Joint Insurance Committee

By The City of Oklahoma City Office of the City Clerk at 7:39 am, Nov 27, 2024 THE CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE Joanna McSpadden Isaac Locke Jeff Cooper Donna Skidmore Larry Slaff Phil Smith George Fina 420 W Main Ste 110, Oklahoma City, OK 73102 Basement Conference Room December 4, 2024 8:30 a.m. 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: December 4, 2024 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. September 4, 2024 III. Information from Vendors IV. Information from Employee Benefits Division A. Plan Performance  AGENDA ITEM II. Approval of September 4, 2024 Minutes  CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE MINUTES September 4, 2024 The Joint Insurance Committee meeting was held on September 4, 2024 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 Isaac Locke, AFSCME Representative Jeff Cooper, FOP Lodge 123 Member Phil Smith, Citizen Member George Fina, Citizen Member Members Absent: Joanna McSpadden, City Manager Designee Staff Present: Jason Long, Total Rewards Manager Richard Mahoney, Asst Municipal Counselor III Taylor Atherton, Benefits Systems Specialist Lolly Landgraf, Sr. Human Resources 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 June 5, 2024 meeting was approved with no objection.  III. Information From Vendors IV. Information from Employee Benefits Division Lockton presented plan performance through June 2024. Review minutes from previous meeting Motion to approve minutes- Donna Skidmore & Second - Phil Smith Mr. Long asked if there were any questions - none were asked. Ms. Young reviewed plan performance materials. Ms. Young indicated the EPO and PPO combined loss ratio is at 91% Mr. Long stated one of the claimants over $300k are on COBRA and should fall off in a couple months. Mr. Long indicated the "old" HMO was fully insured. The 2024 EPO plan is self funded - which in turn means the City is no longer paying United Healthcare profits. Ms. Young indicated that the medical and pharmacy cost details are right in line with the 50/50 split Mr. Fina asked if prescription savings are out there yet. Ms. Young Yes, but are a wash as rebates are going away. Yet, still cost savings on diabetic prescriptions. Ms. Young shared the rolling (paid plans by month) 12 month trend analysis for actives. Ms. Young stated we are seeing the annual cost per employee decrease with implementation of the EPO plan Mr. Slaff asked what is the monthly premiums plan cost share by the City. Mr. Long replied, the PPO is a 80/20 split and the EPO plan is 85/15 split. Mr. Slaff asked what is the timeline to qualify for benefits. Mr. Long stated if hired after 2017 NO health benefits are offered as a retiree. Ms. Young reviewed the Individual Stop Loss Renewal for 2025 slides. Mr. Long stated that our Stop Loss at $300k is significantly lower than other competitors in the market. Mr. Mahoney as what are our reserves and what other cities are self-funded? Ms. Young stated she does not have the numbers with her, but can bring what our reserves are and what other cities are self-funded to the next meeting. Mr. Mahoney said he would like that. Mr. Long mentioned he would like the JIC to be involved in the Stop Loss discussions or definitely have a voice. Mr. Long spoke of 2025 Open Enrollment and asked the committee if they wanted to see anything for the December meeting and there was no responses. V. Citizens to be heard VI. Items from Committee Members VII. Adjournment Mr. Long adjourned the meeting at 9:11 A.M.  AGENDA ITEM III. Information from Vendors  AGENDA ITEM IV. Information From Employee Benefits Division A. Plan Performance City of Oklahoma City Joint Insurance Committee December 4, 2024 Agenda  Plan Performance / Utilization Review -Self Funded Health Plan with BCBS -On-Site Clinic  Open Enrollment Recap LOCKTON COMPANIES | 2 Plan Performance Executive Summary Medical and Pharmacy Plan Performance  On an all-plans combined basis; the plan is running at 93.3% loss ratio (funding vs. expenses). • Projected Per Employee Per Month (PEPY) cost is $14,442 (in November 2023, it was $15,283).  Enrollment increased 2% from the prior plan year.  Plan had 100 claimants over $100k year to date, 8 of those claimants were in excess of the $300k stop loss level. • $650,535 YTD in stop loss reimbursements  Net medical claims account for 59% of gross plan cost.  Net pharmacy claims account for 41% of gross plan cost. Data provided by BlueCross BlueShield of Oklahoma LOCKTON COMPANIES | 4  Executive Dashboard Budget Summary Gross Budget vs. Gross Plan Costs Year to Date Loss Ratio $12,000,000 2023 PY 2023 PYTD 2024 PYTD Avg # Employees 4,774 4,763 4,876 $10,000,000 *Total Paid Amount $87,608,993 $72,798,015 $70,421,585 $8,000,000 *Budget Amount $89,139,698 $74,222,556 $75,453,149 Loss Ratio 98.3% 98.1% 93.3% $6,000,000 Total Paid Claims PEPY $18,352 $15,283 $14,442 $4,000,000 *Total Paid and Budget Amount includes paid claims, stop loss and other adjustments, administration fees, and stop loss premium. $2,000,000 **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. $0 Gross Budget Gross Plan Costs Year to Date Gross Plan Cost Detail Average Enrollment EE Only EE + Spouse EE + Child EE+Children EE + Family Prior YTD Current YTD 6000 Employee Only 1,966 2,047 5000 41% Employee + Spouse 1,089 1,070 1195 1223 4000 244 Net Medical Claims Employee + Child(ren) 276 294 240 276 294 3000 59% 1070 Net Pharmacy Claims Employee + Child(ren) 240 244 1089 2000 Employee + Family 1,195 1,223 1000 1966 2047 Total 4,766 4,878 0 Prior YTD Current YTD Net Paid Claims: Monthly PEPY Year to Date Medical/Rx Claims over $100,000 $20,000 $18,000 $15,551,132 20% $16,000 $14,000 Prior PEPY $12,000 Current PEPY $60,725,059 $10,000 80% $8,000 $6,000 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec LOCKTON COMPANIES | 55 Paid claims over $100,000 All other paid claims  Trend Analysis All Plans $25,000 $23,000 Cost Per Enrolled Employee - Rolling 12 Months $21,000 $18,411 $18,374 $17,777 $17,604 $17,534 $17,323 $17,332 $17,245 $17,416 $17,387 $19,000 $17,048 $16,910 $17,000 $15,000 $13,000 $11,000 Paid Claims Month Net Claims + Fixed Cost #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!… LOCKTON COMPANIES | 6  Plan Performance EPO Active Plans Estimated Cumulative Cumulative Monthly Cumulative Enrolled Premium Month EE EE+S EE+CH EE-CHs EE+F Employee Premium Net Claims (1) Total Plan Costs Total Plan Funded Funded Employees Equivalents Contributions Equivalents Costs Loss Ratio Loss Ratio Jan-24 1,009 400 174 174 836 2,593 $946,548 $4,683,315 $4,683,315 $1,718,716 $1,718,716 $1,718,716 36.7% 36.7% Feb-24 1,007 401 173 172 846 2,599 $953,372 $4,705,794 $9,389,110 $3,555,682 $3,555,682 $5,274,398 75.6% 56.2% Mar-24 1,020 406 173 171 849 2,619 $958,723 $4,733,802 $14,122,911 $3,663,040 $3,663,040 $8,937,438 77.4% 63.3% Apr-24 1,023 409 175 168 845 2,620 $957,686 $4,728,806 $18,851,718 $3,986,293 $3,986,293 $12,923,731 84.3% 68.6% May-24 1,029 408 177 169 853 2,636 $960,977 $4,755,993 $23,607,711 $3,950,391 $3,950,391 $16,874,122 83.1% 71.5% Jun-24 1,040 408 174 169 853 2,644 $961,971 $4,761,058 $28,368,769 $3,570,737 $3,570,737 $20,444,859 75.0% 72.1% Jul-24 1,027 410 175 163 850 2,625 $956,066 $4,732,612 $33,101,381 $3,949,264 $3,949,264 $24,394,124 83.4% 73.7% Aug-24 1,024 406 174 162 850 2,616 $952,185 $4,716,375 $37,817,756 $4,991,410 $4,991,410 $29,385,534 105.8% 77.7% Sep-24 1,040 409 175 160 853 2,637 $956,156 $4,741,265 $42,559,021 $4,278,641 $4,278,641 $33,664,175 90.2% 79.1% Oct-24 1,056 412 176 163 852 2,659 $958,731 $4,766,106 $47,325,126 $4,455,660 $4,455,660 $38,119,835 93.5% 80.5% Nov-24 Dec-24 YTD 10,275 4,069 1,746 1,671 8,487 26,248 $9,562,416 $47,325,126 $38,119,835 $38,119,835 80.5% How do budgeted plan equivalent rates compare EE Cost is 25.1% 19.5% Overfunded to actual plan costs? of Total Cost (1) Reflects the sum of all medical and Rx claims minus stop loss reimbursements and includes Rx rebates. LOCKTON COMPANIES | 7  Plan Performance PPO Active Plans Estimated Cumulative Cumulative Monthly Cumulative Enrolled Premium Stop Loss Month EE EE+S EE+CH EE-CHs EE+F Employee Premium Admin Cost Net Claims (1) Total Plan Costs Total Plan Funded Funded Employees Equivalents Premium Contributions Equivalents Costs Loss Ratio Loss Ratio Jan-24 1,013 663 118 78 369 2,241 $893,444 $2,803,550 $2,803,550 -$804,136 $340,314 $3,049,440 $2,585,618 $2,585,618 92.2% 92.2% Feb-24 1,012 663 118 76 368 2,237 $890,515 $2,795,739 $5,599,289 -$804,469 $340,454 $2,692,566 $2,228,552 $4,814,170 79.7% 86.0% Mar-24 1,016 666 117 79 369 2,247 $889,817 $2,806,055 $8,405,344 -$809,459 $342,566 $3,315,628 $2,848,735 $5,077,287 101.5% 60.4% Apr-24 1,021 665 119 79 374 2,258 $895,904 $2,822,881 $11,228,226 -$811,455 $343,411 $3,778,623 $3,310,579 $6,159,314 117.3% 54.9% May-24 1,020 664 117 77 376 2,254 $892,761 $2,815,937 $14,044,163 -$813,452 $344,256 $3,791,124 $3,321,929 $6,632,507 118.0% 47.2% Jun-24 1,014 664 117 76 375 2,246 $892,092 $2,808,485 $16,852,648 -$813,452 $319,749 $3,294,735 $2,801,033 $6,122,961 99.7% 36.3% Jul-24 1,014 665 119 77 375 2,250 $894,775 $2,814,668 $19,667,316 -$810,956 $318,670 $3,170,631 $2,678,345 $5,479,377 95.2% 27.9% Aug-24 1,023 660 121 77 376 2,257 $895,434 $2,819,488 $22,486,804 -$810,624 $318,322 $6,319,824 $5,827,522 $8,505,867 206.7% 37.8% Sep-24 1,026 659 123 74 375 2,257 $892,809 $2,816,862 $25,303,666 -$814,117 $319,708 $3,462,391 $2,967,983 $8,795,505 105.4% 34.8% Oct-24 1,033 660 122 74 379 2,268 $889,242 $2,824,357 $28,128,023 -$819,606 $321,756 $4,229,306 $3,731,455 $6,699,438 132.1% 23.8% Nov-24 Dec-24 YTD 10,192 6,629 1,191 767 3,736 22,515 8,926,793 28,128,023 -8,111,725 3,309,206 37,104,268 32,301,749 114.8% How do budgeted plan equivalent rates compare to actual plan EE Cost is 0.0% -14.8% Underfunded costs? of Total Cost (1) Reflects the sum of all medical and Rx claims minus stop loss reimbursements and includes Rx rebates. LOCKTON COMPANIES | 8  Plan Performance Retiree Plans Estimated Cumulative Cumulative Monthly Cumulative Enrolled Premium Stop Loss Month EE EE+S EE+CH EE-CHs EE+F Employee Premium Admin Cost Net Claims (1) Total Plan Costs Total Plan Funded Funded Employees Equivalents Premium Contributions Equivalents Costs Loss Ratio Loss Ratio Jan-24 662 512 30 10 36 1,250 $718,864 $1,437,724 $1,437,724 -$207,938 $88,000 $1,606,998 $1,487,061 $1,487,061 103.4% 103.4% Feb-24 660 511 31 10 36 1,248 $716,900 $1,433,796 $2,871,521 -$207,605 $87,859 $1,466,424 $1,346,679 $2,833,739 93.9% 98.7% Mar-24 660 511 31 10 36 1,248 $715,300 $1,430,598 $4,302,119 -$207,605 $87,859 $1,792,148 $1,672,402 $3,019,081 116.9% 70.2% Apr-24 662 510 31 10 39 1,252 $719,173 $1,438,343 $5,740,462 -$208,270 $88,141 $2,013,429 $1,893,299 $3,565,702 131.6% 62.1% May-24 659 509 30 10 40 1,248 $713,924 $1,427,846 $7,168,308 -$207,605 $87,859 $1,905,975 $1,786,229 $3,679,529 125.1% 51.3% Jun-24 656 509 31 11 40 1,247 $714,555 $1,429,107 $8,597,415 -$207,438 $87,789 $1,649,073 $1,529,423 $3,315,653 107.0% 38.6% Jul-24 657 508 32 10 40 1,247 $712,825 $1,425,648 $10,023,062 -$207,438 $87,789 $1,699,106 $1,579,456 $3,108,880 110.8% 31.0% Aug-24 657 503 31 10 42 1,243 $709,526 $1,419,049 $11,442,111 -$206,773 $87,507 $2,965,245 $2,845,979 $4,425,436 200.6% 38.7% Sep-24 658 499 31 10 40 1,238 $704,112 $1,408,220 $12,850,332 -$205,941 $87,155 $1,810,666 $1,691,880 $4,537,860 120.1% 35.3% Oct-24 659 498 31 10 39 1,237 $699,056 $1,398,110 $14,248,442 -$205,775 $87,085 $2,133,331 $2,014,641 $3,706,521 144.1% 26.0% Nov-24 Dec-24 YTD 6,590 5,070 309 101 388 12,458 7,124,235 14,248,442 -2,072,388 877,043 19,042,396 17,847,051 125.3% How do budgeted plan equivalent rates compare to actual plan EE Cost is 0.0% -25.3% Underfunded costs? of Total Cost (1) Reflects the sum of all medical and Rx claims minus stop loss reimbursements and includes Rx rebates. LOCKTON COMPANIES | 9 Preventative Care and Annual Physicals Data provided by BlueCross BlueShield of Oklahoma via Lockton’s InfoLock system LOCKTON COMPANIES | 10 LOCKTON COMPANIES | 11 On-Site Clinic Review Physician Visits and Care through August Data provided by Premise Health LOCKTON COMPANIES | 13 Clinic Utilization through August Data provided by Premise Health LOCKTON COMPANIES | 14 Open Enrollment Recap Open Enrollment Summary Meetings Technology Feedback Wrapping Up • Meetings took • City employees • Employee • Final day to place in the OKC utilized online feedback was submit open Convention enrollment via positive enrollment Center Oracle cloud changes has • Space was • This is the City’s passed. accommodating second year • Benefits Team to for the number using Oracle audit and of attendees Cloud as their provide EOI • Parking was online notifications as accessible enrollment needed. portal. LOCKTON COMPANIES | 16 Independence changes everything. © 2022 Lockton Companies. All rights reserved.