Minutes 04-11-2013 - Laserfiche WebLink

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th June 11 Recommendations presented during the Work Session th June 18 Vendor and plan funding approved with the FY 13-14 budget process* *With the possibility of a new vendor and funding source, approval is needed to ensure timely implementation in preparation for Open Enrollment in October 2013. Medical Plan update 2012 Plan Performance/2014 Renewal Expectation (spreadsheets) Frank Clifton gave same background on the process. Chair Jacobs asked for an explanation of the difference between fully insured and self insured. Mark Browder said when you are fully insured you pay the premium to the insurer and they take all of the risks for the plan. When you are self funded, you hire an administrator to adjudicate your claims and you purchase stop loss insurance, which protects against catastrophic claims. Over the long haul, it is better for a larger entity such as the County to be self funded because there are lower expenses and fewer taxes. Mark Browder made reference to slide 8 and the numbers highlighted in yellow. He said the plan ran well in 2012. The target would be 85%, and Orange County might be getting money back from UnitedHealth because of the spread from 78.16% and 85%. He went over the health plans in detail and how the 80/20 plan works. Starting in 2014, the definition of"full-time employee" will be 30 hours under health care reform. Frank Clifton said a lot of the part-time employees have retired and then come back to Orange County and already have retiree insurance. Commissioner Rich asked if there was credit for wellness programs and Nicole Clark said not at this time. Commissioner Rich said BCBS has reductions in premiums for these types of programs. Frank Clifton said Orange County has tried to expand their wellness program in the last couple of years and they are making some strides. Commissioner Dorosin made reference to slide 11 and the fully insured calculation. He asked if the "2014 Expected Cost" was a $2 million drop as it appears. Mark Browder said they are looking for numbers coming in to be more competitive. Commissioner Dorosin said Orange County switched from Cigna to UHC in 2012 and now they are considering a change again. He asked for the motivation for getting bids. Frank Clifton said the motivation is to make sure Orange County gets competitive pricing on health insurance. Commissioner Dorosin said his opinion is that it is not easy to change plans. Mark Browder said they got direction from the Board last year to go out to bid in 2014. The dissatisfaction last year was the fact that the new plan with UHC was not as rich as the previous plan the County had for years. Commissioner Dorosin asked if the county had ever been self-funded and the answer was no; only with dental insurance. Chair Jacobs asked Mark Browder to articulate more on the advantage of being self- funded. He asked if there was more flexibility in self-funding. Mark Browder said every fully insured insurer files their plans with the state, and if you want to change parts of the plan and it is not in the state's plan design, it is difficult. If an entity is self-funded, it can change the plan without state approval. Chair Jacobs made reference to the revised salmon-colored sheet. Nicole Clark said the original one had a May 1 0th date and should have been May 3 d. This is the only revision.