Agenda - 05-21-2013 - 5a - Laserfiche WebLink

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3 1 June 18th Vendor and plan funding approved with the FY 13-14 budget process* 2 *With the possibility of a new vendor and funding source, approval is needed to ensure timely 3 implementation in preparation for Open Enrollment in October 2013. 4 Medical Plan update 5 2012 Plan Performance/2014 Renewal Expectation (spreadsheets) 6 7 8 Frank Clifton gave same background on the process. 9 Chair Jacobs asked for an explanation of the difference between fully insured and self 10 insured. 11 Mark Browder said when you are fully insured you pay the premium to the insurer and 12 they take all of the risks for the plan. When you are self funded, you hire an administrator to 13 adjudicate your claims and you purchase stop loss insurance, which protects against 14 catastrophic claims. Over the long haul, it is better for a larger entity such as the County to be 15 self funded because there are lower expenses and fewer taxes. 16 Mark Browder made reference to slide 8 and the numbers highlighted in yellow. He said 17 the plan ran well in 2012. The target would be 85%, and Orange County might be getting 18 money back from UnitedHealth because of the spread from 78.16%and 85%. He went over 19 the health plans in detail and how the 80/20 plan works. 20 Starting in 2014, the definition of "full-time employee"will be 30 hours under health care 21 reform. 22 Frank Clifton said a lot of the part-time employees have retired and then come back to 23 Orange County and already have retiree insurance. 24 Commissioner Rich asked if there was credit for wellness programs and Nicole Clark 25 said not at this time. Commissioner Rich said BCBS has reductions in premiums for these 26 types of programs. 27 Frank Clifton said Orange County has tried to expand their wellness program in the last 28 couple of years and they are making some strides. 29 Commissioner Dorosin made reference to slide 11 and the fully insured calculation. He 30 asked if the "2014 Expected Cost"was a$2 million drop as it appears. Mark Browder said they 31 are looking for numbers coming in to be more competitive. 32 Commissioner Dorosin said Orange County switched from Cigna to UHC in 2012 and 33 now they are considering a change again. He asked for the motivation for getting bids. 34 Frank Clifton said the motivation is to make sure Orange County gets competitive 35 pricing on health insurance. 36 Commissioner Dorosin said his opinion is that it is not easy to change plans. 37 Mark Browder said they got direction from the Board last year to go out to bid in 2014. 38 The dissatisfaction last year was the fact that the new plan with UHC was not as rich as the 39 previous plan the County had for years. 40 Commissioner Dorosin asked if the county had ever been self-funded and the answer 41 was no; only with dental insurance. 42 Chair Jacobs asked Mark Browder to articulate more on the advantage of being self- 43 funded. He asked if there was more flexibility in self-funding. 44 Mark Browder said every fully insured insurer files their plans with the state, and if you 45 want to change parts of the plan and it is not in the state's plan design, it is difficult. If an entity 46 is self-funded, it can change the plan without state approval. 47 Chair Jacobs made reference to the revised salmon-colored sheet. Nicole Clark said 48 the original one had a May 10th date and should have been May 3`d. This is the only revision. 49 Commissioner Price asked if there was anything broken with the current system.