Title
Human Resources Risk Management Division, recommending the Board of Supervisors approve the migration of the Blue Shield Self-funded PPO to the CSAC-EIAHealth pooled program. (Est. Time: 45 Min.)
Body
The CSAC-EIAHealth Program offers the benefits of a self-funded program combined with the stability and protection of a much larger risk pool. No plan design changes are recommended or required for the Blue Shield PPO Plan and the County will retain control of the benefit plan design under the EIAHealth Program.
Through EIAHealth, the County’s pharmacy benefit program will move from Caremark to Medco. Medco is the nation’s largest Pharmacy Benefit Manager. The change to Medco will require a slight change in the prescription drug formulary, but all other plan benefits and quality programs will remain the same.
Background:
When chosen as the County’s third party administrator for health/medical benefits, Alliant Insurance Services recommended a comprehensive review of our current health/medical plans. Additionally, Alliant recommended that we consider the cost effectiveness of joining CSAC-EIAHealth. Alliant conducted a comprehensive review or our current health/medical programs, rate structures, and contracts, compared to joining EIAHealth. Additionally, they reviewed rates quotes and programs from other insurance providers. Today’s presentation and recommendations are based on this review and the recommendation of the County’s Health Plan Advisory Committee (HPAC).
In order to determine if the County’s health/medical programs were providing comprehensive coverage at the most affordable price, Alliant analyzed and evaluated:
Joint purchasing options, i.e. CSAC-EIAHealth
Alternative funding options
Provider networks to ensure deepest savings
Current Caremark Pharmacy Program
Cost savings with merging/consolidating carriers
All of the following components were reviewed with the Risk Management team and the Health Plan Advisory Committee (HP...
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