Title
Approve and authorize the Chair of the Board of Supervisors to sign Amendment #5 to Agreement #A-11489 for July 1, 2011 through June 30, 2015 with Central California Alliance for Health (CCAH) for a change in premium amounts for the provision of health plan benefits for In-Home Supportive Service (IHSS) providers.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Chair of the Board of Supervisors to sign Amendment #5 to Agreement #A-11489 for July 1, 2011 through June 30, 2015 with Central California Alliance for Health (CCAH) for a change in premium amounts for the provision of health plan benefits for In-Home Supportive Service (IHSS) providers.
SUMMARY/DISCUSSION:
The Central California Alliance for Health has offered the Alliance Care IHSS health plan since July 1, 2005, providing comprehensive and high quality coverage including hospital, outpatient, primary and specialized care, prescription drugs, mental health services, etc. for IHSS providers who meet eligibility criteria.
The Affordable Care Act requires that CCAH rebate part of the premiums if it does not spend at least 85% of the premiums received on health care services and no more than 15% of the premiums may be spent on administrative costs. This is referred to as the "Medical Loss Ratio" standard of the 85/15 rule. In 2013, CCAH spent only 75.2% on health care services, consequently, CCAH provided a rebate to the County and the premiums for the current year have been reduced. Effective 8/1/14 thru December 31, 2014 the monthly member premiums will be $275 and effective January 1, 2015 thru June 30, 2015, the monthly member premiums will be $409. Monterey County Public Authority is working on the process by which they will reimburse IHSS Providers for their share of the rebate savings.
The agreement total was kept the same so that it is in line with the negotiated rate of $0.69 per hours worked from IHSS Providers, therefor...
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