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.