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Historic Renewal
Medical
Humana
May 1, 2007 Renewal –
Original renewal came in at 12.17% with a loss ratio of 70.8%. Plans were marketed. UHC provided
the most competitive proposal. PHM remained with Humana. The final renewal after benefit
changes resulted in a 8.6% increase.
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Plan changes included and increased out of pocket from $1,000 to $1,500. Increase ER copay
from $75 to
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$100. And the office visit copay was increase from $15 to $20 Primary/$35 Specialist.
May 1, 2008 Renewal –
The initial and final Humana renewal was 8.75% at a 77% loss ratio. The final renewal after benefit
changes was 5.5%. Benefit changes included an increase to the PPO Deductible from $250
Individual/$500 Family to $500 Individual/$1,000 Family.
BlueCross BlueShield of Kansas City
May 1, 2009 Renewal– Initial Humana renewal came in at 25.4%. Marketed plans and moved to
BlueCross BlueShield of Kansas City changing to Base ($1,000 Individual Deductible) and Buy-Up
($500 Individual Deductible) options. Loss ratio at the time of renewal was approximately 67%. The
final increase with changes was 10.7%. Plans were negotiated to include a Maximum Refund
agreement.
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In August of 2010, PHM received a Maximum Refund in the amount of $96,332 for prior year
reconciliation.
May 1, 2010 Renewal –
The initial BCBSKC renewal was 0% with no benefit plan changes running at a consolidated loss ratio
of approximately 29% (combining Humana and BCBSKC data). CBIZ provided a qualified high
deductible plan option for review with a 15% premium savings compared to the Base option.
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PHM retained grandfathered status under the PPACA.
May 1, 2011 Renewal –
The initial BCBSKC renewal was 0%. Negotiated 1 month premium holiday and $5,000 in wellness
funds in addition to the rate pass. Additional qualified high deductible plan option was proposed, but
not implemented.
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Plan changes included healthcare reform required enhancements. Pre-existing conditionexclusions
were removed for all children under age 19. All preventive care cost-sharing was removed (no copays
or coinsurance) so preventive/routine services are covered at 100%. The preventive annual
maximums were removed as well as any plan lifetime maximums. Dependent limiting age was also
extended to age 26 regardless of studentstatus.
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New contribution strategy and wellness incentives were implemented effective May 1, 2011.
Grandfathered status was lost due to changes made.
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In August of 2012, PHM received a Maximum Refund in the amount of $38,950 for prior year
reconciliation.
May 1, 2012 Renewal –
The initial BCBSKC renewal was 9.5%. Negotiated renewal was 6.6% with no plan changes.
May 1, 2013 Renewal –
The initial BCBSKC renewal was 0%. Negotiated renewal was 0% with one month premium holiday.
August of 2013 –
PHM received a Maximum Refund in the amount of $100,511 for prior year reconciliation.
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