TO: The Honorable Board of County Commissioners
THROUGH: John A. Titkanich, Jr., County Administrator
FROM: Suzanne M. Boyll, Director of Human Resources
DATE: June 18, 2025
SUBJECT: Approval of the Retiree Blue Medicare Advantage Renewal
__________________________________________________________________
BACKGROUND
Under Florida Statute, retirees of the County (and qualified spouses) are eligible to continue health insurance under the County’s self-insured Group Medical Insurance Program. Beginning in 2008, retirees who attain age 65 are provided the option to enroll in the BlueMedicare Advantage Plan. The Board of County Commissioners approved the current BlueMedicare Advanced Platinum PPO with Dental, Hearing, Vision benefits in 2024 at a monthly premium of $307.26.
Staff has been provided the annual renewal for this plan reflecting a 10% increase in premium to $337.99 which is an increase of $30.73 per month. The Renewal, Summary of Benefits, and Master Agreement are attached.
ANALYSIS
Changes between current plan benefits and renewal plan benefits
• Allergy injections decreased from $5 to $0
• $0 copay for diagnostic colonoscopy added under Outpatient Hospital and ASC
• $0 copay for Lymphedema Therapy added under Physical Therapy
• Lifescan (One Touch) and Ascensia test strips are preferred; other brands will require Prior Authorization.
• Pharmacy Initial Coverage State decreased from $8,000 to $2,000. Copays are assessed until $2,000 in OOP, then move on to the Catastrophic Coverage stage, where member cost share is $0 for the remainder of the calendar year.
• Retail 90 Rx copays changed from $10/$15/$45/$85 to $9/$24/$105/$195 (Preferred Generic/Generic/Preferred Brand/ Non-Preferred Brand.
In order to provide retirees with the renewal information, the item is presented to the Board for approval.
BUDGETARY IMPACT
The financial impact of the renewal is $30.73 per month per enrolled member. Currently, we have nineteen (19) members enrolled in the Medicare Advantage Plan. Some retirees may qualify for subsidized premiums and the subsidized retiree premiums are funded from the OPEB Trust fund account 701038-368010.
PREVIOUS BOARD ACTIONS
Approval of the 2024 Blue Medicare Advantage Renewal
POTENTIAL FUTURE BOARD ACTIONS
n/a
STRATEGIC PLAN ALIGNMENT
Governance
OTHER PLAN ALIGNMENT
n/a
STAFF RECOMMENDATION
Recommended Action
Staff recommends and respectfully requests that the Board approve the renewal of the Blue Medicare Advanced Platinum PPO plan effective October 1, 2025 through September 30, 2026 and authorize the Chairman to execute the renewal agreement.