Self-Funded Insurance Committee

CITY OF HENDERSON SELF-FUNDED INSURANCE COMMITTEE MINUTES Wednesday, October 18, 2023 I. CALL TO ORDER Chair Dan Pentkowski called the City of Henderson Self-Funded Insurance Committee meeting to order at 1:05 p.m., in the Mayor and Council Board Room, 4th Floor, City Hall, 240 South 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 Dan Pentkowski Christopher Aguiar Maria Gamboa Bret Hyde Nick McLemore JJ Moyes Brooke Stream Shawn Thibeault ABSENT: None ALTERNATES: Carol Banks Michael Charlton Carlos McDade Michael Page ABSENT: Joann Carter (excused) Rebecca Gillis (excused) Charles Hedrick (excused) Michael Openshaw (excused) STAFF: Kristina Gilmore, Assistant City Attorney III (via teleconference) Courtney Redsull, Employee Benefits Manager Michelle Reese, Deputy City Clerk Christine Scott, Employee Benefits Specialist Self-Funded Insurance Committee Meeting Page 2 of 6 Wednesday, October 18, 2023 – Minutes III. PUBLIC COMMENT There were no public comments presented. IV. ACCEPTANCE OF AGENDA (For Possible Action) (Motion) Member Christopher Aguiar introduced a motion to accept the agenda, as presented. The vote favoring approval was unanimous. Chair Dan Pentkowski declared the motion carried. V. NEW BUSINESS 1 MINUTES SELF-FUNDED HEALTH INSURANCE COMMITTEE AUGUST 16, 2023 FINANCE DEPARTMENT Self-Funded Health Insurance Committee meeting minutes of August 16, 2023. Motion) Member Christopher Aguiar introduced a motion to adopt the Self-Funded Health Insurance Committee meeting minutes of August 16, 2023, as presented. The vote favoring approval was unanimous. Chair Dan Pentkowski declared the motion carried. 2 MONTHLY FINANCIAL REPORT FINANCE DEPARTMENT City of Henderson Self-Funded Health Plan monthly financial report for August 2023. Maria Gamboa, Director of Finance, provided a summary of this item and reviewed the following financial reports: Self-Funded Health Insurance Fund (Fund 6051), Retiree Insurance Subsidy, and Stop Loss Restricted Cash, as of August 31, 2023. Self-Funded Insurance Committee Meeting Page 3 of 6 Wednesday, October 18, 2023 – Minutes 3 THIRD-PARTY ADMINISTRATOR MONTHLY REPORT FINANCE DEPARTMENT UMR, Inc., monthly report for August 2023. Russell Garrett, UMR, Inc., presented a summary of this item and highlighted the following reports:  Utilization Summary by Claim Type by Month  Medical Utilization by Claim Category by Month  Enrollment by Tier - Medical  Enrollment by Tier - Dental  Medical Enrollment by Demographic  Medical Claims by Demographic  Dental Enrollment by Demographic  Dental Claims by Demographic  Demographics Summary  Customer Care Call Statistics 4 STOP LOSS COVERAGE FOR PLAN YEAR 2024 FINANCE DEPARTMENT Berkshire Hathaway Specialty Insurance (BHSI) is still reviewing September 2023 claims experience data in order to finalize their stop loss insurance renewal offer. BHSI has presented a renewal proposal for Plan Year 2024, with the understanding that if the remainder of claims data still under review from September 2023 is favorable enough, an alternate, more favorable proposal that has also been presented would apply to the Plan Year 2024 renewal. The status of alternate proposal applicability will be known at the time of the October Self-Funded Health Insurance Committee meeting. Renewal and alternate proposal options also detailed below and in the attached renewal summary. Committee should select one option for recommendation to City Council for approval. Current Deductible – $525,000.00 Estimated current annual premium: $661,288.00 Self-Funded Insurance Committee Meeting Page 4 of 6 Wednesday, October 18, 2023 – Minutes Renewal Options if the September claims data is less favorable: Option #1 – Insure at Current Individual Deductible of $525,000.00 under the BHSI Renewal Proposal Single Rate: $12.74 per employee per month Family Rate: $49.95 per employee per month Estimated total annual premium: $716,822.00 Increase of 8.40% over current year premium Option #2 – Insure at Individual Deductible of $550,000.00 under the BHSI Renewal Proposal Single Rate: $11.76 per employee per month Family Rate: $46.69 per employee per month Estimated total annual premium: $668,928.00 Increase of 1.20% over current year premium Renewal Options if the September claims data comes back favorable: Option #3 – Insure at Current Individual Deductible of $525,000.00 under the BHSI Alternate Renewal Proposal that will become applicable with favorable September 2023 claims data Single Rate: $12.30 per employee per month Family Rate: $48.14 per employee per month Estimated total annual premium: $691,009.00 Increase of 4.50% over current year premium Option #4 – Insure at Individual Deductible of $550,000.00 under the BHSI Alternate Renewal Proposal that will become applicable with favorable September 2023 claims data Single Rate: $11.35 per employee per month Family Rate: $45.00 per employee per month Estimated total annual premium: $644,833.00 Decrease of 2.50% over current year premium Courtney Redsull, Employee Benefits Manager, presented a summary of this item. Shawn Adkins, Gallagher Benefit Services, reviewed the Stop-Loss Renewal Summary for plan Year January 1, 2024, through December 31, 2024, attached to the backup, and answered questions from Committee members regarding unadjudicated claims and stop-loss laser implementation protocol. Self-Funded Insurance Committee Meeting Page 5 of 6 Wednesday, October 18, 2023 – Minutes (Motion) Member Bret Hyde introduced a motion to select Option #1 – Insure at Current Individual Deductible of $525,000.00 under the BHSI Renewal Proposal, effective January 1, 2024, and direct Committee staff to submit to City Council for approval. The vote favoring approval was unanimous. Chair Dan Pentkowski declared the motion carried. 5 DENTAL PLAN ANALYSIS AND RECOMMENDATION TO BID DENTAL CLAIMS ADJUDICATION AND NETWORK SERVICES FINANCE DEPARTMENT Presentation of 12-month dental claims analysis for period ending June 30, 2023, and staff recommendation to direct Gallagher Benefit Services to initiate a Request for Proposals for Dental Claims Adjudication and Network Services. Shawn Adkins, Gallagher Benefit Services, presented a summary of this item which highlighted cost, discount, and coverage differences between dental plans, as well as next steps if a Request for Proposals is initiated. (Motion) Member Maria Gamboa introduced a motion to approve Committee staff to direct Gallagher Benefit Services to initiate a Request for Proposals for Dental Claims Adjudication and Network Services with a January 1, 2025, effective date. The vote favoring approval was unanimous. Chair Dan Pentkowski declared the motion carried. 6 STAFF AND CONSULTANT UPDATES TO COMMITTEE FINANCE DEPARTMENT Updates from staff and Gallagher Benefits Services to the Committee on the following topics:  Gene Therapy benefit language in Summary Plan Description document  Changes to deductibles and out-of-pocket maximums on the Consumer Driven Health Plan in 2024 to ensure compliance with IRS Regulations  Pharmacy plan tiers in Plan Year 2024 with transition to Express Scripts, Inc.  Senate Bill 330 - Subsequent coverage after routine mammograms with findings  Out-of-Network mental health and substance abuse office visits Courtney Redsull, Employee Benefits Manager, and Shawn Adkins, Gallagher Benefit Services, presented a summary of this item. Self-Funded Insurance Committee Meeting Page 6 of 6 Wednesday, October 18, 2023 – Minutes A brief discussion ensued regarding:  Medical advancements and possible applications of gene therapy.  Current plan language and coverage of gene therapy by stop-loss insurance.  Cost of continuation of the Out-of-Network mental health and substance abuse coverage program. 7 EXPRESS SCRIPTS, INC. PHARMACY AUDIT FOR PLAN YEAR 2021 FINANCE DEPARTMENT Presentation of Express Scripts, Inc. Pharmacy Audit for Plan year 2021. Shawn Adkins, Gallagher Benefit Services, presented a summary of this item and stated the results of the audit were clean. Responding to a question by Chair Dan Pentkowski regarding whether an audit would be needed for Carelon Rx, Mr. Adkins stated an audit would be possible at an additional expense. VI. CHAIRMAN\MEMBER COMMENTS Courtney Redsull, Employee Benefits Manager, commended the Committee members on the work they do to ensure healthcare coverage remains affordable. VII. SET NEXT MEETING The next meeting was set for Tuesday, January 17, 2024. VIII. PUBLIC COMMENT There were no public comments presented. IX. ADJOURNMENT There being no further business to come before the Committee, Chair Dan Pentkowski adjourned the meeting at 2:08 p.m. Respectfully Submitted, /s/ Michelle Reese Michelle Reese, Deputy City Clerk.