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Health Care Enhancement III Worksheetxls - New York State Office

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Health Care Enhancement III Worksheetxls - New York State Office Powered By Docstoc
					                                                                                                                                                               Schedule C


                                                         Health Care Enhancement III
                                              Allowable Employer-Paid Premium Offset Worksheet

Instructions:     1) This worksheet is to be utilized for the following two purposes:
                     a) At the time of completing the HCE III Application, providers should compare actual data from 1/1/06 - 12/31/06 to
                         the estimated data from 1/1/07 - 12/31/07 to justify applying for HCE III funding to offset employer paid premium increases .
                     b) When the actual 2007 annual premium is known, providers should compare actual data from 1/1/06 - 12/31/06 to
                         actual data from 1/1/07 - 12/31/07 to justify (for audit purposes) using HCE III funding to offset employer paid premium increases.
                  2) Providers should enter the five figures in the yellow highlighted fields above.
                  3) Providers may use an average when entering the number of OMRDD employees participating in health plan, given that
                     enrollment typically fluctuates throughout a 12 month period.
                  4) For the purpose of this worksheet, employee is defined as an individual working in OMRDD certified, authorized or funded programs.
                  5) For the purpose of this worksheet, premiums are defined as the annual health insurance premiums or portion thereof
                     paid by the employer for employees working in OMRDD certified, authorized or funded programs.
                  6) For the purpose of this worksheet, the base year is 2006.
                  7) If the final calculation is a negative number, HCE III funds cannot be used to offset employer-paid premiums.


             $0      2006 Annual Premium Expense (X)
              0      Number of 2006 OMRDD Employees participating in health plan (A)

             $0      2007 Annual Premium Expense (Y)
              0      Number of 2007 OMRDD Employees participating in health plan (B)

   #DIV/0!           2007 Annual Premium Expense adjusted for base year population (Y * A/B = Z)

   #DIV/0!           Percentage Increase in Health Insurance Premiums (Z - X)/X * 100 = Premium Increase % (PI%)
       0.00%         Trend / COLA (T/C%)
                               Use 2.97%, if more than 80% of provider's OMRDD revenues are from trended programs
                               Use 2.30%, if more than 80% of provider's OMRDD revenues are from programs that receive COLA's
                               Use 2.50%, if neither of the above apply
   #DIV/0!           Percentage of Base Year Premium for which provider may use Health Care Enhancement III Funds (PI% - T/C% = HCE%)

   #DIV/0!           2007 Annual Premium Increase for base year population which exceeds Trend / COLA (HCE% * X)
   #DIV/0!           Annual Premium Increase for new health plan enrollees (X/A) * (B-A) * HCE%
   #DIV/0!           Amount of premium for which provider may use Health Care Enhancement III Funds

				
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