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3.02 3.2 INSURANCE\Empire MediBlue Freedom Medicare Advantage Renewal for 2024-9-11-2023 RESOLUTION AUTHORIZING RENEWAL OF EMPIRE MEDIBLUE FREEDOM (PPO) MEDICARE ADVANTAGE INSURANCE FOR 2024 RESOLUTION NO. ,2023 INTRODUCED BY: WHO MOVED FOR ITS ADOPTION SECONDED BY: WHEREAS, the Town of Queensbury previously entered into an agreement for its employee group health insurance plan with Empire MediBlue Freedom (PPO) Medicare Advantage, and WHEREAS, the Town Board, in conjunction with Upstate Agency LLC, has negotiated a renewal agreement with Empire MediBlue Freedom (PPO) Medicare Advantage for 2024, NOW, THEREFORE, BE IT RESOLVED, that the Queensbury Town Board hereby approves and authorizes a renewal of its Empire MediBlue Freedom (PPO) Medicare Advantage insurance for 2024 with the 2024 monthly premium to be $369.27 per member, and BE IT FURTHER, RESOLVED, that in the event that surcharges, fees or taxes are mandated or imposed on the Town's health insurance policies that are beyond the Town's control, resulting rate changes may be passed on to all employees without further Town Board Resolution, although the Town will provide notice of any such rate changes to all employees and retirees, and BE IT FURTHER, RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to execute any needed agreement and/or documentation and the Town Supervisor and/or Town Budget Officer to take such other and further actions necessary to effectuate the terms of this Resolution. Duly adopted this 1 Ph day of September, 2023, by the following vote: AYES NOES ABSENT: 2 J COST ANALYSIS Town of Queensbury 2024 Renewal Current MAPD Est.Annual Premium %Change $Change Benefit Carrier Current Renewal From Current From Current MAPO Current Empire $417,796 $438,693 5.0% $20,897 'Upstate Agency,LLC is committed to delivering a superior client experience through our customer-centered service model. Upstate Agency wins and keeps clients by operating with complete integrity. Under Section 202 of the Consolidated Appropriations Act,2021(CAA),which was signed into law on December 27,2020,brokers are required to disclose the compensation received by a health insurance issuer.Upstate Agency will receive standard carrier compensation,calculated as a percentage of premium or on a per contract basis for the lines of coverage noted above.These commissions received are for placement/renewal of the Client's insurance/risk management program,claims and billing assistance,plan comparison,open enrollment support,application submission,and other day-to-day servicing. Contingency payments or bonuses are paid on the overall performance of a partial or entire book of business Upstate Agency places with an insurance company,and Upstate Agency's eligibility and the amount of any such compensation may vary depending on the line of business and a number of "contingent'factors related to future performance such as overall premium volume,premium growth year-over-year, persistency, profitability and/or retention targets set by the insurer.As such,a contingency payment received by Upstate Agency from an insurer is difficult to tie back to any particular client insurance policy. / Town of Queensbury A UPSTATE Medicare Advantage with Prescription Drug IA INSUNC January 1, 2024 Effective date m EnnrEE SE„En:am..,o Current vs. Renewal Empire • Plan Benefits In-Network Out-of-Network Deductible None Coinsurance None Out-of-Pocket Maximum $3,400 PrimaryOffice Visit $5 55 Specialist Office Visit $20 LiveHealth Online ed in Full Preventive Services Covered in Full Covered Covered in Full Covered in Full Inpatient Hospital $100($300 O0P per year) 5100($300 O0P per year) Outpatient Surgery $50 $50 Emergency Roam 550 $50 Urgent Care Center $20 520 Ambulance $50 $50 Laboratory testing $20 $20 X-rays $20 $20 MRI/MRA,Cat Scan,PET $50 $50 Diabetic Supplies $0 $0 Physical/Speech/Occupational Therapy $20 520 Skilled Nursing Facility $10 per day for days 1-100 $10 per day for days 1.100 Dura ble Medical Equipment 10%Coinsurance 10%Coi nsura nce Home Health Care Covered in Full Covered is Fin ll Acupuncture(Medicare-Covered) $5(up to 12 visits in 90 days) $s(up to 12 visits in 90 days) Routine Vision Exam $0(limited to a $70 max benefit)every 12 months Lenses&Frames Allowance $100 Allowance every 24 months Dental Allowance None Routing&lean rig Exam $0(limited to a $70 max benefit)every 12 months Hearing Aid Benefit $500 Allowance(every 12 months) Preferred Pharmacy: $10/520/540 Prescription Orug-Part D Standard Pharmacy: $15/$25/$45 When diabetic supplies are purchased through the pharmacy, $0 copa y for preferred brands and$10 copay for non-preferred brands Mail Order(90 day supply) $3D/550/$90 True Out of Pocket Threshold (TrOOP) Coverage gap/donut hole No gap Wellness Program Silversneakers and Nurse Helpline Healthy Meals 14 meals per qualifying event,allows up to (4 events each year 56 meals in total) Rate 99 $351.68 $369.27 Estimated Monthly Cost 534,816 $36,558 Estimated Annual Cost $417,796 $438,693 Percent Change From Current N/A 5.016 This is a benefit summary only and is subject to the terms,conditions,limitations and exclusions set forth in the contract.