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~ • • <br />' SUMMARY FOR EXECUTIVE REVIEW <br />t This analysis of The City of La Porte Employee Medical Plan is made with <br /> the overriding priority in mind that coverage for employees and their <br /> dependents remain available at no cost to them. Containing plan costs <br />' therefore can be achieved through changes in benefit levels and through <br /> more efficient claim filing practices. <br />' The following recommendations have resulted from this study. <br /> 1. Modify the medical plan's benefits to effect a more prudent <br /> sharing of the cost between employee and the City, and to <br />' encourage the use of lower cost alternatives procedures. The <br /> current benefits provide excellent financial protection but <br />' have no emphasis on cost containment. By inserting specific <br />incentives and disincentives, employees will be encouraged to <br /> seek the most cost effective care without sacrificing quality <br /> or physician selection (see Exhibit 6, C, & E). <br />' ' <br /> s Personnel <br />2. Shift the claim filing responsibility from the City <br /> Department to the employees. This is suggested to accomplish <br />' the following: <br /> - Relieve the City of an administrative burden; <br />' - remove the City from a precarious legal position with regard <br /> to the confidentiality of employee medical claims; <br /> - avoid an increase in the claims administration fee by <br /> reducing the number of claims submissions, i.e. claims <br /> currently being filed as incurred would be filed only after <br />' the deductible is met. (See Exhibit D). <br /> If implemented, these changes would preserve the non-contributory status <br /> now enjoyed by City employees and will allow the fund contributions to <br />' remain at 1984/85 levels through March 31, 1986. <br /> <br /> <br />i~ <br />r <br />1 ~~ eE~~ <br />