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HomeMy WebLinkAboutAgenda - 03-15-2012 - 1ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: March 15, 2012 Action Agenda Item No. 1 SUBJECT: OPC Local Management Entity (LME) - Transition Management and Retiree Health Insurance Planning DEPARTMENT: County Manager/OPC PUBLIC HEARING: (Y/N) No ATTACHMENT(S): INFORMATION CONTACT: Gwen Harvey, Assistant County Materials Addressing Two Discussion Manager, 245-2307 Topics including Proposed Resolution Judy Truitt, OPC Area Program Director, 913-4000 PURPOSE: OPC (Orange, Person and Chatham Mental Health LME) is effecting elements of an agreed upon merger with PBH (Piedmont Behavioral Health) effective April 1, 2012. The BOCC is asked to review two management proposals pertinent to the merger - First, creation of an advisory and governance structure; and Second, a transition plan that provides continuation of healthcare benefits for OPC retirees. Details are presented in the following narrative and attachments. BACKGROUND: Considerable analysis and negotiation between OPC and PBH - guided and directed by their appointed boards - has taken place over many months to reach this point in accomplishing a formal merger. The various attachments contain specific details on the history, evolution, and current status of OPC in relation to PBH. The work session setting allows the BOCC dedicated opportunity to discuss concerns in an informal setting. Judy Truitt, OPC LME Director, will guide the BOCC through the proposed measures and summarizing collective efforts. Commissioner Steve Yuhasz is the current BOCC liaison to the OPC Board. Commission Chair Bernadette Pelissier preceded him in this role. Contingent upon work session discussion, the Board of Commissioners is tentatively scheduled to formally consider the attached resolution approving the proposal at the March 22, 2012 regular Board meeting. 2 FINANCIAL IMPACT: There is no financial impact associated with discussion of the two issues related to the Orange Person-Chatham Area Program (OPC). RECOMMENDATION(S): The Manager recommends that the Board discuss both issues as outlined above and in the attachments and provide any direction to staff. Contingent upon discussion, staff will move forward with scheduling the resolution for consideration at the March 22, 2012 regular Board meeting. 3 AGENDA ABSTRACT BACKGROUND Meeting Date: March 15, 2012 Agenda Title: OPC Mental Health, Developmental Disabilities & Substance Abuse Authority - Transition Management Item 1- Resolution Regarding Governance for Consolidated Public Mental Health Entity Operating as a Managed Care Organization Item 2- Healthcare Benefits for OPC Area Authority Retirees Summary of information - Item 1: In February 2011 the Norfh Carolina General Assembly passed legislation which required both implementation of a statewide Medicaid waiver for the public mental health system, as well as consolidation of existing area authorities based on total population. On May 17, 201 1 the Orange County Board of Commissioners voted unanimously to move forward in merger negotiations with PBH, the area authority serving Cabarrus, Davidson, Rowan, Stanly and Union Counties. Since that time Alamance, Caswell, Franklin, Granville, Warren, Vance & Halifax have joined with PBH. On April 1, 2012 the Medicaid waiver will be opened in Orange, Person and Chatham counties, creating what will be at that time a service area of fifteen (15) counties, with a total covered population of 1,442,989. OPC will then move forward in a due diligence process that is expected to lead to the dissolution and subsequent consolidation of OPC into the PBH system on June 30, 2012. In October 2011 PBH hosted a work session with representatives from OPC, Alamance Caswell and Five County to review existing statute regarding governance of public mental health authorities and to consider possible governance options for the new consolidated entity that would be operating as a managed care organization. Under current North Carolina General Statute § 122C-1 18.1 area mental health authorities are governed by Area Boards established by the Boards of Commissioners in each catchment area (see attached). 122C-118.1 indicates that "an area board shall have no fewer than l 1 and no more 4 than 25 members. However, the area board for a mvlticounty area authority consisting of eight or more counties may have up to 30 members... appointments shall take into account sufficient citizen participation, representation of the disabilifiy groups, and equitable representation of the parficipating covnties." Area authorities across the state are concerned that the existing governance model will not adequately supporf operations in a managed care environment from the perspective of both board size and subject specific expertise on the board. On the other hand there are also concerns about the role of the participating counties in the management of behavioral healthcare in the future. A placeholder bill was introduced in the 201 1 long session of the North Carolina General Assembly that opened the door for discussions related to possible changes in the governance model, with the hope that either new or revised legislation could be considered in the 2012 shorf session. To respond to all aspects of this issue and to prepare ourcommunities forsuccessful implementation of the Medicaid waiver, PBH and their participating partners have created the attached proposal related to governance. In summary this proposal creates a Community Oversight Board that is appointed by local Commissioners; is responsible for oversight of the local service system; and has input at the governance level. A new Governance Board would be created with representation from each of the local advisory boards; requires appointment of two Commissioners from within the catchment area; has a voting seat for a Consumer 8~ Family Advisory Committee representative; and has representation from subject specific experts in the field. The proposed model could be adopted under NCGS § 122C-1 18.1 which reads "The boards of county commissioners within the multicounty area shall have the option to appoint the members of the area board in a manner other than as required under this section by adopting a resolution to that effect." Recommended Action: PBH and their participating parfners would ask that the Orange County Board of Commissioners pass the attached resolution. The OPC Area Board met on February 13th and all members in attendance agreed to supporf the model as presented. Summary of information - Item 2: OPC Area Authority is considered a local political subdivision of the state and as such our employees have been eligible to participate in the state employees' retirement system. At the time of retirement healthccire coverage for eligible retirees was defined by policy established by the 5 OPC Area Board (see attached). In summary an individual who was enrolled in the agency's health care plan during their employment would be eligible to continue healthcare coverage as a retiree under specific criteria defined by agency policy. OPC currently has seven retirees who qualified for healthcare coverage, with five additional employees who will be retiring at the end of March. Of the seven current retirees, one will reach will reach the age of 65 at the end of June and would no longer be eligible for the healthcare benefit. A basic profile of the other retirees is attached. When OPC dissolves on June 30, 2012 the agency's current health plan will terminate, including coverage for eligible retirees. As parf of our due diligence process OPC has been exploring options regarding continued coverage for retirees, as well as identifying potential funding to do so. . A workgroup was established that included Commissioners and county management representatives, as well as management staff and legal counsel for OPC. One of the options discussed by the workgroup was for OPC retirees to be covered under a county health plan. Investigation of this option is currently underway. Recommended Action: The OPC Area Board and senior management would ask that the Orange County Board of Commissioners approve identified OPC retirees being included under the county healthcare plan until such time as they are eligible for Medicare coverage. OPC Area Authority will provide funds for #he purpose of funding the post-retirement health insurance benefits for qualified OPC employees. Submitted By: Judy R. Truitt, OPC Area Director/CEO' ' Please note that PBH will be changing the name of the new fifteen county area authority from PBH to Cardinal Innovations Healthcare Solutions. Local community operations centers will continue under their current names, i.e. Orange, Person 8~ Chatham counties will be known as OPC Community Operations Center. GS 122C-I18.1 Page 1 of 2 6 § 122C-118.1. Structure of area board. (a) An area board sha11 have no fewer than 11 and no more than 25 members. However, the area board for a multicounty area authority consisting of eight or more counties may have up to 30 members. In a single-county area authorify, the members shall be appointed by the board of county comrnissioners. Except as otherwise provided, in areas consisting of more than one county, each board of county commissioners withui the area shall appoint one commissioner as a member of the area board. These inembers shall appoint the other members. The boards of county commissioners within the multicounty area shall have the option to appoint the members of the azea board in a manner other tha.u as required under this sectioi~ by adopting a resolution to that effect. The boards of county commissioners in a multicounty area authority sha11 indicate in the business pla.n each board's method of appointment of the area board members in accordance with G.S. 122C-115.2(b). These appointn7ents shall take into account sufficient citizen participation, representation of the disability groups, and equitable representation of participating counties. Individuals appointed to the board shall include two individuals with financial eapertise, an individual with expertise in management or business, and a~i individual representing the interests of children. A member of the board may be removed with or without cause by the initial appointing authority. Vacancies on the board shall be filled by the initial appointing authority before the end of the term of the vacated seat or within 90 days of the vacailcy; whichever occurs first, and the appouitments shall be for the remainder of the unexpired tern1. (b) Except as otherwise provided in this subsection, not more than fifty percent (50%) of the members of the. area board shall represent the following: (1) A physician licensed under Chapter 90 of the General Statutes to practice medicine in North Carolin~ who; when possible, is certified as having complefed a residency in psychiahy. . . (2) A clinical professional from the fields of inental health, developmental disabilities, or substance abuse. (3) At least one family member or individual froin a citizens' organization composed prixnarily of consumers or their family members, representing the interests. of individuals: a. With mental illness; b. In recovery from addiction; or ~ c. With develo~mental disabilities. (4) At least one openly declared consumer: a• With mental illness; b. With developmental disabilities; or c. In recovery from addiction. An individual that contracts with a local management entity (LME) for the delivery of inental health, developmental disabilities, and substance abuse services may not serve on the board of the LME for the period during which the contract for services is ui effect. (c). The board of county corrunissioners may elect to appoint a member of the area authority board to fill concurrently no more than two categories of inembersl-up if the member has the qualifications or attributes of the two categories of inembership. (d) Any member of an area board who is a county commissioner serves on the board in a.i~ e~: officio capacity at die pleasure of the initial appointing authority, for a term not to exceed the member's service as a county commissioner. Any member of an area board who is a county nlanager serves on the board at the pleasure of the initial appointing authority, for a term not to exceed the duration of the member's employment as a county manager. The terms of the other members on the area board shall be for three years, except that upon die initial formation of an area board one-flzird shall be appointed for one year, one-third for two years, and all remaining members for three years. MemUers, other than county commissioners and county inanagers, shall not be appointed for more than two consecutive http://www.ncleg.netlEnactedLegislation/Statutes/HTML/BySection/Chapter_122GGS 1... 2/20/2012 GS 122C-118.1 Page 2 of Z ~ terins. Board members serving as of July 1, 2006, may remain on the board for one additional tern1. This subsection applies to all area authority board members regazdless of the procedure used to appoint members under subsection (a) of tlus section. (e) Upon request, the board shall provide information pertaining to the membership of the board that is a public record under Chapter 132 of the General Statutes. (2001-437, s. 1.11(b); 2002-159, s. 40(a); 2006-142, s. 4(e); 2007-504, s: 1.4; 2010-31, s. 10.7.) llttp://www.ncleg.netlEnactedLegislation/Statutes/HTMLBySection/Chapter_122GGS 1... 2/20/2012 8 ~~~~~~~~ ~~~~~~~~t ~~~~d~ • 1 CFAC Chair or designee • 3 members from each county, appointed by the County Commission - County Commissioner or designee - Consumer or family member - Other citizen or stakeholder 9 ~Qmn~~nit~ ~~r~r~i~ht ~r~ard ~~~~c~n~~~it~~~~~~ - Advise the CEO on the evaluation and hirin~ of the Community Operations Center Executive D~rector - Recommend priorities for expenditure of state/county funds for development of the annual budget - Determine local priorities for inclusion in the area wide strategic plan, as possible - Identify community needs and concerns, monitor resolution of issues - Monitor perFormance at the local (COC) level: • Access to care • Financial status and expenditures • Service delivery • Provider Network size and composition • Outcomes • Consumer satisfaction ~t~~~t`11~ Ct~; ~t~~ C'~ i~ M~mt~~r~ Terms of office: max two four year terms; as long as the individual remains a member of the Community Operations Center Board, regional CFAC, and County Commission. • One representative from each Community Oversight Board (Chair or other elected member) • Two at large County Commissioners from among the counties. Governing Board asks for interested parties among commissioners serving on the Community Operations Center Boards. Goveming Board elects two. • One representative from the regional CFAC, elected by the regional CFAC. • Six members with special expertise in healthcare, insurance, finance, and health/behavioral health physician or other professional ; no more than 2 from any specialty area; from constituent counties if at all possible. (Initially appointed by the Secretary of DHHS. Board committee recruits for vacancies and recommends replacement to the full Board. Vacancies to be elected by the board. ) 10 Governance Board Responsible for: -Policies -Strategic plan -Budget -Hire, fire and evaluate CEO -Monitor deliverables (e.g., pertormance, financial management) -Political advocacy -Strategic planning, including consideration of local priorities brought forward by the COC Boards -Accountable for organizational performance -Responsible for the overall health of the organization -Reporting to the constituent counties -Responsible for responding to concerns and feedback from COC Boards. 11 JOINT RESOLUTION OF THE BOARDS OF COUNTY COMI~~SSIONERS OF ALAMANCE, CASARRUS, CASWELL, CHATHAM, DAVIDSON, FRANKLIN, GRANVILLE, HALIFAX, ORANGE, PERSON, ROWAN, STANLY, LTNION, VANCE AND WARREN COUNTIES WHEREAS, the Boards of County Commissioners of Alamance, Cabarrus, Caswell, Chatham, Davidson, Franklin, Granville, Halifax, Orange, Person, Rowan, Stanly, Union, Vance and Warren Counties previously resolved to be separately served by the Five County, OPC, and PBH Area Authorities; WHEREAS, the State of North Carolina passed Session Law 2011-264, which requires statewide expansion of the 1915(b)/(c) Medicaid Waiver to be managed by Area Authorities operating as Managed Care Organizations; WHEREAS, the North Carolina General Assembly is currently addressing the governance needs of Area Authorities operating as Managed Care Organizations through a Health and Human Services Subcommittee on LME Governance, and intends to pass governance legislation in the 2012 legislative short session; WHEREAS, the Boards of County Commissioners of Alamance, Cabarrus, Caswell, Chatham, Davidson, Franklin, Granville, Halifax, Orange, Person, Rowan, Stanly, Union, Vance and Warren Counties now desire to be served by a single Area Authority operating as a Managed Care Organization with a governance structure that will function under existing law, as well as under the new governance legislation; NOW, THEREFORE, BE IT RESOLVED JOINTLY as follows: Section 1. Resolution and Purpose It is in the interest of the public health and welfare to create an Area Authority to operate North Carolina's 1915(b)/(c) Medicaid Waiver as a Managed Care Organization and to manage all public resources that may become available for mental health, intellectual and developmental disabilities, and substance abuse services, including federal block grant funds, federal funding for Medicaid and Health Choice, and all other public funding sources. Section 2. Establishment of Cardinal Innovations Healthcare Solutions There is hereby created and established pursuant to G.S. 122C-115(c) an Area Authority known as Cardinal Innovations Healthcare Solutions ("Cardinal Innovations"). Pursuant to the 1915(b)/(c) Medicaid Waiver and 42 C.F.R. 438.2, Cardinal Innovations Healthcare Solutions shall operate as a Managed Care Organization and Prepaid Inpatient Health Plan. Cardinal Innovations shall include the Alamance-Caswell, Five County, OPC, and Piedmont Community Operations Centers. 12 Section 3. Governance There is hereby created and established pursuant to G.S. 122C-118.1 an Area Board, which shall be the governing unit of Cardinal Innovations. The Area Board shall be comprised of a single Governing Board and Community Oversight Boards, one for each Community Operations Center. The appointment of inembers to the Governing Board and Community Oversight Boards shall be in accordance with bylaws set forth for such purpose and may be amended as necessary or convenient to comply with changes in state or federal law or to carry out the functions, powers, duties, and responsibilities contained in this Joint Resolution. Due to the complexity of operations, fmancial risk, and responsibility for public funding the Governing Board must be highly functional in order to ensure accountability to funders, the financial solvency of Cardinal Innovations, compliance with state and federal laws and regulations including quality standards, and a service delivery system that is customized for localities and which provides access and choice for citizens in need of inental health, intellectual and developmental disabilities, substance abuse and related services. (1) Membership of the Governing Board shall be comprised of a miY of individuals with the necessary expertise to govern large Managed Care Organizations and individuals who represent the constituencies Cardinal Innovations serves. Membership will be as follows: (a) Two (2) at-large County Commissioners from among the County Commissioners serving on Community Oversight Boards (defined below), selected by the Governing Board, based on diversity of geographic representation; (b) One (1) member from the Regional Consumer and Faxnily Advisory Committee, either the Chair or other elected member; (c) Six (6) members, selected by the Governing Board, with professional experience and expertise in healthcare, insurance, fmance, health/behavioral health, intellectuaUdevelopmental disabilities, and a physician or other clinical professional, and no more than two members from any single specialty area; and (d) One (1) member from each Community Oversight Board, either the Chair or other elected member. (e) Except for members appointed by the Community Oversight Boards and the Regional Consumer and Family Advisory Committee, the initial members of the Governing Board shall be nominated by the PBH Board, with consultation from the Boards of Five County and OPC Area Authorities, and affirmed by the Secretary of the North Carolina Department of Health and Human Services. (2) The Governing Board's primary responsibilities will include determining policy; strategic planning, including consideration of local priorities as determined by the Community Oversight Boards; budgets; hiring and evaluations of the Chief Executive Officer; monitoring of deliverables, including overall performance and financial management; government affairs and advocacy; reporting to constituent counties; responding to concerns and feedback from the Community Oversight Boards; and ensuring the overall health of Cardinal Innovations. (3) The bylaws of the Governing Board shall establish Community Oversight Boards, one for each Community Operations Center, which shall ensure involvement of local stakeholders, promote understanding and collaboration at the local level, and monitor the performance of each Community Operations Center. Membership of the Community Oversight Boards will be as follows: 13 (a) Three (3) members from each County, appointed by each County's Board of Commissioners, and will include a County Commissioner or designee, a consumer or family member, and another citizen or stakeholder; and (b) One (1) member from the Local Consumer and Family Advisory Committee, either the Chair or other elected member. (4) Each Community Oversight Board's primary responsibilities will include advising the CEO on the evaluation and hiring of the Community Operations Center Executive Director; recommending priorities for expenditure of state and county funds for development of the annual budget; determining local priorities for inclusion in the overall strategic plan; identifying community needs and concerns; monitoring resolution of issues; and monitoring performance at the local level, including access to care, expenditure of service funds, number of consumers served, services delivered, provider network size and composition, outcomes, and consumer satisfaction. (5) Each Community Oversight Board will establish its own bylaws based on local needs, but in compliance with standardized requirements established by the Governing Board for quorums, frequency of ineetings, elections of officers, duties of members, committees and committee appointrnents, and attendance standards. Such bylaws are subject to the approval of the Governing Board. Section 4. Functions Cardinal Innovations shall perform all the functions necessary to carry out the purposes of this Joint Resolution, including, but not limited to, the following: (1) To establish accountability for the planning, development, and management of local systems that ensure access to care, quality of services, and the availability and delivery of necessary services, for individuals in need of inental health, intellectual and developmental disabilities, substance abuse, and related services; (2) To operate the 1915(b)/(c) Medicaid Waiver, a proven system for the management of inental health, intellectual and developmental disabilities, and substance abuse services; (3) To manage state funded services for mental health, intellectual and developmental disabilities, and substance abuse services, including federal block grant funds; (4) To manage all other resources that are or become available for mental health, intellectual and developmental disabilities, and substance abuse services; (5) To use managed care strategies, including care coordination and utilization management, to reduce the trend of escalating costs in the State Medicaid program while ensuring medically necessary care, and to deploy a system for the allocation of resources based on the reliable assessment of inedical necessity, functional status and intensity of need. These strategies shall efficiently direct individuals to appropriate services and shall ensure they receive no more and no less than the amount of services determined to be medically necessary at the appropriate funding level; (6) To maintain a local presence in order to respond to the unique needs and priorities of localities; (7) To ensure communication with consumers, families, providers, and stakeholders regarding disability-specific and general 1915(b)/(c) Medicaid Waiver operations by implementing a process for feedback and exchange of information and ideas; 14 (8) To establish and maintain systems for ongoing communication and coordination regarding the care of individuals with mental illness, intellectual and developmental disabilities, and substance abuse disorders with other organized systems such as local Departments of Social Services, Community Care of North Carolina, hospitals, school systems, the Deparhnent of Juvenile Justice and Delinquency Prevention, and other community agencies; (9) To maintain disability specific infrastructure and competency to address the clinical, treatment, rehabilitative, habilitative, and support needs of all disabilities served by Cardinal Innovations; (10) To conduct administrative and clinical functions, including requirements for customer service, quality management, due process, provider network development, information technology systems, financial reporting, and staffing; (11) To maintain full accountability for all aspects of 1915(b)/(c) Medicaid Waiver operations and for meeting all contract requirements specified by the Department of Health and Human Services; and (12) To authorize the utilization of State psychiatric hospitals and other State facilities. Section 5. Powers, Duties and Responsibilities Cardinal Innovations shall have the powers, duties, and responsibilities necessary or convenient to carry out the purposes of this Joint Resolution, including but not limited to, the following: (1) To engage in comprehensive planning, development, and management of local systems for the delivery of inental health, intellectual and developmental disabilities, and substance abuse and related services; (2) To comply with federal requirements for Medicaid, Medicare, block grants, and other federally funded healthcare programs; (3) To perform public relations and community advocacy functions; (4) To maintain a 24-hour a day, seven day a week crisis response service. Crisis response shall include telephone and face-to-face capabilities. Crisis phone response shall include triage and referral to appropriate face-to-face crisis providers. Crisis services do not require prior authorization, but shall be delivered in compliance with appropriate policies and procedures. Crisis services shall be designed for prevention, intervention, and resolution, not merely triage and transfer, and shall be provided in the least restrictive setting possible, consistent with individual and family need, and community safety; (5) To accept donations or money, personal property, or real estate for the benefit of Cardinal Innovations and to take title to the same from any person, firm, corporation, or society; (6) To purchase, lease, obtain options upon, or otherwise acquire any real or personal property or any interest therein from any person, firm, corporation, city, county, government, or society; (7) To sell, exchange, transfer, assign, or pledge any real or personal property or any interest therein to any person, firm, corporation, city, county, government, ar society; (8) To own, hold, clear, and improve property; (9) To appoint a Chief Executive Officer and to fix his/her compensation; 15 (10) To delegate to its agents or employees any powers or duties as it may deem appropriate; (11) To employ its own counsel and legal staff; (12) To adopt, amend, and repeal bylaws for the conduct of its business; (13) To enter into contracts or other arrangements for necessary supplies, equipment, or services for the operation of its business; (14) To appoint committees or subcommittees as it shall deem advisable, to fix their duties and responsibilities, and to do all things necessary in connection with the management, supervision, control, and operation of its business; (15) To enter into any contracts or other arrangements with any municipality, other public agency of this or any other State or of the United States, or with any individual, private organization, corporation, or nonprofit association for the provision, oversight or management of inental health, intellectual and developmental disabilities, substance abuse and related services; (16) To act as an agent for the federal, State, or local government in connection with the management and oversight for the delivery of inental health, intellectual and developmental disabilities, substance abuse and related services To insure its property or operations against risks as it may deem advisable; (17) To invest any funds held in reserves or sinking funds, or any funds not required for immediate disbursement, in property or securities in which trustees, guardians, executors, administrators, and others acting in a fiduciary capacity may legally invest funds under their control; (18) To sue and be sued; (19) To have a seal and to alter it at pleasure; (20) To have perpetual succession; (21) To make and execute contracts and other instruments necessary or convenient, including to provide services to government or private entities, including Employee Assistance Programs; (22) To agree to limitations upon the exercise of any powers confened upon it by this Joint Resolution in connection with any loan; (23) To determine the pay, expense allowances, and other compensation of its officers and employees, and establish position classification and pay plans and incentive compensation plans; (24) To provide for biennial assessments of personnel plans by an independent entity that specializes in human resources development and management to ensure that position classifications and compensation are appropriately matched to industry standards and local job market requirements; and (25) To exercise any or all of the powers conferred upon it by this Joint Resolution, either generally or directly, or through designated agents. Section 6. Effective Date "This Joint Resolution shall be effective as of July 1, 2012. ADOPTED AND RATIFIED in counterparts by the Boards of County Commissioners of Alamance, Cabarrus, Caswell, Chatham, Davidson, Franklin, Granville, Halif~, Orange, Person, Rowan, Stanly, Union, Vance and Warren Counties. 16 BOARD OF CONIlVIISSIONERS OF ALAMANCE COUNTY Approved: , 2012. By: Chaurnan This the day of 2012. ATT'EST: Clerk to the Board BOARD OF COMII~SSIONER5 OF CABARRUS COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMMISSIONERS OF CASWELL COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATT'EST: Clerk to the Board 17 BOARD OF COMI~~SSIONERS OF CHATHAM COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMIVIISSIONERS OF DAVIDSON COUNTY Approved: , 2012. By:, Chanman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMNIISSIONERS OF FRANKLIN COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board 18 BOARD OF COMIVIISSIONERS OF GRANVII.LE COUNTY Approved: , 2012. By: Chauman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMIVIISSIONERS OF HALIFAX COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMMISSIONERS OF ORANGE COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board 19 BOARD OF COMNIISSIONERS OF PERSON COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COIVIlVIISSIONERS OF ROWAN COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMMISSIONERS OF STANLY COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board 20 BOARD OF COMIVIISSIONERS OF UNION COUNTY Approved: , 2012. By: Chauman This the day of 2012. ATT'EST: Clerk to the Board BOARD OF COMIVVIISSIONERS OF VANCE COUNTY Approved: , 2012. By: Chauman This the day of 2012. ATTEST: Clerk to the Board BOARD OF COMMISSIONERS OF WARREN COUNTY Approved: , 2012. By: Chairman This the day of 2012. ATTEST: Clerk to the Board 21 ~ ` ~~~- ,~.:_ - OPC Area Program Policy and Procedures Subject: Health Care Benefits For Eligibie Retirees Policy Manual: Human Resources Area Board Approval: October 2008 Procedures Implementation Date: 4/97 Revision Date: Nov 2000, Dec 2007 Policy: OPC Area Program wifl provide health insurance benefits to eligible retirees as approved by the Area Board. An employee enrolled in an OPC healfh care plan will be eligible to confinue healthcare coverage as a retiree until fhey are eligib(e for Medicare, provided they meet the following criteria: a. They are retiring from OPC, and; b. They have 10 years of service with OPC, and; c. They are at least 60 years old; OR ~ d. They have 30 years of service with OPC at the time of fheir retirement. OPC will contribute one-half of the employer's portion of the health insurance premium for an employee with 10 years of service who meets the above criteria. The percentage wi0 increase by 5% for each additional year of employment with OPC. This, for example, wauld resuft in OPC paying 75°/a of the employer's premium for an employee retiring with 15 years of service with OPC. Ernployees with 20 or more years of service at OPC and who are 60 years of age or older will receive credit fior the entire employer premium. OPC does not contribute to the cost of dental, life, disability or Medicare supplements for re#irees. Employees are responsible f~r the premiums associated writh spousal or dependent coverage. When an employee becomes Medicare-eligible, dependents covered under the OPC healthcare plan are eligible to continue coverage under COBRA in accordance with specific legal requirements that govern that program. 6 OPC Area Authority Retiree Profile As of 7/ 1 /2012 Name DOB Months unfiil Age 65 Projected Cost A 1/23/48 6 4,157.16 B 7/21/48 12 4,365.02 C 8/5/48 13 9,492.18 D 3/17/50 32 25,207.63 E 3/31/51 44 36,458.43 F 11/23/51 52 44,573.76 G 1/14/52 54 ~ 46,602.60 H 4/14/53 69 63,675.22 I 4/13/54 81 78,772.7g J 3/17/55 92 93,894.89 K 9/14/55 95 102,806.13 50~ Benefit 22 GRAND TOTAL $ 510,005.80