
$0.00
$0.00
$0.00
ANNUAL PREMIUM
$0
$0
$0
Annual $ Increase over Current
N/A
$0
$0
%Increase over Current:
N/A
N/A
X74%
..................................................................................................
..................................................................................................
PERS CHOICE
PERS CHOICE
AETNA
(PPO)
(PPO)
Open Access Managed Choice
POS (80.60)
Employee
26
$349.41
$369.74
$518.97
Employee + 1 Dependent
0
$698.82
$739.48
$1,037.95
Employee + 2 or more Dep.
0
$908.47
$961.32
$1,349.32
MONTHLY PREMIUM
$91084.66
$9,613.24
$13,493.22
ANNUAL PREMIUM
$109,016
$115,359
$161,919
Annual $ Increase over Current
N/A
$4343
$32,903
% increase over CurreakN/A
S.82%
48.53%
......................................................................................................................................................................................................................................................
PORAC
PORAC
AETNA
(PPO)
(PPO)
Open Access Managed Choice
POS (80-60)
Employee
0
$399.00
$399.00
$518.97
Employee+ 1 Dependent
0
$733.00
$748.00
$1,037.95
Employee + 2 or more Dep.
4
$931.00
$950.00
$1,349.32
MONTHLY PREMIUM
$3,724.00
$3,800.00
$5,39728
ANNUAL PREMIUM
W688
$45,600
$64,767
Annual $ Increase over Current
N/A
$76
$20,079
% Increase over Current:
N/A
2%
4203%
Participation in the medical plans is based on current medical elections,
Rates above are based on the census data provided by CITY OF LODI.
Final rates are subject to actual emollirmt, plan design(s) selected, underwriting guidelines and approval.
Prepared by ABD Insurance and Financial Services, License #OD58513
Confidential. Modification or reproduction is prohibited.
7/26/2004
CITY OF LODI
MEDICAL - Cost Comparison - Eariv Retirees (Under 65) - Effective January 1, 2005
Participation in the medical plans is based on current medical elections.
Rates above are based on the census data provided by CITY OF LODL
Final rates are subject to actual enrollment, plan design(s) selected, underwriting guidelines and approval.
Prepared by ABD Insurance and Financial Services, License #OD58513. 7/26/2004
Confidential. Modification or reproduction is prohibited. 4
# Covered
KAISER
HMO
KAISER
HMO
KAISER
HMO
MEDICAL
t$la ov. Rx $5115. $ro arrot
tsts 0v. Rx ss/ts. am ta�tmi
i v R:
$305.42
Employee
3
$354.6
$$410.28
Employee+ 1 Dependent
3
$610.84
$709.38
$820.56
Employee + 2 or more Dep.
1
$794.09
$922.19
$1,066.72
MONTHLY PREMIUM
$3,542.87
$4,114.40
$4,759.24
ANNUAL PREMIUM
$42,514
$49,373
$57,111
% Increase over Current:
NIA
N/A
15.67%
....................................................
..................................... _............................................
...................
.....................................................
BLUE SHIELD
....................................................
BLUE SHIELD
AETNA
rsla 0v. Rx ssrls/4s
Mis 0v. RxW15Iis1
n10 ov. $5115/36.sm diml
Employee
13
$315.22
$389.96
$403.04
Employee + 1 Dependent
21
$630.44
$779.92
$806.08
Employee + 2 or more Dep.
6
$819.57
$1,013.90
$1,047.91
MONTHLY PREMIUM
$22,254.52
$17,531.20
$28,454.66
ANNUALPREMIUM
$267,054
$330,374
$341,456
Sao Increase over CWmrst:
NIA
23.71%
27.86% ... ................
..................................... _............................................
...................
.....................................................
PERSCARE
.....................................................................................
PEILSCAIZE
AETNA
(PPO)
(PPO)
Open Access Managed Choice
POS (80-60)
Employee
0
$544.77
$619.93
$518.97
Employee +I Dependent
0
$1,089.54
$1,239.86
$1,037.95
Employee + 2 or more Dep.
0
$1,416.40
$1,611.82
$1,349.32
MONTHLYPREMIU"
$0.00
$0.00
$0.00
ANNUAL PREMIUM
$0
$0
$0
% Increase over Current:
N/A
N/A
•4.74%
.....................................-............................................................................................................................................................................................................................
PERS CHOICE
PERS CHOICE
(PPO)
(PPO)
Open Access Managed Choice
POS (80-60)
Employee
1
$349.41
$369.74
$518.97
Employee+ 1 Dependent
3
$698.82
$739.48
$1,037.95
Employee+ 2 or more Dep.
1
$908.47
$961.32
$1,349.32
MONTHLY PREMIUM
$3,354.34
$3,549.50
$4,982.14
ANNUAL PREMIUM
$40,2S2
$42,594
$59,786
% Increase over Curren t:
N/A
5.82 %
48.53x%
....................................._............................................................................................................................................................................................................................
PORAC
PORAC
(PPO)
(PPO)
Open Access Managed Choice
POS (80-60)
Employee
1
$399.00
$399.00
$518.97
Employee + 1 Dependent
3
$733.00
$748.00
$1,037.95
Employee + 2 or more Dep.
0
$931.00
$950.00
$1,349.32
MONTHLYPREMIUM
$2,598.00
$2,643.00
$3,631.82
ANNUAL PREMIUM
$31,176
$31,716
$43,594
%Increase over Current:
NIA
1.73%
39.83%
§
N' e��
{
rL
Participation in the medical plans is based on current medical elections.
Rates above are based on the census data provided by CITY OF LODL
Final rates are subject to actual enrollment, plan design(s) selected, underwriting guidelines and approval.
Prepared by ABD Insurance and Financial Services, License #OD58513. 7/26/2004
Confidential. Modification or reproduction is prohibited. 4
CITY OF LODI
MEDICAL - Ca1PERS Medicare HMO Cost Comparison
NOTE: Quotes sesame that all retirees over 65 have Medicare A & B.
Prepared by ABD Insurance and Financial Services, License #OD58513 7126!2004
Confidential. Modification or reproduction is prohibited. 5
KAISER
KAISER
KAISER
#COVERED IiMO tion
FAI 'on
HM n
Retiree w/Medicare
1 $273.86
$255.97
$255.97
Retiree w/Medicare + 1 Dependent w1Med
4 $547.72
$511.94
$511.94
Retiree +2 or more Dependents
0 $821.48
$767.91
TOTAL MONTHLY PREMIUM
$2,46A 74
$2,303.73
$2,303.73
TOTAL ANNUAL PREMIUM
$29,576.88
$27,644.76
$27,644.76
%Change over Current
NIA
-6.53%
-6.53%
BLUESHIELD
BLUE SHIELD
AETNA
Open Access Managed Choice POS
# COVERED
(HMO Option)
(HMO tion)
(90-60) or Indmitity
Retiree w/Medicare
10 $319.97
$287.78
$319.68
Retiree w/Medicare. + 1 Dependent w/Med
17 $639.94
$575.56
$639.35
Retiree + 2 or more Dependents
0 $959.91
$863.34
$831.16
TOTAL MONTHLYPREMIUM
$14,078.68
$12,66232
$14,065.75
TOTAL ANNUAL PREMIUM
$168,944.16
$151,947.84
$168,789.00
%C eoverCurrent
N/A
10.0696
-0.09%
,ak�IT'.... A, ,�. .
7CO7P7F_P90C00--P:-P-P)O
PERS Care PPO
AETNA
Open Access Managed Choice POS
(PPO tion)
(90-60) or Indemnit
Retiree wlMedleare
5
$336.07
$289.32
$319.68
Retiree w/Medicare + 1 Dependent wtMed
5
$672.14
$578.64
$639.35
Retiree +2 or more Dependents
0
$1,008.21
$86796
$831.16
TOTAL MONTHLY PREMIUM
$5,041.05
$4,339.80
,$4,795.15
TOTAL ANNUAL PREMIUM
$60,492.60
$52,077.60
$57,541.80
%Change over Current
NIA
-13.91%
•4.88%
'r.P
MW"
omits - :� ,..;...: t ..'�c� 5_ .'_ •. -x €
. �i: �.. A
PERS Choice PPO
PERS Choice PPO
AETNA
Open Access Managed Choice POS
# COVERED
(PPO Option)
(PPO Option)
(90-60) or Indemnity
Retiree wlMedicam
6
$305.67
$279.60
$319.68
Retiree w/Medicare + 1 Dependent w1Med
7
$611.34
$559.20
$639.35
Retiree + 2 or more Dependents
0
$917.01
$838.80
$831.16
TOTAL MONTHLY PREMIUM
$6,113.40
$5,592.00
$6,393.53
TOTAL ANNUAL PREMIUM
$73,360.80
$67,104.00
$76,722.36
% Change over Current
N/A
-8.53%
4.58%
s•{ +ur xH�y.A"t�'rh.$'•' ,'Ml
!r.}Y F -
z:3r= �• - "V
jr 'k; , sxv�fr
tom,.
tr. r r f;s,
X2e.. ....:... ....
.. r... y..'
PORAL
PORAL
AETNA
Open Access Managed Choice POS
# COVERED
(PPO Option)
(PPO Option)
(90-60) or Indernnity
Retiree w/Medicare
0
$351.00
$351.00
$319.68
Retiree w/Medicare + 1 Dependent w1Med
1
$701.00
$701.00
$63935
Retiree +2 or more Dependents
0
$1,049.00
$1.049.00
$831.16
TOTAL MONTHLY PREMIUM
$701.00
$701.00
$639.35
TOTAL ANNUAL PREMIUM
58,412.00
$8,412.00
$7,672.20
%Change over Current
N/A
0.00%
-8.79%
NOTE: Quotes sesame that all retirees over 65 have Medicare A & B.
Prepared by ABD Insurance and Financial Services, License #OD58513 7126!2004
Confidential. Modification or reproduction is prohibited. 5
PacifiCare Revised Quote Information
• Removed Chiropractic Rider
• Updated over 65 rates (Supplement Plan)
CITY OF LODI
MEDICAL - Cost Comparison (Actives) - Effective January 1, 2005
a .
# Covered
KAISER
HM
KAISER
HMO
KAISER
HMO
MEDICAL
ANOv.�ssns.}tpcharof
tstoov.u=ssrts stodd-)
I9Qgy,�
$354.69
Employee
15
$305.42
$410.28
Employee + 1 Dependent
6
$610.84
$709.38
$820.56
Employee + 2 or more Dep.
15
$794.09
$922.19
$1,066.72
MONTHLYPREMIUM
$10,157.69
$23,409.48
$27,078.36
ANNUAL PREMIUM
$241,892
$280,914
$324,940
Annual $ Increase over Current
N/A
$39,021
$83,048
% Increase over Current:
N/A
16.13%
34.33%
.........................................................................................................................................................................................................................................................
BLUE SHIELD
BLUE SHIELD
11100V.RxMsxst
3100v.tUs51154P
rst0ov.�ss,tsrso�
Employee
67
$315.22
$389.96
$345.01
Employee + 1 Dependent
78
$630.44
$779.92
$690.01
Employee + 2 or more Dep.
205
$819.57
$1,013.90
$897.00
MONTHLYPREMIUM
$238,305.91
$294,810.58
$260,821.45
ANNUAL PREMIUM
$2,859,671
$3,537,727
$3,129,857
Annual $ Increase over Current
NIA
$678,056
$270,186
% Increase over Current:
N/A
23.71% .............................i
9.45%
..i
.......................................................-.............................................................................................................................................................................................
PERSCARE
PERSCARE
(PPO)
(PPO)
(PPO Plan U52 - Cat
Employee
0
$544.77
$619.93
$407.38
Employee + I Dependent
0
$1,089.54
$1,239.86
$814.74
Employee +2 or more Dep.
0
$1,416.40
$1,611.82
$1,059.17
MONTHLYPREMIUM
$0.00
$0.00
$0.00
ANNUAL PREMIUM
$0
$0
$0
Annual $ Increase over Current
N/A
$0
$0
% Increase over Current:
N/A
N/A
-15.22%
.........................................................................................................................................................................................................................................................
PERS CHOICE
PER5 CHOICE
PACIFICARE
(PPO)
(PPO)
(PPO Plan U53 - Cho.
Employee
26
$349.41
$369.74
$332.05
Employee + 1 Dependent
0
$698.82
$739.48
$664.08
Employee + 2 or more Dep.
0
$908.47
$961.32
$863.31
MONTHLYPREMIUM
$9,084.66
$9,613.24
$8,633.30
ANNUAL PREMIUM
$109,016
$115,359
$103,600
Annual $ Increase over Current
NIA
$6,343
.$5,416
%Increase over Current:N/A
5.82%
-4.97%
...........................................................................................................................................................................................................................
PORAC
PORAG
PACIFICARE
(PPO)
(PPO)
(PPO Plan U52 - Cal
Employee
0
$399.00
$399.00
$407.38
Employee+ 1 Dependent
0
$733.00
$748.00
$814.74
Employee+ 2 or more Dep.
4
$931.00
$950.00
$1,059.17
MONTHLYPREMIUM
$3,724.00
$3,800.00
$4,236.68
ANNUAL PREMIUM
$44,688
$45,600
$50,840
Annual $ Increase over Current
N/A
$76
$6,152
% Increase over Current:
N/A
29b
11.49%
y
b�
Participation in the medical plans is based on current medical elections.
Rates above are based on the census data provided by CLTY OF LODI.
Final rates are subject to actual enrollment, plan design(s) selected, underwriting guidelines and approval.
ce)
Prepared by ABD Insurance and Financial Services, License #()D58513 7/26/2004
Confidential. Modification or reproduction is prohibited. 7
CITY OF LODI
MEDICAL - Cost Comparison - Early Retirees (Under 65) - Effective January 1. 2005
Tis.,,. ' NI:
# Coveted
KAISER
KAISER
O
KAISER
O
KAISER
ED4
MEDICAL
W@ ov, iu ssn5. $10 Cbir01
($10 OV. Bx $05. $10 ddro)
($14 oy, Ax SM5)
Employee
3
$305.42
$354.69
$410.28
Employee + 1 Dependent
3
$610.84
$709.36
$820.56
Employee + 2 or more Dep.
1
$794.09
$922.19
$1,066.72
MONTHLY PREMIUM
$3,542.87
$4,114.40
$4,759.24
ANNUAL PREMIUM
$42,514
$49,373
$57,111
% Increase over Current:.... ..........
...........
.......................................................................................
.......................................................................
N/A
NIA
SLUE SHIELD
....................... ..............................................15:67%
BLUE SHIELD
PACIFICARE
WD OV, Rx MW)
c$10 qv. Rx $5/15!451
310 ov. Rx $5115!301
Employee
13
$315.22
$389.96
$345.01
Employee + 1 Dependent
21
$630.44
$779.92
$690.01
Employee + 2 or more Dep.
6
$819.57
$1,013.90
$897.00
MONTHLY PREMIUM
$22,254.52
$27,531.20
$24,357.34
ANNUAL PREMIUM
$267,054
$330,374
$292,288
% Increase over Current:N/A
......................................................................................................................................................................................................................................................................................
23.71 %
9.45%
PERSCARE
PERSCARE
PACIFICARE
(PPO)
(PPO)
(PPO Plan U52 - Care)
Employee
0
$544.77
$619.93
$407.38
Employee+ 1 Dependent
0
$1,089.54
$1,239.86
$814.74
Employee + 2 or more Dep.
0
$1,416.40
$1,611.82
$1,059.17
MONTHLY PREMIUM
$0.00
$0.00
$0.00
ANNUAL PREMIUM
$0
$0
$0
% Increase over Current:
......................................................................................................................................................................................................................................................................................
N/A
N/A
-25.22%
PERS CHOICE
PERS CHOICE
PACIFICARE
(PPO)
(PPO)
(PPO Plan U53 - Choice)
Employee
1
$349.41
$369.74
$332.05
Employee + 1 Dependent
3
$698.82
$739.48
$664.08
Employee + 2 or more Dep.
1
$908.47
$961.32
$863.31
MONTHLYPREMIUM
$3,354.34
$3,549.517
$3,187.60
ANNUAL PREMIUM
$40,252
$42,594
$38,251
% Increase over Current:N/A
......................................................................................................................................................................................................................................................................................
5.82%
-4.97%
PORAC
PORAC
PACIFICARE
(PPO)
(PPO)
(PPO Plan U523 - Care)
Employee
1
$399.00
$399.00
$407.36
Employee + t Dependent
3
$733.00
$748.00
$814.74
Employee + 2 or more Dep.
0
$931.00
$950.00
$1,059.17
MONTHLY PREMIUM
$2,598.00
$2,643.00
$2,851.60
ANNUAL PREMIUM
$31,276
$31,716
$34,219
% Increase over Current:
N/A
1.73%
9.76%
s
mi 1 11
"M"Mi WNPI
W100"Mr,_
Participation in the medical plans is based on current medical elections.
Rates above are based on the census data provided by CITY OF LODI,
Final rates are subject to actual enrollment, plan design(s) selected, underwriting guidelines and approval.
Prepared by ABD Insurance and Financial Services, License #01358513. 7/26/2004
Confidential. Modification or reproduction is prohibited. 8
CITY OF LODI
MEDICAL - CaIPERS Medicare HMO Cost Comparison
NO'T'E: Quotes assume that all retirees over 65 have Medicure A & B.
Prepared by ABD Insurance and Financial Services, License #OD56513 7/26/2004
Confidential. Modification or reproduction is prohibited. 9
KAISER
KAISER
KAISER
# COVERED
HMO O tion
HMO 'on)
(HMO Ovtion)
Retiree w/Medicare
l
$273.86
$255.97
$255.97
Retiree w/Medicare + 1 Dependent w/Med
4
$547.72
$511.94
$511.94
Retiree + 2 or more Dependents
0
$821.48
$767.91
TOTAL MONTHLY PREMIUM
$2,464.74
$2,303.73
$2,303.73
TOTAL ANNUAL PREMIUM
$29,576.88
$17,644.76
$27,644.76
% Change over Current
NIA
-6.53%
-6.53%
BLUE SHIELD
BLUE SHIELD
PACIFICARE - Senior
Supplement Plan F
#COVERED
(HMO Option)
(HMD 'on)
Retiree w/Medicare
10
$319.97
$287.78
$309.97
Retiree w/Medicare + I Dependent w/Med
17
$639.94
$575.56
$619.94
Retina + 2 or more Dependents
0
$959.91
$863.34
TOTAL MONTHLY PREMIUM
$14,078.68
$12,662.32
$13,638.68
TOTAL ANNUAL PREMIUM
$168,944.16
$151,947.84
$163,664.16
% Change over Current
NIA
-10.06%
-3.13%
PERS Care PPO
PERS Can PPO
PACIFICARE - Senior
LoVERED
Supplement Plan F
(PPO 'on)
(PPO 'on)
Retiree w/Medicare
5
5336.07
$289.32
$309.97
Retiree w/Medicare +I Dependent w/Med
5
$672,14
$578.64
$619.94
Retiree + 2 or more Dependents
0
$1,008.21
$867.96
TOTAL MONTHLY PREMIUM
$5,041.05
$4,339,80
$4,649.55
TOTALANNUAL PREMIUM
$60,492.60
$52,077.60
$55,794.60
% Change over Current
NIA
-13.91%
.7.77%
yw�{a+.
w u +x+t"W-51
{F,;.�
ZY IiC:v. ;; 3.. ..::
7
PERS Choice PPO
PERS Choice PPO
PACIFICAR19 - Senior
Supplement Plan F
# COVERED
(PPO 'on)
(PPO 21t..)
Retiree w/Medicare
6
$305.67
$279.60
$309.97
Retiree w/Medicare + l Dependent w/Med
7
$611.34
$559.20
$619.94
Retiree + 2 or more Dependents
0
$917.01
$838.80
TOTAL MONTHLY PREMIUM
$6,113.40
$5,592.010
$6,199.40
TOTAL ANNUAL PREMIUM
$73,360.80
$67,104.00
$74,392.80
e over CumntJ�rr
NIA
-853%
1.41%
/4� "owx
nSi•' % d k+
,'
Y't i�RR[�b+�lA
{CM Y �Lll�1f"'J.,1 1, fit4 ,i��3
RRt��
IF
.= .�. ..... - ... ...
PORAL
PORAL
PACIFICARE - Senior
Supplement Plum F
# COVERED
(PPO Option)
(PPO Option)
Retiree w/Medicare
0
$351.00
$351,00
$309.97
Retiree w/Medicare + I Dependent w/Med
1
$701.00
$701.00
$619.94
Retiree + 2 or mom Dependents
0
$1,049.00
$1,049.00
TOTAL MONTHLY PREMIUM
$701.00
$701.00
$619.94
TOTAL ANNUAL PREMIUM
$8,412.00
A412.00
$7,439.28
% Change over Current
NIA
0.00%
-11.56%
NO'T'E: Quotes assume that all retirees over 65 have Medicure A & B.
Prepared by ABD Insurance and Financial Services, License #OD56513 7/26/2004
Confidential. Modification or reproduction is prohibited. 9
CITY OF LODI
MEDICAL - PERS HMO Basic Benefits {Actives &
Blue Shield, Kaiser & Western Health Advantage
$10 co -pay, unlimited
Kaiser (Direct)
$10 co -pay; 20 visits per year (Individual)
PACIFICARE
(HMO BASIC PIAN)
Unlimited
Unlimited
$1,000 maximum benefit per 36 months
(HMO SMP)
None
$10 co-paylvisit
None
20 visits/ner calendar yr
None
100%
100%
100%
$1,5001$3,000 (Kaiser & WHA)
$115001$3,000
$1,5001$3,000
$10 co-paylvisit
$10 co-pay/visit
$10 co-pay/visit
$10 co-pay/visit
$10 co-paylvisit
$10 co-pay/visit
100%
100%
100%
$50 max. co-pay/visit
$50 max. co-paylvisit
$35 max. co-pay/visit
100%
100%
100%
100'%
100%
100'%
100%
10096
100%
(100 da calendar year max)
(100 da calendar year max)
(100 da calendar year max)
Hospital: 100%
Hospital: 100%
Hospital: 100%
Office & Home Visit: $10lvisit
Office & Home Visit: $101visit
Office & Home Visit: $10/visit
100%
100%
100%
$5 Generic/ $15 Brand 1$45 Non -Formulary;
$5 Generic/ $15 Brand
$5 Generic/ $15 Brand l $30 Non -Formulary
(30 days)
(100 days)
(30 days)
Kaiser: $51$15 (100 Days)
$10 Generic 1$25 Brand 1$75 Non -Formulary'
$5 Generic/ $15 Brand
$10 Generic 1$25 Brand l $45 Non -Formulary
$1,000 Out of pocket annual max per person
(100 days)
$1,000 copay annual max for mail order
(Except Kaiser)
100%, up to 30 days/year
100%, up to 30 dayslyear
100%, up to 30 dayslyear
$10 co -pay, unlimited
$10 co -pay, unlimited
$20 co -pay; 20 visits per year
$10 co -pay; 20 visits per year (Individual)
(Kaiser: $10 co a /visit, 20 visits/ ear)
Unlimited
Unlimited
$1,000 maximum benefit per 36 months
$1,000 allowance per aid every 36 months
$10 co-paylvisit(Kaiser & WHA)
$10 co-paylvisit
_ 20 visitslner calendar yr
20 visits/ner calendar yr
This is merely a sttnunary of benefits for comparison purposes. Please refer to the plan proposal for details
Prepared by ABD Insurance and Financial Services, License #01358513.
Confidential - modification or reproduction is prohibited.
$10 co -pay, unlimited
$10 co -pay; 20 visits per year
,000 maximum benefit per 36 months
$10co-pay/visit; 40 visits
Current benefit throwth Landmark
7/26/2004
10
CITY OF LODI
Prepared by ABD Insurance and Financial Services, License NOD58513. 7/2612004
Confidential - modification or reproduction is prohibited. 11
MEDICAL - Ca1PERS PPO Basic Bene t Summary) - PERS Choice and E uivalents
PERSCare
PERS Choice PPO V$2 (like PERSCam) PPO U53 (like PERS Choice)
PPO & Nan -PPO: Individual: $5001 Family: $1,000
PPO & Non -PPO: Individuat $5001 Family: $1,000
PPO & Nan -PPO: Individual $5001 Family $1,000
PPD & Non -PPO: Individual: $5001 Family. $1,000
PPO: 90%
PPO: 80%
PPO: 90%
PPO: 80%
Non -PPO: 60%
Non -PPO: 60%
Nott -PPO: 60%
Non -PPD: 60%
Individual: $2,0001 Family, $4,000
Individual: $3,0001 Family: $6,000
Individual: $2,0001 Family. $4,000
Individual: $3,000! Family. $6,000
PPO: $20 co -pay
PPO: $20 co -pay
PPO: $20 co -pay
PPO: $20 co -pay
Non -PPO: 60%
Non -PPO: 60%
Non -PPO: 60%
Non -PPO: 60%
PPO; 100%
PPO: 100%
PPO: $20 co -pay 1 Non -PPO: 60%
PPO: $20 co-payI Non -PPO; 60%
Non -PPO: 60%
Non -PPD: 60%
$300 max mutdcal year
$300 maximtmVcal year
$250 deductibleJper admission then
PPO: 80%
PPO: 90%
PPO: 80%
PPO: 90% 1 Non -PPO: 60%
Nan -PPO: 60%
Non -PPO: 60% after $2501admission
Non -PPO: 60%
PPO & Non -PPO: $50 co-pay/visit, then 90%
PPO & Non -PPO: $50 co-pay/visit, then 80%
PPO & Non -PPO: $50 co-pay/visit, then 90%160%
PPO & Non -PPO: S50 co-paylvisit, then BO%160%
PPO: 80%
PPO: 80%
PPO: 90%
PPO: 70%
Non -PPO: 80%
Non -PPO: 80%
Nan -PPO: 80%
Non -PPO: 76%
PPO: 90% 1 Non -PPO; 60%
PPD: 80%/ Non -PPO: 60%
PPO: 90% / Non -PPO: 60%
PPO: 80% I Non -PPO: 60%
UR to 100 visits
Up to $6,000 maxlyr
Up to 100 visits7cal year
Up to 100 visitslcal
PPO: 90%1 Non -PPO: 60%, 1st 10 days
PPO: 80%1 Non -PPO: 60%, lat 10 days
PPO: 90% / Non -PPO: 60%
PPO: 80% / Nan -PPO: 60%
PPO: 80% 1 Non -PPO: 60%, next 170 days
PPO: 70%1 Non -PPO: 60%, next 170 days
Up to 180 dayelcal year
Up to 100 days/cal year
PPO: 90% / Non -PPO; 60%
PPO: 80% 1 Non -PPO: 60% (80% for occupational)
PPO: 90% 1 Nan -PPO: 60%
PPO: 8D% I Non -PPO: 60%
Up to $5,000 max
Up to $5,000 lifetime for sptxeNphysical therapy
Up to $2,0001ca) year
Up to $5,000 while insured
PPO: 90%
PPO; 80% 1 Non -PPO: 60%
PPO: 90% 1 Nan -PPO: 60%
PPO: 80% / Non -PPO: 60%
Non -PPO: 60%
Up to $3,000 rams
Up to $3,000Mal year
Up to $3,000 maxlcal year
Participating Pharmacy.
Participating Pharmacy:
Participating Pharmacy:
Participating Pharmacy:
$5 Generic 1$15 Brand 1$45 Non -Formulary (34 days)
$5 Generic ! S 15 Brand 1$45 Non -Formulary (30 days)
$5 Generic 1$15 Brand 1$30 Non -Formulary (30 days)
$5 Generic 1$ 15 Brand 1$30 Non -Formulary (30 days)
$10 Generic ! $25 Brand I $75 Non-Formuiap (90 days)
$10 Generic ! $25 Brand 1$75 Nan -Formulary (90 days)
$10 Generic 1$25 Brand 1$45 Non -Formulary (90 days)
$10 Gone& 1$25 Brand I S45 Non -Formulary (90 days)
SUM copay maxlcal year for mail order
$1,000 copay max/cal year for mail order
$1,000 Out of pocket annual max REr person
$1,000 Out of pocket annual max per person
$250 deductiblelper admission then
PPO: 90%
PPO: 80%
PPO: 90% 1 Non -PPO: 60%
PPO: 80% 1 Non -PPO: 60%
Non -PPO: 60% atter $25WkIndssion
Non -PPO: 60% atter S250/admission
MH: 30 days SA: 15 days
MH: 20 days SA: 20 days
MH: 15 days/cal year
MH: 15 dayslcal year
SA: $12,000 lifetime max for all services
SA: $12,0001ifetime max for all services
SA: $5,000 max/cal year, 3 daya/admisvon
SA: $5,000 maxlcal year, 3 days/admission
PPO: 90% / Non -PPO: 60%
PPO: 80% I Non -PPO: 60%
PPO: 90% 1 Non -PPO: 60%
PPO: 80% / Non -PPO: 60%
MH & SA: 30 visits
MH & SA: 24 visits
MH: 20 visits; SA: 24 visits
MH: 20 visits; SA: 24 visits
Unlimited
$2,000,000
Unlimited
$2,D00,000
PPO: 90%/Non-PPO: 60%
PPO: 80%1 Non -PPO. 60%
PPO: 90% 1 Non -PPO: 60%
PPO: 90% / Non -PPO: 60%
$100 max benefit per 36 months
$1,000 max benefit per 36 months
$2,000 max benefit while insured
$2,000 max benefit while insured
PPO: 90% 1 Non -PPO: 60%
PPO: 80% 1 Non -PPO: 60%
PPO: 90% 1 Non -PPD: 60%
PPO: 80% / Nott -PPD: 60%
Up to 20 visits per year
Up to 15 visits per year
Up to 26 visite per year
$1,000 calendar year maximum benefit
Aix is merely a summary of 8enefirs for comparison
purposes- Please refer to the plan proposal for details.
Prepared by ABD Insurance and Financial Services, License NOD58513. 7/2612004
Confidential - modification or reproduction is prohibited. 11
PacifiCare Letters
* Trend and Retention "Guarantees"
* Response to Provider Concerns
* Lodi Primary Care Medical Associates: Medcore Contracting Letter
12
July 26, 2004
Teri Ezald
ABD
2480 Natomas DI. Sute 200
Sacramento, CA 95833
Re: PacifiCare of California — Trend and Retention Understanding with the City of Lodi
These criteria specify the conditions under which PacifiCare of California (' PacifiCare') will offer a trend
guarantee on the City of Lodi employees and eligible dependents enrolled in the HMO, during the January
1, 2005 -- December 31, 2005 plan year. These criteria supercede any conflicting terms in the PacifiCare
contract or other written materials addressing the relationship between PacifiCare and the City of Lodi.
Please keep in mind that each of these provisions is offered for the plan year outlined above. These
provisions will not be automatically roiled over to future plan years. We will re -consider these upon issuing
our renewal rates and it should be assumed that they do not apply unless specifically called out in our
renewal offer.
Retention Guarantee:
The retention component of the PacifiCare rates will not exceed 12% of the total premium for the renewal
period January 1, 2006 through December 31, 2006. The retention component is inclusive of
administration costs and profit and excludes commission.
Health Care Cost Trend Guarantee:
The health care cost trend guarantee applies to the individual annual trend components that will be used for
the January 2006 renewal rating. It is not a guarantee on the level of the City of Lodi's claims. Any shift
in provider cost reimbursement type from capitated to shared risk will follow standard assumptions. The
trend guarantees does not account for any legislative changes that may impact the rates.
• Capitation
Physician/Hospital Capitation will be trended at 14% over actual provider contract terms for 2005
and based on membership distribution as of the renewal calculation date.
• Claims
Non -Capitated Medical 14.0%
Pharmacy 14.5%
Pharmacy will be trended separately and is based on the group purchasing the 3 tier buy up plan.
This offer is contingent upon the group waiting until 8/15105 to get the 111106 renewal. If you have any
questions, or would like to further discuss the terms of this letter, please feel free to contact me.
Sincerely,
Heidi Duncan
Senior Business Manager
13
July 20, 2004
Terri Ezaki
ABD
2840 Natomas Park Dr., Suite 200
Sacramento, CA 95833
Dear Terri,
The purpose of this letter is to respond to concerns raised in regards to the medical providers/insurance
relationships in Lodi.
PacifiCare's goal is to provide cost effective, quality care to our members while at the same time
supporting our provider relationships that offer a stable, lord network within the eoflflri[lYllty. III addtgon,
PacifiCare provides choice by offering both our HMO & PPO products.
I have attached your comments with our responses in bold print.
a) Please have Provider Relations discuss with Medcore the possibility of extending a
contract to Valley MRI/Lodi MRI. This effort is necessary or this may not go forward. Dixon
was pretty adamant that competition is what will keep costs down and I believe you heard
that loud and clear at the City Council meeting. I recognize that there are no guarantees with
the CalPERS carrier/provider relationships but we need to show a good faith effort with
Pacificare.
Josh Martin, Director of Network Mgmt with PacifiCare spoke to MedCore about this and
they will not contract with Dr. Federal's group. The reason is MedCore's contract Delta
Radiology is not exclusive but it is capitated. If MedCore contracts with Dr. Federal's group
it sets them up for a potential double pay (capitation and fee for service) situation and they
are not willing to put themselves in that position. This makes sense from a business
prospective.
b)I would like to have some assurance from Pacificare that should Lodi Primary Care
cancel with Medcore that contracts in some form would be extended to the Lodi Primary
care physicians. Perhaps, a call from Provider Relations to the Lodi Primary care to
determine what their "feelings" are might be beneficial. The Exec. Administrator is James
McKeon. 208-368-2090. Lynette has already spoken to him but I think I am going to call
too based on the conversation I had with Dr. Federal.
Josh has had multiple discussions with Jim. They are considering starting up a medical
foundation with Sutter and as an interim step they have contracted with Gould Medical
Foundation (a Sutter affiliate). If LPCMA were to terminate with MedCore (very unlikely)
then PacifiCare members could access LPCMA via Gould. We do not do this currently
because it is more cost effective to access LPCMA via MedCore. We could certainly access
them via Gould in the future If needed. Jim is aware of this as well. As a side note,
PacifiCare currently provides health insurance to LPCMA's employees.
c) Determine if Valley MRI/Lodi MRI is available from any other avenue under the HMO
(i.e. Sutter Gould???) and PPO. Of course, the problem is that the cap is with the PCPs
for the HMO will mostly be Medcore.
Valley MRI/Lodi MRI is available in our AMO and PPO networks through Delta IPA.
xy
You will receive a letter from Jim McKeon with comments from the medical
group's perspective
We look forward to working through the concerns since it appears that PacifiCare offers a solid solution to
the City of Lodi by offering products that adequately replace Calpers as well as our ability to offer a robust
stable network of providers. Please free to contract me for further questions.
Sincerely,
Heidi F. Duncan
Senior Business Manager
15
R14 Lodi Primary Care Medical Associates, Inc.
830 South Ham Lane, Suite 24 *Lodi, California 95242 . (209) 366-2000 • fax (209) 366-2020
1 � 1
Wednesday, July 21, 2004
City Council Members
City of Lodi:
This letter is written in response to a request by Josh Martin of PacifiCare.
This letter is to confirm that the physicians of Lodi Primary Care Medical
Associates (LPCMA) have given a verbal commitment to Russ Foster of Medcore
Medical Group that we will be renewing our contract with Medcore for another
year. Our current agreement ends November 30, 2004 and with an extension
the contractual relationship will continue at a minimum through 1113012005.
The discussions regarding the continuation of our contract will start in
early August, 2004 and it is our sincere belief that the strong long standing
contractual relationship between LPCMA and Medcore will continue.
Sincerely,
James T. McKeon
Administrator, LPCMA
209-366-2090
imckeon(a)Ipcma.com
Cc: Russ Foster, Medoore
Josh Martin, Pacif3oare
Corey Colla, M.D.; President, LPCMA
\b
Lodi Professional Firefighters • Local 1225
40 P.O. Box 9841 Lodi, Califomia 95241
Mr. Dixon Flynn, City Manager July, 18 2004
City of Lodi
221 West Pine Street
Lodi, California 95240
Mr. Flynn,
It would be a mistake for the City of Lodi to change health care plans. The Lodi Professional
Firefighters believe it is in the best interest of the City, and their firefighters to stay with
CalPERS medical plans. The savings purposed by Pacific Care will be short lived. CalPERS
has pool of 1.2 million members and are the largest purchaser of pubic health benefits in
California and the second largest purchaser in the nation. CalPERS have a ten year history of
the lowest rates. If we are making a five or ten year decision the decision has to be Ca1PERS.
Please refer to the current Memorandum of Understanding between the City of Lodi and the
Lodi Professional Firefighters, it states the following:
Article XXII - Medical Insurance
22.1 All employees shall be offered medical insurance for themselves and dependents
through CalPERS medical plans. The City shall pay 100% of the premium for
employees only up to the highest HMO available in Lodi. The City shall pay the
balance for the highest cost HMO Plan available in Lodi for the employee with one
dependent less $80.00 per month, and employee with a family less $104.00 per month.
If you have any questions feel free to contact me any time, and thank you in advance for your
time in this mater.
Peter Iturraran, President
Lodi Professional Firefighters
Local 1225
Cc;
LPF Executive BOD
Gary Messing
Joanne Narlock
Affiliated with International Association of Fire Fighters • California Professional Firefighters • AFL-CIO • California Labor Federation