17-A Benefits Sub(12-08-03) - Laserfiche WebLink

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City of Paris Council Benefits Subcommittee December 8, 2003 Page 6 Chairman Guest asked that Mr. Anderson explain the facility charges. Mr. Anderson said that most of these deal with the steps to help to hold the cost down, such as second surgical opinions, pre-admission testing and home health care, hospice care and vision care the deductible will apply just like any other illness. Chairman Guest said the next item is office visit/consultation copay, which is only $15.00 and the proposed is $25. 00. Preventive care benefit is currently $20.00 copay and the proposal is no copay at 100% in network and out of network with the deductible waived. Mr. Anderson advised that they are trying to encourage people to get physicals and catch things early. Mr. Anderson explained that under prescriptions, in the past, employees went to local pharmacies, pay for the prescription, and the employee would file on the insurance and be reimbursed at 80%. Mr. Anderson said that the proposed is kind of a three tier copay based on generic or brand name. Mr. Anderson also explained that the mail service is for maintenance drugs. Mr. Anderson said that he was proposing disease management, which is primarily an educational tool where TML can look at claims history of an employee and can determine, for example, that we might have six employees who have had it. TML would mail them from time to time information on their disease and how to take care of themselves. Mr. Anderson said that the Pediarix Inj ection and Small Pox vaccination is added under wellness benefit like pool subject to annual cap both for injections and admin. Chairman Guest said that under today's market conditions, he felt that Mr. Anderson has done a good job of coming up with alternatives and alternative proposal that can be cost efficient, but they will not know anything until the bids come in. Chairman Guest asked if right now the city is paying $450.00 per employee and