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Page 3 of 4 percentage based contribution and go with a flat dollar amount to help control city costs in the event of a significant premium increase. The breakdown proposed for going with the PEIP HSA plan is as follows: The recommendation is to cover the entire premium of a single plan and $900 of a family plan. In addition to this, $1,025 per month would be contributed to an employees’ HSA account, if applicable. There has been some discussions on whether or not the contribution to Union employees should be the premium amount ($900) or the premium plus HSA amount ($1,025). The PEIP program offers three different plans: Advantage, Value and HSA; and three different networks to choose from: HealthPartners, Blue Cross Blue Shield and Preferred One. An employee would need to choose the network carrier that best fits their needs. Within each network there are primary care clinics. Primary care clinics have been placed into one of four cost levels, depending on the care system in which the provider participates and that care system’s total cost/quality of delivering health care. Cost level 1 is much less expensive than cost level 4. A clinic can be at a different cost level depending on the network. Example: Allina is at a cost level 3 for Blue Cross Blue Shield but it is at a cost level 4 for Preferred One. The max out-of-pocket amounts listed in the table above relate to cost level 2 clinics. If an employee wanted to make Allina their primary care clinic, the max out-of-pocket would be higher. Our current plan has a deductible and max out-of-pocket of $2,000 per person and $4,000 per family. The PEIP HSA plan (Cost Level 2) has a deductible of $2,000 and max out-of-pocket of $3,000 for single coverage, a deductible of $3,200 and max out-of-pocket of $5,000 per family member, and a deductible of $4,000 and max out-of-pocket of $6,000 per family. So the max out- of-pocket is increasing by 50%, $1,000 for single and $2,000 for family with the PEIP HSA plan. This could potentially impact an employee with a single plan by $1,150 per year and an employee with a family plan by $2,150 per year because the max out-of-pocket is increasing and the HSA contribution is decreasing. 2019 PEIP HSA plan $1,500/year Total EE Total Employee Employer City HSA City Cost level 2 Health Dental Premium Portion Portion Contribution Contribution Max out of Pocket Single 461.06 47.58 508.64 - 508.64 125.00 633.64 3,000 per person Family 1,189.28 47.58 1,236.86 336.86 900.00 125.00 1,025.00 5,000 per person/6,000 per family Est. 6% increase Union 1,315.00 Incl.1,315.00 290.00 1,025.00 - 1,025.00 3,000 per person/7,000 per family Premiums