LTC 309-2012 Health Care Premium Rebates m MIAMI BEACH
OFFICE OF THE CITY MANAGER
NO. LTC # 309 -2012 LETTER TO COMMISSION
TO: Mayor Matti Herrera Bower and Members of the City Commission
FROM: Kathie G. Brooks, Interim City Manager
DATE: November 28, 2012 =??
SUBJECT: Health Care Premium Rebates r
This Letter to the Commission is in response to members of the City Commission who h;Yve
inquired as to why those health plans with low loss ratios do not provide a premium rebate
to the plan participants when the premium paid for coverage exceeds the amount `of claim
cost incurred by the plan.
To determine what affects a premium rebate may have on the City's group health plan, and
if a premium rebate is a viable option for the City, the Administration contacted the City's
Benefit Consultant, Gallagher Benefit Services (Gallagher), for guidance. The plan actuary
assigned to the City indicated that while employers have the ability to set prospective
premium and contribution rates that reflect experience by plan, they have uniformly avoided
retroactively rebating contribution dollars by plan based on claim experience. Gallagher is
concerned that such practice would violate Federal laws, such as the Americans with
Disabilities Act (ADA), by rewarding employees for not seeking or receiving medical care,
yet penalizing employees with illnesses. The City, however, may prospectively incentivize
good behavior, for example, by rewarding employees for having a variety of vital signs
tested and then giving discounts for hitting goals for things like blood pressure, body mass
index and cholesterol. As part of the Budget Advisory Committee's review of healthcare
costs, the City will request that it recommend a program to encourage healthy behaviors
and target specific health actions using customized information, financial incentives and
ongoing support for employees.
More specific to the City, there are a few reasons the actuary has advised us a premium
rebate would not be feasible. First, the enrollment in most of the plans is too small to be
statistically sound. You can see a very good illustration of this when you look at the
enrollment and the associated loss ratios by year and by plan provided in the attachment.
As you can see, many plans have few participants and have high claim expenses. When
looking at the plan's loss ratio, the percentage of claim cost paid versus plan premium
collected from those enrolled, the loss ratios for the plans fluctuate from year to year; one
year having a relatively high loss ratio and a subsequent year with a much lower loss ratio.
Even when the plan's enrollment is quite small, the plan's cost may be quite significant.
As an example, in 2009, the Premium PPO had twenty -four (24) active employees, and
experienced a claim loss ratio of nearly 130 %. In 2010, there were seventeen (17) enrollees
with a claim loss ratio of only 31 %. The Premium PPO currently has eleven (11) active
employees in the plan. Through August of 2012, the eleven (11) enrollees had averaged a
We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
loss ratio of just over 60 %. As this shows, with such a small enrolment, even a few
moderate claims can cause huge swings in the plan's cost. We see similar results for the
other plans as well, especially for the plans with lower enrollments. Even if we combine the
enrolment across actives, pre- Medicare retirees and Medicare retirees, we see significant
variation from year to year for any given plan.
Beginning with the City's 2006 Annual Open Enrollment, the Administration has been
educating employees of the premium cost saving provided by Standard HMO and PPO
medical plans. This employee education has been successful in moving the majority of
employees to the City's two lower cost Standard medical plans. This change in coverage
not only provides the employee savings, but also the City, as the premium rates for the
Standard plans are lower than those for the Premium plan. For example, for an employee
enrolled in the Premium PPO plan, the City's premium subsidy is $1,874.46 versus
$1,306.64 for the Standard Plan, providing a monthly savings to the City of $567.82. The
2012 monthly premium cost for the employee and City are included in Attachment B.
Currently of the nine hundred seventy three (973) active employees participating in the
City's medical plan, nine hundred twenty four (924), or 95 %, have elected medical coverage
in one of the City's two Standard plans.
Additionally, the City subsidizes coverage at no less than fifty percent (50 %) of premium
cost for the Premium HMO, the Premium PPO and the POS plans. The City subsidy for the
Standard HMO and Standard PPO is more, 75% for employee only coverage and 60% for
family coverage. So conversely, employees pay no more than fifty percent (50 %) of the
premium of any plan. Unless a loss ratio, including the administrative fees, drops below fifty
percent (50 %), the City is still subsidizing the cost of the coverage. Even if experience on
any one plan is consistently good, the City is still subsidizing the cost of that plan and
employees are not being charged more than fifty percent (50 %) of the cost of the coverage.
KGB /RG /sr
Attachment
F: \HUMA \$all \Sue \Letters To Commission \LTC Health Care Costs Final.docx
Attachment A
City of Miami Beach
Medical Plan Experience by Plan and Enrollee Class
Q 01 Q M N Ln LO N Ln LO r-I ri
Ol M O LO n Q Cn N 0 M M .••� W Ln t0 n O 01 Q 01 Ln M 00 Q M W O M Q In
ar oo tD ri a Ln rn If1 Q rn 0 00 0 ko M ri m n rn Ln o v Ln o rl °• of c
00 a+ .-i M O1 M r 00 r-I N t0 ri Ln O1 N Q O n cn LT n ri Q Ln O n O l0 �"� W p
M 01 n Q 00 t0 M ri Q M O M O r•I M Ln Q 0 ^ Q Q Q LO 00
Q lD W O N
i U Ln Ln tD Q Q Ln n 00 O1 n 00 01 00 41 Ln LO r 41
V? V? V? V? V} V? V? V? V? t4 iN V? rt H r± " , `"'� V1 V? to r1 rl ri ri ri ri u* ri ri
V? Ln to N V? V? V? in VT VT V? V1
U
3 T y N 01 p tD I� Q M N O M M rt Q1 al C:) n O p Q O1 Ln M 00 Q M o0 O M Q Ln
'£ £ >• Ln W N rl Q Ln Q1 Ln Q O1 rl O W M O M N O1 n 01 Ln O Q Ln O N O 01 Q
Li y Ln 01 n Q 00 tD M ri Q M O M o0 tO O Ln Q p n Q Q Q t0 W Q t0 a0 O N
d M M Q Q Q Ln n 00 01 n 00 01 t0 n 01 00 p Lf1 lD n 01
in V} N 1 .4 V? i/? V VT
_ W
L
i+
C
L O1
tD Q O W W O N Q O M Q W Q N li f O N N Ln Ln 00 O O 00 O O M rl rl
O .-i M W W LD M M n n M 00 00 ri 01 n Q Q M M O 01 r1 Ln 01 r1 Ln O n ri H
j w W M Q7 W t0 01 Ln n rl Ln Q W Q O O 01 Q W n Q N M N M m N N M 01 N
p V tD 01 N N Q7 N m N 00 D7 N n " co Q Q 00 Q lD M Q m ul LD 01 Ln tO Ln 01 co
M U N N M ri r-I N N M M N M M Ln Ln lD Ln w n u1 M M Q N N M L ID N Q Q Ln
O T VT N 1^ th V? V? V? VT V} V1 V? V? V? to V? V? V} V? V? Vf V1 V? Vf V?
~ C
0 0) N O 00 00 O N Q O M Q M Ln O Ln O N N Ln Ln 00 0 0 00 O O M r1 .
O p n W t0 M M n n M 00 W n tD r-: Q Q M M O 01 1 Ln M N Ln O n r1 ri
T O Q ^ Q W tp 01 Ln n ri Ln Q 00 Q M ri 01 Q (00 n * N M N M M N ri M 41 N ID ch Czr a) O O' W Q1 ri r! N N N M M N M M ri ri N M M Q N N M Ln W n Ln LD Q Q Ln
C' W V} (n in to V? L? in V? to V? V? in 1^ to in V} to V? V? V? V? to V? V} V? in V? to
G o e o 0 0 0 0 0 0 0 0 o e o \ e o 0 0 0 0 0 0 \° 0 0 0 0 0 0 0 0 0 0� 0 0 0 0 0 0
O 01 01 N 00 N M O N Q n ri M O l0 O W W 00 W W O Q o0 o n n 01 to 01 ri Q r N N n 01 n co Q M
tD r1 ri co ri I� O Ln N t0 M Q t0 W 00 w t0 Q N M ri I- N W O n M r N Ln Ln lD tD n �••� tD p 1 0, O ri
O Q O N 01 O H n Q N Ln M M c0 M Ln Q M 00 p W Ln M W n t0 LD tD M M to o0 rl n 01 al l0 Ln Ln p
C to .--I ri ri ri N N rl ri r1 ri ri r1 N ri r1 r1 H rl N
~ O
J
Q LD t0 Ln n ri 01 n O M o M N o O N W Ln O M Q Ln ri O1 LO O co M Q Q n Ln 00 ri r n Q N M 01
CO M N Q n O n Ln m n Q O 01 LIl 01 M M N H n Ol M N M Q Q Q n c0 N 01 O o0 r M 01 Ol M ri M
N o0 O n tD I LD Ln 01 N m M Ln W Q 01 M to Q lO tD M N M m t0 tD m N n 0 m M O W 01 W N Ln N M
O 1� n Ln 4 w Ln M Ln LD 00 O O N M n r Q O N 01 o N f n M n 01 LD Q tD c0 O ri c0 o n �• i oo n
a N p t0 r O N Ln Ln M Ol M n H Q n N N M 01 Ln 00 N r-I 01 M 00 O ri O 00 ri O O M 01 Q n M Ln Ol 00
O y Q Q tD tD Q M O o0 01 LD (=
n n Q ri M N 00 N M Q M Q N Q W Q Ln Ln ri rl 00 O Ln M 01 00 Ln n ri
~ X lD D1 Q O VT ri ri N ri ri ri Q ri N N VI V? V? V? V) in V? V?
W V1 V? to N V? V? VT in to V? V? V) V? VT V} N V? N N Vf V? t4 V?
V?
co 01 01 ri LO O N O1 M N LD ri ri Q n M " 00 00 r r1 01 Ln O Q Ln Q Q M 00 00 r1 tD O 00 M N n n Q 00
00 01 Q M N W t0 M O n LO Q M Ln tD Ln N " 00 N N O O M 00 Ln t0 O 00 N O M M Q N O Q N 00 Ln
H Ln M r1 ii lD N Ln Q oc o0 Q ri t0 M Ln Ln O Q 01 ri Ln tD N M Ln W W O 01 lD M N M N 00 O 00 r t0
H N N N tD r-I ' O1 01 N O N H ri tD o0 O1 ri O1' Ln M' Q N Q Q t0 Ln O tD Q r-I 00 M n O' n N' 01 00 co 01 01 N
X N Q O t0 N Q Q7 Ln n n n r i O O lD lD 41 Ql I� p M Q N O M M N 0) O n tD O r1 ri V? Q co M H 00 Q M 01 00
O n Lb N N i r1 N V? N V? to V} N Vt• V) V? ri V) in V? V? V? V? AA- N V? in 1^ V? V1 Vt• V! ri ri Vf M
LL U Vl• 4 in r - I V? V? V? Vn in in VT V? N VT
LL V?
O
L
LU ri r t0 Q O ri n 00 n N Q N O to M 01 t0 n O M Ln 01 O Ln r1 t0 M O t0 n W 00 00 M Ln t0 n Ln 01 N
O M n ri to Q rl ri W O n tD t0 O1 N n ri O M In LD N -1 O O 00 00 n n 01 O1 t0 Ln N H 01 Q O N W
L M tD Ln Ln r-1 M O Ln M e - i W M N O� n N Q e-I n N n n n M O O V 01 Ln M 01 00 Ln n O N n n tD
10 £ 06 .••� Q N n Q M N Ln tD a N M N n N r lD Ol u1 M Ln n f\ M n n O D7 n N' 01 Q7 N' Q -4 W Q
N O '� i-i t0 M ri p n 00 N Ol M ri Q Q n Q Ln O Ln N n 01 W tD Q N N Ln o tD o 01 tD 01 ul N N a) N 6) O
90 n t0 O Q M N 01 lc W Ln O Q lD M O O N 00 N N CO N Q N Q M M N ? n W Ln Ln V 01 Ln M o0 t0 Q tD
lE U Ln 00 Q 00 N V? N r-I ri rl Q ri N r-I Ln V? VT VT r y in VT V1 r y VT Vn in r 1 V} V? V} VT in V} r1 H ri N M
£ d n VT to N V! V? to V1 V? to V? V> V? to N V? to V1 Vt• V1 N
LO .Q
n n 00 N 01 00 ri n N 00 r1 N 1` n N tD 01 01 r 01 co O1 n 01 O Q N LO r O cn Ln Ol Q tD 01 Q Ln M M
H n N N N D1 N Q Q O1 H ul O1 01 M N W n Q O Q ri M Ol r-I n Q N tD n Q 00 00 00 00 Ln Q Ln r1 ri
u £
C L 3 to lD Q n LD Q t0 n 00 M Q LD 00 r r N Q Ln W 01 Ol Q M tD Q r- M (n L!1 W p W n O Ln Q lD N t0 Ln
), 0) Q O N n N N ul N n O N Q n O T r-I n W n M N O M 01 d n ri 01 ri Q Q N lD M ri lD n O Q LD Q Q Ln
y� £ Q n N M t0 O ri O O O n ri O O1 O LO r N Ln Ln Q 00 cn Ln M Q N l0 M W p W M M ri W M
V C L O p tO M Q t0 Ln LO Q Q r Ln N M c0 M Ln t0 M Q Ln Ln M Q LD W t0 N Q M ri 01 c0 n M O to to Ln 00
LD Q n t4 N VT rl N ri N M r-I rl V? ir 1 V? V) VT Vf r y V? V} V? n 1 V?
LD V? VT V? V? V) V1 N N N ri l0
Ly a vt v> v> V) to V) A^ to V1 Vt.
c
n p LPL N tO Ln N M O t0 M O LD 00 00 01 Q O N Q O N Ln N M
d T M 0l O M 01 O 00 N O 00 N O n N W n N W 00 Ln c0 tD I-� ri lD Il� ri O W O
Q n LO Q n M o co co O 00 Q LD O1 Q to O1 Ln M 01 O r1 Q O N Q N 00 01
M 00 M to ri n LD ri n rl 00 O1 N 00 01 Ln W oo r1 O M ri o M W r N
A f,0 W n n 00 01 r 00 01 ri Q LD W Q O W n W ri n W r1 ri N Q 01 N n Q1 N n O1 ri Lf)
= a LL ri r1 ri rl ri r1 ri rti N i
" N r ri N ri ri rti N M M N M M ri N N
£ Vf V? in V? V? V? N VT V? V} N V) N N Vf V? V? V? V} V? in VT V) N V? V? V) V? V? V?
3
m Ln tD O1 Ln t0 01 Lf) W al Ln 00 O 01 co O 01 M M 01 O1 Ln O1 O Ln 01 O tD r-I r-I
,£ Ln M n N M n Ln LO LD Ln tD tD Ol n LO 01 N LD lD O o0 M Cl O M p o Q N N
i r M 00 n co 00 O m r o 01 n 00 00 LO 00 00 W Q 00 Ln tD Q N tD Q N n 00 Q
d W Ln T Ln Ln 01 Ln 01 Q Ln 01 Q Ln O1 W O1 01 tD O1 M 00 00 W O N co o N O O1 t0
co M Q M M Q Ln tD n Ln t0 n to n 00 LD 1` 00 Ln Ln tD ri M Ln ri M u7 01 01 ri
N rl ri ri ri N r-I
V? V? V} V? V? V? V} Vt•i/D V? V? V? V?
T Q Ln ri M Q LD 01 M M O N A N O Ln D1 ri n 00 N l0 tD Q Ln M 01 M tb Lf) M M Q ri 00 Q W ri M Lf1 M
y1 _ LD n 00 r N M M M to Q M Q Q Q M M ri N e••1 r-I ri ri ri M M Q M ri tD Ln Q Ln
N £ M M M M
R
O LL
C
W
y W ul M M 01 W O 01 N n ri M O t0 O O M 00 O ul ri M M n N co ri M Q W m LO Ln O O N n M
0 Ol
c0 W O 00 Q Ln Ln Ln LD p N tD n n W lD n M M M N M N N N N M Q Q Q ri ri r m i M M N M� O Q7 O
L0 Ln Q Q Q
d
Q
p r4 N 0 ,'°, a r�i O ., N r�i a° N O ° N r�i 0 « -4-L N 0 .'°,, H .�-I 0 w - 1,44 0 a r a~-1 0 i a r♦ 0 a°.
0 0 o 0 0 0 o 0 0
0 0 0 0 0 o 0 O o 0 0 O 00 o 0 0 o o O 0
W N N N N N N N N N N N N Q N N N N N N - N N N Q N N N m N N N� N N N a
a
O 3 O H O N O LA O LA O H O N O In O LA O H
N� N N N N N N N N N
i
a+
(U a a
a
Ln N t
to > t0 > tD > lD t+ > tD H
v Q a a` a ¢ a` a
O O
O O
a
_ = a a
a £ o £
`m o 100 3
° £ c £
c c
m 1 L0 ;? gym a
K Li a Ln
00 M 0 00 M 0) V n
T rl T e-1 Ln LD N
^
•+ LG 00 tD 00 V N M N
j �-1 0) p -1 0) p Ln 'I 'I
O
V
3 T y W M 00 k6 o6
- Ln ID C14
IV
W 00 LL fl. 1-i cn p 1--I M p Ln rl ri
T W -tn 4^ io V? in. VT V?
L
C O O m O O Ol � Ln .�i 00
O
j a T + m r Ln Ol . N Ln r1 r
« U V M M V co M E N N m
O T VT tR V? V? VT V? VT VT Ln
O N n LO LD rl t0 00 .4' m
N T O M O O O1 N Ln N 00
T O
C a N lD N N tD N Ln 00 N
W
O 0 0 0 0 0 \ o o \ o \ o o \ \ e \ ° \ o \ 0 0 0 \ o \ 0 0 0 \ o \ o \ o \ o \ o \ 0
_ V tD 'T N N 00 Ln LD O lD I� 00 N I� m . W 00 Ql I� V V O N ri O1 rl
r1 N O O Ql I� n 00 r O O Ln M N C O Ln r e 4 M m e Ln Ln tO tD w O n O 0O r - I m Ln Ln
r0 f0 M Ln Ln M rl (A N r n 00 n O N O ri O -e ri N m Ln V' R tD 00 00 00 W Lo Ln r� N m M
C N rl rl N N N N N r1 e-1 rl r1 r-I rl r1 1-i N N ri rt N 11 rl
~ O
J
lD n 00 rl M to V M M 00 N tD 00 to rl O r Ln N N M r1 tD 1- O 0) tD W 00 rl N M ri 'CT n
00 00 r1 m Ln V r n N n N N 00 m LO Ln LO co O O 00 N m M rl O LD 00 LD N V tD rl r-1 00
H Q1 H tD I O1 V 0) M O V Ol t Ln m � V tD tD M t0 O C M 00 r M 00 00 N 01 Ln 01 rl Ln u-, I� V O1 rl co D1 O V O N W rl m M O m N M M 01 lD Q1 N r� Q tD O r-1 V n a t0 ri lD 01 r
« y 00 Ln O1 LO . o0 tD M Ln V m tD r m tD 00 N M M M O 0) CO Ln r1 tO m Ln Ln Ln w V Ln 00 00
C r N r1 to M M N r
N 01 l T-4 00 O1 01 Ln 00 00 rl V r� ri N O rl 00 rl N N N Cl LD r Ln al
X in N V? V? to V? V} V? V T 1^ Ln ? V? U 0) O LD W O Ln M m N O r1 r V M N ri LD
W r1 N ei V VT r-1 V? N V? N V? r4 V? Ln V? V} to V? 4j). VT V1
V? V? V? VT V) to V?
O r� V H N O 00 O Ln m O r r Ln 14 Ol 01 N O V n M C Ln 00 Ln 00 00 N 00 LD r� 01 M 01
ID W tD 0) N 01 00 O M LO O 0) r 00 Ln O 0) Ln cI r M N M Ol M r V Ln O O O 01 r1 c Ln 00
O Ln M 01 N N N 0O O N Ln n cr N tD r-I tD 1l Ln � N O LD 0) O Ol 01 0) r tD r� M N r1 Ln
to O O r. n ri ri 01 rl lD O 01 Ln 0) Ln O1 V N rl I� rl rl ' M Ln 01 V Ln m 41 W tD I r N W Ln
y N c 1 ri V? N r-I rt V M r .
) i N 1 Ln l0 w N tO O 00 r-I O 0 O M M N Ln r1 Ol a 00 N 11 M R M rl
X O V♦ V} V? V? VT V? V? V? V? V) m V ri Ql 00 00 r R N N c-1 Ln r-1 .-i r1 Ln Vn V1 to rl
N rl' rl M V? V? V? ( j V? N V} V? V? V? N N N V? to V? V?
tn
tO O d' m r1 r Ln M 0) Ln N t0 W M Ln V r-I 00 M N r n n .-i N N V r rl Ln 01 Ln Ln N N 00
N N Ln m M Ln W r 00 N N N ri r1 r-I C tD r m m V 0) 0) C CO N N N 00 N m V 01 tD m
Q1 tD N rl n N LD Ln 01 N to l0 N O W Q1 Ln O LO H N N Ol O1 O 00 a0 n l0 D1 M 01
r� M N M N 00 r1 N M N 0) Ln 0) 00 ri 00 O H Ln 00 4 00 O1 N V N V 1-1 Ln ri rl le V M M H
'tp M n Ln W Ln O 1� m r1 M N rl 01 0) O 0) 00 V - M m O Ln O N W V M Ln n N Ln O .-i Ln r
r1 N ri Ln co m N 0) ri . q N M V N 00 Ln O (7 O O Ln Ol O Ln O LD O rl N O r1 ; tD r Ln 00
V V? V? V} V) UT VT V} V? UT Vf V? V), R 00 0) N tD m Ln �q M M N Ol r-1 rl ri M M N ri tD ri
r1 N V) V VT V? V) N to N V? tn to V? tr• V? V? V) to V? V?
V? V? V? to
l oo Ol l0 Ln m M m to . - 1 0) 1l LO el Ln N W Ln 0) O m Ln V r ri N � ri 01 r r O 0) V V
E Ln V Ln LO Ln O M O . LD t0 a Ln 1 N Ln V rl � r M D7 V 1� V I� N M O O R Ln M ri to ri
O 01 N rl M O Ln Ln rl 00 01 � N t0 tD rl N r1 O '7 r- Ln Ln 00 00 N Ln Ln O O OO 00 00 r�
r o Lo v o r? m ri 00 Ln v of S � v 00 r m Ln Ln o m ri Lr to of v o Ln 00 00 ri o m a a
,£ tD 00 O Ln tD t0 r1 V tD .-i 00 w r rl 00 r O N N Ln 00 r1 r1 O N O A Ln LD O N O m LO O LD
ri rl r d' rt ri N V ri N a-1 Ln M I N Ln M ri 01 LO rl Ln 01 n It M N al (� ri 00 C Ln V
V? VT V? VT N V) (n V? V1 VT VF V? Ln tD O N l0 r Ln W N N rl tD ri N r-I Ln M m N Ol N �--�
d r-I r-I r-I V V> v* v> ti to V) Vf VT V) VT to VT v� V1 to to Vf
Ln Ln Ln Ln Ln Ln r-, n a
_T O1 N D1 O1 N C1
=m � O LO r� O - O N C
to
E li LO ri r1 N N L N r-I ri rl
V? N V? V? V? V? V? L} VT
7
N M rl N M rl Ln r n
E ri 0l M 'i 0l M ri N r.,
i
d W Ln N* Ln N V r-I LO Ln
LD I 00 tD I CO Ln Ln tD
in VT V? V? VT V? V) V? V?
T LO 00 tD 1� 0 V V a n 00 N 01 0) m tD 01 m O O tD Ln W 1 m O rl Ln 0 r R N V m O N O
y _ T-1 M Ln N m W rl N O Q1 W tD 00 tD r- tD to rZ tD Ln to r1 N N N
N E p LD LD tD M V R V
m
O V'
C
W
N W Ln N m V ao T O1 01 N V M Ol rt Ln M Ln 00 N D1 O a V M a lD O 1It N N N N
N
m W rl rl ri ri r) M N N 0) m Ln M Ln Ln* M M N M Q1 07 Ql Q1 W lD M V N N N
L p 01 01 Ol Ol Ln In Ln Ln H rl ri N ri rl ri rl
N
a
o . .~-I G .O, N r�l C « H r�l C « ri { « p -1 O « • •� O « . .�-r « r .�-I « r
•y„ 0 0 0 0 0 0 o 0 O 0 0 O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O
Ln
y N N N �+ N N N ++ N N N a� N N N F N N N N N N N N N a N N N N N N
CL ri ri 3 r1 3 e rl O rl O .ti 3 ri 3 r1 3
N N N 4A N kA N N N N N C N vi
d 01
01
a+ d
Ol d'
C LM
N LD
to •''
ri o
U Q d d
C A O O O
N T a a
> ° �- o m M £ M 0.
£
m N N N N « LO 3 m 3
C N «« « -11 d O E C E H
a s F H F H N N N d of d d
fV O M Ln M W M ri N O M LD
O V tD W m LD N 00 O N tD M
ri m O rY ri cY Ln m I� w Ln LD
r-I r-I ri ri ri ri ri ri
o Ln ri n m a r-I 00 m 0 m ma
00 v 0) r-, O o rn 0) o Ln 00 m
ri N Q1 r-1 w nll: O LD M O
00 I M 00 tD oo ri tD Ln r� Ln 00
N O) I 0) 00 Ln 0) M Ln O to N
lz Cri N O 0) O N M M M ri
0) N tD 00 m Ln M N N N N tD
N ri VT N V). VI• V? N V! N V? A^
Vn V? V?
Ln V r-I O r 0) 00 .-i F. n 0) 0) O)
(, 00 LD N N Ln '* N LD V a Ln
lD n O Ln 00 I� N 00 d' tD ri N
0) r-I r- 00 O LD 00 Ln 0) LD � O
O rl V N V Ln 0) 0) r-I m 00 V
0) 0) I-, tD N N .-i LD N N N LD
V? in VT lV VT V? VT V} } V} VT V V?
V T
Ln r-I O I -* Ln .-1 O LD tD '7 n
O tD M Ol r C Ln i M O M I
W M N M N 00 Ln LD Ln O N I
00 Ln tD O Ln ri M O Ln r ri n
ri N N I V 0 0) V M 1 00 00
Ln Q Ln � n 00 C LD N O ri 't 00 ri Lf1 Ln M V co r-i N N ri Ln
V? ? N N V? ri V VT ri V? V} V) V)
V) L} V)
m to N M I� Ln V O ri Ln LD
I n 00 m r-I O T-1 m I� O) N 00
Ln C Ln M I� N N 00 M <7 tD
LD 0) 0) Ln Ln LD ri M d ri m 0)
Lf) -�T M O N R tD M 0) N N M
Lf) N 00 I� M � ri (3 C 1l V lD
00 0) Ln' M co M N 00 M M N' 0)
V? V? V} N VT N V? V? V? V> Vt V)
V?
0 0 0 0 00 m LD 0) r-I O O O
Ln MM V 0) O 0) 0) O O O O
00 M 00 M N o N Ln 0) 00 C 1-
N Q) 00 O 0) 00 00 00 Ln Ln Ln Ln
tD Ln Ln tD ri r-I r-I ri r-I r-1 r-I ri
N w H r4 O O O O
N N r N N N N N
N� N N N N
N
N
f6
U
N N
O1 y
t �
i+ N
C �
W C1: i
m V y
2 W
0 �+ U
H Q d