Joint Insurance Committee

By The City of Oklahoma City Office of the City Clerk at 8:00 am, Jun 12, 2023 THE CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE Joanna McSpadden Isaac Locke Anne Lapuzza Donna Skidmore Larry Slaff Phil Smith June 14, 2023 It is the policy of the City to ensure that communications with participants and members of the public with disabilities are as effective as communications with others. Anyone with a disability who requires an accommodation, a modification of policies or procedures, or an auxiliary aid or service in order to participate in this meeting should contact the ADA Personnel Department Coordinator at 297-2861 or TDD 297-2020 as soon as possible but not later than 48 hours (not including weekends or holidays) before the scheduled meeting. The department will give primary consideration to the choice of auxiliary aid or service requested by the individual with disability. If you need an alternate format of the agenda or any information provided at said meeting, please contact the ADA department coordinator listed above 48 hours prior to the scheduled meeting.  CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE AGENDA and MEETING NOTICE DATE: June 14, 2023 TIME: 8:30 a.m. PLACE: 420 W Main Ste 110, Oklahoma City, OK 73102 Basement Conference Room AGENDA: I. Call to Order II. Approval of Minutes A. March 1, 2023 III. Information from Vendors IV. Information from Employee Benefits Division A. Plan Performance B. Wellness Updates  AGENDA ITEM II. Approval of March 1, 2023 Minutes  CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE MINUTES March 1, 2023 The Joint Insurance Committee meeting was held on March 1, 2023 at 8:30 a.m. in the City Municipal Building, 420 W Main, Ste 110 Basement Large Conference Room Those in attendance were: Members Present: Larry Slaff, Citizen Member Donna Skidmore, Retiree Member Joanna McSpadden, City Manager Designee Anne Lapuzza, FOP Lodge 123 Member Isaac Locke, AFSCME Representative Phil Smith, Citizen Member Members Absent: Staff Present: Jason Long, Benefits Specialist Billy Smith, Benefits Analyst I. Call to Order Jason Long, called to order the Joint Insurance Committee Meeting at 8:33 AM II. Approval of Minutes The minutes of the December 7, 2022 meeting was approved with no objection. III. Information From Vendors A. III. Information From Vendors A. EMSA Presentation Mr. Long introduced Adam Paluka, Administrator of Tulsa EMSA Office. Mr. Paluka provided an overview of emergency and non emergent services and coordination of claims with EMSA care. IV. Information from Employee Benefits Division A. Plan Performance Mr. Long reviewed plan performance materials. Mr. Long indicated HMO running at 89.2% loss ratio through 12/2022 with 67 claimants over $100k in the month of December and projected per employee per year cost of $19,768. Mr. Long also noted PPO running at 101.6% loss ratio through 12/2022 with 45 claimants over 100k in the month of December. Three individuals breached the stop loss deductible as of December 2022. Ms. Young (Lockton) indicated overall loss ratio of 94% for combined plans which trends higher than normal inflation and will create impact as we move into future plan years. Mr. Long indicated dental ran high at 91% ratio and projects a 5% increase. Mr. Long noted overall life plans running hot at 124% Mr. Slaff inquired about corrective action Mr. Long advised increase due to covid and cost of premium on yearly basis. Plan design changes will be considered in upcoming RFP. B. Upcoming Medical / Pharmacy RFP Mr. Long noted RFP released on 1/18 with proposals due back by 2/22 for Medical and RX Medicare Advantage RFP to release on 3/1 with proposals by 4/5 Ms. Lapuza asked what loss ratio goal is acceptable for Medical plans Mr. Plumer indicated self insured, lowest is best for fully insured 80-85% ratio with anything higher affecting renewal rates. Mr. Long motion to approve moving June 7th meeting to June 14th. V. Citizens to be heard VI. Items from Committee Members VII. Adjournment Mr. Long adjourned the meeting at 9:03 A.M.  AGENDA ITEM III. Information from Vendors  AGENDA ITEM IV. Information From Employee Benefits Division A. Plan Performance B. Wellness Updates JOINT INSURANCE COMMITTEE June 14, 2023 Agenda • Medical Plan Performance - HMO plan - PPO plan - Combined (HMO and PPO) • Wellness Updates - HMO with UnitedHealthcare - PPO with BCBSOK 2 HMO Plan Performance Data through April 2023 Executive Summary HMO Plan Medical & Pharmacy Plan is running at an 89% loss ratio through April 2023 (funding vs. expenses)  Projected Per Employee Per Year (PEPY) cost in April 2023 is $20,073 (in April 2022, it was $19,322) Plan had 9 claimants over $100k in the month of April. Net Medical Claims account for 81% of gross plan cost. Net Pharmacy Claims account for 19% of gross plan cost. 4 4  Executive Dashboard Budget Summary YTD Gross Budget vs. Gross Plan Costs Loss Ratio YTD $7,000,000 Gross Budget vs. Plan Costs 2022 PY 2022 PYTD 2023 PYTD $6,000,000 Avg # Employees 2,531 2,582 2,483 $5,000,000 *Total Paid Amount $50,211,831 $16,237,215 $16,287,476 $4,000,000 *Budget Amount $56,317,147 $19,152,438 $18,274,055 $3,000,000 Loss Ratio 89.2% 84.8% 89.1% $2,000,000 Total Paid Claims PEPY $19,768 $19,322 $20,073 89% $1,000,000 *Total Paid and Budget Amount includes paid claims, stop loss and other adjustments, administration fees, and stop loss premium. $0 **Total Paid PEPY is based on year to date net claims and fixed costs and enrollment is set back 1 month to reflect average claim lag. Gross Budget Gross Plan Costs Gross Plan Cost Detail YTD Enrollment Summary YTD Average Prior YTD Current YTD 19% Employee Only 938 924 Employee + Spouse 413 401 Employee + Child(ren) 161 161 Employee + Child(ren) 190 166 81% Employee + Family 881 833 Net Medical Claims Total 2,583 2,485 Net Pharmacy Claims Net Paid Claims: Monthly PEPY Medical/Rx Claims over $100,000 YTD $21,000 $1,278,119 8% $16,000 Prior PEPY $11,000 Current PEPY $15,009,357 92% $6,000 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Paid claims over $100,000 All other paid claims 5 PPO Plan Performance Data through April 2023 Executive Summary PPO Plan Medical & Pharmacy Plan is running at an 107.2% loss ratio through April 2023 (funding vs. expenses).  Projected Per Employee Per Year (PEPY) cost in April 2023 is $15,702 (in April 2022, it was $13,976) Plan had 5 claimants over $100k in the month of April, 1 of those claimants was in excess of the $300k stop loss level. Plan had 27 claimants over $50k. Net Medical Claims account for 56% of gross plan cost. Net Pharmacy Claims account for 51% of gross plan cost. 7 7  Executive Dashboard Budget Summary YTD Gross Budget vs. Gross Plan Costs Loss Ratio YTD $4,000,000 Gross Budget vs. Plan Costs 2022 PY 2022 PYTD 2023 PYTD $3,500,000 Avg # Employees 2,222 2,187 2,238 $3,000,000 *Total Paid Amount $33,419,901 $9,944,932 $11,697,473 $2,500,000 *Budget Amount $32,883,459 $10,814,476 $10,921,200 $2,000,000 Loss Ratio 101.6% 92.0% 107.1% Total Paid Claims PEPY $14,809 $13,976 $15,702 $1,500,000 *Total Paid and Budget Amount includes paid claims, stop loss and other adjustments, administration $1,000,000 fees, and stop loss premium. $500,000 **Total Paid PEPY is based on year to date net claims and fixed costs and enrollment is set back 1 month to reflect average claim lag. 107.2% $0 Gross Budget Gross Plan Costs Gross Plan Cost Detail YTD Enrollment Summary YTD Average 4% -10% Prior YTD Current YTD Employee Only 942 998 56% Employee + Spouse 732 698 Employee + Child(ren) 92 106 51% Employee + Child(ren) 66 73 Employee + Family 356 365 Net Medical Claims Net Pharmacy Claims Total 2188 2240 Admin Fees Stop Loss Premium Net Paid Claims: Monthly PEPY Medical/Rx Claims over $100,000 YTD $18,000 $1,005,919 $16,000 8% $14,000 $12,000 Prior PEPY $10,000 Current PEPY $11,524,327 92% $8,000 $6,000 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 8 8 Paid claims over $100,000 All other paid claims Combined Plan Performance Data through April 2023 HMO/PPO Plans Medical & Pharmacy Combined for Both Plans • Headcounts By Month • Claims By Month • Loss Ratio By Month Estimated Total Plan Costs Monthly Cumulative Enrolled Premium Month Employee Net Claims (includes self funded admin. Funded Funded Employees Equivalents Contributions A nd sto p lo ss fees) Loss Ratio Loss Ratio Jan-22 4,718 $1,883,892 $7,310,626 $7,017,726 $6,822,888 93.3% 93.3% Feb-22 4,699 $1,880,842 $7,274,542 $6,629,650 $6,435,509 88.5% 90.9% Mar-22 4,736 $1,888,177 $7,314,034 $7,860,794 $7,665,173 104.8% 95.5% Apr-22 4,732 $1,882,731 $7,296,053 $7,255,869 $7,061,379 96.8% 95.9% May-22 0 $0 $0 $0 $0 Jun-22 0 $0 $0 $0 $0 Jul-22 0 $0 $0 $0 $0 Aug-22 0 $0 $0 $0 $0 Sep-22 0 $0 $0 $0 Oct-22 0 $0 $0 $0 $0 Nov-22 0 $0 $0 $0 $0 Dec-22 0 $0 $0 YTD 18,885 $7,535,642 $29,195,255 $28,764,039 $27,984,949 95.9% 10 10 Rolling 12 Month Trend Analysis – Annual Cost per Employee Both Plans 11 11 Wellness Updates 13 14 15 16 17 Independence changes everything. © 2022 Lockton Companies. All rights reserved.