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<br /> <br /> <br />September 20, 2024 <br /> <br /> <br />Kristina Handt <br />City Of Lake Elmo <br />3800 Laverne Avenue No <br />Lake Elmo, MN 55042 <br /> <br />RE: January 1, 2025 PEIP Renewal for City Of Lake Elmo - Year One <br /> <br />Dear Kristina Handt: <br /> <br />Thank you for your participation in the Public Employees Insurance Program (PEIP). We hope the program <br />continues to fulfill your insurance needs. <br /> <br />2024 vs 2025 MEDICAL RATES <br /> <br /> Current Rates 2025 Renewal Rates <br /> <br />2025 Renewal Rates <br />With Commission <br />Projected <br />Enrollment <br />High Option Single <br />Family <br />$667.04 <br />$1,738.84 <br />$617.22 <br />$1,644.36 <br />$657.22 <br />$1,684.36 <br />3 <br />10 <br />HSA Option Single <br />Family <br />$471.70 <br />$1,216.30 <br />$425.94 <br />$1,132.78 <br />$465.94 <br />$1,172.78 <br />4 <br />8 <br />In accordance with MN Stat. 471.61, renewal rates for retirees who are under age 65 are blended with the rates for active employees. <br />Eligible retirees currently on continuation are included in the rate structure. <br /> <br />The below information is being provided to you in accordance with the 2024 Transparency Amendment to the <br />HITA legislation. <br /> <br />Summary <br />Agent Commissions Paid as Part of the Premium $40.00 PCPM / $16.13 PMPM <br />Total Premium Dollars in the First 12 Month Period of the Quote, <br />Not Including Commissions <br />$348,735.12 <br />Total Premium Dollars Per Member Per Month Not Including <br />Commissions <br />$468.73 <br />Number of Expected Members 62 <br />Type of Provider Network Broad Tiered Network HMO1 <br />1The PEIP network operates as an HMO within each cost level tier. <br /> <br /> <br />2025 Actuarial Value <br />Plan % of Total Allowed Costs <br />2025 Cost Sharing Projection <br />Plan % of Total Allowed Costs <br />High HSA HIGH HSA <br />89.8% 74.0% 91.1% 82.2% <br />*Please find additional commentary regarding the source of these actuarial values and their applicability on page 4.