Agenda - 10-15-2013 - 5a - Laserfiche WebLink

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23 1 2 Mark Browder, referring to the slide on Fully Insured Quotes, said the quote from United Healthcare 3 ended up costing 6.35%, or $641,000 more for the same benefits. 4 He said, based on analysis, he believes this is the right year to transition to a self-funded 5 arrangement. He reviewed the numbers provided on the 2014 Self Funded Quotes slide (#13). 6 He said that in the process of transitioning other clients from being fully insured to self funded, one 7 of the goals is to make sure that money is there to pay the bills and insure that future renewal is stable. 8 He said the analysis recommends the County keep the current funding level, as there will be claims 9 that have to be paid out in the future. 10 Mark Browder said, referring to slide 15 on Self Funding, the tax savings of self funding would be 11 about 4.5 percent. 12 Commissioner Gordon asked for the total cost figure for the stop loss insurance. 13 Mark Browder said this is on an individual basis and would equal around $800,000. 14 Commissioner Gordon asked how the health exchanges work. 15 Mark Browder said these will not have a direct effect on the county. He said this is for people who 16 do not have coverage; so County employees cannot join the exchange, but dependents will. He said 17 enrollment will start October 1, but there are no plan designs or costs established yet. He said the insurers 18 involved are BCBS, Wellpath, and First Carolina Care. 19 Commissioner Pelissier noted the statement regarding County risk if claims come in higher than 20 expected. She asked if this risk is only for regular claims and not for catastrophic claims. She asked if any 21 of these other counties who are self insured had to pay out more than was expected. 22 Mark Browder said the counties that he manages have had no risk thus far. Regarding the other 23 question, he said there is total plan cost and the maximum cost to the county for this is 5% of where things 24 are today. He said, for individual stop loss insurance, which is for individual claims, the limit is $100,000. 25 He said anything above that is the insurance company's responsibility. 26 Commissioner McKee said there are two sub groups that currently tag onto the insurance (ABC and 27 Community Home Trust). He asked if this will make those groups separately self-insured if the county goes 28 self -insured. 29 Frank Clifton said those groups would be responsible for their own costs now. He said if these 30 groups have a negative effect on the County plan, the cost will be the responsibility of those groups alone. 31 Commissioner McKee said his concern with Community Home Trust is that the County is effectively 32 cutting them loose. 33 Frank Clifton said the County agreement with Community Home Trust leaves them open to find a 34 better plan if possible, and this has always been the case. 35 Diane Shepherd said she talked with Community Home Trust and ABC Board, and both are aware 36 that they would be responsible for their claims as of January 1St 37 Frank Clifton said the County could explore options for these two entities. 38 Commissioner Dorosin asked, if the County were to go self-funded, what changes would be seen 39 from an employee perspective. 40 41 Mark Browder said this is completely invisible to the employees as this is just a funding change. 42 Commissioner Dorosin asked if the recommendation to have United Healthcare as the administrator 43 is based on the established relationship with this group. 44 Mark Browder said United Healthcare was the only firm quote, and staying with this group means 45 that there will be minimum changes because of the existing relationship. 46 Mark Browder said the benefits will be the same, but everyone will get new ID cards. 47 Chair Jacobs asked where there is more flexibility with the self-funding model. 48 Mark Browder said all insurers have to file plan designs and stay within those brackets. He said that 49 over the past several years, plan designs have been implemented that carriers weren't filed for, but could 50 administer. He said that plan designs will be able to be maneuvered around based on needs and costs. 51 Frank Clifton noted that the self funded model allows employees to set up their own dependent plan. 52 Commissioner Gordon referred to attachment 2, and asked about option 1 on page 19. 53 Diane Shepherd said this discussion has been about option 2 this evening. She said option 1 is a 54 self insured plan, but it maintains the health savings account contribution at the 2012-13 level. She said the 55 only difference is an increase in the County contribution to the Health Savings Account.