Discussion and possible action to approve the AETNA Medical Insurance plans, premiums, copays, as well as the AETNA Dental Insurance rates (no changes) for Webb County Employees effective January 01, 2025.
 

2025 AETNA Medical Plan Insurance Summaries
Plan Summary	Current Base Plan	New Base Plan	New Consumer Driven Health Plan (CDHP)
Individual Deductible	$1,000	$1,250	$3,500
Family Deductible	$2,000	$2,500	$7,000
Benefit Percentage	80%	80%	100%
Individual OOP Max (includes Deductible and Cost share)	$5,000	$7,000	$3,500
Family OOP Max (includes Deductible and Cost Share)	$12,500	$17,500	$7,000
Primary Care Physician Co-Pay	$10	$25	$0 after deductible
Specialty Physician Care Co-Pay	$20	$35	$0 after deductible
Urgent Care Co-Pay	$20	$35	$0 after deductible
Emergency Room Co-Pay	$500	$500	$0 after deductible
Retail Rx Co-Pay	Generic Copay $10	Generic Copay $10	$0 after deductible
	MOD Generic $20	MOD Generic $30
	Brand Copay $30	Brand Copay $30
	MOD Brand Copay $60	MOD Brand Copay $60
	Retail Non-Formulary  Copay $50	Retail Non-Formulary  Copay $60
	MOD Non-Formulary  Copay $100	MOD Non-Formulary  Copay $100
	Specialty Preferred Brand  Copay $40	Specialty Preferred Brand  Copay $40
	Specialty Non-Preferred  Copay $60	Specialty Non-Preferred  Copay $60
*Medical Buy-up plan will no longer be offered
*All applicable preventive services and maintenance Rx drugs are covered at 100% for the CDHP
Medical Insurance Employee Bi-weekly Deductions
Employee Only	$20.44	$23.51	$2.03
Employee & Spouse	$186.29	$214.23	$162.78
Employee & Children	$77.68	$89.33	$57.51
Employee, Spouse & Children	$205.71	$236.87	$181.61
			Includes $600 annual County Contribution to a Health Savings Account
*No Changes to Aetna Dental Insurance in 2025
Dental Insurance Employee Bi-weekly Deductions
		Base Plan	Buy-up Plan
Employee Only		$0	$12.28
Employee & Spouse		$13.30	$21.14
Employee & Children		$9.97	$21.14
Employee, Spouse & Children		$21.14	$33.55
*Periodontal scaling and root planing under Preventive Services will be covered at 100% effective 01/01/2025.

 
Issue: The current premiums and plans may require adjustments to progressively maintain funding levels when recommended. 

Solution: Adjust premiums and/or plans based on usage and expenditures when recommended. 

Result: Progressively and appropriately manage and fund the County's health plans.

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