Self-Funded Insurance Committee

CITY OF HENDERSON SELF-FUNDED INSURANCE COMMITTEE MEETING MINUTES Wednesday, August 17, 2022 I. CALL TO ORDER Chair Jim McIntosh called the City of Henderson Self-Funded Insurance Committee meeting to order at 1:06 p.m., in the Green Valley Training Room, City Hall 2nd 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 Nevada Open Meeting Law. PRESENT: Chair Jim McIntosh Thomas Chiello (arrived at 1:41 p.m.) Gary Hargis Daniel Pentkowski (arrived at 1:56 p.m.) Laura Shearin Brooke Stream ABSENT: Bret Hyde (Excused) JJ Moyes (Excused) ALTERNATES: Christopher Aguiar (arrived at 1:14 p.m.) Michael Charlton Maria Gamboa Nick McLemore Shawn Thibeault ABSENT: Carlos McDade (Excused) Michael Page (Excused) STAFF: Andre Dixon, Deputy City Clerk Kristina Gilmore, Assistant City Attorney III Courtney Redsull, Employee Benefits Manager GUESTS: Shawn Adkins, Gallagher Benefit Services Robert Campbell, Gallagher Benefit Services (via videoconference) Russell Garrett, HealthSCOPE Benefits Jonathan Glos, IngenioRx (via videoconference) Kelly Hall, Sierra Healthcare Options Gabrielle Ruelas, IngenioRx (via videoconference) Sarah Stephenson, Sierra Healthcare Options Self-Funded Insurance Committee Meeting Page 2 of 8 Wednesday, August 17, 2022 – Minutes III. PUBLIC COMMENT There were no public comments presented. IV. ACCEPTANCE OF AGENDA Item 7 was moved ahead in the agenda to be heard immediately following Item 1. (Motion) Brooke Stream introduced a motion to accept the agenda, as amended. The roll call vote favoring passage was: Those voting aye: Michael Charlton, Gary Hargis, Jim McIntosh, Laura Shearin, Brooke Stream, and Shawn Thibeault. Those voting nay: None. Those absent: Christopher Aguiar. Those abstaining: None. Chair McIntosh declared the motion carried. V. NEW BUSINESS 1 MINUTES SELF-FUNDED HEALTH INSURANCE COMMITTEE JUNE 15, 2022 FINANCE DEPARTMENT Self-Funded Health Insurance Committee minutes of June 15, 2022. (Motion) Laura Shearin introduced a motion to approve the minutes of June 15, 2022, as presented. The roll call vote favoring passage was: Those voting aye: Michael Charlton, Gary Hargis, Jim McIntosh, Laura Shearin, Brooke Stream, and Shawn Thibeault. Those voting nay: None. Those absent: Christopher Aguiar. Those abstaining: None. Chair McIntosh declared the motion carried. 2 MONTHLY FINANCIAL REPORT FINANCE DEPARTMENT City of Henderson Self-Funded Health Plan monthly financial report for June 2022. Self-Funded Insurance Committee Meeting Page 3 of 8 Wednesday, August 17, 2022 – Minutes Maria Gamboa, Assistant Director of Finance, reviewed and summarized the following financial reports from the backup materials: Self-Funded Health Insurance Fund (Fund 6051) as of June 2022 Cash Basis - Unaudited, Retiree Insurance Subsidy as of June 30, 2022 (Exhibit 1), and Stop Loss Restricted Cash (Exhibit 2) as of June 30, 2022. 3 HEALTHSCOPE QUARTERLY REPORT - 2ND QUARTER PLAN YEAR 2022 FINANCE DEPARTMENT HealthSCOPE quarterly report for 2nd Quarter Plan Year 2022. Russ Garrett, HealthSCOPE, presented the HealthSCOPE quarterly report covering the time period of January – June 2022 and discussed what the numbers show in comparison to last quarter’s numbers. Following an inquiry from Ms. Redsull regarding whether the City’s rate of members utilizing non-network providers for dental is common, Shawn Adkins, Gallagher Benefit Services, said it is common to see similar numbers in other organizations. A brief discussion ensued regarding the number of members utilizing immunization services. Kelly Hall and Sarah Stephenson with Sierra Healthcare Options, discussed the utilization management, telephone advice nurse (TAN), and out-patient case management for Sierra Healthcare members. Responding to the question from Ms. Redsull regarding whether the City’s rate of members utilizing the TAN is normal, Kelly Hall said the City’s rate is on average with what they see among similar organizations. 4 GALLAGHER BENEFIT SERVICES QUARTERLY CLAIMS REPORT 2ND QUARTER PLAN YEAR 2022 FINANCE DEPARTMENT Gallagher Benefit Services Quarterly Claims Report for 2nd Quarter Plan Year 2022. Shawn Adkins, Gallagher Benefit Services, presented a summary of this item and highlighted several noticeable trends in the reports including an increase in dental, medical, pharmacy utilization, and large-procedure claims and routine claims than the historical trend. He said there is still some uncertainty as to when the numbers will find a new normal post-pandemic. Self-Funded Insurance Committee Meeting Page 4 of 8 Wednesday, August 17, 2022 – Minutes A brief discussion ensued regarding what the numbers are showing in comparison of post-pandemic to pre-pandemic plan utilization. 5 DELTA DENTAL ADMINISTRATIVE FEE RENEWAL PROPOSAL FOR PLAN YEARS 2023 - 2024 FINANCE DEPARTMENT Review Delta Dental administrative fee contract renewal proposal for Plan Years 2023 - 2024 and make a recommendation to the Chief Financial Officer for approval. Proposal includes a three percent premium rate increase over current at an estimated additional annual cost of $1,530.00, and a total estimated annual cost of $52,200.00. Courtney Redsull, Employee Benefits Manager, presented a summary of this item and stated the City has received an administrative fee contract renewal offer for Plan Years 2023 - 2024 from Delta Dental with a nominal increase of approximately 3 percent. Following the inquiry of Christopher Aguiar regarding whether staff has noticed a significant drop in providers from Delta Dental, Ms. Redsull and Shawn Adkins, Gallagher Benefit Services, said they have not. However, Mr. Adkins said just in general, they are seeing more dentists dropping out of network nationally. (Motion) Shawn Thibeault introduced a motion recommending to direct staff to present and recommend approval of Delta Dental contract renewal proposal for Plan Years 2023 - 2024 to the Chief Financial Officer. The roll call vote favoring passage was: Those voting aye: Christopher Aguiar, Michael Charlton, Gary Hargis, Jim McIntosh, Laura Shearin, Brooke Stream, and Shawn Thibeault. Those voting nay: None. Those absent: None. Those abstaining: None. Chair McIntosh declared the motion carried. 6 OUT-OF-NETWORK SIERRA HEALTHCARE OPTIONS DENTAL CLAIMS ADJUDICATION FINANCE DEPARTMENT Discuss current status of claims adjudication method for Sierra Healthcare Options out-of-network dental claims, as well as an administrative change to the claims adjudication method moving forward. Shawn Adkins, Gallagher Benefit Services, presented a summary of this item detailing the process of how out-of-network dental claims are being adjudicated among providers and members. Self-Funded Insurance Committee Meeting Page 5 of 8 Wednesday, August 17, 2022 – Minutes Courtney Redsull, Employee Benefits Manager, discussed how these changes will affect billing for providers and members of the plan and what to keep an eye on moving forward. Following the inquiry of Brooke Stream regarding whether staff plans on providing any communication to educate members on these changes, Ms. Redsull said yes, they present the information when onboarding new hires and staff also plans on making another targeted effort to inform members during the open-enrollment process. 7 CITY SELF-FUNDED HEALTH PLAN PHARMACY BENEFIT MANAGER (PBM) CONTRACT RECOMMENDATION FINANCE DEPARTMENT Discuss proposals made for Pharmacy Benefit Manager (PBM) Services by incumbent PBM Express Scripts Incorporated (ESI), and IngenioRx, the recommended bidder, including presentation to the Committee from IngenioRx. Consider approving committee staff to negotiate a three (3) year contract for PBM services with IngenioRx at an estimated annual cost of $3,503,660.00, and an estimated annual savings of $1,162,943.00 per year. Note: This item was heard immediately following Item 2 of the agenda. Shawn Adkins, Gallagher Benefit Services, presented a summary of this item and stated his group recommends switching to IngenioRx for PBM services based on their offered processes and the price savings it would yield to the City’s plan. Gabrielle Ruelas and Jonathan Glos, with IngenioRx and Robert Campbell, Gallagher Benefit Services, presented a PowerPoint presentation via Microsoft Teams discussing IngenioRx and the services they could offer the City. A brief discussion ensued regarding how a potential change in PBM services would affect the Plan’s current users. (Motion) Michael Charlton introduced a motion to approve Committee staff to negotiate a three (3) year contract for Pharmacy Benefit Manager (PBM) services with IngenioRx for presentation to City Council for approval. The roll call vote favoring passage was: Those voting aye: Christopher Aguiar, Michael Charlton, Gary Hargis, Jim McIntosh, Laura Shearin, Brooke Stream, and Shawn Thibeault. Those voting nay: None. Those absent: None. Those abstaining: None. Chair McIntosh declared the motion carried. Self-Funded Insurance Committee Meeting Page 6 of 8 Wednesday, August 17, 2022 – Minutes 8 PLAN YEAR 2023 SELF-FUNDED HEALTH PLAN RENEWAL REPORT AND FUNDING RATES FINANCE DEPARTMENT Review Plan Year 2023 Self-Funded Health Plan renewal report that includes estimated projected funding rate requirements for Plan Year 2023, including possible modifications to medical and dental plan funding. Direct staff to implement the funding rate model selected by the Committee. Funding rate model options include:  Retaining current funding model for medical/prescription drug, dental, and vision rates for active employees, COBRA participants, and retirees, and absorbing any anticipated funding shortage through plan reserves.  Adjust the funding model to increase medical/prescription drug funding to account for projected shortfalls in the funding of these plans. This option will increase medical/prescription drug funding by an estimated 5.6 percent, or $965,921.00 (active employees), in Plan Year 2023.  Adjust the funding model to increase dental funding in both the Delta Dental and Sierra Healthcare Options (SHO) dental plans to account for projected shortfalls in the funding of the dental plans. This option will increase dental funding by an estimated 12.6 percent, or $133,799.00 (active employees), in Plan Year 2023.  Adjust the funding model to increase funding for other benefits (life insurance, long term disability, and employee assistance program) to account for projected shortfalls in the funding of these benefits. This option will increase funding for these benefits by an estimated 3.1 percent, or $16,032.00 (active employees), in Plan Year 2023.  Adopt the medical/prescription drug, dental, and other benefit funding model increases listed above, and adjust the funding model to increase funding by an estimated 5.9 percent, or $1,115,751.00 (active employees), in Plan Year 2023.  Any additional funding model the Committee may suggest, consider, and approve. Shawn Adkins, Gallagher Benefit Services, presented a summary of the Plan Year 2023 Self-Funded Health Plan renewal report and discussed the estimated projected funding rate requirements and possible modifications to the medical and dental plan funding. Courtney Redsull, Employee Benefits Manager, discussed the options available to the Committee to decide from for Plan Year 2023 rates. Self-Funded Insurance Committee Meeting Page 7 of 8 Wednesday, August 17, 2022 – Minutes Responding to the question from Thomas Chiello regarding what is the total shortage that staff is predicting needs to be made up for in Plan Year 2023, Ms. Redsull said approximately 1.15 million dollars. Following an inquiry from Brooke Stream regarding when was the last time the plan charged a rate increase to members, Ms. Redsull said the last year members saw a rate increase on January 1st was in 2018. A discussion ensued regarding the what the members believe is the best way to account for the increase in claims, routine utilization by members, and preparing for the future in regards to potential plan deficits or the need for rate increases. Following the request of Thomas Chiello, Mr. Adkins broke down the monthly increase staff approximates members would pay for full-family coverage. Ms. Redsull clarified that for this item, the Committee is voting on a funding rate for Plan Year 2023 as opposed to who or where the money is coming from if there is a rate increase. (Motion) Chair Jim McIntosh introduced a motion to approve and direct staff to adopt the medical/prescription drug, dental, and other benefit funding model increases listed above, and adjust the funding model to increase funding by an estimated 5.9 percent, or $1,115,751.00 (active employees), in Plan Year 2023. The roll call vote favoring passage was: Those voting aye: Christopher Aguiar, Michael Charlton, Gary Hargis, Jim McIntosh, Laura Shearin, Brooke Stream, and Shawn Thibeault. Those voting nay: None. Those absent: None. Those abstaining: None. Chair McIntosh declared the motion carried. VI. CHAIRMAN\MEMBER COMMENTS Courtney Redsull, Employee Benefits Manager, thanked Laura Shearin and Thomas Chiello for their service to the Committee and congratulated them on their retirements. She said with their retirements, Nick McLemore will replace Ms. Shearin’s position on the Committee and Christopher Aguiar will replace Mr. Chiello on the Committee as of September 1st. The members of the Committee wished Ms. Shearin and Mr. Chiello a happy retirement. Self-Funded Insurance Committee Meeting Page 8 of 8 Wednesday, August 17, 2022 – Minutes Following the inquiry of Daniel Pentkowski regarding members getting charged copays when utilizing mental health services, Ms. Redsull said they should not be getting charged anymore; however, if any Committee member knows of anyone being charged to have them contact Ms. Redsull or her staff. Russell Garrett, HealthSCOPE Benefits, briefly discussed how the mental health claims were being processed to explain why members have been getting charged. He said claim processers have since been briefed on the updates and mentioned the refund processing process for those members who may have been charged a copay. VII. SET NEXT MEETING The next meeting date was set for Wednesday, September 21, 2022, at a time to be determined later. VIII. PUBLIC COMMENT There were no public comments presented. IX. ADJOURNMENT There being no further business to discuss, Chair McIntosh adjourned the meeting at 3:15 p.m. Respectfully Submitted, /s/ Andre Dixon Andre Dixon, Deputy City Clerk