Employee Benefit Trust Minutes - 06/19/1995 •
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CITY OF WICHITA FALLS
EMPLOYEE BENEFITS TRUST MEETING
JUNE 19, 1995
Present:
Greg Humbach, Chair
James Bernina, City Manager
Fred Werner, Director of Finance
Jan Stricklin, Employee Benefits Administrator
Gail Garmon, Employee Benefits Coordinator
The meeting was called to order by Mr. Humbach at 2:00 PM.
The minutes of the May 5, 1994, were approved with no
corrections.
Agenda Items:
Financial Statement:
Ms. Stricklin gave the claims comparison for the
period October 1 , 1993, through May 31 , 1995. The
amount submitted was $4,045,369.46 in paid claims.
One claim was in excess of the $150,000 and our
Stop Loss coverage had reimbursed us a total of
$100,458. 14 at the time of this meeting. Ms.
Stricklin explained that we had also filed for
some additional reimbursement on this individual
and that would be forthcoming. She pointed out
that when comparing the claims paid from October
'93 through May '94 with claims paid for the same
period this fiscal year, the difference is about
$473,000 less for this year. She also stated that
there is approximately $100,000 in claims yet to
be processed as of this date. She noted that due
to the speed and knowledge of the new claims
processor, Jan Ducioame, we are staying much more
current in the daily claims processing procedure.
Ms. Stricklin also presented the claims comparison
graphs showing claims paid for Employee, Spouse,
and Dependents.
Mr. Humbach commented that by looking at the
claims paid out and the amount that had been
budgeted for the Trust, it appeared the Trust is
under the budget projection. Ms. Stricklin
confirmed.
It was discussed that the area of paid claims for
ambulance use and in the mental nervous area, that
the figures are lower than in the past. This is
due to the fact that the ambulance service is a
member of the Prompt Payment Provider program.
Also, the Board, in a previous session, placed a
cap on the total maximum to be paid out for the
Mental/Nervous in-patient and out-patient benefits
which has had an impact on total claims for this
area.
Ms. Stricklin said that some employees are still
voicing concerns over the fact that the plan pays
only 70% of claims from providers not
participating in the Prompt Payment Provider
program.
Discussion of Plan Review:
Ms. Stricklin explained that an employee had
planned to come before the Board concerning the
$500 annual maximum for the Speech Therapy
benefit, but that he had since received some
private assistance from some medical providers.
Therefore, he changed his mind and would not be
appearing.
Other Business:
Mr. Werner asked for a briefing on the Alta RX
prescription program which the Trust had recently
instituted. Ms. Stricklin gave a complete
explanation to the Board on this program.
Ms. Stricklin then reported that the On-Site
Clinic for the skin lesions testing was underway
and that it was going very well . She noted that
the cost of the testing is being totally funded by
the employees. Ms. Stricklin further reported
that over 250 females had gone through the recent
Mammography clinic and approximately that many
males had gone through the prostate cancer
screening. Mr. Berzina questioned how many of
these might have been employees and how many might
have been dependents. It is felt that most have
been employees. Ms. Stricklin said that many
people had expressed to her that they had gone to
the On-Site Clinic when they would not have seen a
doctor otherwise. It was stated by Ms. Stricklin
that there are plans to do the mammography and
the prostate screenings again in six months and
then on a yearly basis. The On-Site Clinic will
also be giving the flu shots again this year.
Also, that other such clinics are being planned
for the possible future. Ms. Stricklin further
explained that the eye exams clinic was totally
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funded by the fees that were charged to the
employees. This was due to the fact that
routine eye care is not a covered benefit under
the current plan. She explained that the
mammography and prostate screenings were paid for
at the rate of $10.00 by each patient and the
additional $40.00 being paid by the Plan. She
stated that there were several screenings that had
detected early problems that might have gone
unchecked had the service not been available
through the On-Site Clinic . Mr . Humbach expressed
his feelings that the program, overall , was a good
one.
Mr . Humbach then questioned why the City had been
reluctant to accept checks from employees for On-
Site Medical services. Ms. Stricklin explained
that in the past the Finance Director had asked tts
not to accept checks, but that in the future
checks would be allowed. Mr. Werner agreed.
Mr . Humbach adjourned the meeting.
Respectfully submitted,
9an41‘.."; 14.7
Stricklin
Employee benefits Administrator