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January 13, 2014Mary Beth Redding
www.bartel-associates.com
City of San AntonioRetirement and Healthcare
Benefits Task Force
2January 13, 2014
Financial Models Purpose: To show the Task Force the expected
general trend of General Fund revenue and expenses 3 Scenarios, with projection based on: 15 year historical growth
20 year historical growth
15 year historical growth with recession 2021-2025
3January 13, 2014
Financial Models Modifications to January 6 Models to reflect Task
Force Input Heathcare Trend: 7% civilian/8% Uniform for 20 years Pre-Paid Retiree Healthcare discount rate remains 8% Compound Annual Growth Rates add one year to each
calculation period Other Projections begin from 2014 budget Revenue reserve increases to 15% beginning in 2016
Results of modified scenarios show no significant changes from models presented last week
4January 13, 2014
Financial Models Key Observations Public Safety expenses have grown faster than revenue
in the past 20 years
Because expenses, especially public safety, grow faster than revenue, the projection model shows: Public safety costs in time exceed total projected revenue
Total projected expenses exceed projected revenues in all future years
A deficit exists beginning in 2015
5January 13, 2014
Projection Model – 15 yr Summary
Public safety costs = 100% of Revenue in 2040
Public Safety Program Costs including all Public Safety Civilian PositionsUniform Salaries
Uniform Leave Buyback, Clothing Allowance, Tuition Reimbursement, Retiree Payouts, Overtime, and non-pensionable pays
Uniform Pension, Pre-Funded Healthcare & Active Healthcare
General Fund Revenue, Net of Reserve from FY 2016
Non-Public Safety General Fund Cost
6January 13, 2014
Projection Model – 20 yr Summary
Public safety costs = 100% of Revenue in 2039
Public Safety Program Costs including all Public Safety Civilian PositionsUniform Salaries
Uniform Leave Buyback, Clothing Allowance, Tuition Reimbursement, Retiree Payouts, Overtime, and non-pensionable pays
Uniform Pension, Pre-Funded Healthcare & Active Healthcare
General Fund Revenue, Net of Reserve from FY 2016
Non-Public Safety General Fund Cost
7January 13, 2014
Projection Model – Recession Summary
Public safety costs = 100% of Revenue in 2024
Public Safety Program Costs including all Public Safety Civilian PositionsUniform Salaries
Uniform Leave Buyback, Clothing Allowance, Tuition Reimbursement, Retiree Payouts, Overtime, and non-pensionable pays
Uniform Pension, Pre-Funded Healthcare & Active Healthcare
General Fund Revenue, Net of Reserve from FY 2016
Non-Public Safety General Fund Cost
8January 13, 2014
Financial Models How Can The Projections Be Changed?These are not suggestions, just observations Short-Term Actions: Reduce expenses or the expense growth rate Salaries Benefits, especially Active Healthcare Services provided
Increase Revenues Mid-Term to Long Term Considerations: Slower effect: Pension or other changes for future hires Change Benefits (Pension and Pre-Funded Healthcare) for Active
Employees Change Benefits (Pension and Pre-Funded Healthcare) for Future
Hires
9January 13, 2014
Summary 3 Scenarios developed as requested by Task
Force: 15 year, 20 year, and Recession
A deficit exists beginning in 2015
Public Safety Expenditures have grown faster than revenue over the past 20 years and are projected to continue to grow faster than revenue
In any of the three scenarios Public Safety could take up to 100% of General Fund Revenue based on historical trends
MHBT Inc. 301 Congresss, Suite 100
Hea
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PART 1
Why have tota
Due to a Collec
up with healthc
have not share
ncluding incre
42% increase. T
allowing the Ci
How much did
The total net p
Civilian plans in
How much did
Total medical a
Civilian:
Fiscal
FY12)
o
o o o
Uniform:
Fiscal
FY12)
o
o o o
ss, Suite 100
has been reta
t benefits an
following are
al healthcare c
ctive Bargainin
care inflations,
d in any of the
asing member
The Civilian em
ty to realize a
d healthcare co
aid medical ex
ncreased 1.02%
d claims increa
and pharmacy
Year 2013 (10/
by 2%, reduci
Net Paid PE
4%
Overall plan
Medical Co
High Cost a
Year 2013 (10/
by 16%, increa
Net Paid PE
increased 4
Overall plan
Medical Co
High Cost a
00, Austin, T
ined to assist
d to offer ou
e our respons
costs increase
ng Agreement,
, causing claim
e premiums du
r cost sharing a
mployees picke
lower total cla
osts increase f
xpenses Per Em
% (1/08 to 9/13
ase in FY13 in t
claims increas
/1/12‐9/30/13) T
ng the City’s o
EPM for this sa
n utilization in
vered Expense
as a percentage
/1/12‐9/30/13) T
asing the City’
EPM for this sa
4%
n utilization in
vered Expense
as a percentage
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t with the his
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ring this time.
and introducin
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from 2008 to 2
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).
total; Civilian
sed 5.7% on a n
Total Net Paid
overall healthca
ame time perio
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e of total spen
Total Net Paid
s overall healt
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e of total spen
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storical analys
o The Healthc
of the questi
in 2005 to $91
plan designs ha
88%, from $25
The Civilian p
g a CDHP. Th
mately 16% of
rend of 37%, ve
2013?
Month increased
versus Unifor
net paid PEPM
(Medical and
are spend by $
od decreased 3
ver prior period
Y13 = $549.95
d = 32.5%
(Medical and
hcare spend by
od also increas
o 90% of memb
Y13 = $829.27
d = 24.9%
H
226-7900 Fa
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1M in 2013?
ave not chang
5M in 2005 to $
plans have ma
e Civilian tota
the current to
ersus the 88%
d 37.8%; the U
rm? What wa
M basis.
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$709K
3%; Medical de
d to 91% of me
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y $6.2 Million.
sed by 16%; Me
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y of San Anto
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$47M in 2013.
ade moderate,
l claims increa
tal through pr
trend on the U
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s the average
decreased (ove
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embers utilizin
increased (ove
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medical benefit
erformance R
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ts Task Force
sk Force.
for adjustmen
Uniform empl
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nd Pharmacy d
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er same time p
ed 21% and Ph
ts
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re and
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nts to keep
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44M, a
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and the
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period
decreased
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Why is the Un
peers?
The Fire and Po
Gross AdequacBenefits
FY 2011
FY 2012
FY 2013
Adequacy of Benefi
healthcare as comp
premium contributi
Why is the City
contribution ra
For uniform em
are subject to n
formal strategy
premiums for d
Out‐of‐Pocket
Uniform emplo
their total heal
expenses. Acc
expenses
What is the av
The Uniform em
premium per E
Why have the
Driven Strateg
Peer Cities off
The Uniform H
negotiation.
ss, Suite 100
iform Gross B
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84.3%
84.2%
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fits: The ratio of gro
pared to the overal
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y contribution
ate so much h
mployees, activ
negotiation. M
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dependents an
costs for Unifo
oyees paid 9%
thcare expens
ording to a 201
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Police or Fire
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00, Austin, T
enefit Adequa
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an Poli
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% 87.6
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oss payments to co
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n rate so much
higher than th
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Minimal change
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of their health
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their Uniform
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overed expenses. A
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Antonio is the o
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an employees.
hcare expense
stin employee
ON Hewitt Stu
ntribution per
ents pay $0 pre
5.
nted standard
ns, employee
populations,
ollective bargai
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higher than th
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re NC
.5% N
.6% N
.5% 77
An indication of ov
ets and Copays are
he Uniform pla
ket and nation
he respective f
made to these h
only major Tex
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In total (prem
compared to C
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emiums for the
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wellness strat
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ining agreeme
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National CDHP
UHMa
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7.0% 83.0
verall benefit plan r
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ans than for th
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fire and police
healthcare ben
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Houston all ha
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Civilian employ
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o premiums an
ents. Any plan
Healthcare Pe
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UHNa
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NA
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richness. The perce
mployees cost shar
he Civilian pla
collective bar
nefit plans and
uniform emplo
ave equal prem
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yees who paid
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ays 43% of the
Civilian empl
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design change
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A NA
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.0% 85.
ent the City pays fo
re percentage; doe
ns? Why are t
gaining agreem
d no philosophy
oyees pay no h
miums, deduct
and out of poc
d approximatel
heir total healt
eir total health
oyee’s average
t such as Cons
an plans? Oth
in wellness pr
es are subject
Review | 3
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d national
HC TX unicipality
A
A
.0%
for the cost of
s not include
the
ments and
y or
healthcare
tibles and
kets),
ly 30% of
thcare
hcare
e annual
sumer
er local
rograms.
to
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What are the C
rates so differe
The Uniform p
shares have act
design changes
Net Paid Medi
FY 2011
FY 2012
FY 2013
2 Year Change
Average Trend
ss, Suite 100
City medical c
ent between C
lans have not c
tually decrease
s and added ad
cal PEPM
e
d
00, Austin, T
osts for the C
Civilian, Police
changed durin
ed as a percen
dditional consu
Civilia
$398.1
$445.2
$433.1
8.79%
4.56%
TX 78701
ivilian, Fire an
e and Fire?
g these time p
tage of total m
umer driven op
n Polic
16 $582
24 $555
16 $715
22.9
12.11
Ph: 512-2
nd Police plans
periods due to
medical spend
ptions to enco
ce Fir
2.11 $53
5.85 $6
5.54 $6
2% 23
1% 11.
H
226-7900 Fa
s for the past
a collective ba
on the plans.
urage membe
re
38.77
01.15
64.52
.34%
.06%
Healthcare Pe
ax: 512-226-7
three years?
argaining agree
The Civilian pl
er engagement
erformance R
7999 www.
Why are the t
ement. Memb
ans have mad
t and keep cos
Review | 4
mhbt.com
trend
ber cost
e benefit
ts low.
MHBT Inc.
W
T
T
301 Congres
What is the FY
The Uniform D
Trends (FY13 o
Civilia
Unifo
Civilia
Unifo
Civilia
Unifo
Civilia
Unifo
$2,
0
1000
2000
3000
4000
5000
6000
ss, Suite 100
Y13 medical cl
Dependents cos
over FY12)
an Employee ‐
rm Employee
an Dependent
rm Dependen
an Spouse +2.0
rm Spouse +1
an Total ‐1.1%
rm Total 16.8
,956 $3,418
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00, Austin, T
aims cost by e
st on average 2
11.9%
+18.3%
+4.4%
nt +15.5%
0%
7.8%
%
%%
$1,305
$
Depen
TX 78701
employees ve
2x’s more than
$2,690
ndent
Ph: 512-2
rsus spouses v
n the Civilian D
$4,488
$4,88
Spouse
H
226-7900 Fa
versus depend
Dependents.
$3,32
82
Healthcare Pe
ax: 512-226-7
dents?
24 $3,420
Total
erformance R
7999 www.
Civilian
Uniform
Review | 5
mhbt.com
m
MHBT Inc.
W
o
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If
a
g
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301 Congres
What are the l
overall claims?
In‐Net
cost sh
increa
Conve
$2.3M
What would th
f the members
about $7‐8M an
greater than $9
designs change
92.5%
93.0%
93.5%
94.0%
94.5%
95.0%
95.5%
96.0%
96.5%
97.0%
ss, Suite 100
ast two years
?
twork utilizatio
hifting, causin
ased In‐Networ
ersely, In‐Netw
M in additional c
he City saving
ship would spli
nnually. If the
9M annually. T
e. Additional s
93.8%
00, Austin, T
of In Network
on has increase
g an increase i
rk utilization a
work utilization
claims as the n
s be if the Uni
it approximate
CDHP or New
These savings
savings would
%
95.0%
Civilian
Network Ut
TX 78701
k utilization le
ed in the Civilia
n the overall In
llowed the City
n decreased on
network discou
iform membe
ely equal to Civ
w Value plan ac
do not include
occur from em
tilization - M
Ph: 512-2
evels for Civilia
an population,
n‐Network dis
y to reduce FY
n the Uniform p
unt deteriorate
rship were to
vilian enrollme
chieved more t
e any value of p
mployee/depen
96
Medical Eligi
H
226-7900 Fa
an and Unifor
, due in part to
count realized
Y13 expenses b
population res
ed along with t
shift to the 20
ent percentage
than 20% of th
premium cost
ndent premium
.4%
93.8
Uniform
ible Charges
Healthcare Pe
ax: 512-226-7
rm and does t
o benefit desig
d by the City of
by $983K over F
sulting in an im
the In‐Networ
014 Civilian be
es, savings wou
he migration, s
sharing; only t
m contribution
8%
s
erformance R
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his have an im
n changes and
f San Antonio.
FY12.
mpact of approx
k utilization.
enefit plans?
uld be equivale
avings would l
the value of th
s.
FY12
FY13
Review | 6
mhbt.com
mpact on
d member
This
ximately
ent to
likely be
e plan
MHBT Inc.
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301 Congres
The Mayor has
What solution
Some of the o
Implem
Make
Create
adjust
Implem
The C
Unifor
A spou
A man
Introd
Limit o
ss, Suite 100
s specifically r
s should the C
ptions should
ment new ben
plan design ch
e multi‐year st
ted automatica
ment a CDHP f
ity should cons
rm plans, and t
usal surcharge
ndatory Popula
ducing Premium
or reduce Out
00, Austin, T
requested this
City consider t
include the fo
efits tiers for n
hanges for Unif
trategy for hea
ally on an annu
for the Union p
sider impleme
the high claim
e for spouses w
ation Health M
m cost sharing
of Network be
TX 78701
s Task Force to
to control cost
ollowing:
new Uniform h
form plan(s) t
alth plans whic
ual basis
plans
nting a depen
costs and tren
who have altern
Management P
across all Emp
enefits to lowe
Ph: 512-2
o provide idea
ts?
hires
o include curre
h allow for me
dent audit give
nds they are in
nate coverage
rogram
ployee/Depend
er overall City c
H
226-7900 Fa
as for controlli
ent employees
edical and phar
en the large pr
curring.
options.
dent Tiers for t
costs
Healthcare Pe
ax: 512-226-7
ing healthcare
s
rmacy plan des
roportion of de
the Uniform p
erformance R
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e costs going f
sign changes t
ependents on t
lans
Review | 7
mhbt.com
forward.
to be
the
CIVILIAN COMPENSATION & BENEFITS
($ in Millions)
FY 2003
FY2004
FY 2005
FY 2006
FY 2007
FY 2008
FY 2009
FY 2010
FY 2011
FY 2012
FY 2013
%Change
Compensation $198 $199 $206 $221 $231 $245 $254 $264 $265 $269 $283 43.0%
TMRS 23 23 25 27 28 31 34 32 34 28 30 34.1%
Social Security 12 12 13 14 14 15 16 16 16 17 18 43.0%
Active Healthcare* 31 35 29 34 36 30 33 40 37 42 43 39.6%
Retiree Healthcare* 8 8 9 11 10 10 10 8 8 7 6 -24.9
• Since 2003, Civilian compensation and benefit costs have increased 40.0%
*Healthcare costs are net premiums
8
UNIFORM COMPENSATION & BENEFITS
($ in Millions)
FY 2003
FY2004
FY 2005
FY 2006
FY 2007
FY 2008
FY 2009
FY 2010
FY 2011
FY 2012
FY 2013
%Change
Compensation $212 $228 $244 $262 $277 $287 $305 $312 $326 $340 $364 71.6%
Pension 45 48 50 52 55 58 62 64 67 70 73 62.9%
Active Healthcare 21 27 26 29 29 31 34 37 42 44 52 141%
Retiree Healthcare 15 14 17 17 19 20 21 22 24 24 25 66.7%
Legal/Vision/Dental 4.7 4.7 4.6 4.8 4.8 4.9 5.0 5.2 5.2 5.2 5.4 13.5%
• Since 2003, Uniform compensation and benefit costs have increased 74.1%
9
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retiremen
PART 2
Question 1: Ca
of the last plan
Fiscal Year
2011
Budget
Actual*
2012
Budget
Actual*
2013
Budget
Actual*
*Actual is base
Question 2: Cagroups? Budget is adopfollowing;
10.2%
Benefo o
70% C
30% C
Use M
Additiindividtrend.was a
ss, Suite 100
has been reta
t benefits an
following are
an the City pro
n three years (
Civilian
$46,674,69
$40,183,29
$45,987,14
$45,585,95
$38,208,68
$43,544,27
d on Booked cl
an the City pro
pted based on a
% regional trend
fit design differ.956 Curren.963 Prior P
Credibility for C
Credibility for P
May, 2013 Enro
ionally there isdual may move Also, plans w blending of pl
00, Austin, T
ined to assist
d to offer ou
e our respons
ovide the actu
(both City and
Uni
94
95
$37,
$38,
49
58
$39,
$39,
89
75
$43,
$47,
laims
ovide a genera
analysis of prio
d rential: nt Period (last 1 Period (12 mon
Current Period
Prior Period
llment Census
s migration asse to a theoreticwere historicallyan design valu
TX 78701
t with the his
r expertise to
es to several
ual amounts b
d Employee co
iform
776,486
,308,940
,926,720
,670,961
,048,781
283,354
al description
or year claims.
12 months) nths prior to Cu
sumptions takecally lower cosy rated and incues and experie
Ph: 512-2
storical analys
o The Healthc
of the questi
udgeted and e
ontributions),
Po
$20,648
$22,347
$23,206
$22,100
$23,751,
$27,101,
of how it ado
Specifically, t
urrent Period)
en into considest option, theircreased based ence to make t
Res
226-7900 Fa
sis of the City
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expended by
excluding the
Uniform by
olice
8,894
7,248
$
$
6,203
0,212
$
$
,532
,834
$
$
pts the budge
the most recen
eration for mor claims will no on their own p the differences
sponse to Tas
ax: 512-226-7
y of San Anto
ement Benefi
ed by The Tas
group (Civilia
e uniformed re
y Group
Fire
$17,127,592
$15,961,692
$16,720,517
$17,570,750
$19,297,249
$20,181,520
eted amounts
nt budget assu
ovement betweot necessarily f performance, s between plan
k Force Ques
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ts Task Force
sk Force.
n, Fire, Police
etiree section
s for each of th
umptions inclu
een plans as w follow that low however this yns less significa
stions | 10
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re and
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e) for each
?
he
ded the
while an wer cost year there ant.
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Question 3: Caeach group (Vaemployee & sp
Question 4: Caemployees (seunderlying tre Due to the potenformation ha
FY 2013 HighClaimants >$
Employees
Spouses
Dependents
Membership Year 20
DGroup Name SFire Police Premier Retiree Premier Retiree Standard Retiree Value Standard Value Grand Total
Membership Year
DGroup Name SFire Police Premier Retiree Premier Retiree Standard Retiree Value Standard Value Grand Total
Membership YearD
Group Name SFire HSA Police Premier Retiree HSA Retiree Premier Retiree Standard Retiree Value Standard Value Grand Total
ss, Suite 100
an the City proalue PPO, Prepouse, employ
an the City proeparating fire aends) so that t
ential for identas been provide
h Cost $50K
Civ
31%
45%
18%
011
Dataum of Single Subscrib
3,
Dataum of Single Subscrib
1, 3,
Dataum of Single Subscrib
1, 3,
00, Austin, T
ovide the averemier PPO, Styee & child(re
ovide claims d and police bec the work grou
tification of inded.
vilians Fire
% 23%
% 20%
% 16%
bers Sum of Subscrib271 377 839 92
116 57
733 967
,453
2012
bers Sum of Subscrib247 369 671 85
113 67
758 ,108 ,416
2013
bers Sum of Subscrib224 161 367 244
7 49
116 104 879
,287 ,438
TX 78701
rage enrollmeandard PPO, n), and emplo
data that illustcause they doup can see whe
dividual inform
Police
29%
13%
% 40%
bers plus Spouse S218 251 270 26 52 21
310 201
1,349
bers plus Spouse S210 249 175 20 45 26
340 272
1,337
bers plus Spouse S209 63
259 66 2 5
27 42
302 356
1,330
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ent by plan by CDHP, Police oyee & family)
trates the clai bargain sepaere the high co
mation, and to
Sum of Subscribers plu
Sum of Subscribers plu
Sum of Subscribers plu
Res
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