Minutes 09-05-2013 - Laserfiche WebLink

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- Includes increasing the County's Health Savings Account contribution from $103.10 to $118 per pay period • The County will purchase stop-loss insurance to protect against catastrophic claims • A self-funded plan will provide greater flexibility for wellness strategies • Lower long term cost by avoiding Health Care Reform and State Premium taxes ($440,000) Mark Browder, representative from Mark III, referring to the slide on Fully Insured Quotes, said the quote from United Healthcare ended up costing 6.35%, or $641,000 more for the same benefits. He said, based on analysis, he believes this is the right year to transition to a self-funded arrangement. He reviewed the numbers provided on the 2014 Self Funded Quotes slide (#13). He said that in the process of transitioning other clients from being fully insured to self funded, one of the goals is to make sure that money is there to pay the bills and insure that future renewal is stable. He said the analysis recommends the County keep the current funding level, as there will be claims that have to be paid out in the future. Mark Browder said, referring to slide 15 on Self Funding, the tax savings of self funding would be about 4.5 percent. Commissioner Gordon asked for the total cost figure for the stop loss insurance. Mark Browder said this is on an individual basis and would equal around $800,000. Commissioner Gordon asked how the health exchanges work. Mark Browder said these will not have a direct effect on the county. He said this is for people who do not have coverage; so County employees cannot join the exchange, but dependents will. He said enrollment will start October 1, but there are no plan designs or costs established yet. He said the insurers involved are BCBS, Wellpath, and First Carolina Care. Commissioner Pelissier noted the statement regarding County risk if claims come in higher than expected. She asked if this risk is only for regular claims and not for catastrophic claims. She asked if any of these other counties who are self insured had to pay out more than was expected. Mark Browder said the counties that he manages have had no risk thus far. Regarding the other question, he said there is total plan cost and the maximum cost to the county for this is 5% of where things are today. He said, for individual stop loss insurance, which is for individual claims, the limit is $100,000. He said anything above that is the insurance company's responsibility. Commissioner McKee said there are two sub groups that currently tag onto the insurance (ABC and Community Home Trust). He asked if this will make those groups separately self-insured if the county goes self-insured. Frank Clifton said those groups would be responsible for their own costs now. He said if these groups have a negative effect on the County plan, the cost will be the responsibility of those groups alone. Commissioner McKee said his concern with Community Home Trust is that the County is effectively cutting them loose. Frank Clifton said the County agreement with Community Home Trust leaves them open to find a better plan if possible, and this has always been the case. Diane Shepherd said she talked with Community Home Trust and ABC Board, and both are aware that they would be responsible for their claims as of January 1 sc Frank Clifton said the County could explore options for these two entities. Commissioner Dorosin asked, if the County were to go self-funded, what changes would be seen from an employee perspective. Mark Browder said this is completely invisible to the employees as this is just a funding change. Commissioner Dorosin asked if the recommendation to have United Healthcare as the administrator is based on the established relationship with this group. Mark Browder said United Healthcare was the only firm quote, and staying with this group means that there will be minimum changes because of the existing relationship. Mark Browder said the benefits will be the same, but everyone will get new ID cards. Chair Jacobs asked where there is more flexibility with the self-funding model. Mark Browder said all insurers have to file plan designs and stay within those brackets. He said that over the past several years, plan designs have been implemented that carriers weren't filed for, but