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Stop Loss Insurance RenewalTHE CITY OF DUB E ~-~-~ MEMORANDUM June 12, 2007 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Specific and Aggregate Stop Loss Insurance Renewal -Health and Prescription Drug Plans Personnel Manager Randy Peck recommends that we continue with HCC Life Insurance Company (formerly known as Allianz) as the stop-loss carrier for the City's health plans for individual and aggregate stop-loss insurance, with a premium in the amount of $463,484.92 effective July 1, 2007. This is a 9.5% increase in premium from the previous year. One of our plan members may have to undergo a bone marrow transplant. As a contingency of the renewal, if the transplant is necessary, it must be performed at a facility that participates in the transplant network. The contracted facilities or centers of Excellence in the Midwest area are the University of Minnesota, Mayo Clinic, University of Wisconsin-Madison, Froedert Hospital-Milwaukee and Nebraska Medical Center. If the City did not agree to this contingency, the premium would increase by an additional $200,000. I concur with the recommendation and respectfully request Mayor and City Council approval. ''l ~~ ~ ~~~ Michael C. Van Milligen MCVM/jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Randy Peck, Personnel Manager THE CITY OF DUB E ~~ Memorandum June 8, 2007 TO: Michael C. Van Milligen City Manager FROM: Randy Peck Personnel Manager SUBJECT: Specific and Aggregate Stop Loss Insurance Renewal -Health and Prescription Drug Plans Health Choices, our health plan administrator, obtained specific and aggregate stop loss quotes from Allianz, which is now HCC Life Insurance Company, our current stop loss carrier, and from two other insurance companies. The following is a summary of the quotes. • HCC Life Insurance Company - $463,484.92 • American National Insurance Company - $640,200.00 • HM Insurance Group - $589,622.00 Sun Life was asked to provide a quote, but declined. HCC Life Insurance Company presented the most competitive quote. Their quote $463,484.52. All of the quotes were based on a specific stop loss of $85,000, which is our current specific stop loss amount. The quote submitted by HCC Life Insurance Company represents an increase in the premium of $40,352.16 or a 9.5% increase. The quote from HCC Life Insurance Company has a contingency. One of our plan members may have to undergo a bone marrow transplant. If the transplant is necessary, it must be performed at a facility that participates in the transplant network. The contracted facilities or Centers of Excellence in the Midwest area are the University of Minnesota, Mayo Clinic, University of Wisconsin-Madison, Froedert Hospital- Milwaukee and Nebraska Medical Center. The transplant network is a national network. If we do not agree to the contingency, the premium would increase by an additional $200,000. If we were to approve this option, our plan administrator would be able to refer the plan member who may need the bone marrow transplant to a facility such as the University of Iowa and the cost, which is estimated at $300,000, would be covered by the stop loss policy. The Health Care Committee recommends that we continue with HCC Life Insurance Company as our stop loss carrier. They also recommend that we maintain the specific stop loss amount at $85,000, and agree to the contingency proposed by HCC Life Insurance Company, which would mean that if the bone marrow transplant is needed, it would have to be performed at a facility that participates in the transplant network. Bill Robinson of Gallagher Benefit Services, our actuarial and benefit consultant, has reviewed the quotes and concurs with the recommendation. Sufficient funds are available in the health insurance reserve to finance this recommendation. Coverage would go into effect on July 1, 2007. The requested action is for the City Council to pass a motion approving the renewal rates submitted by HCC Life Insurance Company effective July 1, 2007 for specific and aggregate stop loss insurance for the City's health and prescription drug plan, as recommended by the Health Care Committee. If you have any questions, please feel free to call. RP:tlb cc: Health Care Committee City of Dubuque Cost Analysis Reinsurance Renewal 2007 Prepared by: (HEALTH CHOICES C~iy of i?utni:~iae larke€ Search S~tlnrvtarY Sinpb F1tsollmeM 121 t?aml EnroNmsnt 387 165,0110 Deduetlhla 5110.000 Dedueflble i~,~ - Dedtrctlble ~•~ Wtth 585 000 Deducllbb Carder Contract rLlatdmum Amwl Flied Costs AtUchmerrt Po1M A+tnual Flxad Goets AttaciNrrenl Pohrt Annwl Flied Costs Attachment PoHrt Arrnusl Pbted Costs Attachment Point' HCC LMe Cum9M PaW 11 000 000 23132 391 569 HCC Llfs Ineunnce Com Renewal Paid 11,000,000 5463,485 56,177,049 5449,279 56,219,246 5428,249 16,260,382 5340,504 56,177,049 Amsrir:an Natbnal MsunnuCom 24112 11,000,000 1640,200 16,204,537 5606,709 16,223,279 1576149 16.241,929 WA WA HM Inwrarres Grou 24/12 11 000,000 9 622 17 15 499 1559,742 57,247,669 5532 288 57 277 227 f0 50 gun Life Declined -Rates are rwt OtNe AI t7rras an ub/ecf fo Mal undevwridnp A,Yrumum AdarJrmem Point k d. ps4etsrminsd oval a aop~loss carrier •el provitls segregate coveryp for poop U~M have a rsductlon in srcdlmeM. TM peeler d the Minimum Aeprepate Attarlxnem Point or da ecwal amud appepate (based on sciud montldy counts muhiPliad by the epgroeats laga) must be mN belors meakd claims becans payabb under die apgreeata covarpe. I:unlayi~ ~.allnrgb City of Dubuque. HCC Life Annual Cost Illustration July 7, 2007 Current Renewal Renewal Renewal }'r. .~ ` °_`I HCC Life Sin le Enrollment 1 1' $85,000 $85;000 $9D,000 - $95;000 Famil Enrollment .387 S ....CiflC Deductible S ciflc Deductible $ eafic Deductible ~ cifie Deductible F,Ixe #~(3.0 . _ f, Specific Coverage (Paid Contract Inc/udaa MadkaL S1 MI°kn LTMJ Pald Sin le Premium 528.13 $40;845 $33.77 $49;034 $32.58. $47,306 $30:.87 $44,823 Famif Premium $78.42 $364;1•$7 $84.86' $394,090 $82.16 $381,551 $78.14`: $362 882. Aggregate Coverage (1Gf 2 conbct Incfudas MedkaL Rx Otvp Card, fi M°Ibn LTMJ Com osite Premium $2.97 $18,105 $3.34 $20,361 $3.35 $20;422 $3.37 $20,544 A re ate Accommodation $0.00 $0 $0.00 $0 $0.00 $0 $0.00 $0 Terminal Liabilit $0.00 $0 $0.00 $0 $0.00 $0 $0.00 $0 Subtotal Sto Loss Premium $423,132.36 $463, 484.52 $449,278.80 $428 248.92 Administration Fees TPA Fee .$17.59 . $107,229 $17.59 $107,229- $17.59' $1U7,229 . ' $4:7:59: $107,229 Utilization Review Fee $0.00 $0 $O.OU' $0 $0:00 $~' $0.00 ' $0' PPO Access Fee $0.00 $0 $0.00- $0 $O.OU $f3 . 50.00: $0 A ent Fee $0.00 $0 $0,00 $.0 $0:00 $0 $0:00' $0 Total Sin le Fixed Cost $48 .69 $,54 .70 $53 .52 $51 .83 Total Famil Fixed Cost $98:98 $1;0 5.79- $1.03.:10 $99 .10 Total Annual Fixed Costs $530,361 $570 ,713 $556,507 $535,478 Chan a Over Prior Year 8% 5°k 1°k A">.'.. Sin le Factor $464.55 $674,527 $488.04 5710,086 $492.4$ $71'5 037 95,77 ' $718 858 Famil Month! Factor $1,231.06 $5 717,043 $1,177.21 $5,466,963 $1 185.23 $5 504 208. 493.U5 $5,540 524 Aggregate Attachment Point $6,391,569 $6,177,049 $6,219,246 $6,260,382 Chan a Over Prior Year -3% -3% -2% Ex ected Attachment Point less 25% corridor $5,113 255 $4,941 639 $4,975 396 $5,008,306 Maximum Liabilit $6,921,930 $6,747,762 $6,775,753 $6,795,860 Ex ected Liabilit $5,643,616 $5,512,353 $5,531,904 $5,543,783 Contingencies: If member has a bone marrow transplant, City must agree to have the transplant done at a facility that is contracted through the transplant network. contracted: Universit of Minnesota, Ma o Clinic, Universi of Wisconsin Madison, Froedert Hos ital-Milwaukee, Nebraska.Medical Center If Cit does not a ree to contin enc listed above the remium will increase b $200,000 $85,000 Aggregating Specific- splitfunding Renewal Deductible $348,504.12 $17.59 $107,229 $0.00 $0 $0.00 $0 $0.00 $0 $45.94 $83.77 $455,733 -14% An, $489:04 $710,086 $1,177.21 $5,466,963 $6,177,049 -3% $4,941,639 .fi ~ ,': t~ ~. $6,632,782 $5,397,372 Following facilities are 5!29!07 ` Per x,~ l .t 1r r a _~ r.. ~~~,, ^~ '~, ,y~~ ..d~,~~,cd„ M~, '~' .~~, r ~ ; ~wr~"'r ~" ,may 5i 1'~ i{,,,~,,9e ~pk ""~I` ~ ,d ~ ~y ~r~+y F' j~+~ ~ '` Nf+' •r ~. a.t k,~j ~',~ ~~..", Plan Enrollment Qty #2 Employees (Average) y r ~~ d ~~., ~ 'S: t ~~' 530 ,~;L,F ".~~ '~ ~~ 525 w~~ . ~ t~. ~ 520 ~~ ~~ 515 ~t ,h. '~°' ` 510 z* ~~', 505 nk ~ r ~~" 500 . ~,~. ,l,.; ~, ~` ~ 495 'i~f' * PY 04/05 PY 05/06 PY 06/07 r ~,. aM1~. r' ~,~.~=, h t F.' ~. L ro', ~ ell ~~. ~~. d~ ~~ ~ ,tea ~. y '~i~ h~r f ,{r k~,ui7~ H+ ~ 7 ~a~~ ~s'~ r7 ,Y..7yy,~~u+~,-, r~,#~a~~ ~,~ ,,,,lit '~~ ~+h,x~ ~, p1 w~ ,' ~ ,q ~ 1~,4 , ~ `,~, ~ a ,~ ',4. * L ~ y.. .~, ,J Covered Lives //Members. l :~~ 1550 Y ' ~ ~ 1500 ~~ ~ ~ ~: "~' ~r ~~.r 1450 G 1400 ~.~,,~ ,~ ~ -~''~• 4~4 'l Y!~' 1350 `~t.~ PY 04/05 PY 05/06 PY 06/07 ka~~ ~~1 k'';'~;t ~,~ ~ L . ^ro M ~'~i `~i y M City of Dubuque July- June 200012001 2001/2002 2002!2003 2003/2004 2004/2005 2006/2006 2006/2007 April Total Medical Claims $ 2,568,296.83 $ 2,823,760.38 $ 3,370,239.13 $ 3,564,430.72 $ 4,203,764.19 $ 3,503,538.40 $ 3,062,233.09 Total Rx Claims $ 533,452.74 $ 650,830.70 $ 693,010.04 $ 868,650.04 $ 888,027.28 $ 919,600.31 $ 833,064.09 Total Dental Claims $ 149,493.27 $ 172,217.08 $ 177,929.72 $ 68,007.78 $ 25 066.50 $ 2,997.60 $ - TotalClaimsCost $ 3,251,242.84 $ 3,646,808.16 $ 4,241,178.89 $ 4,501,088.54 $ 5,116,857.97 $ 4,426,136.31 $ 3,895,297.18 Reinsurance $ 170,354.64 $ 198,397.08 $ 240,374.37 $ 289,913.75 $ 332,780.59 $ 376,176.05 $ 355,087.81 Heatlh Choices Admin $ 93,130.05 $ 95,241.44 $ 103,614.05 $ 102,211.32 $ 104,676.00 $ 101,409.00 $ 92,209.90 Less Reinsurance Reimbursement $ 55,133.41 $ 3,155.38 $ 121,441.60 $ 246,759.98 $ 164,270.03 $ 86,179.92 $ 218,989.22 Total Cost $ 3,459,594.12 $ 3,937,291.30 $ 4,463,725.71 $ 4,646,453.63.. $ 5,390,044.53 $ 4,817,541.44 $ 4,123,605.67 %Change 13.81% 13.37% 4.09% 16.00% -10.62% -14.40% City of Dubuque July- June 2000/2001 2001/2002 2002/Z003 2003/2004 2004/2005 2005/2006 2006/2007 April. Employees 529 541 535 533 528 519 508 Total Medical Claims $ 4,855.77 $ 5,221.93 $ 6,300.49 $ 6,687.49 $ 7,962.93 $ 6,747.31 $ 6,025.65 Total RxClaims $ 1,008.58 $ 1,203.57 $ 1,295.55 $ 1,629.74 $ 1,682.14 $ .1,771.02 $ 1,639.24 Total Dental Claims $ 282.64 $ 318.48 $ 332.63 $ 127.59 $ 47.48 $ 5.77 $ - Total Claims Cost $ 6,146.99 $ 6,743.98 $ 7,928.67 $ 8,444.82 $ 9,692.55 $ 8,524.09 $ 7,664.89 Reinsurance $ 322.08 $ 366.89 $ 449.37 $ 543.93 $ 630.37 $ 724.46 $ 698.72 Heatlh Choices Admin $ 176.08 $ 176.13 $ 193.70 $ 191.77 $ 198.28 $ 195.30 $ 181.44 Less Reinsurance Reimbursement $ 104.24 $ 5.84 $ 227.03 $ 462.96 $ 311.17 $ 165.97 $ 430.91 Total Cost $ 6,540.91 $ 7,281.17 $ 8,344.71 $ 8,717.55 $ 10,210.03 $ 9,277 88 $ 8,114 14 %Change 11.32% 14.61% 4.47% 17.12% -9.13% -12.54% Loss Ratio (Stop-Loss) 32.36% 1.59% 50.52% 85.11% 49.36% 22.91% 61.67% Grand Total Loss Ratio (Stop-Loss} 45.64% .. . .^ , ~` ~ ~ (+, 7, M ryy^ ti ~, ~ ,5~~,,4 n~~`' ~ F..i4q ,~Y~!t ;~ F ^~ .i} ~ii~ .~i` P~ti ~~!' .a 'S' ,{ ~ ~1 . .`P ~y ~ " ~ - ~•~ r~~:~. ~+ ~~`!~j~', ~~r:,~,. ~1M : `~ 2~~~~ya '~^.ry+~'y'~(~+Fi~l~~+ Q ~• .p ,;.M~roiyp'~''{ ~ ~Tr `~~ k'~ ~p ,A~(f~ ~ .'4 5, f.P.~'•,f , lti F~' e`'~,~r:-'."r+i`f''lt~ ,t+ lir. ~'~ '~q~'~ FI `'~ ~"+`~~.. ' !M ~~, .' .+ S \b?. ~~i' MP "W. ,,,dY~ .~b. r a ~""~ i_, i~},,~~ larA_'~?i~~ ~' ~~ 1 i'~+i' ~ y.~t • 4 1. t'/$` ~+ .fA '~.. - ~ ~~ ~M h 1~~ ~i.. ~A.',~~. ~~,C ~?~}~ar f `~~}~1r1R"*'`F~`1 +n~~+ 4 1 ~ I'~h f` J~ +~~~^~~i~~. ,,. 'J~~~~4 ~.`~F. J~ ~~~~~ ~ #~ _ ~, '~'yy ~., ~`1~1 ~-- '~` •~' ~* ~,+~~ Q^' ~. ~ ' ~ ~ '. w>~. JS.i "".fir, ~4,• ",~iy f7 "'qY. ~6' -: '~~1~'+v.~ h ~'F. ''~~ ~ City of Dubuque Claims Paid ~~' ~ ~ ,' City of Dubuque Claims Paid ~~tiw~.. r ~ ~' a, ~~ ~',b July 2006-Apri12007 ,, July 2005-June 2006 ~~ ~ ?~ ,~:;,; r r'° Dental $2,998 ~'"A M ~. ~ A~ t ,'~~ ~. r '„ Poc $833,064 AN, ~ ~~ ~ ~~'~~" 21.4% "~'~~ ~{'?~, ^ Dental ~~~' ~.~'~, hr~ ~~ ^Medical ~~,~~~~~~~ ~~-~:~ ~ '~ ~ ~ nt~.. ~'.'~ Poc $919 600 " ,~,~~ ~' 'r~~ ®Medical /, 20.8% ^ ~ Medical ^ RX ~ ~,, ,A'~"~~`r Medical ^ ~ _~'~4: ~;~ , .", $3,062,233 ,~"~` ;, $3,503,538 ~~ "~~' ~,"~''~ ~ 78.6% ~,~ ~>~~ 79.2% t''~±~"'A i K, ^~..t I ~,+ ~r.~y~r ,Y 7F e.. ~` t,t.. ~,~.~'1i .'3'w '~Yy~1 '~, ~: a~~n.t 7':t', -'~I~ M .~ ,A.*. ,kk .~'--~~;,,~t• 'e". A ';j1Y ti': 1~' •~~i~.. .y: !" ",y,~.. '. ,:t4~p~r •;r 4 ~~,,,~r.~ r '~ _?~.~",.;~~~~M~~,G ~r, ~..,~~ t: ;.;'f ,~ ~„~ ~~,~~;,;~~•.7R *. ~# Cityof Dubuque Claims Paid ~~, , f-, q`~ :~Y~r;~~,,, ~°, ~~ .~•~ ~~~~~',~~~. ;.~'s~'~f Ju1y2004)une 2005 :~•'.t'~ ~~~ '~t~.~ w ~~ ',; ',r~ ~"{"e7~,`~ ~r, ~; ..afi~ ~~ '.~. ~~ -,s y~. is ' ,~ ~ ~i '' ,e'+~ .~i'.{a ~ '~ ~+1Ri~~~ 3 ~ ~, t k ~,. ~t ~ J,Y •~ ~ } J+17"` 7 ~* '~~'- ~p "y ' ~,x_ n. '^ 25,067 0.5% ~~ ~ ~r~,f ~ ~`'~~ i '~'~^b .CAA bI~ 'f .~,1/~,F 1~'~C $ ~ ~!e!. {. ~.y 'd' F. 4. ,~y~,., Y/#y ' ~1^ a+~1'~ 4ry4.~t'~ ~ ,y~~, _..~:~f,, + ~'0~~ ,,~ - ,.q~~,.~ll r -P!•ti'~ ~'~!'~ ~~1 ,~~,y, ~ ~' ^ Dental ~:., ~ `~~ ~' ~~ . ~~~ ' of A 1 i'~p'~ ~,d~A.,.M ' .~ ~,~~ ~C $888,027 •:r ~' .r~ ~ °~, `F '.r ''~a .. ~ '~ A ~ 17.4 /° k ~• ,w~"i~ 4d` , ~~;~~~~,, ,+,.~i, _~~r~, ~.,,~~ b_ ^Medical ~T .~ - ~,y ~ ~ - ~~~ ~ ,- , ?~ +~c`'^Y,i~ ~i#i' 3'',+1r~~r~Al{r~'~~"«,~4?~'' J~~,~~,+,i,a- +r~rr'E /~" `I...r ,~C,}~Y. ~"~?.~~ "~ ~ 4.'F.x,[~"~F+,b'~r"A '~ r'rr;~' ,>*~!,,6„ My `I"l~aR~ ~-, S#`^~-~ ~i, '~+'''`~{4~~~~S~F .~~,~~~~:tt'1~ ' ~ ,~~~~~~ `*i~~lR'~, ' Medical ^ ~ ~ ~ y x , -~E.~Rt13+~t~r b«;'~~~"k +~y >~~ ,~iy ~~,~,~s."`~ ', `~" ~ . , a,- $4,203,764 ~' * ~ I _ t'". 'T` ~ ~ ~ ' r 82.2 /° ,~ 4 ~ ~, -' • ~N~ ,~ `a ` o 1.. l i X' `. p_ ~ ~: r it ... N '!' ,~ . l,. ~ ~ i~'4 'M wd y' ... 1. n ~ ,r ~~.rv. ~. vl^ a ,r~,. ~''~' 1 M~7'.~ ~. '~ I~7 rb..~71. y r /~ ^: 11 ~i ~ i 1 * ~ A ~i- s , ~~:-, ~ `~~~` 1$".~-:~'M" ,'`.,~,~~.~~~~ _ .i~~~'.'IC..,{"`y.=f.-r ;%.el- _-~ 5'~NM .~j"•.`.' .+.'M''',...M_~~~+.~~i Ft`~ir'~I'.~~"';~,Ic+i~4 ,.'S,~7. w!1"_~. 3Y~A''.~-,4'1:~ ~ ~y' ~t;~ r"w'!:...:?~ ~'' y ,~ ~ .~±. '~ ~' ~-,~.} i ~ ~` ck ,. ~ Sf~+I"r ~~ ,Yak ~~ ~ 4~ \ "~~~r,•8~ ~~ ~' ~'^ it i~ i,y ~`~. .,y '~ .~ ~ .1 ~ ~ w . ~, . t + '++y+,y~ `, 4.+~{p,~y',~ w , 4 Ff ~ "y4 ~yf~ 5 ~ "~T Nr 4S ~.j~' `~~i °~ 4S~f ~~.~~ ~~+y Y y iTt 7i fF`r~S ~.a-~~ k ~"~~'?~+~~~i9'~r~I~ .6.'~ ~,jr~,~~~L6 ~~ ~~ ~ [ ~, ~ City of Dubuque Total Plan Savings r ~ •~; r July 2006-April 2007 ~'~,~} ~~" Plan Design Total Charges $6,212,120 $'^,«"? . Reductions .,.:~ ... .~.~. $1,010,559 ~+ ~ ,~ 16.3% ~'~ ~~; ~ '~!' ~°~~'~ HC Contract ~": ; Reductions Total Paid ~~ .~ $1,306,264 Claims ~'~~'~ ." , ~ 21.0% $3,895,297 _~'A~~~ t ,, 62.7% ~° ' ~° .* ;.a r Total Paid Claims ^ HC Contract Reductions ^ Plan Design Reductions 9 t `E. "~. I.~. 'K' ~. f. ..~~'Tom?.+,~.,~s~`~-..~~'~::~~~',; ~ ; if~ .~. ~, ~ ,. ,. ~r~,.~~ "~ ~ r ~~ ..~,;JS-~?~'.,.S.~Cf'Y;'k~a ~S.4.f,~`7 ,.7.~y~,R-, ' ~~`'~ k Cityof Dubuque Total Plan Savings ~j ~ -~- ~,~ ~ July 2005-June 2006 ~~~ ~}~,.~,~i Plan Design Total Charges $6,617,516 ~'~'~~ ''~~~'~ ~' Reductions `~'~~ $938,600 ~~~ ,~~'^.n 14.2% °~ • l ~~ HC Contract ~\ ~"~ Reductions Total Paid $1,252,780 Claims 18.9% $4,426,136 +~+" 66.9% ~~ r~w'+}~} 4 ~} ~1' r ~ ro fir. , y~''~ L1 "~ ' ~ ;~R , '~+,`r'' `"~ .,y. 4:".~`ri~'~" ~~;`~ ~ ',~ {~,.~ •-°~w ~ '-t~`;.e~ ' f`:~ "y ~,"± s,,. ~'~t°~°~'+ 4~~{~~J~t '~ ~ ~}~ City of Dubuque Total Plan Savings ~gg' •~:~~`~•<y ~~~~ ~~~~ ~r'x~ 7*°':~ ~ ~ Jul 2004-June 2005 ~ry~~ ~~W~ ~~~ 4• ~~ • - .,,; ~~ ~,~, ~,~ ~ ~;~ ~ ~y"~~ ~ Plan Design Tota Charges $7,017,596 ~''~-~ : ~~ •~ ., Reductions ~~,,~„~ ~' $789 143 '' ~ ^ ~*.~~~~~~'.+.`~:'.~ C.."~~~~' r ~~~~ _`.! .""k •y,`w, 11.2% ~^j r~ ,yy~. ~y M ~_ ll~, ~~ ;~~~ ,1,, ,~,.~- ~. ~~ , .~~t'~i~ ~,,, ~. ` HC Contract Reductions ~: $1,111,596 Total P id 15.8% a Claims $5,116, 858 ~`,' 72.9% °;~ t,, ,,,,~.. ~.~, j~'+i~'~~,F ^ Total Paid Claims ^ HC Contract Reductions ^ Plan Design Reductions k ^ Total Paid Claims ^ HC Contract Reductions ^ Plan Design Reductions '~~'~ ~BYc~ ay~S~I~fF ~;~~"'~. ! ~r . l "w ~ t-Y ' :. ,.,~t v, `~ .~. ~ ~ ~ ~ (,~ r '"" '~ t '~ 1 ~ ~,'"'4 ~}~ mud `. /" ~ . . ' *`,~~,,-~ City of Dubuque Total Cost ~.~~+~~.''~ July 2006-April 2007 }r y~C91 M ' "'" ' ~' FiC Admin ~* 1,'' Reinsurance '~ Fee $355,088 $92,210 2.1% r r.~°. ~',~;~~1~,.+'•,?' L ~' - 1 '~''M~a J4 ~,-.~" ~ ~ F 'M yt! NI...M.~•j. ~~Ir`rl ~. ~ ~~: •~/, } }~'~F'+l ~'a7~ 1,',~ N tT ~~t, ^j~~l~'y a~~ 1 ~,t • 1i~~f.'~!'a~~ ,yn,L~ j~} F'R ~ Y ,rte ~.~-'*'J ,1st" } y:. ~ Jn. ~.. ,{~2' t~fe~.~v ~ ~t 4 `~"tYJF ~i ~ I r ;'"~~r~ Dubugue Total Cost City of r~•~~~~ July 2005~June 2006 ~, .,tom , ~~?~'~ ;~` HC Admin ' ~ %4:~,~ C~,;'' $101,409 ~~` ` ~'"^" Reinsurance 2.1% .~ r " `,~;,/ ' Rx $833,064 ^ Medical a~ ~.~ r) ~.. ? #"`~ 19.2% ^ Rx ~ ~'~,'''. ~ ~' ,~ r ,1.~ ~_i9 ~~, T~, :: ^ Reinsurance Fee r ~. ~ ~ ..:~ '''~ ^ HC Admin. ~' Pf~.,;~; ~~~~ ,~ r , ~ c; .:~i ,~`A`'~5 Medical ~. , ~.. q, R* ~~ °~ $3,062,233 r ` R" 70.5% •„ r ~•w: r ~ y a~ •4'. s. _ ~ ~ , '~"~" ~ , ''y`Y'.~'~ ^~1.~ ax '> bflj Lr'~ r. a{~I'"~~k` : ,T ~'y *'Y ' . •y~ ~ , . ~t •+~Tr' '~ it ~~ ~ ~' t'~~r~~! A+ ~y~•, ~~ ~ A~ ~~~4.5~1~~~r.. ~ ~' t~ h ,µ •I~i 1r~l ..Y t .a ~'+ / rr-•i-~ ~T~y~ .,~,>t'C`,3 •~'~~~~4~ -~ ,,s„ , ~~`,~~~ 7 ~4x ; 1~ ;~ ~" ~,~:~ Fee $376,176 Dental $2,998 7.7% 0.1 Rx $919,600 18.8% a 'k~ .F'Ma,"'1r'r:T ~ =1~,~',"r"1h : A:~~P'a''41.a"~'rww ' ~si"'S ~ :T~ _ City of Dubuque Total Cost July 2004-June 2005 ~.D ~ i+.. Xb ~ ,,a~ ± a'~~R . T~-~r,~.~ r~~ ti ~*1 ,,,., HC Admin ~,~~r~r~` ' ~~ ~ ~" i ~` ~` ~ ~..*~" ~~'~ ~ ~ 6, ~~~`~ 104 676 2°/ b ~ 4 , ~~ ,~ ~~ ~r5~ •~ ;~~ ~-~,,~ . ~~_~ Reinsurance$ ~ ° ~* ~~ . ~ ~~~ ~^ ~~ *~,`~~`^~' ~.,~ ~~,+~~ "r,. ~ . ' Fee $332,781-. Dental $25,067 ,. ~~ ~, .~' ~. '~,~ ~ ~ ~?'`~,~ ti'~',>~~. ~r~,,. `~ 4~~-." Rx $888 ~" ~ ' ~ -~ ~k ''1 p~4,'' kd~'1 ~~-,, ,• ~..~ ~4.. .~ r~^ ,027 9 ~- ~ ~~~ 1 ~..-~yJrG~, ny a _r, ~~7 +~ [~C~ A'L„ .,~.. " ^Vr' -r -a ~,~ ~~ ~h' r r"~-~~ ~ ,~'' ~~4~ r.~~'~~ .~ gy~rl ~ ,; ~•~ ~~ry~~y,~MrY"!I!'r~T~~' - ~]l'a'~' ~t,'F~ . ~~~•, ~.;'.'' ~;Y'.'~ r, w ~ Medical $4,203,764 76% ^ Dental ^ Medical ^ Rx ^ Reinsurance Fee ^ HC Admin i Medical $3,503,538 71.4% g ' ^ Dental ~~ ® Medical ^ Rx ^ Reinsurance Fee ^ HC Admin y$ rry} p+ x ~kr,t'- rl,~' ~y} ~~~ P,'~ ~~~ t a w ~ ~. t r ~. 4~',r h I`~ ~~ M1" .~~;"`,~ y~'~'y ~ ~ ~~.~4.r~4.7 `Fw fL~d ~~ y~e~~ *~~~ 1~ ~~~~ .