Loading...
Employee Benefit Trust Minutes - 11/09/2005 CITY OF WICHITA FALLS EMPLOYEE BENEFITS TRUST MEETING November 9, 2005 Present: Bill Sullivan, Chair Darron Leiker, City Manager David Winney, Director of Human Resources Gail Garmon, Employee Benefits Coordinator The meeting was called to order at 1.00 PM Agenda Items: Evaluate Clinical Services Proposals The Board first discussed the current working situation of the On-Site Clinic. Jim Dockery stated that presently anyone working for the City, whether full or part time, and their dependents, are eligible to use the clinic for the same $10.00 fee that active employees pay. This is true whether or not those people are covered under one of the health plans. He was concerned that this arrangement kept people from enrolling in the City's health coverage. Darron Leiker stated that if this situation were to continue, then those not on a plan should at least be charged a higher fee than those on the plan. The $10.00 fee does not pay for the services of the Clinic and those who are on the plan are subsidizing those who are not. Jim explained that the City is planning to enter into a plan with Blue Cross/Blue Shield where participants would have a copay when utilizing office visit services with their primary physicians, effective January 1, 2006. Darron Leiker stated that he felt the clinic would be utilized even less after the copay plans go into effect. Joe Bryan, P.A. was present to discuss his proposal for clinic services Jim Dockery stated that Joe's proposal was for 2236 hours (the current 43 hours per week), at $145.00 per hour, $324,220.00 per year and that his current contract which ends January 15, 2006, is for $225.00 per hour. Jim asked whether or not it would be possible to enter into an agreement for less hours which Joe said he would agree to, especially with the low number of patients currently being seen in the Clinic. Joe explained that the Clinic originally (in 1992) operated four hours per day, three days a week. He stated that the hours had, over the years, increased but that the hourly fee had increased only once. Darron inquired as to what were the busiest hours for the clinic which Joe explained were from 7am to 11 am. Bill Sullivan inquired as to whether or not most people, for return to work physicals, pre-employment physicals, etc., could be seen in the morning hours. Joe felt that this was possible. He said he would probably cut the clinic staff to one PA if the hours were reduced. He then stated that he would be willing to work on a month to month basis, rather than sign a year long contract, while the Board assesses the effects of the new coverage on the clinic services. He further stated that his proposal allows for some services currently being paid for by the City, to be paid for by his corporation. Darron Leiker inquired about Joe's future plans with regard to retirement. Joe stated that his intention is to work through the end of 2006, then retire and turn the clinic services over to Ken Phillis, the second PA currently working in the clinic. At that time, Joe Bryan and Associates would cease to exist and the City's agreement would be with Ken Phillis. The option of the clinic staff setting the appointments, currently being handled through the Personnel office, was also discussed. Joe felt that the clinic staff could easily handle the appointment setting. Jim asked about the current clerical staff in the clinic. Joe said that he would retain both of those positions. Bill Sullivan asked what Joe felt would be the minimum number of hours needed to accommodate the current number of patients being seen in the clinic. What number of hours would be sufficient to meet the patient needs and also be a workable situation for Joe. Darron expressed the need to not cut the clinic hours so much that the needs of the City and the patients were not being met. Joe stated that he would be willing to work whatever hours the Board felt was needed. Joe then stated that he had been, for purposes of his proposal, able to obtain a much lower rate for laboratory procedures performed in the clinic, through the United Regional Reference Lab, thus generating considerable savings to the City (approx. $70,000). Joe further stated the convenience of the clinic for work comp injuries, return to work physicals, etc. These are currently performed at the clinic rather than the City sending the employee elsewhere. The Board then visited with Ken Phillis, PA regarding his proposal. Ken Phillis began by stating the he had decided to put in a separate proposal because he is not a part of Joe Bryan and Associates. He is a contract worker and if the bid were awarded to Joe Bryan and Associates, that would not necessarily include him. Therefore, he submitted a bid of his own. He explained he is a certified Family Practice PA as well as a certified Surgical PA, allowing him to perform many procedures that some PA's cannot. He further stated that he is currently seeing all of the patients with high blood pressure, diabetes, depression, etc. Within the last eight months, he had diagnosed three men with early stages of prostate cancer, allowing for early treatment and cure. He then explained that his bid includes laboratory procedures at cost plus 15% and x-rays and immunizations at cost. Bill Sullivan inquired as to what Ken would like to see done at the clinic that is not currently being done. Ken said that right now the clinic is doing everything that would be done at a full service clinic. They do not have all of the modern equipment, but it is being done. If awarded the contract, he intends to add more modern equipment and modernize the clinic esthetically (paint, new furniture, etc.). Jim Dockery inquired as to whether or not his proposal includes the association with Dr. Torn Talbert, which Ken said it did. When asked about the busy time in the clinic, Ken stated that since he sees some of the more complicated patients, he is busy in the afternoon. However, he sees no real demand for the 5-6 PM time period. Bill Sullivan asked whether he thought the hours of the clinic could be downsized. He stated that the early morning 7-8 AM is good for people who get up not feeling well but are not sick enough to stay off work. They can come in, then go on to work. He stated he would be willing to amend the number of hours in his proposal if needed. Jim Dockery inquired about the $10.00 fee currently charged for a visit to the clinic. Ken did not feel it a good idea to offer the services for -0- copay. He felt that a small copay kept people from coming in when not really sick and coming to the clinic for unnecessary reasons. In closing, Ken stated that he would like to see some education of the employees as to the services that are offered in the clinic that they might not be aware of. He stated that he would be willing to go out to the departments and help with education or produce a flyer to be distributed. The Board then met with representatives from the Family Health Center regarding their proposal. Present were Dr. Susan Strait, Dr. Scherrba and Tracy Franklin. Bill Sullivan explained that the proposal paperwork presented to them called for a proposal based on 1500 pre employment physicals, 1500 drugs screens, 300 non DOT screens, 300 blood panels and 1000-1600 sick visits. These figures were derived from services at the on-site clinic for the previous year. He stated that the need for the number of patients and hours might need to be altered based on the new health coverage taking effect January 1, 2006. Dr. Strait stated that although the proposal was pretty straight forward except for the office visit hours, based on the current on-site operation, so they had based their proposal on patient encounters: $50.00 per encounter, $85 per physical, $27 per hour for after hours care and $75 per drug panel. X-Rays were bid at $30, EKG's at $27 and full physicals at $115. Dr. Strait stated that the Family Health Center can offer board certified physicians, better continuity, better environment, a bigger building and 24 hours, 7 days a week, 365 days a year services. Jim Dockery stated that currently patients at our on-site clinic are seen within 10-15 minutes and inquired as to the probable wait time for patients at the Family Health Center. Dr. Strait stated that their policy is to see patients within 30 minutes of arrival. Dr. Strait further explained that they have the capability of doing lab work on site but that they can also contract through other labs for additional discounted services. This concluded the discussion with Family Health Center representatives. Jim Dockery stated that he had spoken with Cassie Stennett and there had been some changes concerning the two stop loss proposals from J. Allen Hall and ING that were reported in a previous meeting. On a conference call with Cassie, she reported that previously J. Allen Hall had presented a 24/12 proposal vs. ING's proposal for a 15/12 contract. J. Allen Hall was now presenting a 15/12 proposal. The difference in the two 15/12 contract proposals would be a savings of$25,000 on fixed costs but an exposure of $600,000 more on claims with J. Allen Hall and an additional $25,000 spent in fixed cost but limited by $600,000 on claims exposure with ING. Her recommendation was to go ahead with ING because of the discounts available with Blue Cross/Blue Shield and ING is tied to BC/BS.. She felt that it was worth spending the $25,000 for more insurance through ING. Contracting with ING allows an overall lower annual budget by approximately $600,000. thus allowing for lower premiums. Discussion of Employee and Retiree Health Premiums At a previous meeting, Cassie Stennett stated that she would work on a possible premium structure for the Blue Cross/Blue Shield plans. Jim Dockery would supply the current premiums figures and number of participants currently in each plan. He and Cassie would use these figures to compile possible premium levels that would meet the needs of the plan and insure that sufficient monies would still be collected. Cassie stated that she had submitted figures to Blue Cross/Blue Shield and did not have sufficient data at this point to allow the Board to set premiums but that she would be presenting her suggestions to them in the near future. She would report back to Jim Dockery. Discussion of Future Modification of Employee Benefits Trust Committee Bill Sullivan explained that the City Council had expressed an interest in adding an additional member to the Employee Benefits Trust Committee. He stated that the addition may need to be made by Mayoral appointment. He will check on this. Jim Dockery made a motion that the Board add one additional voting member from either the health insurance field or a health care professional. Darron Leiker seconded the motion. Motion carried. The meeting was adjourned at 5:00 PM. Respectfully submitted, r (a A rJ Gail Garmon Employee Benefits Coordinator