Self-Funded Insurance Committee

CITY OF HENDERSON SELF-FUNDED INSURANCE COMMITTEE REGULAR MEETING MINUTES Wednesday, November 20, 2019 I. CALL TO ORDER Chairman Dan Pentkowski called the City of Henderson Self-Funded Insurance Committee meeting to order at 9:04 a.m., in the Westgate Conference Room, 1st Floor, City Hall, 240 Water Street, Henderson, Nevada 89015. II. CONFIRMATION OF POSTING AND ROLL CALL Courtney Redsull, Employee Benefits Manager, confirmed the Self-Funded Insurance Committee meeting had been noticed in compliance with the Open Meeting Law by posting the Agenda three working days prior to the meeting at City Hall, the Multigenerational Center, the Whitney Ranch Recreation Center, Fire Station No. 86, the Nevada Public Notice Website, the City of Henderson Website, and by mailing and emailing a copy of the Agenda to everyone appearing thereon on the Agenda Master Mailing List and Emailing List. PRESENT: Chairman Dan Pentkowski Tom Chiello John Day Jennifer Fennema (left at 9:59 a.m.) Gary Hargis Brett Hyde Jim McIntosh ABSENT: Laura Shearin ALTERNATES: Christopher Aguiar Michael Charlton Maria Gamboa Carlos McDade JJ Moyes Melissa Wright ABSENT: Michael Dye STAFF: Victoria Dasis, Deputy City Clerk Kristina Gilmore, Assistant City Attorney III Sally Ihmels, Assistant Director of Human Resources Courtney Redsull, Employee Benefits Manager Self-Funded Insurance Committee Page 2 of 8 Wednesday, November 20, 2019 – Minutes GUESTS: Shawn Adkins, Gallagher Benefit Services Lissette Gaona, Sierra Healthcare Options Lisa Hau, Human Resources Business Partner Judy Morang, Sierra Healthcare Options III. PUBLIC COMMENT There were no public comments presented. IV. ACCEPTANCE OF AGENDA (Motion) Mr. McIntosh introduced a motion to accept the agenda as presented. The vote favoring approval was unanimous. Chairman Pentkowski declared the motion carried. V. NEW BUSINESS NB-1 MINUTES SELF-FUNDED HEALTH INSURANCE COMMITTEE AUGUST 21, 2019 HUMAN RESOURCES Self-Funded Health Insurance Committee meeting minutes of August 21, 2019. (Motion) Mr. Day introduced a motion to adopt the meeting minutes of August 21, 2019, as presented. The vote favoring approval was unanimous. Chairman Pentkowski declared the motion carried. NB-2 MONTHLY FINANCIAL REPORT HUMAN RESOURCES City of Henderson Self-Funded Health Plan monthly financial report. Maria Gamboa, Accounting Manager, referred to the backup material and reviewed the following financial reports: Self-Funded Health Insurance Fund (Fund 6051); Retiree Insurance Subsidy; and Stop Loss Restricted Cash, as of October 31, 2019. Self-Funded Insurance Committee Page 3 of 8 Wednesday, November 20, 2019 – Minutes NB-3 LOOMIS MONTHLY CLAIMS REPORT HUMAN RESOURCES Loomis monthly claims report. A representative from The Loomis Company was not in attendance. Shawn Adkins, Gallagher Benefit Services, reviewed the Loomis monthly claims report, which included the Paid Claims Analysis and the Large Claim Summary. Mr. Adkins said the medical enrollees are overstated due to Loomis double counting the out-of-area members. He explained Loomis counts them once for being in the greater Las Vegas service area and once for being on the Cigna plan. Mr. Adkins said the medical enrollee count will be accurate next year once the plan moves to HealthSCOPE. Responding to an inquiry by Mr. Day regarding the stop loss reimbursements, Mr. Adkins said both medical and prescription costs are covered; however, he stated the Loomis report does not include pharmacy on the large claimants on pages 22-24 in the backup material. NB-4 SIERRA HEALTHCARE OPTIONS MONTHLY REPORT HUMAN RESOURCES Sierra Healthcare Options (SHO) monthly report. Judy Morang, Sierra Healthcare Options, stated she has been in communications with Anthem Hills Medical Group and Family Doctors of Green Valley and hopes to have their practices as contracted providers by January 1, 2020. She stated she has also been working on contract proposals with National Seating & Mobility, Cologuard, which is processed by Exact Sciences Laboratory, and TeamHealth Emergency Physicians. Ms. Morang reported that Edgepark Medical Supplies is now contracted with the plan. She said this company provides durable medical equipment such as breast pumps and walkers. Ms. Morang stated the cardiovascular and thoracic surgeons at MountainView Hospital have been contracted on the HCA insurance plans, and noted the hospital is continually adding physicians. Ms. Morang said she is always willing to add providers to the network and encouraged the Committee to submit any recommendations they may have. Self-Funded Insurance Committee Page 4 of 8 Wednesday, November 20, 2019 – Minutes NB-5 HEALTH PLAN OF NEVADA STATUS REPORT HUMAN RESOURCES Health Plan of Nevada monthly status report. Courtney Redsull, Employee Benefits Manager, stated she did not receive any updates from the Health Plan of Nevada representative. NB-6 GALLAGHER BENEFIT SERVICES QUARTERLY REPORT HUMAN RESOURCES Gallagher Benefit Services 3rd Quarter 2019 report. Shawn Adkins, Gallagher Benefit Services, stated the Internal Revenue Service will still be requiring the 1095 tax forms even though it is no longer federally mandated for individuals to have health insurance. Mr. Adkins referred to the backup material and gave the Gallagher Benefit Services third quarter 2019 report, which provided data through September 30, 2019. He stated the plan has a surplus of $1,686,358.00 and expects the plan to be in a positive position for the remainder of 2019. NB-7 STOP LOSS COVERAGE FOR PLAN YEAR 2020 HUMAN RESOURCES Review the stop loss insurance renewal options for Plan Year 2020. Renewal options also detailed in the attached renewal proposal and renewal analysis. Select one option for recommendation to City Council for approval. Renewal at Current Deductible Individual Deductible: $525,000.00 Single Rate: $7.26 per employee per month Family Rate: $32.56 per employee per month Estimated total annual premium: $382,589.00 Increase of 38.5% over current year premium Alternative #1 Individual Deductible: $550,000.00 Single Rate: $6.76 per employee per month Family Rate: $30.82 per employee per month Estimated total annual premium: $361,606.00 Increase of 30.9% over current year premium Self-Funded Insurance Committee Page 5 of 8 Wednesday, November 20, 2019 – Minutes Alternative #2 Individual Deductible: $600,000.00 Single Rate: $5.98 per employee per month Family Rate: $27.97 per employee per month Estimated total annual premium: $327,424.00 Increase of 18.5% over current year premium Courtney Redsull, Employee Benefits Manager, provided an overview of the stop loss insurance renewal options for Plan Year 2020. She explained Gallagher Benefits Services put a bid out to nine other stop loss carriers; however, eight of the carriers declined to bid because their rate did not compare to what the current carrier offered for a renewal, and one carrier did not respond. Ms. Redsull stated the current carrier presented alternatives if the Committee wanted to choose a higher deductible, rather than the proposed current deductible. She explained that a higher deducible would have lower premium costs and summarized Alternative #1 and Alternative #2. Following an inquiry by Mr. Chiello regarding why the premium costs were raised, Ms. Redsull said it was due to high claim activity in 2019. Shawn Adkins, Gallagher Benefit Services, concurred and added that the premium may have also been affected by the number of individuals on the plan. He stated carriers typically consider businesses credible when there is a minimum of 5,000 individuals on the plan. Mr. Adkins cautioned the Committee if they choose to increase the deductible, there could be additional claims exposure to the plan. A discussion ensued regarding the details of each stop loss insurance renewal option. (Motion) Mr. Chiello introduced a motion to select the stop loss insurance coverage renewal at the current deductible rate of $525,000.00 for Plan Year 2020, and directed staff to submit the renewal to the City Council for approval. The vote favoring approval was unanimous. Chairman Pentkowski declared the motion carried. Self-Funded Insurance Committee Page 6 of 8 Wednesday, November 20, 2019 – Minutes NB-8 UTILIZATION OF UNITED HEALTHCARE CHOICE PLUS NETWORK BY LOCAL AREA MEMBERS HUMAN RESOURCES Discuss various options for allowing local area members to utilize the United Healthcare (UHC) Choice Plus network and direct staff to implement the option the Committee selects. Option #1 Local area members may access the United Healthcare Choice Plus network without prior-authorization when traveling outside the Sierra Healthcare Options network service area, and in need of emergency services. They may also, with prior-authorization, access the UHC Choice Plus network for services that are not available in-network through the Sierra Healthcare Options local network. Option #2 Local area members may access the United Healthcare Choice Plus network without prior-authorization when traveling outside the Sierra Healthcare Options network service area, and in need of emergency services. They may also, with prior-authorization, access the United Healthcare Choice Plus network for any other services, regardless of whether the services are available in-network through the Sierra Healthcare Options local network. The prior-authorization requirement on this option includes services that would not normally require prior-authorization if the services were being accessed within the Sierra Healthcare Options local network. Option #3 Local area members may utilize the United Healthcare Choice Plus network for any services, and will only be required to seek prior-authorization of such services if prior-authorization would also be required if seeking those same services through the Sierra Healthcare Options local network. Option #4 Any other viable option presented by a Committee member. Courtney Redsull, Employee Benefits Manager, stated the plan will be moving forward with HealthSCOPE Benefits next year and the Committee will need to select how they would like the out-of-area United Healthcare Choice Plus plan to be set up. She summarized the options outlined above and stated HealthSCOPE’s current system would align with Option #3. A discussion ensued regarding the possibilities of each option for allowing local area members to utilize the United Healthcare Choice Plus network. Self-Funded Insurance Committee Page 7 of 8 Wednesday, November 20, 2019 – Minutes Following an inquiry by Chairman Pentkowski regarding if either option will affect the plan more than the other, Mr. Adkins said the pricing and administrative configurations currently align with Option #3. Ms. Redsull said there have been instances where services were not available in-network; however, she worked with Sierra Healthcare Options and Behavioral Healthcare Options to try to bring those providers in-network. Following an inquiry by Mr. Day regarding who makes the decision for pre-authorizing services, Ms. Redsull said Sierra Healthcare Options makes the decision. Ms. Redsull stated the pre-authorization requirements would be based on the services being requested, not where the services are conducted. Mr. Hargis inquired how Option #3 would affect the out-of-stated college students on the plan. Ms. Redsull stated the college students will be automatically designated through United Healthcare Choice Plus, and they will be serviced through Sierra Healthcare Options when they are here locally. (Motion) Mr. Hargis introduced a motion to selected Option #3 for local area members to utilize the United Healthcare Choice Plus network, and directed staff to implement the option. The roll call vote favoring passage was: Those voting aye: Tom Chiello, John Day, Jim Dunlap, Gary Hargis, Brett Hyde, Carlos McDade, Jim McIntosh, JJ Moyes, and Dan Pentkowski. Those voting nay: None. Those absent: Jennifer Fennema and Laura Shearin. Those abstaining: None. Chairman Pentkowski declared the motion carried. VI. CHAIRMAN\MEMBER COMMENTS Mr. Chiello requested an item be added to a future agenda to discuss which pharmacies are authorized to provide flu shots under the health plan. Mr. Day requested vaccinations be included on the discussion item. Courtney Redsull, Employee Benefits Manager, said the CVS MinuteClinic locations are authorized to provide flu shots, and that she will put Mr. Chiello’s and Mr. Day’s requests on a future agenda. Ms. Redsull stated she will schedule the 2020 Self-Funded Health Insurance Committee meetings from 1:00 p.m. to 3:00 p.m. She noted that the February 2020 meeting will be meeting on the fourth week of the month and the November 2020 meeting will be moved to the second week of the month. Self-Funded Insurance Committee Page 8 of 8 Wednesday, November 20, 2019 – Minutes Sally Ihmels, Assistant Director of Human Resources, commended Ms. Redsull and her team for their efforts with the new Ben Admin project. VII. SET NEXT MEETING The next meeting was not scheduled. VIII. PUBLIC COMMENT There were no public comments presented. IX. ADJOURNMENT There being no further business to conduct, Chairman Pentkowski adjourned the meeting at 10:11 a.m. Respectfully submitted, ____________________ Victoria Dasis, Deputy City Clerk