Insurance Coverage and Employee Benefits Survey September 2010

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1 Insurance Coverage and Employee Benefits Survey September 2010

2 ACKNOWLEDGEMENT The VEA acknowledges the valuable assistance given by division superintendents and staff. Their replies to VEA questionnaires make many of our research studies possible. PROJECT TEAM Carol Donohue Linda Shotwell Copyright 2010 by Virginia Education Association, Incorporated Price of Report: $5.00 plus 5% sales tax per copy No charge for single copies to individual VEA members. No charge for first 5 copies ordered by a local association. VEA member discount: copies, 10%; copies, 15%; 100 or more copies, 20%. No discount to nonmembers. Payment must accompany all orders. Order from the Virginia Education Association, 116 South Third Street, Richmond, VA

3 Insurance Coverage and Employee Benefits Survey September 2010

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5 Table of Contents Page Introduction... 1 Narrative Health Insurance Coverage Health Insurance Carrier/Plan Information... 2 Policy Provisions... 2 Teachers Enrolled in Health Insurance Plans... 3 Health Insurance Annual Premium Costs... 4 Narrative Other Insurance Coverage Stand Alone Dental and Vision Insurance Policies... 7 Disability and Other Insurance... 8 Insurance Coverage for Teachers on Official Leave and for Retired Teachers... 8 Local Retirement Plans and Flexible Spending Accounts... 8 Suggested Guidelines for Insurance Glossary of Terms Tables Health Insurance Coverage Table 1: Health Insurance Carrier/Plan Information Table 2: Policy Provisions Table 3: Teachers Enrolled in Health Insurance Plans Table 4(a): Health Insurance Annual Premium Costs (Emp. Only, Emp. & One, Emp. & Spouse, Family) Table 4(b): Health Insurance Annual Premium Costs (Employee & Children) Tables Other Insurance Table 5(a): Stand Alone Dental Insurance Coverage (Emp. Only, Emp. & One, Emp. & Spouse, Family) Table 5(b): Stand Alone Dental Insurance Coverage (Employee & Children) Table 6(a): Stand Alone Vision Insurance Coverage (Emp. Only, Emp. & One, Emp. & Spouse, Family) Table 6(b): Stand Alone Vision Insurance Coverage (Employee & Children) Table 7: Disability and Other Insurance Coverage Offered and Division Contributions Table 8: Insurance Coverage Available for Teachers on Official Leave Table 9: Health Insurance Coverage for Retired Teachers Table 10: Local Retirement Defined Benefit Plans and Tax Sheltered Annuities Table 11: Early Retirement Incentive Plans and Flexible Benefit Plans Table 12: Flexible Benefit Plans... 63

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7 Insurance and Benefits Introduction The Insurance Coverage and Employee Benefits Survey displays data about employee benefits in Virginia public schools for The variety of the fringe benefits offered is diverse across the Commonwealth. All school divisions provide health insurance, including prescription drug benefits, to teachers. The graph below shows the most commonly offered benefits, excluding the universally offered health insurance and the number of local school divisions offering each benefit. Localities and Benefits Flexible Spending Stand-alone Dental Disability Ins. Early Retirement Surveys were completed by 125 of Virginia s 132 school divisions and the data in this report were compiled from those surveys. The report is organized into two sections. A narrative is in section one. The second section shows detailed tables on health insurance and other kinds of coverage. The comment sections of some tables contain qualifications or additional information given by localities. VEA edits comments for clarity and space limitations. Virginia Education Association 1

8 Health Insurance Coverage Health Insurance Carrier/Plan Information Table 1 (Pages 13-17) shows the name of the insurance company plan selected by the majority of participants as well as the type of plan. Anthem is the primary carrier for most of the school divisions in the state. About 72% or 90 of 125 reporting school divisions have an Anthem plan. The majority of school divisions have most employees enrolled in a PPO plan (73 of 125 reporting divisions). Other services included in the plan such as prescriptions, dental care and vision care are shown. Most localities use just school employees experience in their insurance plan (81 or 65%). One hundred twenty-five plans include prescription coverage as part of their health insurance premium. Dental health insurance coverage is available under the primary carrier for 45 plans. Many others provide a stand-alone plan. Vision coverage is available under the primary carrier for 118 plans. Some localities offer stand-alone vision coverage. Policy Provisions Policy provisions for the health insurance plan chosen by the majority of teachers in each school division are presented in Table 2 (Pages 18-23). The table shows deductibles for individual and family policies, the stop-loss amount for individual and family policies, HMO/PPO cost per visit, the maximum amount allowed for major medical care, the co-insurance percentage, and whether or not the policy requires pre-authorization. Individual deductibles range from $100 to $3,000, with an average deductible amount of $434 for the 67 school divisions that reported a deductible (fifty-eight divisions reported their plans had no deductible). Family deductibles range from $150 to $6,000, with an average deductible amount of $941 for the 67 school divisions that reported a deductible. Stop-Loss amounts range from $500 for Employee Only in Fairfax to $10,000 for Family coverage in Pittsylvania and Pulaski. One hundred fifteen of respondents have a stop loss provision. Virginia Education Association 2

9 Most school divisions 89% or 111 divisions - have no maximum on medical benefits. The 13 localities that do report a maximum most often have a cap of $1 million. One locality did not respond to the question. Office Visit costs ranged from $0 to $50, with a $15 (Primary Care Physician) to $40 (Specialist) co-pay being the most common. Most school division health plans (121) call for a co-pay. Eighty-four divisions require co-insurance for visits with most (61) at an level. A second opinion is required for only three policies; however 89 require pre-authorization. Teachers Enrolled in Health Insurance Plans Table 3 (Pages 24-26) shows the number of full-time equivalent teachers who are eligible to enroll in all health insurance plans, the number actually enrolled in these health insurance plans, and the percentage of those eligible who are enrolled. Caution should be used when interpreting these data; in some instances, the number of teachers reported by local school divisions as eligible or participating in available health insurance plans may include other school employees or retirees in addition to teachers. All localities have at least 1/3 of eligible teachers participating in an available health care plan. Participation rates of 90% or higher can be found in 7 localities. On average, about 76% of eligible employees are enrolled in each locality. Virginia Education Association 3

10 Health Insurance Annual Premium Costs The graph below shows the average total cost of health insurance over the past five years. The cost of coverage has increased about 25% between and Coverage for employee-only increased $950 from an average of $4,684 a year to $5,634, while Family premiums have gone up $2,733 from $12,344 to $15, Average Total Cost of Health Insurance Employee Only Employee + One Employee + Spouse Family Tables 4(a) and 4(b) (Pages 27-34) show the total cost of the premium and the amount paid by the school board. In Table 4(a), the data are shown for Employee Only, Employee and One Dependent, Employee and Spouse, and Family. Table 4(b) gives the information for the school divisions offering an Employee and Children rate. School Boards pay a larger percentage of the total costs for Employee-Only coverage; on average, School Divisions pay 88% of the cost. Sixteen school divisions or 13% cover all of the cost of employee only insurance. The average employer pick-up of costs for Family coverage is just over 50%, with employees picking up an average cost of $7,334. Out-of-pocket premium costs vary dramatically across localities and across coverage types. The premium percentage paid by localities ranges from 19% to 100% depending on the type of coverage. Virginia Education Association 4

11 The chart below gives summary information on total cost for health insurance premiums in Description Total Premium Employee Only Minimum 3,174 Maximum 7,795 Average 5,634 Employee and One Dependent Minimum 5,294 Maximum 13,542 Average 9,275 Employee and Spouse Minimum 6,665 Maximum 15,848 Average 11,003 Family Minimum 9,241 Maximum 22,822 Average 15,077 Teachers who pay part of the premiums pay between $12 and $3,018 annually for Employee Only plans. The average total cost of Employee Only plans is $5,634; the teacher s share of the premium, on average, is $715 of the total cost. Total Employee Only premium costs in ranged from $3,174 to $7,795 Virginia Education Association 5

12 The teachers share of annual costs for Employee plus One Dependent plans is between $360 and $7,320. The average total cost of Employee and One Dependent plan is $9,275; the teacher average share is $3,242 (35%). The maximum total cost for this coverage is $13,542 and the minimum is $5,294. The teachers cost is between $181 and $9,260 for Employee and Spouse plans. On average, teachers pay $4,629. The average total cost of Employee and Spouse plans is $11,003, ranging from $6,665 to $15,848. The out of pocket cost to teachers is between $275 and $13,809 for Family plans. The average cost to the teacher for Family plans is about $7,338 or about half of the total average cost. The total cost for Family coverage ranges from $9,241 to $22,822. The average of the family plan is $15,077. Employees Average Out-of-Pocket Costs for Health Insurance Premiums 10,000 6,338 6,539 6,720 6,884 7,338 2,855 3,988 2,867 4,166 2, ,022 4,373 3,242 4,629 5, Employee Only Emp. + One Emp. + Spouse Family 0 About 74% or 92 local school divisions reported a separate category of Employee and Children for health insurance premiums. These localities are shown in Table 4(b). Health insurance costs take a large bite out of educator s paychecks. In many localities, the salary of a ten-year teacher who pays for family coverage is considerably less after this deduction than the pay of a starting teacher. Virginia Education Association 6

13 In Lunenburg, as one example, a starting teacher in made $36,129. The teacher s share of the health insurance costs (Employee Only coverage) took $1,366 from the paycheck, leaving $34,763 after the health insurance costs. Veteran teachers making $39,455 (ten years experience) paying their share of family insurance premiums of $10,656, netted, after that deduction, less than $29,000. Health insurance costs can significantly reduce the salary of experienced teachers. In 94 of the 125 school divisions in the state that reported, teachers with ten years on the job make less, after the health insurance deduction, than do beginning educators. Other Insurance Coverage Additional insurance coverage is available to some school division employees. Other insurance offered includes coverage for such things as disabilities, dental and vision care, inpatient hospital payments, and cancer insurance. Stand Alone Dental and Vision Insurance Policies Dental and vision insurance are offered separately from health insurance in many jurisdictions (Tables 5 and 6, Pages 35-42). Dental insurance as a separate product is offered by about 75% or 90 localities; stand alone vision insurance is less common, offered by only 18% or 22 school divisions. Of the 90 school divisions with stand alone dental coverage available, the cost is borne completely by the employee in over half of the jurisdictions (53). The provisions in the dental insurance plans (Table 5, pages 35-39) vary significantly from place to place as do premiums, which range from $155 to $1,576 depending on the locality and type of coverage. Thirteen school divisions provide 100% of the Employee Only cost. Eighteen school divisions contribute a set amount regardless of the type of coverage. Table 6 (Page 40) shows stand alone vision coverage that is available to school division employees as reported by 22 school divisions. Although the school divisions make these policies available, only one school division pays any portion of any type of plan. Costs for Employee Only coverage range from $57 to $171. Family plans range from $141 to $392 a year. Virginia Education Association 7

14 Disability and Other Insurance School divisions offer other kinds of insurance to educators. Table 7 (Pages 43-47) gives information on other types of insurance. Ninety-three localities offer disability insurance. Other insurances shown in Table 7 include long term care, cancer, and accident insurance plans. Insurance Coverage for Teachers on Official Leave and for Retired Teachers On Leave Many school divisions allow teachers on official leave to continue in their group insurance plans. Table 8 (Pages 48-52) shows Life, Health, and Income Protection plans that may be continued. Special conditions may apply. Retirees Similarly, many school divisions allow teachers who have retired from the school division to continue in the health insurance plans in which they were enrolled. Table 9 (Pages 53-58) displays insurance coverage information for retired teachers. Again, certain conditions may apply. The table shows the period of time that retired teachers may remain in the group health insurance plan beyond the required eighteen-month COBRA period, as well as cost information. Forty-six school divisions participate in the payment of health insurance premiums for retired teachers. Their contribution ranges from $120 to $7,045 annually. Table 9 also gives additional details on insurance for retirees. Local Retirement Plans and Flexible Spending Accounts There are other benefit programs in place for teachers in many local school divisions. Local retirement options, early retirement plans, and flexible spending accounts are fairly common offerings. Teachers in all Virginia school divisions participate in the Virginia Retirement System, a Defined Benefit Program. Table 10 (Page 59) shows local school divisions with a locally-provided Defined Benefit Plan for retired teachers, as well as Tax Sheltered Annuities (TSA) and the amount the locality contributes to the TSA. Five localities reported that they had a local defined benefit retirement program. All school divisions have a TSA available to Virginia Education Association 8

15 staff; fourteen report a local contribution to this retirement option. Contributions are sometimes dollar amounts and sometimes a percentage of salary. Tables 11 and 12 (Pages 60-65) show the availability of the Early Retirement Incentive Plan (ERIP) and Flexible Benefit Plans. Both benefits are available in many localities. ERIP plans are available in 49 localities. Health care flexible spending accounts are available in 112 localities. Dependent care flexible spending accounts are available in 101 localities. Conclusion Health Care costs continue to climb for educators in the State and for everyone across the nation. some guidelines regarding health insurance and other benefits that are summarized on page 10. VEA has Virginia Education Association 9

16 Suggested Guidelines for Insurance Association representatives should be included on health insurance committees that develop and evaluate proposals from health care vendors. The Association should be represented on any committee looking at methods of controlling costs or enhancing services including regional coalitions, tiered prescription plans, health management programs, wellness programs, and cafeteria-style benefit plans. The Association should analyze trend information on claims experience and other relevant data for each school division health insurance renewal. Associations should work to ensure that health insurance plans don t impose large out-of-pocket costs for employees through unreasonable cost shifting mechanisms such as deductions, co-pays or stop-loss provisions. Associations should study the advantages and disadvantages of alternatives for controlling health care costs: pharmacy benefits managers; prescription drug audits; health savings accounts; regional consortia; the State s Local Choice Plans, etc. All School Divisions should make available group insurance plans for health insurance, dental insurance, vision and disability insurance to employees and their family members and should contribute to the premiums for these plans. The School Division s percentage share of health premiums should never decrease. School Divisions should pay 100% of the costs of Employee-Only health coverage for health and dental care and should contribute at least 70% of the costs for other health insurance options: employee and spouse; employee and dependents; and family. School Division retirees should remain eligible for the group health insurance plan at least until the retiree is eligible for Medicare coverage. School Divisions should contribute to the cost of the health insurance premium for retirees. Health insurance plans should have an unlimited lifetime maximum. All School Divisions should offer flexible benefit plans for health care premiums to its employees. Virginia Education Association 10

17 Glossary of Terms COBRA - The Consolidated Omnibus Reconciliation Act (COBRA) requires employers with 20 or more employees to continue to offer coverage in their group health plan to former employees, retirees, spouses, and dependent children. The time frame that coverage is required to be offered ranges from 18 to 36 months depending upon the circumstances. Co-insurance - The amount you are required to pay for medical care in an indemnity plan or preferred provider organization (PPO) after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent. Co-pay - A cost sharing arrangement in which a person pays a specific charge for a specific medical service -- $10 for an office visit or $5 for a prescription. Deductible - The amount of money you must pay up front each year to cover your medical expenses before your insurance starts paying. Defined Benefit Retirement Plan - This retirement plan guarantees a certain level of retirement income based on years of service and salary level. The employer invests the funds usually through a trust. Defined Contribution Plan - This retirement plan has investments managed by the employee and the employer provides a contribution. Disability Insurance or Income Protection - Short-term disability income insurance provides a benefit of a percent of income for a short disability or for the first part of a long disability. Long-term disability income insurance provides disability income benefits that begin at the end of a waiting period and continue until the person returns to work, dies, or becomes eligible for pension benefits. Early Retirement Incentive Plans - ERIPs provide incentive payments to early retirees. The payments are usually spread over several years in return for some amount of continuing consultant work by the retiree. Flexible Benefit Plans - Flexible Benefit Plans are employer programs that allow employees to use before-tax dollars to pay for many regular family expenses. The money employees contribute to the Plan is not subject to Federal and State Withholding Taxes or Social Security and Medicare contributions. Tax-free expenses which can be paid through a Flexible Benefit Plan include: Child/Dependent care expenses necessary to employment ($5,000 maximum per family per year) Out-of pocket medical, dental, and vision expenses, including insurance premiums if employee paid Employee-paid disability insurance premiums Employee-paid term life insurance premiums up to $50,000 in death benefit After-tax choices may also be offered on a voluntary basis such as long-term care insurance, group auto, home owners and rental insurance and Pre-Paid Legal Services Virginia Education Association 11

18 Health Insurance Plans - Health Insurance plans range from indemnity (or fee-for-service) to health maintenance organizations. Indemnity plans are the most expensive, least restrictive insurance. Indemnity or Fee-for-Service Any provider, any time Deductible - $ Insurance pays a percent, once deductible is met, of usual and customary charges Usually (80:20 or 70:30) The percent left for you to pay is co-insurance Some have lifetime limits Preferred Provider - PPO Any provider, but less costly within PPO network Co-pays and percentage coverage with a greater percentage covered in network Point of Service - POS Primary Care Physician (PCP) but access to other doctors is covered at a lesser amount PCP visits usually require only a co-pay PPO visits require co pay and co-insurance Outside network, co pay and higher co-insurance Health Maintenance Organization - HMO Primary Care Physician directs to other services Set monthly fees Preauthorization - A cost containment feature of many group insurance policies where the insured must contact the insurer or primary care physician prior to a hospitalization or surgery and receive authorization for the service. Stop-loss provision - A health insurance policy provision specifying that the insurer will pay 100 percent of the insured's eligible medical expenses after the insured has incurred a specified amount of out-of-pocket expenses under the co-insurance feature. Tax-Sheltered Annuities - Tax-advantaged retirement savings programs designed primarily for employees of educational organizations. The employee's eligible contributions, made through salary reduction agreements, are sheltered from Federal and State income taxes (but not Social Security taxes) until an annuity is received or the contributions are withdrawn. Virginia Education Association 12

19 Table 1: Health Insurance Carrier/Plan Information Majority of Employees Participate in: Primary Carrier Plan Type Other Coverage Included under Policy R Card Dental Vision Policy Renewal Date Claims experience based on: Accomack United Healthcare Choice/Choice Plus HMO Albemarle Southern Health Point of Service POS 10/10 School and Local Gov't Employees Alexandria United Healthcare Choice(HMO) HMO 07/10 School Employees Only Alleghany Anthem KeyCare 20 PPO 06/10 School Employees Only Amelia Amherst Anthem KeyCare 30/300 PPO Appomattox Anthem KeyCare 500 PPO 10/10 School and Local Gov't Employees Arlington Kaiser Permanente HMO HMO 01/11 School Employees Only Augusta Southern Health VirginiaValue POS 01/11 Other Bath United Healthcare Virginia - Choice Plus PPO 07/10 School and Local Gov't Employees Bedford County/City Piedmont Community Health Plan $1500 deductible PPO 07/10 School Employees Only Bland Anthem KeyCare 15 PPO 07/10 School Employees Only Botetourt Anthem Blue Cross Blue Shield KeyCare 200 PPO Bristol United Healthcare of River Valley POS POS 07/10 School and Local Gov't Employees Brunswick Anthem - The Local Choice Key Advantage 500 PPO 10/10 Virginia Local Choice Plan Buchanan Buckingham Southern Health pos2000 POS Buena Vista Anthem Local Choice PPO 10/10 Virginia Local Choice Plan Campbell Anthem KeyCare 300 PPO Caroline CIGNA Open Access Plus In Network HMO Carroll Anthem Blue Cross Blue Shield The Local Choice PPO 10/10 Virginia Local Choice Plan Charles City Anthem HealthKeepers 15 HMO Charlotte Anthem HealthKeepers HMO 05/10 School Employees Only Charlottesville Anthem KeyCare15 PPO 07/10 School Employees Only Chesapeake Anthem Blue Cross Blue Shield PPO PPO Chesterfield Anthem HealthKeepers 15 HMO 01/11 School and Local Gov't Employees Clarke Anthem BCBS - The Local Choice Key Advantage 300 PPO 07/10 School and Local Gov't Employees Colonial Beach Anthem Blue Cross Blue Shield KeyCare 25 PPO 10/10 * School Employees Only Colonial Heights Anthem HealthKeepers 10 Open Access HMO 07/10 School Employees Only Covington Anthem - The Local Choice Key Advantage Expanded PPO 07/10 Virginia Local Choice Plan Virginia Education Association 13

20 Table 1: Health Insurance Carrier/Plan Information Majority of Employees Participate in: Primary Carrier Plan Type Other Coverage Included under Policy R Card Dental Vision Policy Renewal Date Claims experience based on: Craig Anthem Key Advantage Expanded PPO Culpeper Anthem Blue Cross Blue Shield HealthKeepers 15 HMO 10/11 School and Local Gov't Employees Cumberland Anthem Blue Cross Blue Shield HealthKeepers HMO 10/10 School and Local Gov't Employees Danville Anthem KeyCare 500 PPO Dickenson Anthem KeyCare 300 PPO 09/10 School Employees Only Dinwiddie Anthem HealthKeepers Open Access 25 HMO Essex Fairfax County/City CareFirst BCBS Blue Preferred PPO PPO 01/11 School Employees Only Falls Church United HealthCare Choice Plus PPO 07/10 Other Fauquier Anthem KeyCare 10 PPO 07/10 School and Local Gov't Employees Floyd Anthem Blue Cross Blue Shield PPO KeyCare 20 PPO Fluvanna Southern Health Point of Service POS 10/10 School and Local Gov't Employees Franklin City Anthem Blue Cross Blue Shield Key Advantage Expanded PPO 10/10 Virginia Local Choice Franklin County Anthem Blue Cross/Blue Shield KeyCare 500 PPO Frederick Anthem KeyCare 15+ PPO Fredericksburg Anthem Blue Cross Blue Shield Key Advantage Expanded PPO 07/10 School Employees Only Galax Anthem KeyCare 20 PPO Giles Anthem BCBS - The Local Choice Key Advantage 300/ Key Advantage Expanded PPO 07/11 Virginia Local Choice Plan Gloucester Anthem HealthKeepers HMO Goochland Anthem HealthKeepers 20 HMO Grayson Primary PhysicianCare High Plan PPO 11/10 School Employees Only Greene Optima POS POS Greensville Anthem - The Local Choice Key Advantage Expanded PPO 10/10 Virginia Local Choice Plan Halifax Anthem KeyCare 300 PPO Hampton Anthem KeyCare PPO Hanover Southern Health Care POS POS 10/10 School and Local Gov't Employees Harrisonburg Anthem KeyCare 20+ PPO 07/10 School Employees Only Henrico Southern Health Care HMO HMO 01/11 Other Henry Anthem KeyCare PPO 07/10 School and Local Gov't Employees Virginia Education Association 14

21 Table 1: Health Insurance Carrier/Plan Information Majority of Employees Participate in: Primary Carrier Plan Type Other Coverage Included under Policy R Card Dental Vision Policy Renewal Date Claims experience based on: Highland Anthem KeyCare 30 PPO 07/10 School Employees Only Hopewell United Healthcare Choice HMO 07/10 School Employees Only Isle of Wight King George United Healthcare 2V-B HMO 07/10 School Employees Only King Queen Optima Health Vantage HMO King William Anthem HealthKeepers HMO Lancaster Optima Health HMO HMO Lee Lexington Anthem Key Advantage PPO 07/10 School and Local Gov't Employees Loudoun CIGNA Healthcare Point of Service POS 01/11 School and Local Gov't Employees Louisa Coventry Plan 2 (500) PPO 07/10 School and Local Gov't Employees Lunenburg Anthem - The Local Choice Key Advantage Expanded PPO 10/10 Virginia Local Choice Plan Lynchburg Piedmont Community Health Plan $400 deductible High Option PPO Madison Southern Health $500 Deductible HMO HMO 10/10 School and Local Gov't Employees Manassas City Anthem - The Local Choice Key Advantage Expanded PPO 07/10 Virginia Local Choice Plan Manassas Park Anthem Key Advantage Expanded PPO 07/10 Virginia Local Choice Plan Martinsville Anthem Blue Cross Blue Shield Lumenos Consumer Drive Health Plan with HSA PPO 07/10 School and Local Gov't Employees Mathews Anthem HealthKeepers HMO Mecklenburg Anthem HealthKeepers HMO 07/10 School Employees Only Middlesex Anthem HealthKeepers 15 HMO Montgomery Anthem Blue Cross Blue Shield PPO PPO Nelson Anthem Key Advantage Expanded PPO 10/10 Virginia Local Choice Plan New Kent United Healthcare Standard Choice HMO HMO Newport News Anthem HealthKeepers HMO Norfolk Northampton Anthem KeyCare 20 PPO Northumberland Anthem Blue Cross/Blue Shield Local Choice POS 07/10 Virginia Local Choice Plan Norton Anthem - The Local Choice Key Advantage Expanded PPO 10/10 Virginia Local Choice Plan Nottoway Anthem HealthKeepers HMO 07/10 School Employees Only Virginia Education Association 15

22 Table 1: Health Insurance Carrier/Plan Information Majority of Employees Participate in: Primary Carrier Plan Type Other Coverage Included under Policy R Card Dental Vision Policy Renewal Date Claims experience based on: Orange Anthem HealthKeepers Open Access HMO 10/10 School and Local Gov't Employees Page Anthem KeyCare 10+ PPO Patrick Gateway Primary Physician Care HMO 10/10 School and Local Gov't Employees Petersburg Anthem HealthKeepers HMO Pittsylvania Anthem KeyCare PPO Poquoson Optima Health Optima 10/20 HMO Portsmouth Optima Health HMO HMO 07/10 School Employees Only Powhatan Anthem - The Local Choice Key Advantage Expanded PPO 07/10 Virginia Local Choice Plan Prince Edward Anthem Key Advantage 200 PPO Prince George Anthem HealthKeepers HMO 07/10 School and Local Gov't Employees Prince William Anthem Blue Cross Blue Shield KeyCare Enhanced PPO PPO 07/10 School Employees Only Pulaski Anthem Blue Cross/Blue Shield Lumenos QHDHP POS 07/10 School Employees Only Radford Anthem Key Advantage Expanded PPO 07/10 Virginia Local Choice Plan Rappahannock Anthem KeyCare200 PPO Richmond City Anthem POS OA 20 POS 07/10 School Employees Only Richmond County Peninsula Health Care Product 25 - Open Access HMO Roanoke City United Healthcare Traditional PPO - Wellness Compliant PPO 01/11 School Employees Only Roanoke County Anthem KeyCare PPO 07/10 School Employees Only Rockbridge Anthem KeyCare 25 PPO 07/10 School Employees Only Rockingham Southern Health Point of Service POS 10/10 School and Local Gov't Employees Russell Salem Anthem KeyCare 20 PPO 10/10 School and Local Gov't Employees Scott Anthem KeyCare 20 PPO 07/10 School Employees Only Shenandoah Anthem - The Local Choice Key Advantage 200 PPO 07/10 School Employees Only Smyth Anthem - The Local Choice Key Advantage Expanded PPO 10/10 Virginia Local Choice Plan Southampton Anthem Key Advantage PPO 07/10 School Employees Only Spotsylvania Anthem - The Local Choice Key Advantage Expanded PPO 10/11 School Employees Only Stafford Anthem Blue Cross Blue Shield KeyCare 100 PPO 07/10 School Employees Only Staunton Southern Health VirginiaValue POS 01/11 School Employees Only Virginia Education Association 16

23 Table 1: Health Insurance Carrier/Plan Information Majority of Employees Participate in: Primary Carrier Plan Type Other Coverage Included under Policy R Card Dental Vision Policy Renewal Date Claims experience based on: Suffolk Anthem HealthKeepers 10 HMO Surry Anthem - The Local Choice Key Advantage Expanded PPO 10/10 Virginia Local Choice Plan Sussex Anthem HealthKeepers HMO Tazewell Anthem BCBS - The Local Choice Key Advantage 300 Other Virginia Beach Optima Health HMO HMO 01/11 School and Local Gov't Employees Warren Anthem KeyCare 20 PPO Washington Anthem KeyCare 200 PPO Waynesboro Southern Health Point of Service POS 01/11 School Employees Only West Point Anthem HMO HMO 03/11 School Employees Only Westmoreland Anthem BCBS - The Local Choice Key Advantage 500 PPO Williamsburg/JCC Anthem - The Local Choice Key Advantage 200 PPO 10/10 Virginia Local Choice Plan Winchester Anthem Blue Cross Blue Shield KeyCare 500 PPO 07/10 School Employees Only Wise Anthem Key Advantage 200 PPO 07/10 School Employees Only Wythe Anthem KeyCare 20 PPO York Anthem Blue Cross Blue Shield of Virginia KeyCare 300 PPO PPO Count Virginia Education Association 17

24 Table 2: Policy Provisions (In-Network where applicable) Individual Family Cost per Visit Major Medical Stop-Loss $ $ $ $ $ $ $ % Deductible Stop-Loss Deductible Stop-Loss PCP* Specialist Maximum Co-Insurance Accomack 500 2,500 1,000 5, Unlimited Second Opinion Policy Requires: Pre- Authorization Albemarle 0 1, , $2 million 100/None ** Alexandria 0 2, , Unlimited 100/None Alleghany 0 3, , Unlimited Amelia Amherst 300 2, , Unlimited ** Appomattox 500 2,500 1,000 5,000 ** ** Unlimited ** Arlington Unlimited 100/None Augusta 250 2, , Unlimited Bath Unlimited Bedford County/City 1,500 2,000 3,000 4, $2 million 100/None Bland 0 2, , Unlimited Botetourt 200 2, , ** Unlimited Bristol 250 2, , Unlimited 100/None Brunswick 500 3,000 1,500 9, Unlimited 70/30 Buchanan Buckingham 2,000 4,500 4,000 9, Unlimited Buena Vista 200 1, , Unlimited Campbell Unlimited Caroline 0 1, , $1 million 100/None Carroll 100 1, , Unlimited 90/10 Charles City 0 2, , Unlimited 100/None ** Charlotte 0 2, , Unlimited Charlottesville 0 2, , Unlimited ** Chesapeake 0 1, , Unlimited 90/10 Virginia Education Association 18 17

25 Table 2: Policy Provisions (In-Network where applicable) Individual Family Cost per Visit Major Medical Stop-Loss $ $ $ $ $ $ $ % Deductible Stop-Loss Deductible Stop-Loss PCP* Specialist Maximum Co-Insurance Chesterfield Unlimited 100/None Second Opinion Policy Requires: Pre- Authorization Clarke 300 2, , Unlimited Colonial Beach 500 3,750 1,000 7, Unlimited Colonial Heights 0 1, , Unlimited 100/None Covington 100 1, , Unlimited 90/10 Craig 200 2, , Unlimited Culpeper 0 2, , Unlimited 100/None Cumberland 0 2, , Unlimited 100/None Danville 500 2,500 1,000 5, Unlimited Dickenson 300 3, , Unlimited Dinwiddie 0 3, , Unlimited 100/None Essex Fairfax County/City , Unlimited 90/10 Falls Church 0 1, , Unlimited 100/None Fauquier 0 1, , Unlimited 90/10 Floyd 0 3, , Unlimited Fluvanna 0 2, , Unlimited 100/None Franklin City 100 1, , Unlimited 90/10 Franklin County 500 2,500 1,000 5, Unlimited Frederick 0 2, , Unlimited ** Fredericksburg 100 1, , Unlimited ** Galax 0 3, , Unlimited ** Giles 300 3, , Unlimited Gloucester 0 1, , Unlimited 100/None Goochland 0 2, , Unlimited Virginia Education Association 19 18

26 Table 2: Policy Provisions (In-Network where applicable) Individual Family Cost per Visit Major Medical Stop-Loss $ $ $ $ $ $ $ % Deductible Stop-Loss Deductible Stop-Loss PCP* Specialist Maximum Co-Insurance Grayson 0 3, , Other Second Opinion Policy Requires: Pre- Authorization Greene 750 4,000 1,500 8, Unlimited Greensville Unlimited 100/None Halifax 300 2, , Unlimited Hampton 0 1, , Unlimited 100/None Hanover 0 2, , Unlimited 100/None Harrisonburg 0 3, , Unlimited ** Henrico 150 2, , Unlimited 100/None ** Henry 0 3, , Other Highland 1, , Unlimited Hopewell 0 1, , Unlimited 100/None Isle of Wight King George 0 1, , Unlimited 100/None King Queen 1,000 3,500 2,000 7, Unlimited 70/30 King William 0 3, , Unlimited 100/None Lancaster 500 3,500 1,000 7, Unlimited 70/30 Lee Lexington 100 1, , Unlimited Varies Loudoun 500 2,500 1,500 5, Unlimited Louisa 500 2,500 1,000 5, Unlimited ** Lunenburg Unlimited 90/10 Lynchburg 400 1, , $1 million Madison 500 3,500 1,000 7, Unlimited Manassas City 100 1, , Unlimited Other ** Manassas Park 100 1, , Unlimited 90/10 Virginia Education Association 20 19

27 Table 2: Policy Provisions (In-Network where applicable) Individual Family Cost per Visit Major Medical Stop-Loss $ $ $ $ $ $ $ % Deductible Stop-Loss Deductible Stop-Loss PCP* Specialist Maximum Co-Insurance Martinsville 3,000 ** 3,000 6,000 ** 6,000 0 ** 0 ** Unlimited 100/None Second Opinion Policy Requires: Pre- Authorization Mathews 0 3, , Unlimited 100/None Mecklenburg 0 2, , Unlimited Other ** Middlesex Unlimited 100/None Montgomery 0 1, , Unlimited 100/None ** Nelson 100 1, , Unlimited Other ** New Kent 0 2, , Unlimited 100/None Newport News 0 1, , Unlimited 100/None Norfolk Northampton 0 3, , Northumberland 250 2, , Unlimited Norton Unlimited 90/10 Nottoway 0 2, , Unlimited 90/10 ** Orange 0 2, , Unlimited Page 0 1, , Unlimited 100/None Patrick 2,000 6,000 4,000 9, ** $1 million Petersburg 0 3, , Unlimited 100/None Pittsylvania 1,000 5,000 2,000 10, $1 million Poquoson 0 1, , Unlimited 100/None Portsmouth 0 1, , Unlimited 100/None Powhatan 100 1, , Unlimited 90/10 ** Prince Edward 200 1, , Unlimited Prince George 0 2, , Unlimited 100/None Prince William 300 ** 3, ** 6, Unlimited 70/30 ** Pulaski 1,250 5,000 2,500 10,000 ** ** Unlimited Virginia Education Association 21 20

28 Table 2: Policy Provisions (In-Network where applicable) Individual Family Cost per Visit Major Medical Stop-Loss $ $ $ $ $ $ $ % Deductible Stop-Loss Deductible Stop-Loss PCP* Specialist Maximum Co-Insurance Radford 100 1, , Unlimited Second Opinion Policy Requires: Pre- Authorization Rappahannock 200 1, , Unlimited Richmond City 0 1, , Unlimited 100/None Richmond County 0 3, , Unlimited 100/None Roanoke City 500 2,000 1,000 4, Other Roanoke County 0 3, , Unlimited Rockbridge 500 2,500 1,000 5, Unlimited Rockingham 500 3,000 1,000 6, $1 million 100/None Russell Salem 100 2, , ** Unlimited ** Scott 0 3, , $1 million Shenandoah 200 1, , ** 35 ** Unlimited Smyth Unlimited Southampton 100 ** 1, ** 3, Unlimited Other ** ** Spotsylvania 100 1, , Unlimited Other ** Stafford 100 ** 1, ** 2,000 ** ** Unlimited ** ** Staunton 250 2, , Unlimited Suffolk 0 1, , Unlimited 100/None Surry 0 1, , Unlimited 100/None Sussex 0 2, , Unlimited 100/None Tazewell 300 2, , Unlimited ** Virginia Beach 100 1, , Other 100/None Warren 0 4, , Unlimited Washington 200 1, , Unlimited 90/10 Waynesboro 250 2, , Unlimited Virginia Education Association 22 21

29 Table 2: Policy Provisions (In-Network where applicable) Individual Family Cost per Visit Major Medical Stop-Loss $ $ $ $ $ $ $ % Deductible Stop-Loss Deductible Stop-Loss PCP* Specialist Maximum Co-Insurance West Point 0 2, , $1 million 100/None Second Opinion Policy Requires: Pre- Authorization Westmoreland 500 3,000 1,500 9, Unlimited Williamsburg/JCC 200 3, , Unlimited Other ** Winchester 500 1,500 1,000 3, Unlimited ** Wise 200 1, , Unlimited Wythe 0 3, , Unlimited York 0 2, , Unlimited Averages 434 2, , Averages reflect the average of local school divisions that have a dollar amount for the policy provision. * ** Primary Care Physician Albemarle, Amherst, Appomattox, Charles City, Charlottesville, Frederick, Fredericksburg, Galax, Harrisonburg, Louisa, Mecklenburg, Montgomery, Nottoway, Salem, Southampton, Stafford, Tazewell, Winchester - Preauthorizations may be required for certain procedures, services, and/or medications. Appomattox - 20% co-pay for primary care physicians or specialists. Botetourt - $15 co-payment for eye exam. Henrico - Second opinions are covered but not required. Manassas City - Co-insurance required for specific services. Martinsville - No co-pay after deductible has been met. The school board makes an annual HSA (Health Savings Account) contribution--$720 for employee only; $1,200 for employee plus dependents. They also reimburse the last $1,000 of deductible for employee only or $2,000 for employee plus dependents through an HRA (Health Reimbursement Account). Nelson - Co-insurance ranges from 10% to 20% or can be a flat dollar amount depending on service provided Patrick - Co-pay for specialist is 80% after deductible. Powhatan - Dental co-insurance is higher (20% to 50%) depending on service. Prince William - Co-insurance and deductible apply to out-of-network claims only. Maximum out-of-pocket does not include any co-payments or prescriptions. Pulaski - Co-pays are 20% of actual cost after deductible. Salem - Co-pay for specialist is 30% of actual cost after deductible. Shenandoah - Co-pays range from $20-$25 for primary care physician; $35-$40 for specialists. Southampton - Deductible applies only to cetain medical services; co-insurance ranges from 10% to 20%. Spotsylvania, Williamsburg/JCC - Co-insurance varies per service rendered. Stafford - Co-pays are 80% after deductible. Wellness, annual physicals, diagnostic labs, x-rays, and hospitalizations are excluded from deductibles or co-insurance. Virginia Education Association 23 22

30 Table 3: Teachers Enrolled in Health Insurance Plans Number of FTE* Teachers Eligible Enrolled Percentage Number of FTE* Teachers Enrolled Eligible Enrolled Percentage Enrolled Accomack Albemarle 3,201 2, Alexandria 2,145 1, Alleghany Amelia Amherst Appomattox Arlington 4,092 2, Augusta 1,832 1, Bath Bedford County/City 1,700 1, Bland Botetourt Bristol Brunswick Buchanan Buckingham Buena Vista Campbell 1, Caroline Carroll Charles City Charlotte Charlottesville Chesapeake 5,670 4, Chesterfield 7,300 5, Clarke Colonial Beach Colonial Heights Covington Craig Culpeper 1, Cumberland Danville Dickenson Dinwiddie Essex Fairfax County/City 26,525 19, Falls Church Fauquier 2,432 1, Floyd Fluvanna Franklin City Franklin County 1, Frederick 2,000 1, Fredericksburg Galax Giles Gloucester Goochland Grayson Greene Greensville Halifax 1, Hampton 3,071 2, Hanover 2,800 2, Harrisonburg Henrico 6,687 5, Henry 1,253 1, Highland *FTE = Full-Time Equivalent positions. Some numbers may be estimates. Virginia Education Association 24

31 Table 3: Teachers Enrolled in Health Insurance Plans Number of FTE* Teachers Eligible Enrolled Percentage Number of FTE* Teachers Enrolled Eligible Enrolled Percentage Enrolled Hopewell Isle of Wight King George King Queen King William Lancaster Lee Lexington Loudoun 8,936 7, Louisa Lunenburg Lynchburg 1,590 1, Madison Manassas City 1, Manassas Park Martinsville Mathews Mecklenburg Middlesex Montgomery 1,200 1, Nelson New Kent Newport News 4,770 3, Norfolk Northampton Northumberland Norton Nottoway Orange Page Patrick Petersburg Pittsylvania 1,529 1, Poquoson Portsmouth 2,300 1, Powhatan Prince Edward Prince George Prince William 10,166 6, Pulaski Radford Rappahannock Richmond City 3,856 3, Richmond County Roanoke City 2,032 1, Roanoke County 2,317 1, Rockbridge Rockingham 1,915 1, Russell Salem Scott Shenandoah 1, Smyth Southampton Spotsylvania 3,200 2, Stafford 3,900 2, Staunton Suffolk 2,132 1, Surry Sussex *FTE = Full-Time Equivalent positions. Some numbers may be estimates. Virginia Education Association 25

32 Table 3: Teachers Enrolled in Health Insurance Plans Number of FTE* Teachers Eligible Enrolled Percentage Number of FTE* Teachers Enrolled Eligible Enrolled Percentage Enrolled Tazewell Virginia Beach 10,613 8, Warren Washington 1, Waynesboro West Point Westmoreland Williamsburg/JCC 1,816 1, Winchester Wise Wythe York 1, Total 181, , avg. *FTE = Full-Time Equivalent positions. Some numbers may be estimates. Virginia Education Association 26

33 Table 4(a): Health Insurance Annual Premium Costs Employee Only Employee and One Dependent Employee Plus Spouse Family Total School Division Share School Division Share School Division Share School Division Share Total Total Total Amount Cost $ Amount Percent Cost $ Amount Percent Cost $ Amount Percent Cost $ Amount Percent Accomack 6,021 4, ,015 6, ,314 6, Albemarle 7,525 7, ,065 7, ,369 7, ,497 7, Alexandria 6,043 4, ,606 8, ,606 8, ,124 10, Alleghany 6,792 5, ,808 6, ,208 7, ,308 8, Amelia Amherst 5,214 3, ,107 5, ,453 5, Appomattox 4,382 4, ,188 4, ,817 4, ,447 4, Arlington 5,276 4, ,888 7, ,828 10, Augusta 4,960 4, ,508 4, ,508 4, ,912 4, Bath 7,021 6, ,410 8, ,571 11, Bedford County/City 5,148 4, ,532 6, ,240 6, ,540 6, Bland 6,306 4, ,571 4, ,107 4, ,656 4, Botetourt 5,474 5, ,940 5, ,954 5, ,803 5, Bristol 5,086 4, ,172 5, ,172 5, ,732 5, Brunswick 5,508 5, ,188 6, ,188 6, ,868 7, Buchanan Buckingham 4,309 4, ,049 8, ,788 13, Buena Vista 6,300 4, ,004 6, ,016 7, Campbell 4,128 3, ,172 6, ,172 6, ,240 6, Caroline 6,166 5, ,749 11, ,205 13, Carroll 5,880 4, ,884 5, ,884 5, ,876 6, Charles City 6,189 5, ,140 5, ,140 5, ,329 5, Charlotte 4,896 4, ,708 4, ,708 4, ,256 4, Virginia Education Association 27

34 Table 4(a): Health Insurance Annual Premium Costs Employee Only Employee and One Dependent Employee Plus Spouse Family Total School Division Share School Division Share School Division Share School Division Share Total Total Total Amount Cost $ Amount Percent Cost $ Amount Percent Cost $ Amount Percent Cost $ Amount Percent Charlottesville 5,406 4, ,112 6, ,454 6, ,142 7, Chesapeake 5,771 5, ,873 8, ,305 11, ,643 13, Chesterfield 5,430 4, ,688 5, ,588 5, ,017 8, Clarke 5,496 4, ,164 5, ,164 5, ,844 7, Colonial Beach 4,665 4, ,345 4, ,450 4, ,136 4, Colonial Heights 5,616 4, ,244 6, ,860 9, Covington 6,600 4, ,216 8, ,216 8, ,820 11, Craig 6,108 4, ,304 5, ,304 5, ,488 9, Culpeper 6,321 5, ,229 5, ,947 5, ,450 5, Cumberland 5,483 5, ,287 5, ,881 5, ,244 5, Danville 4,370 4, ,896 4, ,423 4, ,465 4, Dickenson 4,834 4, ,734 7, ,052 12, Dinwiddie 5,232 4, ,688 5, ,328 6, ,404 10, Essex Fairfax County/City 6,185 5, ,370 9, ,370 9, ,462 11, Falls Church 5,767 4, ,076 8, ,076 8, ,397 11, Fauquier 6,643 6, ,831 7, ,606 10, ,596 11, Floyd 6,192 5, ,022 6, ,381 3, ,098 7, Fluvanna 5,496 5, ,724 6, ,212 8, ,580 9, Franklin City 6,144 4, ,364 5, ,364 5, ,584 7, Franklin County 5,161 5, ,633 5, ,929 5, ,143 5, Frederick 5,602 5, ,075 5, ,005 6, ,629 6, Fredericksburg 6,120 5, ,328 9, ,328 9, ,524 12, Virginia Education Association 28

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