HomeMy WebLinkAboutMinutes 08-30-2011 APPROVED 10/4/2011
MINUTES
ORANGE COUNTY BOARD OF COMMISSIONERS
WORK SESSION
August 30, 2011
7:00 p.m.
The Orange County Board of Commissioners for a Work Session on Tuesday, August 30,
2011 at 7:00 p.m. at the Southern Human Services Center, in Chapel Hill, N.C.
COUNTY COMMISSIONERS PRESENT: Chair Bernadette Pelissier and Commissioners
Valerie Foushee, Alice M. Gordon, Barry Jacobs, Pam Hemminger, and Earl McKee
COUNTY COMMISSIONERS ABSENT: Steve Yuhasz
COUNTY ATTORNEY PRESENT: John Roberts
COUNTY STAFF PRESENT: County Manager Frank Clifton and Clerk to the Board Donna S.
Baker (All other staff inembers will be identified appropriately below)
Chair Pelissier announced that Commissioner Yuhasz was out of town and
Commissioner Gordon may be able to arrive at 8:30 p.m.
1. Comprehensive Water Resources Review and Discussion
a) Jordan Lake Allocation, Partnership and Draft Regional Water Supply Plan
Environment, Agriculture, Parks and Recreation Director Dave Stancil said that there are a
lot of things going on with water resources with the County and there are going to be decision
points for the Board of County Commissioners will need to make in the coming months. This
has been a multi-departmental process.
Water Resources Coordinator Tom Davis made a PowerPoint presentation.
Jordan Lake Partnership
and Allocation Update
August 2011
Outline
- Jordan Lake Allocation and Jordan Lake Partnership (JLP) Timeline Updates
- JLP Phase I Regional Water Supply Plan (RWSP)
o Water Demand Projections
- JLP Phase II RWSP
o Water Supply Alternatives
- Interconnections Study
- WASMPBA (Water and Sewer Management Planning and Boundary Agreement)
- Western Intake Feasibility Study
Jordan Lake Allocation Timeline
- Cape Fear River Basin modeling underway
- Cape Fear River Basin Water Supply Plan to start in Fall 2011
- Draft Jordan Lake Allocation Applications now due May 2012
- Final Jordan Lake Allocation Applications now due August 2012
- EMC determines allocations in late 2012/early 2013
- A reminder that the RWSP will not serve as Orange County's Jordan Lake Allocation
Application to NC DWR.
JLP Timeline
- Phase I RWSP (water demand) complete September 2011
- Phase II RWSP (supply alternatives) with modeling and analysis complete March 2012
- Final RWSP complete April 2012
- Phase I Interconnections Study complete September 2011
- Phase II Interconnections Study complete October 2011
- JLP consultant (?) completes JL Allocation Applications - February through August
2012
Regional Population Estimate—population will double in the next 30 years
JLP Phase I RWSP
- Water Demand Projections developed by Planning in three Urban Transition Areas
including Economic Development District (EDD) zones
o Land use analysis used to develop projections
0 2040 demands will be used by DWR in allocation process:
Eno 0.534 MGD
Hillsborough Area 0.695 MGD
Buckhorn 1.195 MGD
(Including Orange County's Efland and Mebane zones)
Total: 2.424 MGD
Level 1 vs Level 2 Allocation Costs
Phase II RWSP will include evaluation of supply alternatives
Interconnections Study
- Draft report underway
o Includes locations of planned and proposed regional interconnections
o Participants
o Demand
o System Interconnections
o Design
o Location
o Agreements
- Feasibility study will be completed this fall.
Interlocal Agreements
Durham - water and sewer service in Eno EDD
Mebane — expanded Buckhorn service area?
Hillsborough —forthcoming
WASMPBA — Does language need to be modified?
Additional Item
Western Intake Feasibility Study start Fall 2011
Commissioner Jacobs said that, presumably, the Buckhorn Economic Development
District would be served by Mebane. He asked why Orange County would be providing water
if it is coming from Mebane's systems.
Craig Benedict said that if Mebane has a certain amount of water through their
agreements, if they ever reach their allocation limit and needed to justify to the State that they
were going to service a larger area, then Orange County could offer some of the capacity
allocation. With Durham, the 0.5 million gallons is not on the radar for Durham, but it is part of
a growth area and Durham can accommodate what is needed there.
Frank Clifton said that the County is going to invest several million dollars in utility
infrastructure and he would not want that infrastructure to be impinged if there was not viable
water available.
Commissioner Jacobs said that Mebane will be annexing this area and he thinks that
Orange County should try and get the allocation, but it is not a persuasive argument.
Commissioner Jacobs said that it is great to have this agreement, but he wants to
discuss how water will be shared in droughts because it has never been resolved.
Dave Stancil said that this is supposed to be an important part of this process and the
partners should be reminded of this.
Commissioner Jacobs said that the WSMBA originally contemplated including Mebane
and Durham in the agreement. He sent a suggestion that the meeting with Mebane includes
discussion about specific land use issues, and it seems that this is one of them —to have
Mebane be a party to the agreement.
Commissioner Jacobs asked about the western intake. Dave Stancil said that Durham
is taking the lead on this discussion and this will be the most substantial financial commitment.
This will be a big decision for local governments. This conversation will begin in earnest this
fall.
Chair Pelissier made reference to page 4 and the future utilization of Jordan Lake. She
asked about the additional infrastructure in Orange County.
Craig Benedict said that if there is a western intake, it would start in Chatham County,
but it would come around OWASA and through Orange County. The base of the infrastructure
is not in Orange County, but it has to travel through. This would involve water lines and other
conduits to split to OWASA and over to Durham.
Dave Stancil said that there would be a big investment to get into Buckhorn in the near
future.
Chair Pelissier said that she is concerned that this might be a backup for the Buckhorn
EDD.
Commissioner Jacobs said that the County Commissioners need to tread lightly when
speaking about increased infrastructure in Orange County because it is a red flag for some
people.
Commissioner Jacobs made reference to page 3 and said that there are two
unresolved issues in this study. One is the issue of inter-basin transfer and the other is water
supply alternatives. He suggested putting a positive statement about the County's water
principles in a resolution.
Chair Pelissier said that Commissioner Jacobs' comments could be discussed in
agenda review.
b) Regional Nutrient Management Rules
Dave Stancil said that most of the Orange County falls in either the Neuse River or
Falls Lake Basin.
Tom Davis made a PowerPoint presentation.
Terry Hackett from Erosion Control in the Planning Department, Kenny Ray, and Gail
Hughes made part of the PowerPoint presentation also.
Regional Nutrient
Management Rules
August 2011
Overall Goals
Jordan Lake Goal: Meet chlorophyll-a and pH standards lake-wide by reducing nutrients
entering lake:
Upper New Hope: 35%N and 5%P
Haw River: 8%N and 5%P
(measured against baseline yrs. 1997-2001)
Falls Lake Goal: Meet chlorophyll-a and turbidity standards lake-
wide by reducing nutrients entering lake:
Entire Lake: 40% N and 77% P
(Measured against baseline yr. of 2006)
Jordan Lake Watershed and Arms - map
Falls Lake and Jordan Lake
Both sets of rules require nutrient reductions from:
- Existing Development- stormwater
- New Development— stormwater
- Agricultural Lands
- Fertilizer Management (Jordan Lake only)
o Also from:
■ State and Federal Facilities
■ Wastewater Treatment Plants
Nutrient Trading programs also established.
Existing Development—stormwater
A "Staged Approach" for both sets of NM rules:
Jordan Stage 1: Program submitted to DWQ in 2009:
Relies on staff efforts (education, IDDE program, etc) and other
measures to reduce nutrient loading.
If water quality violations in Jordan Lake are not reduced enough:
Jordan Stage II: Program must then reduce N by 35% and P by 5% from ED lands-
How? Retrofits ? Uncertain at this time.
Falls Stage 1: By 2021 program must reduce stormwater loading back to
baseline levels.
Falls Stage 2: Continue efforts in order to reduce N by 40% and P by 35%
How? Retrofits? Uncertain at this time.
Agriculture
For both watersheds agriculture defined as:
- Commercial production of crops or horticultural products (other than trees).
- Production or management of:
0 5 or more horses
0 20 or more cattle
0 20 or more swine (outside a feedlot) or 150 or more in a lot.
0 120 or more sheep
0 130 or more goats
0 650 or more turkeys
0 3,500 or more chickens, or any combination in excess of 20,000 Ibs
Jordan Stage 1: Voluntary measures to collectively reduce loading in each arm:
Upper New Hope arm: 35% N reduction
Haw River arm: 8 % N reduction
By August 2012 WOC determines if goals have been reached.
If not, LAC is formed and Ag operations must register.
Jordan Stage II: By August 2015 EMC will require BMPS in watersheds "as
needed to ensure that the goal is met" by August
2018.
EMC could also require individual compliance, and WOC could
recommend means for offsite credits to be available.
Agricultural Rules — Fertilizer Management
- Only in Jordan Lake watershed.
- By 2012, applicators must complete training (or apply according to nutrient
management plan) to apply to parcels greater than 5 acres.
- Preliminary staff estimate of 1,500 parcels in Orange County and more than 10,000 in
entire watershed.
Agricultural Rules — Falls Lake watershed
Falls Stage 1: By January 2012 operations must register. LAC & WOC
also formed.
By 2020 must voluntarily collectively reduce N 20% and
P 40% (vs. 2006).
Falls Stage 2: If Stage I goal not met, LAC must determine how to
implement uniform individual measures by 2036 of:
- Minimum 20' vegetated buffer on cropland
- Vegetated livestock exclusion buffers in pastures
By 2036 ag must meet reductions of 40% N and 77% P.
Agricultural Rules
- Falls Lake accounting tool not presently available.
- Jordan Lake accounting tool recently made available. But...
- Jordan Lake WOC still working to determine ag accounting methodology for uniform
implementation. County staff must determine draft ag baseline by February
2012.
Nutrient Trading
- Buying and selling of nutrient credits is intended as a means of easing compliance but
few details of trading programs are currently available. Many unknowns remain.
- Upper Falls watershed impacts can only be offset by loading reductions (offsets)
located in upper watershed.
Craig Benedict made reference to Nutrient Trading and said that he had been working
with Triangle J Council of Governments to reexamine Transfer of Development Rights.
Frank Clifton said that the County's cost of this plan has been detailed, but it is hard to
guesstimate the costs to landowners yet and the impact of this on agriculture.
Commissioner Jacobs asked about the amount of nitrogen that is produced from septic
systems.
Dave Stancil said that three groups that will be impacted heavily by these rules are
agriculture, wastewater operators, and potentially septic tank owners.
Commissioner Jacobs said that the Wake County Board of Commissioners had an
issue about charging a fee for septic system inspections. He said that one of the things that
could come out of this is a system of septic system inspections. He thinks that it will be
inevitable under these rules.
Commissioner Jacobs asked about the Eno Use Capacity Agreement. Kevin Lindley
said that the model was completed but it is very complicated. Commissioner Jacobs asked for
a status report on this agreement and the possibility of making the model more usable.
Kevin Lindley said that the capacity use users had their annual meeting last week and
a request for a change in allocation needs to come from one of the stakeholders — either
Orange County, Hillsborough, Orange-Alamance, or Piedmont Minerals.
Commissioner Jacobs asked that Orange County as a user ask for this and Chair
Pelissier said that it would be discussed at agenda review.
Commissioner McKee said that these rules will end up being mandated and the result
to reduce these levels will stifle economic development in northern Orange County.
Frank Clifton made reference to Commissioner Jacobs' comment about septic tanks
and said that the rules would apply mainly to those properties that are located very close to
streams.
Commissioner Hemminger said that one of the major problems about all of this is that
the only measuring point is in the lake, no matter what Orange County tries to do. They need
to be thinking about a septic system evaluation system at some point, and in the meantime,
Orange County needs to at least show that it is being proactive.
Commissioner McKee made reference to monitoring all stream crossings at the County
line. He wants to know where the County is on that and he would like this to be brought back
to the Board regarding how to implement this as fast as possible. He would like to monitor this
on a continual basis. He would like to do independent testing for Orange County's own stream
levels.
Frank Clifton said that the staff needs to work up a cost estimate and analysis for this
testing process.
Commissioner Jacobs made reference to the septic tank issue and said that Orange
County does not have to differentiate septic tanks or charge a fee, but he bets that most
people do not ever have their septic tanks pumped every five years as recommended. He
suggested a system that provided a reminder for pumping septic tanks and a requirement to
provide proof of septic tank pumping.
Chair Pelissier asked what farmers would be told if they have to reduce their nutrient
load, but they cannot grow crops without some sort of fertilizer. She is concerned about the
impact on agriculture.
Commissioner Gordon arrived at 8:36 PM.
Dave Stancil said that he thinks that Orange County can implement measures in both
of the watersheds that will enable the County to get to the needed loading standards.
Terry Hackett said they do have concerns about the impact on farmers and many are
trying to get by with the minimum amount of nitrogen and phosphorous, and many are under-
fertilizing their pastures. These rules are voluntary now, but may become mandatory at some
point in the future.
Dave Stancil said that a lot of people would agree that the Falls numbers are not really
attainable.
c. Update on Upper Neuse River Basin Association Activities
Dave Stancil said that there are other entities that are in the same boat as Orange
County in that there are significant costs associated with the rules. This group is interested in
trying to challenge some of the assumptions that have been made to date. There is discussion
about hiring a consultant.
Commissioner Hemminger said that the dues are expected to go up again in the near
future.
2. Follow-up Review of Proposed Draft Oranqe County Addressinq and Road Naminq
Ordinance
GIS Manager Steve Averett from Information Technology reviewed this issue. He said
that he incorporated changes from the June 16th work session in the draft. The changes were
highlighted. The changes were on the top and bottom of page 4, page 8, and page 9.
Commissioner Gordon made reference to the bottom of page 9 and said that it still
says, "criminal penalties." John Roberts said that this is supposed to say, "civil penalties."
John Roberts read the correct language for Penalties:
A. Civil Penalties. The violation of any provision of this Ordinance shall subject the
owner or occupant to a civil penalty in the amount of $50 to be recovered by the
County in a civil action due to the nature of a debt if the owner or occupant does not
pay the County within 14 days after being cited for a violation of the Ordinance.
Each day after the 14 days have elapsed is a separate offense. Payment of the
civil penalty imposed in the civil proceedings pursuant to this subsection does not
relieve a person of their liability for any other fees, fines or other penalties imposed
under this Ordinance.
Chair Pelissier asked if everyone was comfortable with this revision and Commissioner
Jacobs and Commissioner McKee said no.
John Roberts said that this could be a one-time fine or an everyday fine. It is a policy
decision for the Board to make.
Commissioner McKee said that he would prefer not to have an everyday fine.
Commissioner Jacobs said that after the first fine, it would be time to mediate and then
after 14 days, send another one, etc. He thinks it would be burdensome to send a fine each
day.
John Roberts said that the Manager would have settlement authority. Commissioner
Jacobs asked that this be added into the ordinance.
This will be added into the ordinance.
Commissioner Foushee said that she would support what Commissioner Jacobs
brought forward and she would not want to put anything in the ordinance that they would not
enforce. She liked the part of the ordinance about allowing the violator to have seven full days
before the second offense occurs and then to have a period of time for there to be a new
notice.
Frank Clifton suggested that violators have 60 days to respond to a notice before the
first fine is issued, then 14 days thereafter, then 14 days after that, then 7 days. Each notice
will be via certified mail.
The Board agreed.
Commissioner Jacobs asked the attorney to come back with all fines that the County
charges for various violations.
John Roberts said that he would get this list from the departments.
3. Employee Benefits Updates and Preliminary Recommendations
Frank Clifton said that the consultants are here tonight. He went through the process.
He said that Commissioner Jacobs raised some issues at the last meeting about Moore
County and its plan. He will show this information versus existing County coverage. Moore
County is self-insured.
Katherine Cathey, Interim Human Resources Director, made a PowerPoint
presentation. She introduced Tracy Macardy from Mark III, Benefits Manager Diane Shepherd,
and Mark Browder from Mark III.
Employee Benefits
BOCC Work Session
August 30, 2011
Orange County Employee Benefits
Benefits Provided to
Permanent Employees:
- Health Insurance
- Dentallnsurance
- Annual Leave
- Sick Leave
- Holidays
- Retirement
- Life Insurance
- Supplemental Retirement Plans
- Supplementallnsurance
- Tuition Refund
- Longevity Pay
- Flexible Compensation Plan
Additional Benefits Available to Eligible Employees Include:
- Civil Leave
- Employee Assistance Program
- Credit Union Membership
- Discounts, including Orange County SportsPlex
- Employee Appreciation & Service Awards Programs
- Family and Medical Leave
- Funeral Leave
- Military Leave
- Parking at worksite, at no cost
- Payroll Savings Bond Plan
- Retiree Health Insurance
- Social Security
- Promotion and Transfer Opportunities Program
- Wellness Program
Background
- Staff provided information relating to employee benefits in the Manager's
recommended budget for FY 2011-12 and at the May and June work sessions.
- Health Insurance
o Funding for up to a 15% (approximately $550,000) health insurance premium
increase.
o Annualized, this increase is equivalent to a 3% salary increase for all permanent
employees.
- Other Employee Benefits
o Supplemental Retirement Contributions
o Flexible Compensation Plan
o Dentallnsurance
o Vision Coverage
Supplemental Retirement Contributions
- Orange County contributes $715 per year ($27.50 per pay period) for each permanent
general employee to one of three Plans (Prudential 401(k), ICMA-RC 457, or
Nationwide 457).
- The total County contribution of $715 per employee is approximately $543,000 per
year.
- When given a choice between receiving the $715 supplemental retirement benefit or
using it to defray their health care premiums, employees chose the following:
Supplemental Health Premiums
Retirement
Total Respondents 372 59% 41%
Without Dependents 178 65% 35%
With Dependents 182 53% 47%
Sworn law enforcement officers would not be able to reduce the state-mandated County
contribution to 401(k).
Flexible Compensation Plan (FSA)
- The County provides a Section 125 Flexible Compensation Plan with a plan year from
December 1 to November 30.
- This Plan includes:
o Tax sheltering of health and dental premiums
o Separate Flexible Spending Accounts for Health Care and Dependent/Child
Care
- If the County implements a Health Savings Account (HSA), the new FSA Plan Year
would change to January 1 to December 31.
Dental Insurance
- Self-insured dental plan through Delta Dental of North Carolina.
- Beginning in 2009, the County initiated a plan to gradually increase its reimbursement
levels for claims each year.
- With an increase in reimbursements for major restorative services (crowns) in 2012,
conversion to Delta Dental's standard reimbursement rates will be complete.
- No increase in premiums required.
Vision Benefits
- Current health insurance plans cover an annual routine eye exam for employees with a
$15 co-pay.
- Numerous employees have requested a benefit that would include eyeglasses or
lenses.
- The UHC vision benefit is a routine exam every two years.
- With a HSA, all vision exams will be subject to the deductible and co-insurance.
- With BOCC approval, Orange County will select a stand-alone vision plan as an
addition to health insurance coverage.
- Employees who chose to participate will pay for the coverage on a pre-tax basis.
Health insurance
Health Insurance Renewal Goals
- Meet the FY 2011-12 budget
- Minimize impact on employees with and without dependents
- Offer employees a choice of two plans
- Enable the County to pay the same individual and dependent share regardless of
plans, and
- Minimize future increases so health insurance can remain sustainable and provide
continuity of coverage.
2012 Health Insurance Plan Options
- The renewal options include:
o Option 1 — HMO and POS plans that closely reflects the current benefits
o Option 2 — HMO plan that closely reflects the current benefits and an HSA plan
o Option 3 — POS and HSA
- The proposed plan funding provides the same County contribution regardless of the
plan an employee selects, within each option.
- A representative from Mark III will present the plans and discuss UnitedHealthcare.
Comparison of 2012 Plan Options (chart)
UnitedHealthcare
- Provided the County with the lowest renewal rates for 2012
- UHC Services
o Extensive network of providers (includes 95% of the current CIGNA providers
utilized by employees)
o Comprehensive reporting
o Consultative services
o SimplyEngaged wellness benefits and rewards
o Health care management to improve health care quality
o Care Coordination to identify at-risk patients
o Web, mobile, and print communications
UnitedHealthcare
Corporate Facts
- Incorporated in 1977
- Serves more than 70 million Americans, including the following groups in NC
o Progress Energy
o Duke Energy
o Guilford County
o City of Greensboro
o Rockingham County,
o Columbus County
o Delta
o Cisco
o Time Warner
- Oversees approximately $120 billion in health care spending annually
- Serves all 50 States (including over 920,000 North Carolinians)
- United Health Group, UnitedHealthcare's parent company, is one of the largest health
care services companies in the U.S.
Reputation and Recognition
- Fortune Magazine ranked United Health Group #1 in the 2010 rankings of the Most
Admired Companies in America for innovation in the health insurance and managed
care sector.
Health Savings Accounts (HSA): Overview
A health savings account (HSA) is a tax-favored savings account created for the purpose of
paying medical expenses.
- Tax-deductible
Contributions to the HSA are 100% deductible (up to the legal limit).
- Tax-free
Withdrawals to pay qualified medical expenses are never taxed.
- Tax-deferred
Interest earnings accumulate tax-deferred, and if used to pay qualified medical
expenses, are tax-free.
- HSA money are employee accounts
HSA contributions aren't forfeited at the end of the year; funds continue to grow, tax-
deferred.
Qualifying for a Health Savings Account:
- Requires Coverage under a High Deductible Health Plan (HDHP)
- Cannot have any other health plan coverage (TriCare, Medicare) that is not an HDHP
- Cannot be enrolled in Medicare
- Cannot be claimed as a dependent on another person's tax return
High Deductible Health Plan (HDHP)
- Has a deductible of at least $1,200 for individual coverage and at least $2,400 for
family coverage. These amounts are adjusted periodically.
- Costs less than "traditional" plans.
- Preventive care is 100% covered and is not subject to the deductible. All other services
are subject to the deductible.
- After reaching the deductible, the employee shares the cost of health care by paying a
percentage of the cost (co-insurance) until a maximum out-of-pocket limit is reached.
- After reaching the limit, all services are paid at 100% .
Health Savings Account: How It Works
- An employee establishes a Health Savings Account with the Local Government Federal
Credit Union (LGFCU).
- The employee owns his or her account and receives a debit card with this account.
- Money may be contributed to this account on a pre-tax basis, up to an annual
maximum .
- The HSA can be used to pay for health insurance deductibles, co-insurance, and
qualified medical expenses, including those not covered by the health insurance, like
dental and vision care.
- Any money left in the account at the end of the year will be available to the employee
for use later.
An HSA Is Not the Best Option for Everyone
- HSA funds can be used only for qualified medical expenses.
- Potentially higher out-of-pocket medical costs with a HDHP.
- For the HSA to be of value, employees need to be diligent about saving money.
- Funds used for something other than qualified health care expenses are taxable and
subject to financial penalties.
- Employees with other health insurance coverage, such as Medicare, are not allowed to
have an HSA.
- Domestic partners do not qualify as a dependent under IRS guidelines.
Self-Funding Health Insurance
- Self-funding was not recommended for FY 2011-12. 2012 will be a transitional year as
the County learns the true costs of health coverage for employees and retirees through
claims data and actual costs.
- Staff will review self-funding for 2013 as a method of reducing and controlling costs.
- A County-operated employee clinic may potentially offer increased cost reductions and
productivity. With an employee clinic offering a no-cost option to employees for minor
illnesses, on the job injuries, and preventive care, employees could save time, and both
the County and employees could reduce health care expenses.
Dependent Coverage
- The County currently pays the cost of coverage for employees and retirees for both the
HMO and PPO plans.
- The County subsidizes the premium cost for the employee's and retiree's dependent
coverage at 52%, based on the lower priced plan (currently the PPO plan).
- Continuation of the subsidy at this level maintains a "family friendly" feature of
employment with Orange County.
- In a survey of employees completed in May 2011, only 16% of respondents felt the
subsidy should be changed.
- Approximately 47% of employees and 30% of retirees currently have dependent
coverage.
Community Home Trust Participation
- May 2011 letter to BOCC from CHT Executive Director
- Request to remain members of the Orange County health plan
o NCACC coverage through Orange County since 1991
- 8 full-time employees do not adversely affect the County's renewal
- CHT pays their premiums
- If BOCC approves CHT's continued participation, an MOU would define terms of
agreement
- This option has not been extended to other outside agencies
Discussion Points
- Dentallnsurance
o Reimbursement for Major Restorative Services
o Delta Dental enhanced benefits
- Vision Coverage
o Voluntary vision plan for employees
- Community Home Trust
o Continued participation
o Terms of MOU
- Health Insurance
o Plan designs and premium structure for 2012
Consumer Driver Health Plans (CDHPs)
- The underlying assumption is that consumers will make more informed choices and
forego unnecessary or excess medical care if they have to use more of their own
money to pay for it.
- Lower cost premiums make them a popular choice.
- Surveys show that although CDHPs may help plan participants and employers lower
costs, some participants may not be as satisfied with them as they were with a
traditional plan.
Comparison of Traditional Plans and Health Savings Account
Comparison of Flexible Spending Account and Health Savings Account (HSA)
Commissioner Gordon asked about a list of network providers. Also, she asked about
the meaning of co-insurance and POS versus PPO.
Mark Browder from Mark III said that United Healthcare was 5-10% better than any of
the other providers. He continued with the PowerPoint and described the options. He said
that POS (Point of Service) and PPO are very similar. There are in and out-of-network
benefits.
Tracy Macardy said that the Point of Service has more individual protection. This is the
product that United Healthcare leads with.
Commissioner Gordon asked about confirming authorization. Tracy Macardy said that
normally the participating providers do, but under the POS contract, the individual is not liable
for doing any kind of authorization, but it falls on the participating doctor in the network and the
participating hospital.
2012 Renewa/ Options
After going through an extensive bid process, United Healthcare provided the most competitive
responses for Orange County.
- The renewal options include:
o Option 1 — HMO and POS plans that closely reflects the current benefits with an
18% increase.
o Option 2— HMO plan that closely reflects the current benefits and an HSA plan
that is a 16% increase.
o Option 3— POS and HSA dual option for a 5% increase.
Mark Browder went through the breakdown of what is covered with each plan.
From a funding standpoint, the County's responsibility for the HMO plan would be a
little under$8.2 million for this. Employee contribution would be about $1.8 million. Total
funding for the plan would be a little over$10 million.
The County's responsibility for the County for Option 3 is $7.5 million. The employees'
liability is $1.6 million. The total is about $9 million.
Tracy Macardy gave a website for the list of providers: www.uhc.com.
Katherine Cathey said that this is a lot of information and they have talked with
employees through the ERC. She asked the Board to follow up with Human Resources in the
days to come. There have been a lot of comments from employees.
Frank Clifton said that this is going to come before the Board for a decision next month
and they are planning to bring this back for board approval on September gtn
Discussion ensued on when the Board would be making a decision on this issue.
Commissioner Gordon made reference to page 8 at the top and asked what the cost
numbers for the out-of-network service would be.
Mark Browder said that the POS product has an out-of-network component and the
HMO does not. The out-of-network benefit is not a focus because 99.5% of the time all of the
benefits accessed are in-network. He will get this information.
Commissioner Gordon asked about preexisting conditions for employees when they
switch over and it was answered that there would be none.
Commissioner McKee asked if there has been feedback from employees on the plan
that is better. Katherine Cathey said that the employees want to keep the plan they have now.
She said that the possibility of raising the copays is causing anxiety.
Commissioner McKee said that he has heard feedback that any increase in healthcare
equates to a decrease in salary.
Frank Clifton said that the real issue is that historically, employees do not pay for their
coverage and it is a benefit. He said that he wants to educate the employees on this.
Mark Browder said that one of the reasons they prefer Option 3 is that it provides an
affordable option for dependent coverage.
Katherine Cathey said that she is trying to take into account the compounding factor of
the increases and how this affects the employees.
Commissioner Jacobs said that he appreciates the work that has gone into this. He
made reference to page 4 and said that he would like to see a long-term strategy and move
toward being self-insured like Moore County. He said that he did some research on United
Healthcare and he is alarmed that Orange County is going to be working with them. He said
that hospital executives have ranked UHC the worst insurance company in the United States.
He stated several other comments that he researched that had negative feedback for UHC.
Commissioner Jacobs said that he is comfortable with Community Home Trust and he
would like to do something similar to the firefighters.
Mark Browder said that Guilford County is self-funded with UHC, so they are not fully
insured. The City of Greensboro is also. Moore County is a UHC customer and they have had
clients fully insured with UHC and have had no issues. He said that with his experience in the
public sector, he has not seen these problems. If the County wishes to do something else,
there are other options, but it would cost more.
Commissioner Hemminger asked why most employees prefer HMO's and Diane
Shepherd said that it pays 100% and employees only have to pay copays. Otherwise, it is
virtually identical to the PPO.
Commissioner Hemminger said that she could not approve Option 2 for families and
dependents because it is just too much of an increase in premiums.
Frank Clifton said that if the Board wants to forego United Healthcare, he needs to
know tonight so that they can rework the costs.
Commissioner Jacobs said that he would like to see an option with another insurance
company.
Commissioner McKee asked if this could be reviewed in a year and changed if it was
not suitable. It was answered yes.
Commissioner McKee said that he understands Commissioner Jacobs' concerns, but
he is partially comfortable with moving ahead with the options as presented, with the
understanding that it can be reevaluated in a year.
Commissioner Jacobs said that he would like staff to look into the comments and
contact UHC and report back.
Commissioner Foushee said that she wants to hold to the dates as already structured,
because it is very complicated and it will be more complicated to get the employees to
understand all of the changes.
Commissioner Jacobs made reference to Option 3 and asked if there was a direct
relationship between the amount of increase and the size of the deductibles. It was answered
yes. He said that one option would be to look at making some adjustments to the deductibles
so that there is not such a severe impact on employees.
Staff will bring another option related to this.
Vision Coveraqe:
Commissioner Foushee said that she supports a voluntary vision program for
employees and the Board of County Commissioners agreed.
Retiree Insurance Coveraqe:
Frank Clifton said that this is an update only on post retirement benefits. He made
reference to the handout on Moore County. With Moore County, if an employee had at least
15 years of service before retiring, they can participate in the insurance program, but with full
cost. In Orange County, after 10 years of service, the County pays 100%. After 20 years of
creditable service, with the last 15 years in Moore County, it pays 50%. After 30 years of
creditable service with the last 15 years in Moore County, it pays 75%.
This post-employment benefit is growing in Orange County between $4-5 million every
year. It is now $16 million. This equates to about 3 cents on the tax rate annually. There are
some options. One option is to address the qualification strategy and change the amount of
years needed to participate.
Financial Services Director Clarence Grier pointed out the importance of addressing
this in the near future.
Commissioner Hemminger said that she wants more information on this on how this is
handled throughout the region.
Commissioner Gordon said that she is surprised that the County has given incentives
for people to retire to save money and now the liability is going up.
Commissioner Jacobs said that the County has made a commitment to its employees
that this benefit will remain. He understands the fiscal reality part, but he wants to be very
careful with this.
Commissioner Foushee said that she hears the staff, and she hopes that the
information brought back will reflect the value of the employees.
With no further items to discuss, the meeting was adjourned at 10:48 p.m.
Bernadette Pelissier, Chair
Donna S. Baker, CMC
Clerk to the Board