5.e Health Partners health insurance renewal - resolution 09 20 16 01CITY OF SCANDIA
RESOLUTION NO.: 09-20-16-01
RESOLUTION APPROVING HEALTH CARE PLAN AND ESTABLISHING CITY
CONTRIBUTION TO EMPLOYEE
HEALTH INSURANCE BENEFITS FOR 2017
WHEREAS, the Scandia City Council has determined that it is the best interest of the City to
provide a health insurance plan to help maintain the health of its current employees and to enable the
city to attract and retain a quality workforce; and
WHEREAS, it is now necessary to determine the insurance plan and contributions to premium
costs for the period from 12/1/2016 to 11/30/2017;
NOW, THEREFORE, BE IT HEREBY RESOLVED BY THE CITY COUNCIL OF
THE CITY OF SCANDIA, WASHINGTON COUNTY, MINNESOTA, that it should and hereby
does approve the Health Partners: Empower HSA Open Access Gold 1750-100 Rx Plus for the
period of 12/1/16 to 11/30/17; and
FURTHER BE IT RESOLVED, that for calendar year 2017, the City of Scandia's
contribution to the total cost of providing health insurance benefits shall be as follows: 100% of
premium for single coverage, 80% of premium for family coverage, $120/month HSA contribution for
those on single plan and $160/month for those on a family plan.
Adopted by the Scandia City Council this 20' day of September, 2016.
Randall Simonson, Mayor
ATTEST:
Neil Soltis, Administrator/ Clerk
♦ HealthPartners-
Your Empower HSA Open Access Gold 1750-100 Rx Plus with the Open Access network will be renewed, unless
we hear from you prior to 11/01/2016
Group Name:
Group Number:
Renewal Plan:
Renewal Rate Area:
City of Scandia
27432
Empower HSA Open Access Gold 1750-100 Rx Plus
MN -8
Renewal Monthly Rate
Age
Renewal Rate
0-17
$265.19
18
$ 265.19
19
$265.19
20
$265.19
21
$297.97
22
$297.97
23
$297.97
24
$297.97
25
$299.16
26
$305.12
27
$312.27
28
$323.89
29
$333.43
30
$338.20
31
$345.35
32
$352.50
33
$356.97
34
$361.74
35
$364.12
36
$366.50
37
$368.89
38
$371.27
39
$376.04
40
$380.81
41
$387.96
Renewal Date: 12/01/2016
Renewal Network: Open Access
County: Washington
Age
Renewal Rate
42
$394.81
43
$404.35
44
$416.26
45
$430.27
46
$446.96
47
$465.73
48
$487.18
49
$508.34
50
$532.17
51
$555.71
52
$581.64
53
$607.86
54
$636.17
55
$664.47
56
$695.16
57
$726.15
58
$759.23
59
$775.62
60
$808.69
61
$837.30
62
$856.07
63
$879.61
64
$893.91
65-115
$893.91
Rating Requirements and Provisions
• In accordance with ACA regulations, HealthPartners charges premiums for up to three dependents under age 21,
regardless of family size.
• Upon renewal, premiums for members ages 21 through 64 will be adjusted for age, calculated as the age at renewal.
• 75% participation after eligible waivers.
• Employer will contribute a minimum of 50% of the single premium
• This renewal of coverage is made with the understanding that the employer qualifies as a small employer under
state and federal law. Should information be received that proves the employer is not a small employer, or if there
are demographic changes that affect participation, the offer becomes null and void and HealthPartners reserves the
right to re-evaluate this proposal to the extend permissible under state and federal law.
RatelnfoMed Revised 01/01/2016
27432-201607131106327878/36700 ***Confidential*** ari
Prepared: 07/13/2016 rF
006300RE N E W027432201612010M20160715434
4£ti41L09lOZW0IOZIo1n77ci,/7
:!:! CA
CLC
X OL
W 40
L
r >-
_O
u �
GJ
m
E
N
m
O
A�
W
^C
5L
L
L
O
LL
1-0
4)
m
d
t
al
W
L
O
d
m
u
iil
a
u
C
a
a
oc
50
c =^
O
a
� �°
411a a
O
O
+
ri f0
ri
14
CLO
C
N
CO
C
_
C
Q
a
u
s
t
0
C
O
C
C
>
L
CLn
CU ro
Ln
CU co
C
O
c
c Q 40-
c
a `0
o f
.>-
3
a
4
E
0
` 00
Y
Ln
� In
O
Z
C
CLA U
•O.
L
.- O
CD
=
tD
O p ih L
3:^
O
LD
p i/)-
m
C
C0
•L
C
d00
O
s
Ln
E
C 3 L O
3
E
C
L
O
r -I to
+�
a
Ln
L
Ln
a ',
L mu
O
C
o
0 to O�
E Eth
L
m O�
E E
L E
G1
,Q
Ui
t!�
f— Lim
L
O
L
O
L
O
C
(D
C 0�0
c
to
O
O
O O
O
O
M
N
m N
m
N
v
c
�
CC
S=
C
C
1=
O
N
i
m
L7 t6
i
fO
1
L
1
a
1
O
CL
a
O a
r
O
CL
a
O
O m
O
m
0
.�
o
c
CD
O OL
O�
CD
t
C 'o
C
0
O
O
O'n
O
C
N
E
C
fO
E
M
C
Q.
a
M
Q
N
�ra
E c c
CA
a
E
LA
c c
Ln
a
m O
f°
C
x CL
m
x
CL
Ln
Q M
O
a
E(U=
E
ami
2 �` ^,
o
L
LM :2,>
ri Y >
ELf)
r-1
CU
>Lo
E
Ln LA
r -I ry
Ln
kD
Lv
rq O c
a.
E
u
p c
a .
E
v
aNi 3
m
>
L� C
O m cH
X
W
L
I-
C
O (D
X
W
L E
_
C
fD
w
r'I
r'I
ri
r•I
N
N
N
N
ri
rel
14
C
C
C
C
m
m
m
m
L
L
L
L
0
w
w
L2
m
m
m
m
E
to
J
_
•E
N
c
CA
:t fC N
c
LA _
c
O
p 2
E a p
E
J
++ CL
>-=
Q 4+ CL
_?
J
d
3
.0
W
Y
Q a
Q cu
N 2 p• a
Y L Q`
a
Y
Q
CC
+L+
C
C
m L
O m
O L
C
2
p N
a
0 *'
a Q *' 4'
N
a
u c
to
O
C
`�
Ln
%L C `~
O = H0
C
m
a
++
a
a
4+ c a r
++
Q
c Q
3
=
O L
3 O O L
=
to
c V1
0
Q
no
0 z o tD
0
2
a x
iil
a
u
C
a
a
oc
50
O
a
4A
m
u
L�}
" w
U
a
Z
U
?
0
0
0
0
0
0
a,
c
a
v
a
0
Ln
Ln
o
o
O
N
Ln
U
4
O
w
w
m
m
m
eM
-1
,q
O
v}
LA
v}
ih
in
v}
V�-
vv
v}
in•
Ln
14
L}�-
n
v
m
I'n
to
L
I
m
E
E
E
E
E
E
E
_
•>
L
ai
L
=
`
LL
IL
LL
LL
LL
LL
LL
O
C
O
z
a+
LA
N
Ln
N
Ln
Ln
LnLon
O
mtO
L
a
L
>
m
14
14
t4
1
In
Le
0
M
.0
vii
v}
v}
>
;j
>
'a
a
s
m
ets
m
m
iv
m
ro
u
u
2
a
3
>
Z
Z
Z
Z
Z
Z
O
O
O
i
r1
-0
r -I
a
CL
C7
m
c
c
c
c
c
c
c
L
L
L
L
L
m
m
m
L
O
L
O
L
O
L
O
L
O
c
c
c
c
c
O
O
O
O
O
4J
r1
GJ r 1
GJ
r1
GJ
r1
C
0
c 0
c
0
c
0
c 0
i
N
` N
L
N
`
N
L N
CL
aC
°ate
0a�
CciL
0
0
0
0
0
o
O
u
u
s
O
N
LA
O
O
LA
LA
N
LA
U
v}
N R
U
'I
Ln
-0
4-
aJ
O+
aJtio
7
to
00
i
N
E
E
E
E
E
E
E
c
•O
>
i
N
LL
LL
LL
LL
LL
LL
4J
w
LL
UL.1
L
a
>
\
\
\
\
\
\
\
4J
i
u +0
L 4+
u
•L
C
f7J
=
O
Ln
O
O
O
O
O
Ln
O
LA
O
Ln
O
Ln
L
v m
y u
fL
++
f-
O
O
n
fl
M
f\
U 2
'O X O
w
�
>
y
M
R*
Rt
M
M
LO
M
t,
U m
C .0 U
to
.0
`
>
v}
An
v?
v}
v}
v}
V?
in
•>i.
C
y
= c
IA
-0
-0
a
w
to
La
ro
m
eo
Lv
ro
aL
i.I L
L
`
L
LL
a
3
M
y
L>
'>
'>
-0a
> c c
w
c
o.
c m
>
>
>
>
>
.
M CL
u ZUCL(Dumu
.
c
5
c
c
c
c
N
N
N
N
N
rl
rl'
rl
ri
rl
C
C
C
ci
C
4�
40
4�
N
4)
GJ
4)
40
N
m
m
Ln
ca
m
4+
u
a
a
-0
3
en
v
ami
v
0
0o
ao
2
++
W
W0
L�
c
C
c
a
p
Ln
o
a o
a�
Q O
Ln Do
CLIA
c
s
cLA
i£
N
do,
o
o=
CD
w
a
,+o+
a
s
0 3
0
0
0
0
o
a, O
c
a, w
0
ar O
3=
Lan
rOo
3 a
��
can
'v
E
LA
Ln
rt
r1
c m
c N
crn
_
c'.
•m
6.
cu
'>
c
vai
'>
L
o
L
Lan
0
0
0
0
E>
E 0
E
Z
=
a
Z
d
2
c
(�
l7
(7
C7
L in
Lu m
L in
0
En
z
0