09-06-07 Chapter 172 Employee Retiree Insurance and Benefits Board Meeting

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Comments Matt Daeumer: If I go to my stomach specialist he bills under the Humana plan $52 dollars. I pay $35 dollars of that so, he is getting $17.00 dollars from the plan. If I see his assistant he bills $37 dollars to the plan, I pay $35 dollars of that amount and the plan pays $2.00 dollars. That's a little heavy handed on the co-pay for the employee. The employee is paying 90% to see the P A and 60 or 70 % to see the doctor. That is higher than anything else in this plan. I would like to see us lower the office co-pays. Comments Sabina Leins: If you lower the co-pays that will increase the plan cost. Comment Sammy Jacobs: If that is the case, we need something more flexible where if you don't see the specialist you are not paying that full specialist portion. Comments Matt Daeumer: My point is Aetna is supposed to have even bigger discounts than Humana. So, I am going to be paying even more of the portion under Aetna. Comments Juliane Graham: So what you are saying is if we lower the cost to $30 dollars it is not going to increase the cost of the plan. Because the discount that Aetna is offering is going to offset that $5 reduction in the coverage. Request Matt Daeumer: Can you look at the number of doctor visit we had to see what the impact would be to the plan? Also, please look at prescription drugs for last year. This way we could see the impact on the plan if we changed the price of our tiers to $5, $10 and $25. Comments Michael Dolby: Remember, that drives the cost up and how much it is going to be is what will determine if it is cost effective. Question Juliane Graham: How do these prices compare to other plans? Comments Matt Daeumer: I know Harris County pays $2 for generic and $7 for name brand. Sabina Leins: One thing about that and you are right. Some people will take whatever the doctor gives them initially. Many people are not going to ask the doctor if there is something at this level or a generic they can take instead of the one the doctor orders. Comments Matt Daeumer: Everything I take there is not a generic for it, it's not available. I would take a generic if it was available. I understand everything I am talking about is driving the cost up. But, we have to look at the fact the plan save a million dollars last year. I am not trying to spend the entire million dollars.