Self-Funded Insurance Committee

CITY OF HENDERSON SELF-FUNDED INSURANCE COMMITTEE REGULAR MEETING MINUTES Wednesday, September 16, 2020 I. CALL TO ORDER Chairman Jennifer Fennema called the City of Henderson Self-Funded Insurance Committee meeting to order at 1:04 p.m., in the Valley View Conference room, City Hall, 1st Floor, 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 Jennifer Fennema Tom Chiello (via WebEx) John Day (via WebEx) Gary Hargis (via WebEx) Brett Hyde (via WebEx) Dan Pentkowski (via WebEx) Laura Shearin (via WebEx) ABSENT: Jim McIntosh ALTERNATES: Christopher Aguiar (via WebEx) Michael Dye (via WebEx) Maria Gamboa (via WebEx) Carlos McDade (via WebEx) JJ Moyes (via WebEx) Melissa Wright (joined at 1:27 p.m. via WebEx) ABSENT: Michael Charlton STAFF: Andre Dixon, 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 7 Wednesday, September 16, 2020 – Minutes GUESTS: Shawn Adkins, Gallagher Benefit Services (via WebEx) Bre Beaumier, Employee Benefits Specialist (via WebEx) Russell Garrett, HealthSCOPE Benefits (via WebEx) Lissette Gaona, Sierra Healthcare Options (via WebEx) Kelly Hall, Sierra Healthcare Options (via WebEx) Judy Morang, Sierra Healthcare Options (via WebEx) III. PUBLIC COMMENT There were no public comments presented. IV. ACCEPTANCE OF AGENDA (Motion) Mr. Pentkowski introduced a motion to accept the agenda as presented. The roll call vote favoring passage was: Those voting aye: Chiello, Day, Fennema, Gamboa, Hargis, Hyde, Pentkowski, and Shearin. Those voting nay: None. Those absent: None. Those abstaining: None. Chairman Fennema declared the motion carried. V. NEW BUSINESS NB-1 MINUTES SELF-FUNDED HEALTH INSURANCE COMMITTEE AUGUST 19, 2020 HUMAN RESOURCES Self-Funded Health Insurance Committee meeting minutes of August 19, 2020. (Motion) Chairman Fennema introduced a motion to adopt the meeting minutes of August 19, 2020, as presented. The roll call vote favoring passage was: Those voting aye: Chiello, Day, Fennema, Gamboa, Hargis, Hyde, Pentkowski, and Shearin. Those voting nay: None. Those absent: None. Those abstaining: None. Chairman Fennema declared the motion carried. Self-Funded Insurance Committee Page 3 of 7 Wednesday, September 16, 2020 – Minutes NB-2 MONTHLY FINANCIAL REPORT HUMAN RESOURCES City of Henderson Self-Funded Health Plan monthly financial report. Maria Gamboa, Accounting Manager, referred to pages 14-17 of the backup material and reviewed the financial reports as of July 31, 2020. She said the financial report would include figures for the month of July as the numbers from August were not ready in time to present at this month’s meeting. Shawn Adkins, Gallagher Benefit Services, clarified that the “Stop loss claims payments received” figure listed on the table of page 15 in the backup material is a residual carry over from the prior year and not a new large claim. NB-3 HEALTHSCOPE MONTHLY AND QUARTERLY CLAIMS REPORT HUMAN RESOURCES HealthSCOPE monthly and quarterly claims report. Russell Garrett, HealthSCOPE Benefits, referred to pages 18-25 of the backup material and reviewed the HealthSCOPE monthly reports for July 2020. He said this report is different than the quarterly report presented last month because last month’s report was a quarterly report and contained comparisons from HealthSCOPE’s book of business, whereas this report is more of a snapshoot comparison of the paid claims and utilization figures for the month of July. Following an inquiry by Shawn Adkins, Gallagher Benefit Services, regarding what the data shows regarding the deferred services members may have been putting off due to the COVID-19 pandemic, Mr. Garrett said he would look into providing the Committee more specifics on claims being filed to gauge whether the numbers are showing a large increase in deferred services claims for the third and fourth quarters. Responding to an inquiry by Courtney Redsull, Employee Benefits Manager, regarding the large month-to-month uptick in emergency room and urgent care utilization, Mr. Garrett stated he believes some of the numbers are representative of a larger claim that was paid out following a member’s accident. Self-Funded Insurance Committee Page 4 of 7 Wednesday, September 16, 2020 – Minutes NB-4 SIERRA HEALTHCARE OPTIONS MONTHLY REPORT HUMAN RESOURCES Sierra Healthcare Options monthly report. Kelly Hall, Sierra Healthcare Options, referred to pages 26-31 of the backup material and provided an update on Sierra Healthcare Options’ monthly report. Ms. Hall stated she is part of the Sierra Healthcare Options utilization management team and prepared the reports to provide the Committee a general idea of the utilization behind the functions in various parts of the departments. Responding to a question by Courtney Redsull, Employee Benefits Manager, regarding whether Sierra Healthcare Options have noticed any adverse effects caused by case managers not being allowed on site in hospitals during the pandemic, Ms. Hall said they have not experienced any adverse effects as their staff actively makes daily rounds to hospitals and communicates with members telephonically to provide case management. Additionally, she said they will continue on-site case management again as soon as hospitals allow for it. NB-5 HEALTH PLAN OF NEVADA STATUS REPORT HUMAN RESOURCES Health Plan of Nevada monthly status report. Note: Due to Amber Hubber with Health Plan of Nevada being unavailable for today’s meeting, the Committee did not hear this item. NB-6 PLAN DESIGN OF SELF-FUNDED HEALTH PLAN FOR PLAN YEAR 2021 HUMAN RESOURCES Review Plan Year 2021 Self-Funded Health Plan renewal report that includes cost projections for various plan design changes including a lower co-payment for doctor-on-demand services, inclusion of some vaccinations in the pharmacy plan, and options for lowering annual out-of-pocket maximum. Direct staff to implement the plan design changes selected by the Committee. Note: It was consensus of the Committee to discuss items NB-6 and NB-7 together, but vote on separately. Courtney Redsull, Employee Benefits Manager, clarified that item NB-6 provides the Committee the opportunity to discuss whether they would like to include any of the proposed plan design changes that were discussed at last month’s meeting in the 2021 Self-Funded Health Plan. Self-Funded Insurance Committee Page 5 of 7 Wednesday, September 16, 2020 – Minutes Shawn Adkins, Gallagher Benefit Services, referred to pages 32-43 of the backup material and provided an overview of the 2021 Self-Funded Health Plan renewal report and potential plan design change options under consideration for the 2021 Self-Funded Health Plan. Following an inquiry by Mr. Pentkowski regarding the cost savings the plan can expect to see on a monthly basis from members utilizing generic versus brand name prescription medication, Mr. Adkins stated the group, as a whole, has a high generic prescription utilization rate; therefore, the plan has almost hit a saturation point of cost savings from maximizing the generic prescription utilization savings. Responding to a question by Mr. Pentkowski regarding whether increasing Dispatch Health utilization would provide a significant cost savings to the plan, Mr. Adkins stated they are not predicting to see a net-cost-savings for more members utilizing Dispatch Health, other than in cases where members were able to avoid having to go to the emergency room for care. Following an inquiry by Ms. Redsull regarding what type of vaccines Mr. Adkins’ group foresees being available at pharmacies, Mr. Adkins stated they anticipate pharmacies to offer the COVID-19 vaccine when it is widely available to the public. Additionally, he said pharmacies generally do not offer things like travel vaccinations; however, standard vaccines like for the flu, shingles, HPV, and whooping cough are commonly offered. A discussion ensued regarding potential plan design changes, projected plan costs estimates, and the option packages for the 2021 Self-Funded Health Plan. (Motion) Mr. Hargis introduced a motion to direct staff to implement lowering the co-payment for doctor-on-demand services to $25.00 and add Express Scrips vaccine program as described in Option 2 on page 36 of the backup material as plan design changes for Plan Year 2021. The roll call vote favoring passage was: Those voting aye: Chiello, Day, Fennema, Gamboa, Hargis, Hyde, Pentkowski, and Shearin. Those voting nay: None. Those absent: None. Those abstaining: None. Chairman Fennema declared the motion carried. Self-Funded Insurance Committee Page 6 of 7 Wednesday, September 16, 2020 – Minutes NB-7 PLAN YEAR 2021 SELF-FUNDED HEALTH PLAN RENEWAL REPORT AND FUNDING RATES HUMAN RESOURCES Review Plan Year 2021 Self-Funded Health Plan renewal report that includes Conservative, Optimistic, and Best Estimate projected funding rate requirements for Plan Year 2021 for the various plan design changes the Committee has requested to consider. Direct staff to implement the funding rate model selected by the Committee that includes the Committee's selected plan design changes as well as whether to fund plan design changes through participant premium rate increase or through plan reserves. Courtney Redsull, Employee Benefits Manager, clarified that under item NB-7, the Committee will decide whether to fund any potential increase in plan costs from the plan design changes to the 2021 Self-Funded Health Plan, which was approved under item NB-6, through a participant premium rate increase or through plan reserves. Following an inquiry by Chairman Fennema regarding how much the plan reserves had changed over the year, Maria Gamboa, Accounting Manager, stated that the plan reserves amount did not change from last year to this year. A discussion ensued regarding the plan reserves amount and considerations for planning how to fund any potential increase in costs for Plan Year 2021. (Motion) Chairman Fennema introduced a motion to direct staff to establish funding rates for Plan Year 2021 according to the best estimate funding model that includes the plan design changes approved by the Committee under NB-6 and fund any potential additional plan design costs for Plan Year 2021 through the plan reserves. The roll call vote favoring passage was: Those voting aye: Chiello, Day, Fennema, Gamboa, Hargis, Hyde, Pentkowski, and Shearin. Those voting nay: None. Those absent: None. Those abstaining: None. Chairman Fennema declared the motion carried. VI. CHAIRMAN\MEMBER COMMENTS There were no chairman\member comments presented. VII. SET NEXT MEETING The next meeting was set for Wednesday, October 21, 2020. Self-Funded Insurance Committee Page 7 of 7 Wednesday, September 16, 2020 – Minutes VIII. PUBLIC COMMENT There were no public comments presented. IX. ADJOURNMENT There being no further business to conduct, Chairman Fennema adjourned the meeting at 2:56 p.m. Respectfully submitted, ____________________ Andre Dixon, Deputy City Clerk