Agenda - 09-16-2014 - 6a - Laserfiche WebLink

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7 1 Commissioner Gordon asked how to figure out if something breaks even for United 2 Healthcare. 3 Mark Browder said this goes back to the second slide on the 2013 plan experience. He 4 noted the bottom right hand side, which shows a 79 percent loss ratio. He said based on where 5 the targets are, this is a break even or slight positive position for United Healthcare. 6 Commissioner Gordon asked about the 79% loss ratio. 7 Mark Browder said with healthcare reform, the target loss ratio is 85 percent. He said 8 this shows that United Healthcare did not make significant amounts of money while insuring the 9 plan. 10 Commissioner Gordon asked how the stop loss ratio figures in. 11 Mark Browder referred to slide 5 and said the County pays for stop loss insurance, and 12 the pooling point is $105,000. He noted that in March the County received reimbursement from 13 a claimant that from $181,000. He said reimbursement was received for that month for that 14 high claimant. 15 Commissioner Gordon asked about slide 6 and questioned what numbers go into 16 determining what the contribution has to be. 17 Mark Browder said everything above the contribution lines falls into the green line on 18 slide 6. He said there is a claims expectation for 2015, which takes the current 12 months of 19 claims and trends it forward. He said the administration and stop lost insurance costs are 20 estimated, the health care reform fees are considered, as well as the HSA costs, and this totals 21 about $11,739,828. 22 Commissioner Gordon said the 14.3 percent increase is higher than other numbers, 23 such as the inflation rate and cost of living increases. 24 Mark Browder said health care claims are increasing at a rate greater than inflation, and 25 health care reform adds additional costs. 26 Chair Jacobs said March 2013 and July 2013 had higher claims, and there is logic to 27 this since people are more active in March, and in July school is out. He asked why this jump in 28 March was not projected. 29 Mark Browder said historically claims activity is around $600,000, so $900,000 is a 30 significantly different month. He said July was up, but not as significantly as March and 31 November. He said the March increase was due to abnormal claim activities. 32 Commissioner Pelissier asked how the County can assess whether it is still an 33 advantage to remain self insured moving forward. 34 Mark Browder said a projection could be done to show what a fully insured renewal 35 would look like; however, the County is not paying 2 percent in premium taxes to the state, and 36 in 2015, 3 percent in health insurance tax to the federal government. He said this equates to 37 $500,000 in avoided costs automatically from self funding. He said he works with 30 counties 38 across the state, and there is a wide disparity in what renewals look like. He said when a client 39 asks for a fully insured quote compared to a self funded quote, it is often an increase in the mid 40 teens. He said there has only been one situation where the fully insured plan was competitive 41 to a self funded plan, and this was a small company with high expenses. 42 Chair Jacobs said there has been discussion about offering in -house medical care for 43 employees and whether it was advisable to do this through the County health department or 44 not. He asked if there have been any further discussions about this issue. 45 Michael Talbert said no. He said this project was put on hold when the County lost their 46 HR Director. He said it is not advisable to do this through the County health department. He 47 said many entities do this through UNC Healthcare, and this will be investigated. 48 Chair Jacobs asked if this is something that the new HR Director will be asked to look 49 into.