The URL can be used to link to this page

Home My WebLink About*Other - BOCCOctober 31, 2019 ic22f � � E Vi -EE D OCT 3 1 2019 3 Grant County Heal & Wellness Committee 35 C. St. NW Suite 308 PO Box 37 Ephrata, WA 98823 509.766.3190 -Phone The Grant County Health and Wellness Committee (HWC) would like to make several recommendations concerning benefits offered to Grant County Employees. The HWC has had many discussions regarding benefits with the focus on benefit plan design changes. At the October monthly meeting, the HWC discussed each of the following and a ballot was sent out on October 25. The recommendations are as follows with results of the ballot immediately following. 1. The HWC recommends to accept the health plan renewal through HMA at a 6% increase to the Medical Funding with Dental and vision plans to stay at 2019 funding levels. This increase would be cost shared between the County and the Employees based on the design structure already in place. a. 19 votes to accept, 1 vote to reject 2. The HWC recommends to accept the stop -loss renewal through Sun -life at a 17.5% increase to the renewal. a. 17 votes to accept, 3 votes to reject 3. The HWC recommends to replace Lincoln Financial (voluntary Benefits) and Sun Life (Group Life) with Mutual of Omaha a. 19 votes to accept, 1 vote to reject 4. The HWC recommends to cover labs/x-rays (now to be changes to imaging) at a constant coinsurance of 80% to reduce confusion and claims processing. a. 20 votes to accept, 0 votes to reject 5. The HWC recommends to 'decline HMA's request to cover Out of Network claims based on a References Based Pricing versus current Reasonable & Customary method. a. 2 votes to accept, 18 votes to reject 6. The HWC recommends to add hearing exams to the list of preventative benefits covered by Grant County a. 20 votes to accept, 0 votes to reject 7. The HWC recommends adding hearing aids as a defined benefits covered at 80% for both In Network and Out of Network and a cap of $ 500 per calendar year. a. 20 votes to accept, 0 votes to reject 8. The HWC recommends adding Behavioral Health and Dermatology to the services available through MDLive a. 1 vote for behavioral health only, 17 votes for behavioral health and dermatology, 2 votes to reject 9. The HWC recommends to decline adding Air Ambulance with a group contract through LifeFlight a. 0 votes to accept, 20 votes to reject 10. The HWC recommends to decline adding an HSA benefit plan as an option with the current Core & buy -up pians. "TO MEET CURRENT AND FUTURE NEEDS, SERVING TOGETHER WITH PUBLIC AND PRIVATE ENTITIES, WHILE FOSTERING A RESPECTFUL AND SUCCESSFUL WORK ENVIRONMENT." a. 0 votes to accept, 20 votes to reject . The HWC declines to make a recommendation regarding outpatient rehabilitation as there was a tie in. 11 i the voting. a. 4 vote Option 1, 0 votes option 2, 8 votes option 3, 8 votes t reject}, 12. The HWC recommends to decline making any changes to the dependent maternity care benefits provided, keeping them at the current benefit of covering dependent maternity complications only. a. 3 vote Option 1, 4 votes option 2 13 votes to reject '*�m � 1 e Please let me know if you have additional questions or would like additional details. Respectfully, "Brittany M. Ran Chairperson Health and Wellness Committee CC: Kirk Eslinger, Laurissa Perez, Barbra Vasquez, Elisabeth Lauver, Rebecca Martinez `fat{ d tn,s da!y of. *014e,/. 20 _ Beard o C;-,u.nty s%`-"on-imissioners Gra.it-C-`oiJHLiN. W shilnt°t;Jn Dist f¢-'3 Dist # ) Dist "TO MEET CURRENT AND FUTURE NEEDS, SERVING TOGETHER WITH PUBLIC AND PRIVATE ENTITIES, WHILE FOSTERING A RESPECTFUL AND SUCCESSFUL WORK ENVIRONMENT." At)stain Barbara Vasquez From: Brittany M. Rang Sent: Tuesday, November 5, 2019 11:02 AM To: Barbara Vasquez Subject: HWC Recommendation 1. Accept health plan renewal through HMA at a 6% increase to the medical funding. Dental and vision plans to stay at 2019 funding levels. Rationale: Plan spending is over budget by about $1 million in 2019 and we don't know how expensive 2020 will be. It could be under budget like we were in 2016, or we could run over again. A6% increase to funding for the 2020 medical plan is enough to keep pace with medical cost trend, and should prevent us from needing a large increase in 2021. Renewal package pages 8-13 HUB recommends Grant County accept. .... . . ...... X.: X.: X X.. ............... .. ... ... ....... .. ...... . . X.... ............... ...... ... . ...... .. .... I .. 1. ............... I . ...... I ..... .. ............ X X. .............. 1 11 ............... .... .............. .................... r . . . . ............ ...... . . ....IV o 2. Accept stop -loss renewal through Sun -life at a 17.5% increase to the renewal. Rationale: This is a highly competitive renewal rate given our current year of claims experience. HUB recommends Grant County accept. ......... . * .... . .. ..... ................... . . ..... . .. . ................ . .......... ..... ... . . .. ....... ..... .................. ...... ... ... ............ X* X .. ......... . ....... ... ............ .......... ......... ............. . . . . ........ :: . . ......... ... ee:,.,: ................. .. . .......... .................... .. ... . . ........ ....... .. ................... ......................... .............. ....... . 3. Replace Lincoln Financial (Voluntary Benefits) and Sun Life (Group Life) with Mutual of Omaha Rationale: Lincoln Financial has been the voluntary benefits carrier for several years. The first year transition had a lot of issues and we hoped that once the administrative issues were solved the program would run smoothly. However,, we hear from HR,. Payroll and employees that the experience has not improved much. Our current broker (HUB) recommended that we consider the very competitive and in some ways superior options Mutual of Omaha offers. For example, they are offering a guarantee of coverage without providing past health information. See renewal package pages 47-67 HUB recommends Grant County accept . ......... ............. ............ : ..... .............. . . .... ........ X.: ........... ............. ................. ... . .. ... .. ...... . . . . ree: .1. e ..... .. . .................... X: ............... .................... . ....... .......... .............................. 4. Cover Lab/X-rays (imaging) at constant coinsurance to reduce confusion and claims processing: a. Current Benefit: In -Network: 80% / Out of Network: 60% b. Proposed Benefit: In -Network: 80% / Out of Network: 80% Rationale: There have been issues when a Preferred provider orders lab or imaging services from a non - preferred provider. The employee is confused by the billing because they did not know the lab or imaging office were out of network. This change would make it so the employee does not have to pay the extra fees associated with an out of network visit. Renewal package page 42 HUB recommends Grant County accept .... ............... .......... . ............. .......... ..... . .. .. `." . ............. ...... .. X.: . ..... ............ . . .... 0 . .. ... . . xx X. .................. ree'es ....... .. .... ..... ..... ....... .... ......... ................ ......... . 5. Consider covering Out of Network claims based on a References Based Pricing vs current Reasonable &Customary method Rationale: This provides a potential cost savings to the plan for out of network plan paid benefits, however, it may shift the balance of the costs to the employee. HUB recommends Grant County reject '::,:::;:::::::.::::::::':::::::.::.::::.::::::::::::::::.::::::::::::::::::.::::::::.:.::::.::.::::.::.::::::::::::::::::::::::::::::::::::::::: :. :X..:.::.. ..::::::.::.::.::.::.::.::.::.::::.::::.:::......:.:::.:.::::::.::.::.:::::::: ..:..:..:..:..::.:..:.:..::.:.: . 1'l Q :lies :,: ree._.::.:: 6. Consider adding Hearing Exams to Preventative benefits a. Current Benefit: No Benefit b. Proposed Benefit: In Network: 100%, deductible waived / Out of Network: No Benefit Rationale: Hearing exams are relatively low cost to the plan and employees requested that this service become covered by the plan. HUB recommends Grant County accept :.: Samc� :......::ee........g::::::: 7. Consider adding Hearing Aids a. Current Benefit: No Benefit b. Proposed Benefit: In Network: 80% / Out of Network: 80%, Limited to $500 CYM Rationale: This is a defined benefit with a cap of $500 per calendar year and is not expected to cost the Grant County plan much. Employees requested that hearing aid coverage be added to the plan. HUB recommends Grant County accept rX :.:: :::.: . :::......::::.:.::::::..:.:.::: :.. A ree,:::::......:::::::......: 8. Consider adding additional services available through MDLive a. Current Benefit: MDLive —General Office Visits ($1.00 PEPM) b. Proposed Benefit: L Option 1: MDLive with Behavioral Health ($1.35 PEPM) ii. Option 2: MDLive with Behavioral Health and Dermatology ($1.60 PEPM) Rationale: Adding these benefits provides the plan with potential savings for office visit costs and provides a wider network of providers for the employees. HUB recommends Grant County accept option 2 ::.:.:...N. :.::.:.:.:.:.:.:...:..::::::...:.......:..::..::.:.:.:::..::.:....::..:.:::::::.::::..........:::.:: n..:2:................................ ::..:::::.:::.................. Q.o_ .. :.:..::.::::.:.::....... XX tion::::. .:::::::::.:.:::::.::::.::.:: .::...:.:.:.:.:.:.: _ 9. Consider Adding Air Ambulance with group contract through LifeFlight a. Current Benefit: Covered under the health plan without a limit b. Proposed Benefit: Add LifeFlight Membership ($59/employee), limit air ambulance benefit to $10,000. The benefit plan design must be pre -approved by LifeFlight, 2 12. Consider changing dependent care with either full maternity benefits or no maternity benefits at all. c. Current Benefit: vii. Dependent maternity complication benefits only d. Proposed Benefit: viii. option 1: Full dependent maternity benefits ix. option2: No dependent maternity benefits Rationale: Currently the plan provides dependents with maternity complications only. Limiting dependents maternity benefits to complications may lead to inconsistency in claims, confusion for members and misalignment between plan administration and stop -loss. HMA's Care Management department may determine a complication falls under the coverage for complications; however, stop -loss could determine the issue is management of a difficult pregnancy but not a classifiably distinct complication of a pregnancy. HUB had no recommendation on this, but did state that most medical plans do not cover maternity benefits for dependents. ...... ..... Wr: e :::;::::::: . . .......... . ..... a C► t 0 1.:.::..:.:: : :::;::.:,: ;;::: ::: , ..:. n :...:. .. C t�on�..:2...:: .:..:..:...: ; p.:.::...: o ..........................................................................::.:.:::::::::p :::...:::.: :.:.:.:.::.::.. Thanks, 4 Rationale: Provides the employee with additional coverage but still requires that the Grant County plan pay for services as primary. LifeFlight reserves the right to approve of the Grant County benefit arrangement and we can't be certain what terms they would accept. HUB recommends Grant County reject 10. Consider Adding an HSA Benefit Plan as an option with the current Core &Buy -Up Plans a. Current Benefit: N/A b. Proposed Benefit: iii. Deductible: $1500, 2x Family (aggregated) iv. Out of Pocket Maximum: $5000,2x Family (aggregated) v. In- Network: 80%/ Out of Network: 60 vi. Costs of the benefit plan to match the core plan Rationale: This would be a new third plan option for employees. The option of having an HSA account & provides a potential for tax costs savings to the employee. If an employee were to elect the HSA plan, they would not be able to be double covered by another plan unless that plan was also HSA eligible and the tax savings would be split between the two plans. The cost to the employee would be the same as the Core plan with the addition to the deductible. HUB recommends Grant County reject .......... AL re e . :::.::::::::::::..::::::::.:..::::::::::.. .. ...::......Ye .......... .......... No ..;.:..::.:. 11. Consider adding a separate benefit category for massage therapy and no longer covering it under outpatient rehabilitation and Consider removing visit limits for massage therapy/ acupuncture/ chiropractic care or set a 20 -visit limit if seeking cost control measures a. Current Benefit: L 60 -visit limit for all rehabilitation services including physical therapy/massage therapy/acupuncture/chiropractic care b. Proposed Benefit structures: ii. Option 1:60 -visit limit for rehabilitation services including physical therapy /acupuncture/ chiropractic care &new benefits category for massage therapy iii. Option 2: 60 -visit limit for rehabilitation services including physical therapy; 20 -visit limit for massage therapy /acupuncture/ chiropractic care iv. Option 3: 60 -visit limit for rehabilitation services including physical therapy; no visit limit for massage therapy /acupuncture/ chiropractic care Rationale: Evidence -based guidelines promote acupuncture, chiropractic care and massage therapy as effective noninvasive treatments for both acute and chronic back pain. Tends in the HMA book of business indicate limiting such benefits can increase plan spend on both opioids and surgeries to treat musculoskeletal disorders (MSDs). Changing this benefit would decrease the cost of chronic disease management while promoting alternative medicine and provides members with access to alternative care that is less costly than seeking surgery as a first treatment option. Renewal package page 28 HUB had no recommendation on this 3