[1. CALL TO ORDER ]
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TODAY'S TUESDAY, JANUARY 3RD, 2023.
WE WILL NOW CALL THE CITY'S COUNCIL SPECIAL MEETING TO ORDER AT 6:16 PM STATE THAT WE HAVE A QUORUM OF COUNCIL.
ITEM NUMBER THREE ARE PUBLIC COMMENTS.
MADAM SECRETARY, DO WE HAVE ANY PUBLIC COMMENTS? ONE MOMENT.
[(a) Update discussion on Health Insurance premiums for calendar year 2023]
NUMBER FOUR, OUR DISCUSSION AND POSSIBLE ACTION TO UPDATE DISCUSSION ON HEALTH INSURANCE PREMIUMS FOR CALENDAR YEAR 2023.PROPOSED PRESENTER IS MARTIN RUSSELL, DIRECTOR OF HUMAN RESOURCES, AND THAT'S GONNA CHANGE TO MS. HEIDI RODRIGUEZ, THE HUMAN RESOURCE MANAGER.
UM, MY, THAT'S AS, UH, MS. JONES ALREADY PRESENTED.
I AM THE HR MANAGER HERE AT THE CITY.
UM, ON OCTOBER 19TH, 2020, THE CITY COUNCIL APPROVED THE AUTHORIZATION TO AWARD A THREE YEAR CONTRACT TO UNITEDHEALTHCARE FOR THE SERVICES OF HEALTH, DENTAL, AND VISION INSURANCE FOR THE CITY EMPLOYEES.
IN THE FIRST YEAR OF THIS CONTRACT, THE CITY SAVED ESTIMATED 600,000.
YEAR TWO, THE CITY'S CONTRIBUTION RATE WAS KEPT AT 9.9%.
UH, IN THE THIRD YEAR, THE CITY'S CONTRIBUTION WAS REACHED TO 27%.
UH, TODAY WE HAVE MIKE WEAVER FROM THE HUB INTERNATIONAL.
HE WILL BE PROVIDING US WITH AN OVERVIEW OF OUR HEALTH INSURANCE.
DO WE HAVE, BEFORE HE COMES UP, DO WE HAVE A, A, A SLIDE PRESENTATION? YES, WE DO.
UM, AS MS. RODRIGUEZ HAD SAID, MY NAME IS MIKE WEAVER AND I AM WITH HUB INTERNATIONAL.
WE REPRESENT THE CITY A AS, UH, AS THE HEALTH AND WELFARE CONSULTANT FOR YOUR BENEFIT PROGRAMS. WE HAVE DONE SO FOR APPROXIMATELY THE LAST EIGHT YEARS, AND EACH YEAR WE TAKE A LOOK AT THE RENEWAL, WE GIVE RECOMMENDATIONS, AND WE ALSO GO OUT TO BID FOR A REQUEST FOR A PROPOSAL IF NEEDED.
UH, I WAS ASKED THIS EVENING TO JUST KIND OF TAKE YOU THROUGH A QUICK OVERVIEW OF THE BENEFIT PROGRAM, UM, AND SPECIFICALLY THE MEDICAL, BECAUSE WHEN WE LOOK AT THE EMPLOYEE BENEFITS, THE MEDICAL IS SUCH A LARGE PERCENTAGE OF THE OVERALL COST THAT IT REALLY DRIVES THE ENTIRE PROGRAM FOR YOU.
I'LL GO INTO SECTION NUMBER ONE FIRST.
UM, THE HEALTH INSURANCE IS THROUGH UNITEDHEALTHCARE, AND THAT IS FOR THE MEDICAL, DENTAL, AND THE VISION.
UH, YOU HAVE TWO DIFFERENT MEDICAL PROGRAMS THAT YOU OFFER.
UH, ONE PROGRAM IS A HIGHER BENEFIT OPTION.
IT'S, UH, A PPO WHERE THE EMPLOYEE EMPLOYEES CAN GO ANYWHERE THEY WANT FOR HEALTHCARE COVERAGE.
THE SECOND MEDICAL OPTION IS WHAT IS CALLED A QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN.
IT HAS, UH, HIGHER DEDUCTIBLE AND ALSO IS ELIGIBLE FOR A HOUSE SPENDING ACCOUNT WHEREBY THE EMPLOYEES CAN SET ASIDE MONEY OF THEIR OWN ON A PRE-TAX BASIS TO USE FOR HEALTH COSTS.
AND ALSO THE CITY CONTRIBUTES MONEY TO THAT HSA PLAN.
UM, LIKE I SAID, THE DENTAL ENVISION ARE PART OF THE BUNDLED PACKAGE, AND THE PACKAGE IS OFFERED TO ACTIVE EMPLOYEES, UH, RETIREES THAT ARE PRE 65, AND ALSO RETIREES THAT ARE AGE 65 OR OLDER.
THE, THE PLAN IS FULLY INSURED FOR ALL COVERAGES.
THAT MEANS THAT YOU ARE ON A GUARANTEED COST, UH, WHATEVER YOU PAY, REGARDLESS OF HOW THE CLAIMS EXPERIENCE RUNS, THEY CANNOT COME AFTER YOU FOR ADDITIONAL MONEY.
AND ALSO, IF YOUR PLAN RUNS WELL, THEN YOU KNOW, THERE ARE NO REFUNDS AVAILABLE.
YOU PAY YOUR GUARANTEED COST, BUT THE CITY IS NOT ON A SELF-FUNDED BASIS.
YOU ARE ON A GUARANTEED COST, A FULLY INSURED BASIS.
I WANTED TO POINT OUT THE LOSS RATIO IS REALLY THE DRIVER FOR WHAT THE RENEWAL RATES ARE.
AND SO THE LOSS RATIO IS, IS SIMPLY DEFINED AS THE PERCENTAGE BETWEEN
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TAKING THE TOTAL CLAIMS AND DIVIDING BY THE TOTAL PREMIUM.INSURANCE CARRIERS TYPICALLY LOOK FOR LOSS RATIOS AROUND 85%.
AND SO IF YOU KNOW YOUR LOSS RATIO IS RUNNING 70 TO 80%, THEN YOU KNOW YOU'RE HAVING A GOOD YEAR.
AND TYPICALLY THE RESULT WILL BE A, UH, A, A NO CHANGE RENEWAL OR A MINOR INCREASE.
BUT, UH, ON TOP OF THE LOSS RATIO, REMEMBER YOU DO HAVE MEDICAL TREND BECAUSE THE CLAIMS THAT ARE USED USED ARE SEEING TODAY ARE GOING TO BE APPROXIMATELY 8.4% HIGHER, UH, INTO THE NEW YEAR.
I'M GONNA GO OVER THE PREMIUM AND CLAIMS INFORMATION, SPECIFICALLY JUST THE MEDICAL, BECAUSE THE MEDICAL IS WHAT REALLY DRIVES THE COST OF THE BENEFIT PACKAGE.
WE'RE TAKING A LOOK AT THE LAST 12 MONTHS OF CLAIMS THAT WERE USED WHEN THE RENEWAL WAS DONE BY UNITEDHEALTHCARE.
ON THE LEFT, WE HAVE THE PREMIUM FOR MEDICAL AND PRESCRIPTION DRUGS.
AND THEN THE NEXT COLUMN ARE THE ACTUAL PAID CLAIMS. AND THEN REMEMBER WE TALKED ABOUT THE LOSS RATIO.
AND SO FOR THE MOST RECENT 12 MONTHS THAT UNITEDHEALTHCARE LOOKED AT WHEN DOING YOUR RENEWAL, YOUR LOSS RATIO WAS APPROXIMATELY 113%.
I BROUGHT UP THE CLAIMS OVER 50,000 FOR YOU, UH, SO THAT YOU CAN SEE WHERE A LOT OF THESE DOLLARS ARE GOING.
AND, YOU KNOW, APPROXIMATELY 36% OF YOUR CLAIMS ARE BEING PAID OUT IN LARGE CLAIMS ACTIVITY.
WE WOULD LIKE TO SEE THAT PERCENTAGE RATHER THAN 36%, SOMEWHERE UNDER 30%, BUT IT'S CERTAINLY, UM, NOT OUTSIDE OF THE RANGE THAT WE SEE FOR OTHER CITIES.
THIS IS THE RESULT OF THE 2023 RENEWAL.
UM, ALL OF THE COVERAGES RECEIVED A NO CHANGE EXCEPT FOR THE MEDICAL, BASED ON MAINLY THE RATE, THE, UH, LOSS RATIO THAT THE CITY WAS HAVING WITH UNITEDHEALTHCARE.
WE ENDED UP WITH A RATE INCREASE OF 27% TO BE EFFECTIVE ON JANUARY 1ST, 2023.
AND THOSE PREMIUM RATES ARE GUARANTEED FOR 12 MONTHS UNTIL ONE ONE OF 2024.
THE ORIGINAL INCREASE REQUESTED BY UNITED HEALTHCARE WAS A 36.1% INCREASE, WHICH WAS NEGOTIATED DOWN TO 27%.
UH, YOU'LL SEE THE CURRENT RATES ARE RUNNING JANUARY 1ST, 2022 THROUGH DECEMBER 31ST, 2022.
AND SO THE RENEWAL RATES ARE EFFECTIVE ONE ONE OF 23, AND THEY WILL BE GUARANTEED FOR THE FULL PLAN YEAR.
AND YOU ARE ALL, YOUR PLAN YEAR HAPPENS TO BE ON A CALENDAR YEAR BASIS AS WELL.
THE MEDICAL RENEWAL HISTORY AND COMPARISON, I JUST WANTED TO SHOW YOU WHAT THE INCREASES HAVE BEEN OVER THE LAST SIX YEARS.
YOU'LL SEE THAT THIS YEAR WAS THE HIGHEST AT 27%, AND THAT WAS, WAS REALLY BASED ON THE HIGH UTILIZATION FOR THE PRIOR TWO YEAR PERIOD WITH UNITEDHEALTHCARE.
AND AGAIN, THE ORIGINAL INCREASE, UH, REQUESTED INCREASE WAS 36.1%.
LAST YEAR, YOU HAD A 9.9% INCREASE ON MEDICAL.
AND THE REASON FOR THE 9.9% INCREASE WAS THAT WHEN UNITEDHEALTHCARE QUOTED YOUR PLAN FOR JANUARY 1ST, 2021, THEY GAVE YOU A TWO YEAR RATE GUARANTEE.
THEY GUARANTEED THE RATES FOR 2021, AND THEY SAID, NO MATTER WHAT, YOU KNOW, HOWEVER YOUR CLAIMS EXPERIENCE RUNS, WE WILL GUARANTEE THAT YOUR RATES FOR 2022 WILL BE NO HIGHER THAN 9.9%.
AND SO THAT'S HOW WE GOT TO THE 9.9 FOR 2022 BECAUSE THE CLAIMS EXPERIENCE THAT THEY HAD WHEN THEY RAN THROUGH THEIR FORMULA INCREASE, IT WAS INDICATING ALMOST, UH, WELL, IT WAS INDICATING A LITTLE BIT OVER A 42% INCREASE.
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2021 WAS THE YEAR THAT WE DID GO OUT TO A, UH, UM, R F P REQUEST FOR PROPOSAL.BASED ON THE RESULTS OF THAT, R F P UNITEDHEALTHCARE HAD A VERY COMPETITIVE, UH, ARRANGEMENT FOR THE CITY.
WE WENT WITH UNITEDHEALTHCARE AND THE MEDICAL RATES WERE ALMOST 10% LOWER THAN WHAT YOU WERE PAYING TO BLUE CROSS BLUE SHIELD FOR THE 2020 PLAN YEAR.
THE OVERALL SAVINGS WAS APPROXIMATELY $564,000 IN THE PRIOR THREE YEAR PERIOD.
YOU WERE WITH BLUE CROSS BLUE SHIELD, AND YOU CAN SEE, UH, THE INCREASES WENT FROM 2020, WHICH WAS 4.2%, AND THEN 2018 THERE WAS A 19.4%.
THE REASON FOR THE VARIATION IS BASED ON THE CLAIMS ACTIVITY THAT THE CITY HAD FOR THOSE TIME PERIODS.
THIS IS JUST A SAMPLE OF DIFFERENT RENEWALS FOR, UH, OTHER CITIES THROUGHOUT THE STATE OF TEXAS.
UM, YOU'LL SEE THERE ARE SOME CITIES HAVE RECEIVED, UH, AS MUCH AS A 29% INCREASE IN THIS SAMPLING.
UH, WHEREAS ANOTHER CITY UP IN MONTGOMERY COUNTY RECEIVED A 3.1 AND THE BIG DRIVER ON THE INCREASES TO MEDICAL ARE THE CLAIMS EXPERIENCE THAT YOUR EMPLOYEES AND THEIR COVERED DEPENDENTS ARE EXPERIENCING.
I WANTED TO, UH, MY, THE, THE LAST SLIDE THAT I HAVE, UH, WE HAD TALKED ABOUT GOING OUT TO BID DURING 2023 TO BE EFFECTIVE JANUARY 1ST, 2020 24.
THIS IS A TIMELINE OF THE RFP PROCESS.
BEGINNING IN THE SPRING, WE HAD PROPOSED THAT WE WOULD PUT TOGETHER A BENEFITS COMMITTEE OF YOUR EMPLOYEES FROM DIFFERENT DEPARTMENTS.
AND THE PURPOSE OF THAT IS TO GAIN INPUT FROM THEIR EMPLOYEES THAT ARE IN THE VARIOUS DEPARTMENTS AND ALSO FOR THE CITY TO BE ABLE TO COMMUNICATE WITH THE DEPARTMENTS THROUGH THIS INSURANCE COMMITTEE.
WE WERE PROPOSING TO DO THAT IN THE SPRING BETWEEN MARCH AND MAY, SO THAT WE CAN BE READY TO START DRAFTING THE BENEFITS THAT WE WANT TO GO OUT TO AN R F P FOR IN JUNE AND JULY.
THAT R F P DRAFT WILL BE READY IN AUGUST, AND THEN IT'LL BE SENT OUT TO THE CARRIERS THE VERY BEGINNING OF SEPTEMBER FOR A RETURN DATE OF OCTOBER AS EARLY AS WE CAN IN OCTOBER.
THE REASON FOR THAT 90 DAY PERIOD BEFORE YOUR EFFECTIVE DATE OF JANUARY, FIRST OF 2024, IS IT ON FULLY INSURED GROUPS.
THE INSURANCE COMPANIES TYPICALLY WILL NOT GIVE YOU A, A GUARANTEED RATE MORE THAN 90 DAYS OUT.
SO THAT IS USUALLY THE TIME PERIOD THAT WE HAVE TO WORK WITH IN ORDER TO GET A GUARANTEED RATE FOR JANUARY THE FIRST.
IF WE PUSH THEM AND GET RATES BEFORE OCTOBER 1ST, THEN THEY WILL BE ESTIMATED OR, UH, PROJECTED RATES FOR ONE, ONE, THEY WON'T BE GUARANTEED.
AND THEN OCTOBER IS WHERE WE DO ALL THE ANALYSIS AND MAKE RECOMMENDATIONS, UH, THROUGH THE CITY TO THE CITY COUNCIL SO THAT ANY CHANGES CAN BE IMPLEMENTED ON JANUARY THE FIRST, AND WE HAVE TIME TO GO THROUGH THE PROCESS FOR OPEN ENROLLMENT AND COMMUNICATING ANY CARRIER CHANGES OR BENEFIT CHANGES TO THE EMPLOYEES.
BUT I WANTED TO OPEN THIS UP TO QUESTIONS.
UM, BUT THAT, UH, WHAT'S REALLY THE OVERVIEW THAT I WANTED TO GIVE YOU, I SEE COUNCIL FOR EMORY, EMORY IN THE QUEUE.
UH, GO BACK AND PUT THE, UH, CLAIMS EXPERIENCE
UH, THIS SHOWS MEDICAL AND RX PREMIUMS ARE WE TRYING TO MANAGE SEPARATELY THE MEDICAL SIDE AND THE RX SIDE ARE, ARE WE, UH, HOW ARE WE HANDLING THOSE, UH, OUR EX UH, PORTION OF THE,
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OF THE PREMIUM? UH, WE KNOW WHAT, WHAT OUR EXPERIENCE IS, AND DO WE HAVE SOME OPPORTUNITIES TO MAYBE LOOK AT SOMETHING IF WE'RE NOT ALREADY, UH, YOU KNOW, A STANDALONE RX PROGRAM THAT, UH, MIGHT HELP US, UH, DEFER SOME OF THE, UH, THE MEDICAL PREMIUMS? UM, THAT, THAT'S A GOOD QUESTION.ON FULLY INSURED GROUPS, UH, TYPICALLY THE MEDICAL AND THE PRESCRIPTION DRUGS ARE TOGETHER.
UM, UNITEDHEALTHCARE HAS A SEPARATE SUBSIDIARY CALLED OPTUM THAT HANDLES THE PRESCRIPTION DRUGS FOR THEM.
UM, OPTUM ALSO WORKS ON SELF, UH, FUNDED GROUPS.
AND SO THAT OPTUM PRESCRIPTION DRUG PROGRAM, YOU KNOW, DOES HANDLE, UH, STANDALONE PRESCRIPTION PROGRAMS ON SELF-FUNDED GROUPS, BUT ON FULLY INSURED GROUPS, IT'S TYPICALLY A BUNDLED PROCESS.
AND THAT'S THE SAME THING THAT YOU SAW WITH BLUE CROSS BLUE SHIELD.
DO WE KNOW WHAT THE RATIO IS BETWEEN, UH, MEDICAL LAND AND DRUG COST? I CAN GET THAT FOR YOU.
I, I DON'T HAVE IT, UH, IN, IN FRONT OF ME, BUT TYPICALLY THE RX IS GOING TO RUN, YOU KNOW, ANYWHERE FROM 20% TO 30% OF THE TOTAL.
AND DO, UM, WE HAVE A, UM, UH, A MALE LOGGER? YES, SIR.
AND, AND THE MAIL ORDER PROGRAM IS THERE FOR PEOPLE THAT ARE ON MAINTENANCE MEDICATIONS.
UM, IT, IT'S A CONVENIENCE FOR THE INSURED, THE PARTICIPANT, BUT ALSO, UH, THEY GET A LITTLE BIT BETTER PRICING MM-HMM.
AND SO IT IS ENCOURAGED THAT YOUR EMPLOYEES AND THEIR COVERED DEPENDENTS USE THE MAIL ORDER WHEN POSSIBLE.
HOW DO WE COMMUNICATE THAT TO OUR EMPLOYEES THAT, YOU KNOW, THERE IS A, UM, A MAIL ORDER PROGRAM AND IT'S MORE HR, UH, IT'S LESS COSTLY TO, TO THEM? I'LL HAVE TO OKAY.
INFORMATION, YOU KNOW, THAT THAT IS COMMUNICATED THROUGH THE COMMUNICATIONS, UH, THE EMPLOYEE BENEFIT GUIDE.
UH, THAT WE PUT TOGETHER AND GIVE TO EACH ONE OF YOUR EMPLOYEES.
UM, THE COPAY, I IS A, A LITTLE BIT LESS FOR THE MAIL ORDER.
UM, BUT IT, IT'S NOT A SUBSTANTIAL SAVINGS.
UH, SOMETIMES SOME OF THE PRESCRIPTION PROGRAMS WILL ACTUALLY MANDATE, UH, THAT THE INSURED USES THE, UH, THE MAIL ORDER PROGRAM IN ORDER TO INCREASE THE UTILIZATION.
I, I, I GUESS I'D JUST ASK THAT, UH, IF, IF YOU HAVEN'T ALREADY, UH, CONSIDERED LOOKING AT SPLITTING THOSE OUT IN, UH, A, UH, A STRONG COMMUNICATIONS PROGRAM TO THE EMPLOYEES THAT, UH, UH, THE VALUE OF USING THE, THE MAIL ORDER DRUG PROGRAM MM-HMM.
SO MY QUESTION IS, WHEN THIS WAS PUT THROUGH THE BUDGET THAT WE JUST HAD, HOW MUCH OF AN INCREASE HAVE WE ADDED AND WORSE IS WHERE IT IS TODAY? WHO WOULD KNOW THAT? UM, I KNOW THAT WE HAVE A, UM, WE HAVE AN AMOUNT THAT WAS APPROPRIATED FOR MEDICAL ADJUSTMENTS IN THE AMOUNT OF APPROXIMATELY $300,000.
SO THAT'S THE AMOUNT THAT WE HAD FOR THE INCREASES IN MEDICAL.
SO IF WE HAD 300, WHAT IS THE AMOUNT TODAY? BECAUSE THIS IS GONNA TAKE A MOTION AND A VOTE FOR AMENDMENT ADJUSTMENT.
SO ON THE, UM, LATER AND THE REGULAR AGENDA, WE DO HAVE A BUDGET ORDINANCE, UH, AMENDMENT, WHICH INCLUDES A REQUEST FOR $100,000.
UM, WE'VE LOOKED AT, UM, OUR CURRENT COST, UH, WHAT WE HAVE SAVED THROUGH VACANCIES IN THE PAST.
AND SO LET'S SAY IN 2021, WE SAVED, UM, ALMOST A MILLION IN MEDICAL BASED ON VACANCIES.
AND WHEN PEOPLE WERE HIRED, LAST YEAR WAS APPROXIMATELY 600,000.
SO THE 600,000 WITH THE 300,000, WE BELIEVE THAT, UM, WE'LL BE ABLE TO COVER, UM, WHAT WE HAVE BASED ON WHEN PEOPLE ARE ACTUALLY, UH, EMPLOYED AND WHETHER OR NOT THEY UTILIZE THE AMOUNT THAT WAS BUDGETED.
SO WE BELIEVE THAT, UM, IF ANYTHING RIGHT NOW, WE WOULD NEED AN ADDITIONAL $100,000.
SO THE PROJECTION MADE WAS FOR 300, AND NOW IT'S 400 IS WHAT YOU'RE SAYING TO COVER THIS? I BELIEVE IT'S CLOSE TO A MILLION TO COVER THIS.
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SO WHAT IS THE AME? SO YOU'RE ONLY ASKING ON THE AMENDMENT FOR A HUNDRED THOUSAND? THAT IS CORRECT.BUT THE OTHER AMOUNT IS COMING FROM IS A COST SAYING YES, THAT'S CORRECT.
SO YOU'LL PROBABLY SEE, UH, A REQUEST WITH THE FISCAL YEAR 2024 BUDGET.
SO FROM THE COST SAVINGS, EXPLAIN, SO I CAN UNDERSTAND FROM THE COST SAVINGS OF DIFFERENT, SEVERAL DIFFERENT INITIATIVES.
THAT'S WHAT ALLUDED TO SOME OF, WHEN WE SAY WE HAVE A X AMOUNT OF MONEY PUT ASIDE FOR, UM, YOU KNOW, UH, SALARY, UH, SURVEY AND ALL OF THIS, THAT'S ALL THIS COST SAVINGS FROM MULTIPLE DIFFERENT LEVELS.
SO, UM, THE COST SAVINGS THAT I WAS REFERRING TO WAS THE TOTAL AMOUNT BUDGETED FOR MEDICAL BENEFITS VERSUS, VERSUS WHAT WE ACTUALLY PAID.
SO YOU'RE SAYING THIS IS NOW CLOSE TO A MILLION.
WHAT I'M SAYING IS THE ADDITIONAL COST WITH THE 27% INCREASE IS CLOSE TO A MILLION DOLLARS, UM, OVER WHAT WAS ANTICIPATED AT THE PRIOR RATE.
SO, MR. WEAVER, I HAVE A COUPLE QUESTIONS FOR YOU.
SO DID, WERE YOU CONTACTED DURING THE BUDGET TIME TO, UH, MAKE THIS PRESENTATION? BECAUSE OBVIOUSLY, CLEARLY ON THE SCREEN RIGHT UP HERE THAT SHOWS A PROJECTION.
SO DID YOU SHARE THAT WITH HR? UH, IT WAS SHARED WITH HR, YES.
SO, UH, I'M JUST TRYING TO UNDERSTAND RIGHT, BECAUSE WE'RE COMING IN HERE, YOU ARE ASKING US TO APPROVE THIS.
SO I JUST WANT TO KNOW IF THIS WAS SHARED, HOW COME THIS FACTOR WASN'T CONTRIBUTED INTO THE COST WHEN THE BUDGET WAS MADE? AT THAT TIME, IT WASN'T SHARED WITH US THAT IT WOULD BE 27%.
I'M NOT SURE IF THE ENTIRE EVALUATION, AS FAR AS THE CLAIMS AT THAT POINT IN TIME WAS DONE.
THEIR ESTIMATE IS BASED ON A CALENDAR BASIS.
WHEN WE STARTED OUR BUDGET PROCESS, THAT WAS IN APRIL, MAY.
SO WE DIDN'T HAVE, YOU KNOW, SOME OF THE MONTHS OF EXPENDITURES THAT THEY'RE LOOKING AT WHEN THEY, UM, PROJECT WHAT THE POTENTIAL INCREASE WOULD BE.
SO MR. WEAVER, WOULD YOU SAY YOUR PROJECTION WAS WRONG? Y YOU KNOW, OUR, OUR PROJECTION IS ALWAYS A PROJECTION.
UM, SO CAN YOU FLIP TO THE NEXT SLIDE? YES, SIR.
UM, THE PROJECTION THAT WE HAD BASED IN, UM, JULY, WE WERE JUST LOOKING AT YOUR CLAIMS EXPERIENCE AND WE HAD THE MEDICAL, UH, PRESCRIPTION DRUG INCREASE PROJECTED AT FOUR, APPROXIMATELY 49 AND A HALF PERCENT IN INCREASE.
SO I'M FINE WITH THIS, BUT I'M ASKING IS, IS THIS, I MEAN, COULD WE HAVE ANTICIPATED BETWEEN HR, FINANCE AND YOU AS A THIRD PARTY VENDOR WHO'S KEEPING US WITH LOOKING AT OUR CLAIMS, LOOKING AT OUR HISTORY? SO TO GO BACK INTO NOW, OBVIOUSLY THAT WHOLE AMOUNT OF MONEY CITY MANAGER IS NOT COMING OUT OF, UH, IT'S, SOME OF IT IS COMING OUTTA COST SAVINGS.
CAUSE THAT MONEY COULD HAVE GONE TO SOMETHING ELSE.
SO WHERE DID WE, WHERE DID WE COME UP NOW WITH THIS ALMOST OF THIS TYPE OF A DIFFERENCE IS WHAT I'M ASKING? AND HOW DO WE AVOID THIS IN THE NEXT CYCLE, WHICH IS 2324? BASED ON, ON, UM, MY CONVERSATIONS, VARIOUS CONVERSATIONS, WE HAD THE MAXIMUM AMOUNT OF 31%.
UM, BUT IT WAS NOT FINAL AT THAT POINT.
AND I GUESS WORST CASE SCENARIO, WE COULD HAVE BUDGETED AT THE 31% AND NEGOTIATED IT DOWN OR WHATEVER WE WERE GONNA DO, AND IT WOULD'VE BEEN COST SAVINGS.
BUT I THINK BECAUSE WE WERE IN THE MIDDLE OF NEGOTIATING THAT AMOUNT, THERE WAS NO ADDITIONAL AMOUNT PUT IN FOR THAT IF, AND IT WAS LEFT AT THE SAME AS IT WAS THE PRIOR YEAR.
IN THE FUTURE, WE WOULD BE LOOKING AT PROJECTIONS AND BUDGETING, UH, AT LEAST HAVING A CONVERSATION RIGHT.
ABOUT THE WORST CASE SCENARIO AND WHAT THAT WOULD LOOK LIKE AND HOW THAT WOULD IMPACT THE BUDGET.
AND THEN WE WOULD MAKE DECISIONS FROM THERE.
THAT'S EXACTLY WHAT, WHAT YOU ANSWERED IT.
BUT LAST QUESTION IS, I KNOW IN CORPORATE LEVEL THEY DO FOR, UM, UH, TOBACCO USAGE AND HEALTH, UH, INITIATIVES THAT THEY MAKE ALL OF THEIR EMPLOYEES GO THROUGH IN ORDER TO RETROFIT.
WHAT DO WE DO HERE FOR, AS FOR EMPLOYEES OF, SO THAT WAY, OBVIOUSLY SOME OF THESE ARE ACUTE AND YOU CAN'T CHANGE THAT, UH, ISSUES, BUT WHAT ARE THE PLANS THAT WE HAVE HERE? UM, MY UNDERSTANDING IS THAT,
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UH, WE ARE NOT DOING ANYTHING FOR, UH, TOBACCO USAGE OR, UH, ANOTHER, I'M TALKING ABOUT ANOTHER ONE IS BIOMETRIC SCREENINGS.UM, MOST OF THE CITIES THAT WE RE WE REPRESENT, UH, THEY DO HAVE IT, IT, AND IT, IT, IT'S NOT A, UH, UM, UH, A SURCHARGE.
I MEAN, WE, WE HAVE TO BE CAREFUL NOT TO PRESENT IT AS A PENALTY, BUT, UH, THERE IS A DIFFERENTIAL, UH, IN PREMIUM PAYMENT FOR THE EMPLOYEE.
AND OFTENTIMES THE SPOUSE, UH, BASED ON WHETHER OR NOT THEY DID THEIR ANNUAL PHYSICAL AND THEIR BIOMETRIC SCREENINGS, UM, IT DOESN'T MATTER WHAT THE RESULTS ARE, BUT IT'S IMPORTANT THAT PEOPLE DO THOSE SCREENINGS TO MAKE SURE, UH, THAT THERE'S SOMETHING, UH, YOU KNOW, AS SIMPLE AS BLOOD PRESSURE.
UH, I HAVE, YOU KNOW, HAD BLOOD PRESSURE SCREENINGS DONE AND THERE ARE TIMES WHERE AN EMPLOYEE OF A CITY, UH, RATHER THAN BEING ALLOWED BACK TO THEIR WORKSTATION, THEY WERE TAKEN TO THE HOSPITAL AND ADMITTED THROUGH THE ER BECAUSE THEIR BLOOD PRESSURE WAS THAT HIGH.
UH, AND TOBACCO USAGE, UH, LIKE YOU HAD MENTIONED, IS, IS ANOTHER AREA THAT TYPICALLY A LOT OF CITIES WILL WORK ON BECAUSE THEY DON'T WANT YOU USING TOBACCO BECAUSE IT, IT'S BEEN SHOWN THAT TOBACCO USERS HAVE HIGHER MEDICAL COSTS.
SO I DON'T KNOW WHAT THE PRACTICE OF THE CITIES ARE MUNICIPALITIES ARE, BUT WHAT I'M ASKING IS, DO YOU HAVE OTHER CITIES OBVIOUSLY BIOMETRIC, UH, YOU KNOW, IT, IT HELPS BECAUSE IF MY PREMIUM IS GONNA GO UP X AMOUNT AND IF COUNCIL MEMBER RILEY DOESN'T, YOU KNOW, IS WELL FIT ON WELLNESS, YOU KNOW, AND THEN NOW MINE SHOULD GO UP BASED ON I'M NOT FIT PERFECTLY OR I'M SMOKING OR, OR I'M, MY WELLNESS IS NOT THE SAME.
BUT NOW, AND THAT'S WHY I BELIEVE THAT A LOT OF THESE COMPANIES HAVE GONE TO BIOMETRIC TESTING BECAUSE IT TAKES AWAY FROM HER PREMIUM GOING UP.
YOU KNOW, RIGHT NOW IT'S JUST A UNILATERAL MOVE CUZ EVERYBODY'S GO UP.
SO IF THERE ARE PLANS OUT THERE, I MEAN, NOT FOR NOW, BUT I'M JUST SAYING, YOU KNOW, THAT'S SOMETHING THAT I WOULD LIKE FOR Y'ALL TO LOOK AT AND SEE BECAUSE WHY SHOULD SOMEONE WHO DOESN'T DO ANY OF THAT SHOULD PAY THE SAME VERSUS SOMEONE WHO IS NOT, YOU KNOW, AND I WOULD SAY CITY MANAGER, JUST A COMMENT IS MOVING FORWARD, YOU KNOW, JUST MAKE SURE, CUZ BUDGET AMENDMENTS IS WHERE IT KILLS US.
AND IF WE ARE USING SOME OF THESE COST SAVINGS, YOU KNOW, TO ADJUST SALARY SAVINGS OR SALARY SURVEYS AND ALL OF THAT, AT THE END OF THE DAY THAT MONEY IS GETTING SHORT, SHORT, SHORT.
AND SO WE WANT TO MAKE SURE THAT IF WE ARE PROJECTING SOMETHING OUT THERE, THAT IT STAYS THERE.
AND SO WE WANT TO MAKE SURE, AND I JUST WANT TO MAKE SURE THAT WE, WHAT WE SAY IT, YOU KNOW, AND IT KIND OF STAYS AND I GET IT A FEW HUNDRED THOUSAND HERE AND THERE IS NOT THE BIG DIFFERENCE, BUT THAT NUMBER SHOULDN'T DROPPED DOWN DRASTICALLY.
I'LL END IT WITH THAT COUNCIL MEMBER RILEY? YES, I HAVE A, A FEW QUESTIONS.
WHAT IS THE, THE AVERAGE, UM, HANG ON, WHAT IS THE, THE AVERAGE ON THE, THE LOSS RATIO? CAUSE I SEE IN THE PREVIOUS SLIDE, UM, THE NUMBERS ARE JUMPING ALL OVER ANYWHERE FROM 80% TO 113%.
WHAT IS, WHAT IS THE AVERAGE, WHAT IS THE NORM? UH, THE, THE NORM SHOULD BE 85%.
SO CAN YOU GO BACK TO THAT PREVIOUS SLIDE? CERTAINLY.
SO ON AVERAGE, OURS IS AT ONE POINT, UH, 113.43%.
UM, SO WITH THAT AND THE INCREASE, THE 27% INCREASE, HOW DOES THAT IMPACT OUR, OUR EMPLOYEES ON THEIR SIDE? WHAT TYPE OF INCREASE ARE THEY GONNA EXPERIENCE? UH, UM, THE OVERALL, UH, PREMIUM INCREASES BY 27% AND THEN IT, IT'S A CITY'S DECISION ON HOW TO ALLOCATE THAT BETWEEN THE EMPLOYEES AND, AND THE EMPLOYER.
AND THEN MY OTHER QUESTIONS ARE, UM, DO Y'ALL DO PREVENTATIVE COVERAGE SUCH AS LIKE THE LEAP TEST? ARE YOU FAMILIAR WITH THE LEAP TEST? I, I AM.
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COUNTRY AND WE HAVE IMPLEMENTED OTHER PROGRAMS. UH, TYPICALLY, UH, WITH A CITY POPULATION, UH, IT, IT'S GOING TO BE THINGS LIKE DIABETES AND WEIGHT.AND WE DO HAVE PROGRAMS SPECIFICALLY FOR THOSE TYPES OF CONDITIONS THAT WE HAVE IMPLEMENTED IN OTHER CITIES.
UM, AND IT KIND OF MAKES IT HARD TO MAKE A DECISION.
UM, AS IT RELATES TO THAT PARTICULAR QUESTION, AND I'LL JUST ELABORATE.
THE LEAP TEST IS, UM, IT'S A NUTRITIONIST TYPE DIETARY TYPE TEST WHERE THE BLOOD WORK IS TESTED EXTENSIVELY AND IT TELLS YOU WHAT TYPE OF FOODS YOUR BODY IS REACTING TO THAT'S CAUSING TYPE OF HEALTH ISSUES.
SO THAT WAY THAT PARTICULAR DIETICIAN CAN NOW THEN, UM, CONSULT WITH THAT STAFF MEMBER OR THAT EMPLOYEE WHAT FOODS THAT THEY SHOULD STAY AWAY FROM BECAUSE IT'S INCREASING CHRONIC ILLNESSES OR IT'S INCREASING JOINT PAIN, HEADACHES, THINGS OF THAT NATURE.
UH, SO IT'S A, IT'S A VERY, UM, IT'S AN EXPENSIVE PREVENTATIVE TEST, BUT IT'S A VERY, UM, GOOD CHOICE FOR EMPLOYEES TO TAKE ADVANTAGE OF IF THIS PARTICULAR COVERAGE WOULD COVER THAT.
UM, I WOULD JUST ASK, IF POSSIBLE, IF YOU COULD JUST CHECK INTO SOMETHING LIKE THAT BECAUSE IT'LL HELP, UH, MAINTAIN THE LONGEVITY OF, OF STAFF MEMBERS IN THEIR HEALTH.
IF THEY KNOW IF THERE'S SOMETHING THAT THEY'RE EATING THAT'S CAUSING CERTAIN PROBLEMS IN THEIR BODY, IT'S NOT AN ALLERGIC REACTION, IT'S NOT AN ALLERGY TEST, IT'S SOMETHING A LITTLE BIT DIFFERENT.
UM, IT'LL JUST HELP THEM IMPROVE IN THEIR HEALTH AND SOME OF THESE OTHER ISSUES WHERE WE'RE SEEING THE CHRONIC, UM, ON THE NEXT SLIDE FORWARD WHERE YOU'RE SEEING SOME OF THESE OTHER ISSUES, SOME OF THOSE THINGS, UM, AND OTHER HEALTH CONCERNS COULD BE EITHER MINIMIZED OR, OR DECREASED.
THE OTHER QUESTION I HAVE IS MENTAL HEALTH COVERAGE.
WHAT TYPE OF MENTAL HEALTH COVERAGE IS A PART OF THE PLAN WHEN, UM, OUR STAFF MEMBERS ARE STRESSED, OVERWHELMED? IS THERE COUNSELING AVAILABLE OR PART OF THIS PARTICULAR PLAN? IT, IT IS.
THE FIRST LINE, UH, OF COUNSELING IS THROUGH YOUR E A P EMPLOYEE ASSISTANCE PROGRAM.
UH, THAT'S THROUGH ALLIANCE, ALLIANCE WORK PARTNERS.
UH, THEY SPECIALIZE IN GOVERNMENTAL ENTITIES ACROSS THE STATE OF TEXAS.
UM, ONCE IT REACHES THE MAXIMUM THERE, IT GOES INTO THE MEDICAL PLAN.
AND DO STAFF MEMBERS HAVE THE OPTION OF DOING A PPO O OR AN HMO? THEY DO ONCE A YEAR DURING OPEN ENROLLMENT.
YOU CAN CHOOSE YOUR PLAN, EITHER THE PPO OR THE QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN.
UH, BUT YOU CAN, AND YOU CAN CHANGE THAT THROUGHOUT THE YEAR, BUT ONLY IF YOU HAVE A QUALIFYING EVENT AND QUALIFYING EVENT IS DEFINED BY THE FEDERAL GOVERNMENT.
AND THEN MY LAST QUESTION IS, UM, THIS PARTICULAR, UM, DOES UNITEDHEALTHCARE OFFER THE ON-CALL NURSE SERVICES? THEY DO AND ALSO, UH, THE, THE DOCTOR A AS WELL, UH, AND THE CITY ALSO HAS, UH, A SEPARATE PROGRAM, UH, THAT THEY OFFER, YOU KNOW, WHERE THE EMPLOYEES CAN UTILIZE THAT VIRTUAL PHYSICIAN.
WELL, THANK YOU FOR ANSWERING MY QUESTIONS.
UM, I WOULD JUST DO A REQUEST, UM, AS WE MOVE FORWARD, IF YOUR TEAM, YOUR COMMUNICATIONS TEAM COULD DO A LITTLE BIT MORE MARKETING TO LET OUR STAFF MEMBERS KNOW WHAT ALL IS AVAILABLE TO THEM, UM, FOR SERVICES, FOR PREVENTATIVE AND FOR FOR GOOD MENTAL HEALTH.
I DON'T SEE ANYBODY ELSE IN THE QUEUE.
THIS ITEM REQUIRES NO MOTION OR NO.
[5. CLOSED EXECUTIVE SESSION]
ITEM NUMBER FIVE, WE'RE GONNA MOVE TO OUR CLOSED EXECUTIVE SESSION.TIME IS 6:50 PM CITY COUNCIL WILL NOW GO INTO A CLOSED EXECUTIVE SESSION PURSUANT TO SECTION 5 51 0.07, ONE OF THE TEXAS GOVERNMENT CODE.