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Employee Benefit Trust Minutes - 05/04/2022 City of Wichita Falls Employee Benefits Trust Board Meeting Minutes May 4th, 2022 The meeting was held in the City Council Conference Room at Memorial Auditorium, 1300 Seventh Street, Wichita Falls, TX 76301. Present: Darron Leiker, City Manager Kinley Hegglund, City Attorney Christi Klyn, Director of Human Resources Jessica Williams, Chief Financial Officer Angela Bosma, Employee Benefits Specialist II Brent Weegar, HUB Intl, Senior Vice President Sara Collins, HUB Asst Vice President/Acct Mgr (remote) Heath Haigood, Benefits Analyst Agenda Items: Meeting was called to order at 10:02 am II. Minutes from the previous meeting on 8/26/21 were approved. III. Financial Report was included in the HUB presentation IV. HUB International presentation (taken directly from the HUB 5/4/22 binder): a. "Overview i. Financial Results: The City of Wichita Falls'total per capita healthcare cost increased by +5.8% at year-end 2021. Per capita health claims increased by +0.2% and prescription claims increased by +16.0% at year end. For the 2021 plan year, there were 27 claimants over$50k accounting for$4.1 m or 33.9% of claims spend. In comparison, for 2020 plan year, the City had 29 claimants over$50k, accounting for$5.6m or 45.8% of claims spend. There were $0 in stop loss reimbursements vs $443k in stop loss premiums paid. ii. COVID-19: In regard to COVID-19 claims, the City has incurred a total of$1.3m of claims related to testing, treatment, and vaccination charges since 1/1/21. There have been 160 or 7.4% of claimants who have been diagnosed with COVID-19. iii. Renewal: The City of Wichita Falls renews all lines of coverage except for the Dental policy for the 2023 renewal. The City retains two renewal options and HUB will pursue multi-year rate guarantees to extend through the final renewal option for the City of Wichita Falls. HUB will request that renewals be delivered by 7/1/22. Stop Loss will not be delivered until 9/1/22 due to required claims history. b. Historical Cost Analysis c. Utilization Review d. Budget Presentation e. Benchmarking f. Plan Design and Contributions g. Strategic Recommendations: i. Health Plan design: No significant adjustments are reqcoomended to plan designs and it is a continued recommendation for the City to sponsor the HSA pain for 2023 and limit adjustments to plan design and funding. This will continue migration to a plan with incentives for better management of plan costs. HUB is recommending the following short and long term considerations: 1. Short Term: Pharmacy Benefit management— Embarc Protection Program and High Performance Formulary; Out of Network Benefit Exclusion — EPO plan; Behavioral Health Benefits — City clinic 2. Long Term: Narrow Network Plans (HMO/High Performance); Patient Navigation Program; Expert Medical Opinion Services; and Audit Services (Pre/Post). ii. Contributions: For the 2022 Plan year, the City is projected to fund 78% of the total cost of health care. The City funds 93% to employee only and 69% to dependent coverage for the HSA plan. The City is cost neutral between the HSA and CAT plans however funds more to the PPO Core plan. It is recommended to consider moving the PPO Core plan towards cost neutrality over time. iii. Retiree Plans: As a best practice, the City applies separate risk adjusted rates for the retiree health programs which explicitly states the employer and employee subside levels of retiree risk. Currently the City funds between 59% and 56% of the retiree only premium and 0% toward dependent coverage. The City is cost neutral between the HSA and CAT plan however funds more to the PPO Core plan. It is recommended to consider moving the PPO Core plan towards cost neutrality over time. It is recommended for the City to consider contracting with HUB to conduct the Retiree Rate Study and GASB 74/75 calculations. Our integrated approach and expertise will provide the City with seamless active and retiree benefits consulting. iv. Compliance Items of Note: The 2022 PCORI fee is $2.79 per covered life on the health plan and is due by July 31, 2022. No Surprises Act and Title II of the Consolidated Appropriations Act of 2021 will require implementation of multiple provisions over the next few years. Additional information on requirements of health plan providers and employers are included in the appendices of this report. v. Dental: The Humana dental plan of benefits and funding structures are in line with benchmarking. No significant changes are recommended at this time. The dental administrative fees are in a rate guarantee with Humana until 1/1/23. vi. Vision: The fully insured Superior vision plan of benefits and funding structures are in line with benchmarking. No significant changes are recommended to the plan design or funding levels at this time. The vision premiums are in a rate guarantee with Superior until 1/1/24. vii. Life and Disability: The Symetra life and disability plan of benefits are in a rate guarantee period until 1/1/23. The life insurance is in line with benchmarking, however it is recommended to evaluate increasing the $7,000 monthly maximum benefit for the long term disability plan. This change would ensure all employees receive a full 40% core/60% buy up income replacement if too sick or hurt to work. viii. Employee Engagement: 1. Concierge Services: The Alight program engaged 28 households for 41 solutions for a total of$17k in savings over the 2021 plan year(0.21 to 1 ROI) 2. Employee Assistance Program: The Deer Oaks Employee Assistance program engaged 40 cases over the 2021 plan year with a utilization rate of 3.5% 3. Airrosti Program: 111 Cases with 96% improved outcomes and 100% satisfaction 4. Employee Communication Allowance: $10,000 for the 2022 plan year. Our communications and design team will assist in crafting an engagement plan to leverage benefits education and communication for City employees. ix. Optional Products discussion: 1. Group Optional Products (Hospital/Accident, Critical Illness, STD) 2. Benefit HUB Discount Program x. HUB Resources: 1. Texas City Managers Association — Employment Agreement Consulting 2. Financial— Bond Proceeds Management 3. Compensation, Performance Review, Leadership Consulting/Training 4. Absence Management Consulting and Optimization h. Renewal Timeline V. QuadMed Behavioral Health presentation VI. With no further business, the meeting was adjourned at 1204 hours. Prepared by: Angela D. Bosma, EBSII City of Wichita Falls/HR Department