SUBJECT:
Title
Request Approval of Group Healthcare Cost and Approval of No Balance Billing for Emergency Medical Services Provided by Marion County Fire Rescue to Employees, Retirees, and Dependents on the Group Healthcare Plan (Budget Impact - Neutral expenditure of $33,132,358 in the Insurance Fund and revenue decrease of $50,000 in the General Fund as proposed in FY 2024-25 budget)
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INITIATOR: |
DEPARTMENT: |
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Sara Caron, Director |
Human Resources |
DESCRIPTION/BACKGROUND:
Marion County offers group health insurance to all full-time employees and dependents of the Board of County Commissioners, Clerk of Court, Sheriff, Property Appraiser, Tax Collector, Supervisor of Elections, and Hospital District. The County became partially self-insured effective October 1, 2020 with Florida Blue providing claims administration services and reinsurance.
This year’s actuarial funding recommendation with claims through March represents a 0% increase. Total incurred claims from May 2023 through April 2024 were $32.6 million, with FY 2025 expected claims being $41 million. The 60-day reserve funding required by the State is $6.8 million. The County’s current reserve balance exceeds this required amount.
Since the implementation of self-insurance and in an effort to assist in mitigating long-term healthcare costs, the County previously entered a three-year Agreement with the Heart of Florida to provide an Employee Medical Center which expired on September 30, 2023. An amendment to the Agreement outlining the revised terms will be presented at a future Board Meeting.
The total proposed health insurance cost includes the Employee Medical Center, Employee Assistance Program and Wellness incentives for a total of $41.2 million; with employees and retirees having a 0% increase to their current contribution, for a total remaining cost to the County of $33.1 million.
In an effort to continue to provide affordable services, it is requested that Marion County Fire Rescue accept the fee currently negotiated as the allowable amount by Florida Blue and the co-insurance as the maximum charge for services and not balance bill employees, retirees, or their dependents covered under the Group Healthcare Plan, for ambulance transportation within Marion County. This will have an estimated budget impact of $50,000 revenue reduction annually to Marion County Fire Rescue.
BUDGET/IMPACT:
The total estimated group healthcare cost is $41,247,343, with employee and retiree contributions of $8,114,985, leaving a total estimated neutral budget impact of $33,132,358 in the Insurance Fund (5010) and a $50,000 decrease in General Fund (0010) Ambulance Fees revenue (AA305342-342600) in the proposed FY 2024-25 budget.
RECOMMENDED ACTION:
Recommended action
Motion to approve a 0% increase to the County’s Group Healthcare Plan with a cost estimated at $33,132,358 and approve no balance billing for Emergency Medical Services provided by Marion County Fire Rescue for employees, retirees, and dependents covered on the group healthcare plan to be effective October 1, 2024; and direct Budget to reduce the General Fund Ambulance Fees revenue (AA305342-342600) by $50,000 in the proposed FY 2024-25 budget.
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