Self-Funded Insurance Committee

CITY OF HENDERSON SELF-FUNDED INSURANCE COMMITTEE MEETING MINUTES WEDNESDAY, AUGUST 18, 2021 I. CALL TO ORDER Chairman Daniel Pentkowski called the City of Henderson Self-Funded Insurance Committee meeting to order at 1:06 p.m., in the Tuscany Conference Room, City Hall 3rd 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 and Emailing List. PRESENT: Chairman Daniel Pentkowski Thomas Chiello John Day Gary Hargis Jim McIntosh Laura Shearin Brooke Stream ABSENT: Bret Hyde (excused) ALTERNATES: Maria Gamboa JJ Moyes (Left at 2:20 p.m.) Shawn Thibeault ABSENT: Christopher Aguiar (excused) Michael Charlton (excused) Michael Dye (excused) Carlos McDade (excused) Melissa Wright (excused) STAFF: Andre Dixon, Deputy City Clerk Kristina Gilmore, Assistant City Attorney III Courtney Redsull, Employee Benefits Manager GUESTS: Shawn Adkins, Gallagher Benefit Services Russell Garrett, HealthSCOPE Benefits Kelly Hall, Sierra Healthcare Options Amber Hubber, Health Plan of Nevada Sarah Stephenson, Sierra Healthcare Options Self-Funded Insurance Committee Meeting Page 2 of 8 Wednesday, August 18, 2021 – Minutes III. PUBLIC COMMENT There were no public comments presented. IV. ACCEPTANCE OF AGENDA (For Possible Action) (Motion) Mr. Hargis introduced a motion to accept the agenda, as presented. The vote favoring approval was unanimous. Chairman Pentkowski declared the motion carried. V. NEW BUSINESS 1 MINUTES SELF-FUNDED HEALTH INSURANCE COMMITTEE JUNE 16, 2021 FINANCE DEPARTMENT Self-Funded Health Insurance Committee meeting minutes of June 16, 2021. (Motion) Mr. McIntosh introduced a motion to adopt the meeting minutes of June 16, 2021, as presented. The vote favoring approval was unanimous. Chairman Pentkowski declared the motion carried. Self-Funded Insurance Committee Meeting Page 3 of 8 Wednesday, August 18, 2021 – Minutes 2 MONTHLY FINANCIAL REPORT FINANCE DEPARTMENT City of Henderson Self-Funded Health Plan monthly financial report for June 2021. Maria Gamboa, Accounting Manager, reviewed the Self-Funded Health Plan monthly financial report for June 2021. A brief discussion ensued regarding the plan’s coupon and rebates process. Following an inquiry by Chairman Pentkowski regarding why the numbers are showing a projected deficit, Ms. Gamboa stated it is partly due to the timing of the City’s annual contribution of $230,000.00 that will be accounted for in next month’s financials. Courtney Redsull, Employee Benefits Manager, stated there will be an agenda item at a future meeting for the Committee to consider potentially increasing the plan’s risk in order to lower premiums for members. Self-Funded Insurance Committee Meeting Page 4 of 8 Wednesday, August 18, 2021 – Minutes 3 HEALTHSCOPE QUARTERLY REPORT FINANCE DEPARTMENT HealthSCOPE quarterly report for 2nd Quarter 2021. Russell Garrett, HealthSCOPE Benefits, presented the HealthSCOPE quarterly report covering the period of January 2021 through June 2021. Mr. Garrett said to follow up on a question asked at a previous meeting regarding where gastrointestinal disorders typically rank in the reported claims, those claims ranked fifth and accounted for approximately 7.3 percent paid on claims in 2020’s fourth quarter reports. Additionally, gastrointestinal disorders ranked fourth and accounted for approximately 7.4 percent paid on claims in 2021’s second quarter reports. Following an inquiry by Courtney Redsull, Employee Benefits Manager, regarding the percentage of the membership who have not filed a claim this year, Mr. Garrett said 35.5 percent of the membership has not filed a claim this year. Responding to a question by Chairman Pentkowski regarding where Dispatch Health visits are accounted for in the numbers, Mr. Garrett said he will confirm where those figures are accounted for in the report and follow up with the Committee at the next meeting. Mr. Garrett said claim payments regarding Diabetes have stayed consistent as they normally account for 0.8 percent paid on claims; however, they accounted for 1.1 percent paid on claims in this quarter’s report. A brief discussion ensued regarding the process that occurs when hospitals that members utilize are no longer considered in-network within the plan. Shawn Adkins, Gallagher Benefit Services, stated as a follow up to the discussion from the last meeting, his group is still projecting an increase in dental claims as the numbers are showing a trend of dental services being one of the highest benefits being utilized by members. Mr. Garrett presented a report titled, “2022 Compliance Update,” covering how HealthSCOPE plans on complying with the Consolidated Appropriations Act (CAA). A discussion ensued regarding the potential effects and changes to the medical industry stemming from meeting the new requirements established by the CAA. Self-Funded Insurance Committee Meeting Page 5 of 8 Wednesday, August 18, 2021 – Minutes 4 SIERRA HEALTHCARE OPTIONS MONTHLY REPORT FINANCE DEPARTMENT Sierra Healthcare Options monthly report. Kelly Hall and Sarah Stephenson, Sierra Healthcare Options, presented a summary of the Sierra Healthcare Options monthly report. Courtney Redsull, Employee Benefits Manager, requested a list of common reasons that would cue SHO case managers to call members for case management that she could provide to plan members for reference. Chairman Pentkowski suggested providing information on the benefits of utilizing services such as Teladoc and Dispatch Health rather than emergency room visits with the correspondence being sent out to members during open enrollment. 5 HEALTH PLAN OF NEVADA MONTHLY STATUS REPORT FINANCE DEPARTMENT Health Plan of Nevada monthly status report. Amber Hubber, Health Plan of Nevada, presented a summary of this item and stated the six Southwest Medical Convenient Care facilities located across the valley will be closing down on September 1, 2021. She said she doesn’t believe there will be a mailing to members informing them of the closures; however, she believes the plan is to post information on the member website and at the location of the closed facilities. Courtney Redsull, Employee Benefits Manager, requested a list of the facilities that will be closing down. Self-Funded Insurance Committee Meeting Page 6 of 8 Wednesday, August 18, 2021 – Minutes 6 GALLAGHER BENEFIT SERVICES QUARTERLY REPORT FINANCE DEPARTMENT Gallagher Benefit Services quarterly report for 2nd Quarter 2021. Shawn Adkins, Gallagher Benefit Services, presented a summary of this item and highlighted several noticeable trends in the reports including a surge in dental claims and lower large-procedure claims and routine utilization claims than the historical trend. He said staff are still uncertain as to when the numbers will revert back to pre-pandemic trends. Mr. Adkins said members should be cautioned about knowing beforehand whether a potential COVID-19 test is being categorized as medically necessary or for occupational health or surveillance purposes to avoid any unexpected charges due to denial of claims. A discussion ensued regarding how heart and lung claims for police and fire department personnel are being reported and processed in relation to other plan members. Mr. Adkins stated the Committee will be presented with several options discussing potential changes to the plan including determining whether to raise, decrease, or have a rate pass. Self-Funded Insurance Committee Meeting Page 7 of 8 Wednesday, August 18, 2021 – Minutes 7 REVIEW STATUS OF DUEXIS ON PHARMACY PLAN FORMULARY FINANCE DEPARTMENT Review the status of the combination drug Duexis on the pharmacy plan formulary and consider the following options: • Remove Duexis from the pharmacy plan formulary at an estimated annual plan savings of approximately $90,000.00 • Place Duexis on a required Step Therapy at a cost of $0.03 per member per month, an estimated cost to the health plan of approximately $1,500.00 annually • Take no action to the status of Duexis on the pharmacy plan formulary Courtney Redsull, Employee Benefits Manager, and Shawn Adkins, Gallagher Benefit Services, presented a summary of this item. Responding to a question by Mr. Chiello regarding how many members are utilizing Duexis scripts, Ms. Redsull said 14 members filled scripts last year and 15 members have filled scripts this year. A discussion ensued regarding potential alternative options to Duexis available to members and the communication plan to inform members of the available options if a change is made. (Motion) Mr. McIntosh introduced a motion to remove Duexis from the pharmacy plan formulary as of January 1, 2022. The vote favoring approval was unanimous. Chairman Pentkowski declared the motion carried. VI. CHAIRMAN\MEMBER COMMENTS Following an inquiry by Shawn Adkins, Gallagher Benefit Services, whether the Committee would like to review other combination scripts like Duexis and alternatives for savings to the plan, it was a consensus of the Committee to have agenda items on future meetings to discuss potential options. Courtney Redsull, Employee Benefits Manager, said the October Self-Funded Insurance Committee Meeting might conflict with the schedule of the 2021 IFEBP Employee Benefits Conference; therefore, the Committee may have to adjust the meeting date for October. Ms. Redsull requested any member interested in attending the conference, either in person or virtually, to contact her for information regarding registration reimbursement. Self-Funded Insurance Committee Meeting Page 8 of 8 Wednesday, August 18, 2021 – Minutes VII. SET NEXT MEETING The next meeting date was set for September 15, 2021, with a time to be determined. VIII. PUBLIC COMMENT There were no public comments presented. IX. ADJOURNMENT There being no further business to discuss, Chairman Daniel Pentkowski adjourned the meeting at 2:59 p.m. Respectfully Submitted, _____________________ Andre Dixon, Deputy City Clerk