TOWN OF WESTBOROUGH
COST IMPACT OF PROPOSED HEALTH PLANS
February 24, 2010
Plan Type Coverage Headcount Current Plans Total Annual Total Annual Total Annual Projected Proposed Plans Projected Total Projected City Total Projected
Rates as of Cost City Cost Employee Cost Plan 7/1/2010 Cost Cost Employee Cost
3/1/2010 Headcounts
Active Blue Choice POS City Contribution Employee Blue Choice Value City Contribution Employee
Non-Medicare Contribution Plus POS Contribution
75% 25% 75% 25%
POS Individual 102 $761.08 $931,562 $698,671 $232,890 102 $731.84 $895,772 $671,829 $223,943
Family 123 $1,996.28 $2,946,509 $2,209,882 $736,627 123 $1,919.59 $2,833,315 $2,124,986 $708,329
POS Totals $3,878,071 $2,908,553 $969,518 $3,729,087 $2,796,815 $932,272
Fallon Select City Contribution Employee Fallon Select City Contribution Employee
HMO Contribution Higher Copay Contribution
Plan
75% 25% 75% 25%
HMO Individual 74 $594.07 $527,534 $395,651 $131,884 37 $483.20 $214,541 $160,906 $53,635
Family 213 $1,544.54 $3,947,844 $2,960,883 $986,961 107 $1,256.30 $1,613,089 $1,209,817 $403,272
Fallon Direct City Contribution Employee
Higher Copay Contribution
Plan
75% 25%
37 $420.39 $186,653 $139,990 $46,663
106 $1,092.98 $1,390,271 $1,042,703 $347,568
Harvard Pilgrim City Contribution Employee HMO Blue Value City Contribution Employee
HMO Contribution Plus HMO Contribution
75% 25% 75% 25%
HMO Individual 24 $885.81 $255,113 $191,335 $63,778 24 $709.00 $204,192 $153,144 $51,048
Family 52 $2,303.10 $1,437,134 $1,077,851 $359,284 52 $1,862.00 $1,161,888 $871,416 $290,472
HMO Totals $6,167,626 $4,625,721 $1,541,907 $4,770,634 $3,577,978 $1,192,659
Totals 588 $10,045,697 $7,534,274 $2,511,425 588 $8,499,721 $6,374,793 $2,124,931
Notes: Total Premium Savings $1,545,977
1. Premiums and headcount provided by Town of Westborough February 22, 2010 Total Town Premium Savings $1,159,482
2. Assumes 50% of current Fallon Select subscribers enroll in proposed Fallon Select and 50% enroll in proposed Fallon Direct HMO's Total Employee Premium Savings $386,494
3. Assumes 100% of current Harvard Pilgrim HMO subscribers enroll in HMO Blue Value Plus HMO
Boston Benefit Partners, LLC 2010
TOWN OF WESTBOROUGH
PROJECTED 5-YEAR AGGREGATE COST SAVINGS OF PROPOSED VALUE PLANS
PREMIUM ASSUMPTIONS: ALL PLANS 75/25
February 2010
Costs FY 2011 FY 2012 FY 2013 FY 2014 FY 2015
Total Annual $10,045,697 $11,050,267 $12,155,293 $13,370,823 $14,707,905
Westborough Plans Cost
and Costs Total Annual $7,534,274 $8,287,700 $9,116,470 $10,028,117 $11,030,929
75/25 Town Cost
Contribution Split Total Annual $2,511,425 $2,762,567 $3,038,823 $3,342,706 $3,676,976
Employee Cost
Total Annual $8,499,721 $9,349,693 $10,284,662 $11,313,129 $12,444,442
Proposed Plans Estimated Cost
and Costs Total Estimated $6,374,793 $7,012,270 $7,713,497 $8,484,846 $9,333,331
75/25 Town Cost
Contribution Split Total Estimated $2,124,931 $2,337,423 $2,571,166 $2,828,282 $3,111,110
Employee Cost
Total Annual $1,545,977 $1,700,574 $1,870,631 $2,057,694 $2,263,463
Cost Savings
Projected Savings
Total Annual $1,159,482 $1,275,430 $1,402,973 $1,543,271 $1,697,598
Under Proposed
Town Savings
Plans
Total Annual $386,494 $425,143 $467,658 $514,424 $565,866
Employee Savings
Total Projected 5-Year Premium Savings $9,438,339
Total Projected 5-Year Town Premium Savings $7,078,754
Total Projected 5-Year Employee Premium Savings $2,359,585
Notes:
1. Westborough premium assumption calculate a 10% average yearly increase
2. Westborough employees will pay higher costs for office visits and prescription drugs wihich will offset a portion of their premium savings.
3. Office visit copays will increase to $10 on July 1, 2010, to $15 on July 1, 2011, and to $20 on July 1, 2012
Boston Benefit Partners, LLC 2010
TOWN OF WESTBOROUGH
WHAT WILL THIS FEEL LIKE TO THE MEMBER?
BLUE CHOICE POS (CURRENT) versus BLUE CHOICE VALUE PLUS POS
February 24, 2010
Blue Choice
Blue Choice POS Value Plus POS
(Current) (Proposed)
[PCP Referred Benefits] [PCP Referred Benefits] Impact on Employees
Service 25% Employee Contribution 25% Employee Contribution Annual Premium
Annual Single Premium $2,283 $2,196 $88
Annual Family Premium $5,989 $5,759 $230
Member Copayments
GP Office Visit Copay $5 $10 $5 higher per visit cost
ER Visit $25 $75 $50 higher per visit cost *
Radiology (MRI, PET, CT) No charge $75 $75 higher per service cost *
Hospital Admission
No charge $150 per admission $150 higher per admission cost *
Outpatient Surgery No charge $100 per incidence $100 higher per incident cost *
Drugs (Retail)
Tier 1 $10 $10 Same copay
Tier 2 $20 $25 $5 more per script
Tier 3 $35 $50 $15 more per script
Drugs (Mail Order; 90 day supply)
Tier 1 $10 $20 $10 more per script
Tier 2 $20 $50 $30 more per script
Tier 3 $35 $110 $65 more per script
Note:
* Town proposal includes a Health Reimbursement Arrangement for ER, Radiology, Inpatient, and Outpatient copayments
Boston Benefit Partners, LLC
TOWN OF WESTBOROUGH
WHAT WILL THIS FEEL LIKE TO THE MEMBER?
FALLON SELECT HMO (CURRENT) versus FALLON SELECT HIGHER COPAY HMO
February 24, 2010
Fallon Select HMO
Fallon Select HMO Higher Copay Plan
(Current) (Proposed) Impact on Employees
Service 25% Employee Contribution 25% Employee Contribution Annual Premium
Annual Single Premium $1,782 $1,450 $333
Annual Family Premium $4,634 $3,769 $865
Member Copayments
GP Office Visit Copay $5 $10 $5 higher per visit cost
ER Visit $25 $75 $50 higher per visit cost *
Radiology (MRI, PET, CT) No charge $75 $75 higher per service cost *
Hospital Admission
No charge $150 per admission $150 higher per admission cost *
Outpatient Surgery No charge $100 per incidence $100 higher per incident cost *
Drugs (Retail)
Tier 1 $5 $10 $5 more per script
Tier 2 $15 $25 $10 more per script
Tier 3 $35 $50 $15 more per script
Drugs (Mail Order; 90 day supply)
Tier 1 $10 $20 $10 more per script
Tier 2 $30 $50 $20 more per script
Tier 3 $105 $70 $35 less per script
Note:
* Town proposal includes a Health Reimbursement Arrangement for ER, Radiology, Inpatient, and Outpatient copayments
Boston Benefit Partners, LLC
TOWN OF WESTBOROUGH
WHAT WILL THIS FEEL LIKE TO THE MEMBER?
FALLON SELECT HMO (CURRENT) versus FALLON DIRECT HIGHER COPAY HMO
February 24, 2010
Fallon Direct HMO
Fallon Select HMO Higher Copay Plan
(Current) (Proposed) Impact on Employees
Service 25% Employee Contribution 25% Employee Contribution Annual Premium
Annual Single Premium $1,782 $1,261 $521
Annual Family Premium $4,634 $3,279 $1,355
Member Copayments
GP Office Visit Copay $5 $10 $5 higher per visit cost
ER Visit $25 $75 $50 higher per visit cost *
Radiology (MRI, PET, CT) No charge $75 $75 higher per service cost *
Hospital Admission
No charge $150 per admission $150 higher per admission cost *
Outpatient Surgery No charge $100 per incidence $100 higher per incident cost *
Drugs (Retail)
Tier 1 $5 $10 $5 more per script
Tier 2 $15 $25 $10 more per script
Tier 3 $35 $50 $15 more per script
Drugs (Mail Order; 90 day supply)
Tier 1 $10 $20 $10 more per script
Tier 2 $30 $50 $20 more per script
Tier 3 $105 $70 $35 less per script
Note:
* Town proposal includes a Health Reimbursement Arrangement for ER, Radiology, Inpatient, and Outpatient copayments
Boston Benefit Partners, LLC
TOWN OF WESTBOROUGH
WHAT WILL THIS FEEL LIKE TO THE MEMBER?
HARVARD PILGRIM HMO (CURRENT) VERSUS HMO BLUE VALUE PLUS
February 24, 2010
Harvard Pilgrim HMO HMO Blue Value Plus
(Current) (Proposed) Impact on Employees
Service 25% Employee Contribution 25% Employee Contribution Annual Premium
Annual Single Premium $2,657 $2,127 $530
Annual Family Premium $6,909 $5,586 $1,323
Member Copayments
GP Office Visit Copay $5 $10 $5 higher per visit cost
ER Visit $50 $75 $25 higher per visit cost *
Radiology (MRI, PET, CT) No charge $75 $75 higher per service cost *
Hospital Admission
No charge $150 per admission $150 higher per admission cost *
Outpatient Surgery No charge $100 per incidence $100 higher per incident cost *
Drugs (Retail)
Tier 1 $5 $10 $5 more per script
Tier 2 $15 $25 $10 more per script
Tier 3 $35 $50 $15 more per script
Drugs (Mail Order; 90 day supply)
Tier 1 $10 $20 $10 more per script
Tier 2 $30 $50 $20 more per script
Tier 3 $105 $110 $5 more per script
Note:
* Town proposal includes a Health Reimbursement Arrangement for ER, Radiology, Inpatient, and Outpatient copayments
Boston Benefit Partners, LLC