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Employee Benefit Trust Minutes - 06/12/2023 City of Wichita Falls Employee Benefits Trust Board Meeting Minutes June 12th, 2023 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 International, Senior Vice President Blaze McCarthy, Senior Account Manager Tye Petty, Account Exective Agenda Items: I. Meeting was called to order at 3:00 pm. II. Minutes from the previous meeting on 10/27/22 were approved. III. The financial report was included within the HUB presentation. IV. 2023 Mid-Year review by HUB International: "Overview: Financial Results: The City of Wichita Fall's total per capita healthcare cost decreased by 16.0% at yearend 2022. Per capita health claims decreased by -21.0% and prescription claims decreased by -10.8% at yearend. Over the past 5 years, the City has achieved a 0.4% average claims trend vs the nation at 6.2%. Through April, the 2023 total per capita costs are up 13%over prior period results when compared to 2022. The City had 2 large claimants paid in January and has seen claims reductions toward normative levels since. Claims expenses for FY23 are within budget projections at this time. Renewal: The City renews Medical, PBM, Stop Loss, Vision and EAP policies for the 2024 plan year. The City retains one final renewal option before and RFP is required for the 2025 plan year. HUB will request that renewals be delivered by 7/1/23. Stop Loss will not be delivered until 9/1/23 due to required claims history. Moving Forward: The City has experienced significant growth in its fund balance due to positive fund performance over the past 5 years. For FY24, it is recommended to consider utilizing fund balance to improve the health insurance program and align with best practices/municipal benchmarks." Some of the PY24 changes that were discussed include: active employee premium holidays (1 entire month per quarter) in addition to the 3 check months, lowering medical deductibles and out of pocket maximums, lowering the specialist copays and increasing the City's contribution to the HSA accounts. "Strategic Recommendations: Budget: Projected fund balance for year-end FY23 is expected to grow over$2.5M and exceed $12.2M in cumulative fund balance. HUB recommends a minimum fund balance of 25% of total expense which is $3.5M for FY23. For FY24, it is recommended to consider utilizing fund balance to take measured steps toward improving the City's health insurance program and align with best practices/municipal benchmarks. Health Plan Design: HUB has provided the City with plan options including the following recommended considerations for the 2024 Plan Year: Reduction to deductibles except for required increase to HSA Plan, Reductions to out of pocket maximums for all plans, elimination of inpatient and outpatient surgery copay for core and cat plans, reductions to specialist copays levels for core and cat plans, increase in employer contributions to HSA accounts, and elimination of out of network benefits (EPO plan). "Contributions: For the 2023 Plan Year the City is projected to fund 78.0% of the total cost of health care. The City funds 92.5% to employee only and 68.6% to dependent coverage for the HSA plan. The City is cost neutral between the HSA and CAP plans however funds more to the PPO Core plan. It is recommended to consider moving the PPO Core plan towards cost neutrality over time. However, for FY24, it is recommended to apply no increase to the employee contributions and consider a one-time (2024 plan year) premium holiday for employees. The budget includes a 3 month premium holiday if implemented by the City. 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. HUB has provided the recommended premium structure for Retiree rates assuming the City implements the new plan options. Although increases are required for retiree rates, retirees would have access to the improved plan designs if implemented by the City. 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 1/1/25. 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. Life and Disability: The Symetra life and disability plan of benefits are in a rate guarantee period until 1/1/25. The life insurance is in line with benchmarking, however it is recommended to evaluate increasing the $7,000 monthly maximum benefits for the long term disability plan. HUB will provide the proposal at our renewal meeting. Health Clinic services: The City continues to experience positive results from the Employee Health Clinic. In 2023, the City expanded its services and implemented a 16 hour per week behavioral health counselor. The provider visits have steadily increased each month since a flood impacted services. HUB is evaluating pricing to increase provider time if needed in FY24. Trending Focus Areas and Benefits: - Benefits Administration and on-line enrollment o Year-round online enrollment o EDI Enrollment feeds to carriers o Consolidated billing (one check) o Paid as PEPM or through voluntary product commission o Pet insurance Renewal Timeline was the last item discussed." This was the end of the HUB presentation; everything italicized is directly quoted from the HUB presentation binder. V. Express Scripts contacted the benefits office to extend an offer to add certain HIV medications to our SaveOnSP formulary. This will result in additional savings for the City (up to $0.30 PMPM). The members of the board voted to approve this action. VI. The Covid-19 Public Health Emergency and National Health Emergency ended on 5/11/23. Based on that action, the following changes were made to the City's health plan: Covid-19 diagnostic tests and testing-related visits are now covered at the member's regular benefit level, Over-the-counter Covid- 19 diagnostic tests are not covered through medical or pharmacy benefits, and FDA-authorized Covid-19 vaccines will be covered at the preventive benefit level at an in-network provider office or in-network pharmacy. VII. City ordinance 128-83 established the Employee Benefit Trust Fund, appointed the trust committee and authorized the trust committee to utilize city resources in conducting the business of the trust. Over the years, there have been many changes to the trust agreement. Today, the EBT board voted to update the agreement, incorporating all previously approved changes and one new change regarding board members (from "Deputy City Manager" to "City Manager Designee"). The board voted to incorporate all of the changes and send the document to City council for approval. VIII. Chief Financial Officer and EBT Board member Jessica Williams indicated that the fund balance has grown to a balance that exceeds normal balance limits and requires attention. She requested that the board make a policy recommendation to be effective immediately. The board approved the request. IX. As an addition to the agenda, a current City employee was allowed to speak to the employee benefit trust board. The employee requested the removal of the City's medical plan exclusion for gender dysphoria treatments. If further discussion is necessary, this subject will be an agenda item for an upcoming meeting. X. With no further business, the meeting was adjourned at 1638 Prepared by: Angela D. Bosma, EBSII City of Wichita Falls/HR-EBT