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Agenda Item #
Memorandum
To: Board of Directors
From: Stephen Hollabaugh-Assistant General Manager
Date: June 14, 2002
Subject: Consideration of adding Well Baby Care Coverage to the District's
Medical Insurance Program —Workshop
It has come to the Districts attention that our current medical plan does not include'Well Baby
Care Coverage". Some of our younger employees have young children and have inquired
about this coverage. The coverage offered through our current plan is described on the attached
ElectREChoice handbook on page 13, which is attached to this memo.
In summary, the coverage covers 20 physicians'visits from birth through age 20 (or through 18 if
not a full time student). Each physician exam is covered at 100 percent of reasonable and
customary charges up to$90 per exam, and immunizations are covered at 100 percent with a
limit of$500 per year. The annual deductible does not apply to this benefit.
The District has tried to hire qualified individuals and many of these employees are in their child
raising years. The out of pocket expense for immunizations of small children can add up quickly
for a young family.
The District currently has about six employees with very young children. It is assumed that most
of the need for this kind of coverage is when children are very young(the first six years)and
immunizations are on a schedule during these years.
I have requested a quote from NRECA of what adding this coverage to our medical plan will cost
the District but have not received it as of the time the Board packets were going out. I will bring
that information to the Board meeting for discussion.
If the Board were to agree to fund such coverage, a discussion as to the economics of
funding this through NRECA or self-funding this benefit through the District would be
appropriate.
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NEEMENEEMEN102=0
The following chart summarizes mental health and substance abuse coverage under the indemnity structure
of ElectREChoice:
r
Gninsurance Maximum-Benefr £oInsurance,. RilaxI UM SetaeliE:. .
Charges are subject to deductible.
ISSUES FOR DECISION MAKERS
YOUR CO-OWS CHOICES
N Is your current level of mental health coverage
adequate?
t
' It Does your benefits philosophy support a change ;
in this type of coverage?
® Would you be able to provide mental health and
substance abuse coverage through a local
group of providers such as an employee assis-
tance program?
I PREVENTIVE MEDICAL CARE
�f
With preventive medical care, conditions detectedu&� ,
early can usually be treated with less medical
intervention and at a lower cost than later serious WELL-CHILD CARE VISITS THROUGH AGE 20
conditions. ElectREChoice offers: Significantly enhanced from the previous well baby
care option, this covers 20 physicians' visits from
III Well-child care, birth through age 20 (or through age 18 if not a full-
® Adult immunizations,and time student). Each physician exam is covered at
100 percent of reasonable and customary charges
' Physical exams for the employee and the up to $90 per exam, and immunizations are covered
employee's spouse. at 100 percent with a limit of$500 per year. The
annual deductible does not apply to this benefit.
' Please note: a special immunization, called Synagis,
which is occasionally given to premature babies, is
' not included in this benefit. Synagis is not included in
the American Academy of Pediatrics' Recom-
mended Childhood Immunization schedule.
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