Self-Funded Insurance Committee

CITY OF HENDERSON SELF-FUNDED INSURANCE COMMITTEE MINUTES Wednesday, August 21, 2024 I. CALL TO ORDER Chair Nick McLemore called the City of Henderson Self-Funded Insurance Committee meeting to order at 1:03 p.m., in the Council Chambers Conference Room, 1st 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 Nick McLemore Christopher Aguiar Maria Gamboa JJ Moyes Michael Page Dan Pentkowski Brooke Stream ABSENT: Shawn Thibeault (excused) ALTERNATES: Carol Banks Joann Carter Michael Charlton Rebecca Gillis Michael Goodwin Charles Hedrick Carlos McDade ABSENT: Michael Openshaw (excused) STAFF: Kristina Gilmore, Asst. City Attorney (left at 1:28 p.m.) Courtney Redsull, Employee Benefits Manager Michelle Reese, Deputy City Clerk Bethany Sanchez, Asst. City Attorney (arrived at 1:28 p.m.) Self-Funded Insurance Committee Meeting Page 2 of 8 Wednesday, August 21, 2024 - Minutes III. PUBLIC COMMENT Tiffany Reardon, 89015; Elizabeth Lopez, no zip code provided; Juanita Kariuki, no zip code provided; and Alyssa Perea, no zip code provided; expressed their support for Item 5 to include fertility benefit treatment options without an infertility diagnosis requirement, and stated it would help support employees, could be a valuable recruitment incentive, would provide more equitable opportunity for family creation, would be more in line with upcoming bills to be presented in this state legislative session, and would be more straightforward, as what constitutes an infertility diagnosis can be unclear. IV. ACCEPTANCE OF AGENDA (Motion) Member JJ Moyes introduced a motion to accept the agenda, as presented. (Vote) The vote favoring approval was unanimous. Chair Nick McLemore declared the motion carried. V. NEW BUSINESS 1 MINUTES SELF-FUNDED HEALTH INSURANCE COMMITTEE JUNE 26, 2024 FINANCE DEPARTMENT (Motion) Member Dan Pentkowski introduced a motion to approve the Self-Funded Health Insurance Committee minutes of June 26, 2024. (Vote) The vote favoring passage was unanimous. Chair Nick McLemore declared the motion carried. 2 MONTHLY FINANCIAL REPORT FINANCE DEPARTMENT Rebecca Gillis, Accounting Manager, reviewed the City of Henderson Self- Funded Health Plan monthly financial report for June 2024, including the Retiree Subsidy and Stop Loss Restricted Cash reports. Self-Funded Insurance Committee Meeting Page 3 of 8 Wednesday, August 21, 2024 - Minutes 3 THIRD PARTY ADMINISTRATOR QUARTERLY REPORT FINANCE DEPARTMENT Russ Garrett, UMR, Inc., provided a summary of the UMR, Inc. quarterly report for 2nd Quarter 2024 and highlighted the following:  Utilization Summary by Claim Type  Cost Distribution by Claim Type  High-Cost Claimants  In Network Discounts  Diagnosis Grouper Summary  Inpatient Summary  Emergency Room/Urgent Care Summary  Emergency Room/Urgent Care by Provider  Dental Claims Summary  Quality Metrics  Teladoc usage A brief discussion ensued on increase to the cost of diagnostic labs and x-rays, as well as how to steer members to appropriate services in regard to emergency room, urgent care, or primary care as well as in-network providers. 4 GALLAGHER BENEFIT SERVICES QUARTERLY CLAIMS REPORT FINANCE DEPARTMENT Shawn Adkins, Gallagher Benefit Services, reviewed the Gallagher Benefit Services quarterly claims report for 2nd Quarter 2024. He stated the plan is running at a deficit; however, things are expected to balance out. He noted medical claims have increased compared to last year but are still lower than the national trend. 5 PLAN DESIGN CHANGE CONSIDERATION - FERTILITY TREATMENT BENEFIT FINANCE DEPARTMENT Courtney Redsull, Employee Benefits Manager, presented a summary of the history of this item and noted any new discoveries or changes since the item was last presented in June 2024. A discussion ensued regarding the scope of the coverage, comparable coverage throughout the market, sex preferential genetic testing of embryos, and fiduciary burden to the plan. Self-Funded Insurance Committee Meeting Page 4 of 8 Wednesday, August 21, 2024 - Minutes (Motion) Member Maria Gamboa introduced a motion for coverage of any FDA approved fertility treatment, and associated medications and lab work, with a lifetime limit of $20,000.00. (Vote) The roll call vote favoring passage was: Those voting aye: Maria Gamboa, Nick McLemore, JJ Moyes, Brooke Stream. Those voting nay: Chris Aguiar, Michael Goodwin, Michael Page, Dan Pentkowski. Those absent: None. Those abstaining: None. Chair Nick McLemore declared the motion failed. (Motion) Member Chris Aguiar introduced a motion to table the item to the end of the agenda. (Vote) The vote favoring passage was unanimous. Chair Nick McLemore declared the motion carried. Note: It was determined that Michael Goodwin was incorrectly counted in the previous vote as an alternate for Shawn Thibeault, whose assigned alternate, Michael Openshaw, was also absent. Per Committee bylaws, members have assigned alternates which are not interchangeable. Note: This item was reopened after Item 11 at 3:30 p.m. Upon reopening the item, a brief discussion ensued regarding the limits of coverage and cost to the plan for the design change. (Motion) Member Brooke Stream introduced a motion for coverage of any FDA approved fertility treatment, and associated medications and lab work, with a lifetime benefit limit of $15,000.00, effective January 1, 2025. (Vote) The roll call vote favoring passage was: Those voting aye: Maria Gamboa, Nick McLemore, JJ Moyes, Brooke Stream. Those voting nay: Chris Aguiar, Michael Page, Dan Pentkowski. Those absent: Shawn Thibeault. Those abstaining: None. Chair Nick McLemore declared the motion carried. 6 PLAN YEAR 2025 SELF-FUNDED HEALTH PLAN RENEWAL REPORT AND FUNDING RATES FINANCE DEPARTMENT Shawn Adkins, Gallagher Benefit Services, reviewed the options for the Plan Year 2025 funding model options as identified in the staff report. Self-Funded Insurance Committee Meeting Page 5 of 8 Wednesday, August 21, 2024 - Minutes A discussion ensued regarding the health plan reserves, which have decreased by one million dollars since the beginning of 2024, and that the plan has not had a rate increase since 2019. (Motion) Member Maria Gamboa introduced a motion for funding increases for Plan Year 2025 addressed partially through funding rate increases of 9.7% for the City and 9.4% for active and retired employees, and partially through a one-time Plan Reserve Buy Down (approximately $500,000.00 for Active Employees and $141,467.00 for Retirees). (Vote) The vote favoring passage was unanimous. Chair Nick McLemore declared the motion carried. 7 SELF-FUNDED HEALTH PLAN ACTIVE EMPLOYEE MONTHLY PREMIUM RATES FOR PLAN YEAR 2025 FINANCE DEPARTMENT Courtney Redsull, Employee Benefits Manager, presented a summary of this the monthly premium rate options for active employees in Plan Year 2025 as identified in the staff report. (Motion) Chair Nick McLemore introduced a motion for funding increases for Plan Year 2025 addressed partially through funding rate increases (approximately 9.4%) and partially through Plan Reserve Buy Down (approximately $500,000.00 for Active Employees). Corresponding Active Employee Coverage Tier Monthly Premium Rates:  Employee Only: $100.87  Employee + Spouse: $241.19  Employee + Child(ren): $187.02  Employee + Family: $307.22 (Vote) The vote favoring passage was unanimous. Chair Nick McLemore declared the motion carried. 8 SELF-FUNDED HEALTH PLAN RETIREE MONTHLY PREMIUM RATES FOR PLAN YEAR 2025 FINANCE DEPARTMENT Consider the options for retiree monthly premium rates in Plan Year 2025 as presented in the staff report. Self-Funded Insurance Committee Meeting Page 6 of 8 Wednesday, August 21, 2024 - Minutes (Motion) Chair Nick McLemore introduced a motion for funding increases for Plan Year 2025 addressed partially through funding rate increases (9.4% Increase), and partially through Plan Reserve Buy Down (approximately $141,467.00 for Retirees). Corresponding Retiree Coverage Tier Monthly Premium Rates: Sierra Healthcare Options Dental  Retiree Only: $630.96  Retiree + Spouse: $1,293.48  Retiree + Child(ren): $1,135.74  Retiree + Family: $1,798.27 Delta Dental  Retiree Only: $656.67  Retiree + Spouse: $1,346.17  Retiree + Child(ren): $1,182.00  Retiree + Family: $1,871.53 (Vote) The vote favoring passage was unanimous. Chair Nick McLemore declared the motion carried. 9 PEDIATRIC NEUROPSYCHOLOGICAL EVALUATION OUT-OF-NETWORK BENEFIT SET-UP ON THE CONSUMER DRIVEN HEALTH PLAN FINANCE DEPARTMENT Courtney Redsull, Employee Benefits Manager, presented a summary of this item including limitations on the benefit set-up of the out-of-network pediatric neuropsychological evaluation benefit on the Consumer Driven Health Plan. Ms. Redsull stated specific messaging would be presented to members during open enrollment. 10 PREVENTIVE PROSTATE-SPECIFIC ANTIGEN (PSA) TEST FINANCE DEPARTMENT Courtney Redsull, Employee Benefits Manager, and Shawn Adkins, Gallagher Benefit Services, discussed changes to the status of the Prostate-Specific Antigen (PSA) screening previously recommended by the United States Preventive Services Task Force. Due to no longer being considered a preventative screening, members would need to pay out of pocket as it would not be covered by insurance. Members expressed an interest in bringing a voting item forward on a future agenda regarding continued coverage of the PSA screening in a preventive capacity. Self-Funded Insurance Committee Meeting Page 7 of 8 Wednesday, August 21, 2024 - Minutes 11 PROPOSAL FOR SERVICES TO NEGOTIATE GROUND AND AIR AMBULANCE CLAIMS FINANCE DEPARTMENT Courtney Redsull, Employee Benefits Manager, provided a summary of the item to discuss the proposal from Gallagher Benefit Services to negotiate pricing on ground and air ambulance claims as identified in staff report. Potential savings to the plan based on a percentage of savings model. Enhance the scope of services. (Motion) Member Michael Page introduced a motion to direct staff to work with Gallagher Benefit Services to implement an amendment to the existing agreement for consulting services between the City of Henderson and Gallagher Benefit Services, to expand the scope of services to include these ground and air ambulance claim negotiation services at a fee of 20% of savings yielded to the City Self-Funded Health Plan. (Vote) The vote favoring passage was unanimous. Chair Nick McLemore declared the motion carried. VI. CHAIRMAN\MEMBER COMMENTS A brief discussion ensued regarding marketing to display the value added to the plan to show enhanced benefits alongside increase in cost to members. Member Joanne Carter noted that even with the rate increase the cost to employees is still very low compared to the private sector. VII. SET NEXT MEETING The next meeting was set for Wednesday, September 18, 2024. VIII. PUBLIC COMMENT There were no public comments presented. Self-Funded Insurance Committee Meeting Page 8 of 8 Wednesday, August 21, 2024 - Minutes IX. ADJOURNMENT There being no further business to come before the Committee, Chair Nick McLemore adjourned the meeting at 3:46 p.m. Respectfully Submitted, /s/ Michelle Reese Michelle Reese Deputy City Clerk