HomeMy WebLinkAboutAgenda - 04-05-2016 - 7-c - Recommendations for Employee Health Insurance and Other Benefits 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: April 5, 2016
Action Agenda
Item No. 7-c
SUBJECT: Recommendations for Employee Health Insurance and Other Benefits
DEPARTMENT: Human Resources
ATTACHMENT(S): INFORMATION CONTACT:
1. Benefit Highlights Brenda Bartholomew, Human Resources
2. Current Premium Equivalent Cost Director, (919) 245-2552
Share for Medical, Dental and Vision Diane Shepherd, Benefits Manager,
Benefits (919) 245-2558
PURPOSE: To approve the Manager's recommendations regarding employee health and
dental insurance and other employee benefits effective July 1, 2016 through June 30, 2017.
BACKGROUND: The County provides employees with a comprehensive benefits plan,
including health, dental and life insurance, an employee assistance program, flexible
compensation plan and paid leave for permanent employees. Additionally, the County
contributes to the Local Governmental Employees' Retirement System and a supplemental
retirement plan.
Staff provided relevant information related to the recommendations of this abstract to the Board
of County Commissioners at the March 29, 2016 Work Session Meeting.
The County has been self-funded since January 1, 2014 for medical and pharmacy plans and
continues to be self-insured for the dental plan. The County transitioned from a twelve-month
calendar plan year to a twelve-month fiscal plan year in 2015 aligning with the County's fiscal
year. In February 2015, the Board of County Commissioners approved Gallagher Benefit
Services (GBS) as Broker of Record for the administration of benefit programs, which include
health, dental, vision, and other voluntary programs for employees and retirees.
Since the County's insurance plan is self-funded, the County uses a third party administrator
(TPA) to administer and manage claims. To take advantage of changing market dynamics and
services, the County periodically solicits proposals from companies offering TPA services. On
behalf of Orange County, Gallagher Benefit Services (GBS) conducted a competitive solicitation
for service consideration in FY2016-2017.
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Currently, UnitedHealth Care (UHC) is the Third Party Administrator (TPA) for the County's
Medical Plan. GBS conducted a TPA Marketing Analysis. UHC, Meritain/Aetna, CIGNA and
BCBSNC provided quotes to GBS for review and recommendation by the Manager. With
careful consideration of all proposals, it is recommended to continue TPA services with
UnitedHealth Care.
The UHC renewal was negotiated from $41.50 per employee per month to $29.50 per employee
per month with a guaranteed fee for 2 years and a 3 percent rate cap for July 1, 2018's renewal;
this equates to approximately $150,000 savings. The difference between the top two
competitors was $6,500 for annual fixed costs. The variable cost or the utilization/claims costs
were essentially identical between the top two competitors.
Wellness funding by the TPA was also considered and UHC was the most competitive. UHC
will fund $25,000 each year for the next three years. The closest competitor was $12,500
respectively.
Health Insurance
Gallagher Benefit Services (GBS) estimates no change in the FY2016-2017 health care budget.
In addition, no plan design changes are recommended. All covered benefits, co-pays, co-
insurance and deductibles are expected to remain the same. Administrative fees and claims
utilization are considered when setting premium equivalent rates. The administrative fee
savings of $150,000 represents approximately 1.29 percent of the current FY budget ($11.6
million). The administrative fee reduction is projected to be absorbed within claims utilization;
therefore the Manager is not recommending a change to the current year budget or premium
equivalents for FY2016-2017.
Almost all full time and part time benefited employees participate in the County's group health
insurance plan. As of January 16, 2016, the plan covered 871 employees and 160 County
retirees under the age of 65. Attachment 1 provides information on benefit enrollment for years
2011 through 2016 and an overview of voluntary enrollment and participation. Attachment 2
provides monthly premiums for medical programs as well as the cost share between employees
and the County.
Dental and Vision Insurance
Delta Dental is the County's current dental provider and Community Eye Care provides the
County's vision plan. As part of three year contract, the County will continue providing dental
coverage through Delta Dental. The current budget for dental insurance coverage is
approximately $320,000 annually. No increase in premium is recommended for FY 2016-2017.
In fact, the County will improve the dental plan design by removing diagnostic and preventative
services from the annual maximum of $1,200 of covered services to promote preventative oral
health care. The monthly employee cost share of dental and vision premiums is also provided in
Attachment 2.
Other Employee Programs
The County will continue to offer health screenings to all employees. In the fall of 2016, the
Health and Human Resources Departments coordinated flu clinics for employees and Human
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Resources held two Breast Cancer Awareness Days (for mammograms). See Attachment 1 for
more detail on Employee Wellness Activities and Orange County Sportsplex enrollment.
FINANCIAL IMPACT: There is a $150,000 savings in health insurance budget and no increase
for dental costs compared to the FY2015/2016 budget. The administrative fee reduction is
projected to be absorbed within claims utilization; therefore the Manager is not recommending a
change to the current year budget or premium equivalents for FY2016-2017.
SOCIAL JUSTICE IMPACT: The following two Orange County Social Justice Goals are
applicable to this agenda item:
• GOAL: FOSTER A COMMUNITY CULTURE THAT REJECTS OPPRESSION AND
INEQUITY
The fair treatment and meaningful involvement of all people regardless of race or color;
religious or philosophical beliefs; sex, gender or sexual orientation; national origin or
ethnic background; age; military service; disability; and familial, residential or economic
status.
• GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY
The creation and preservation of infrastructure, policies, programs and funding necessary
for residents to provide shelter, food, clothing and medical care for themselves and their
dependents.
RECOMMENDATION(S): The Manager recommends that the Board:
1. Approve the recommendation of contracting with UnitedHealth Care as the County's
Third Party Administrator for the County's health insurance programs;
2. Grant authority to the Manager to renew the Third Party Administrator contract with
UnitedHealth Care;
3. Grant authority to the Manager to contract with a Stop Loss Insurance Carrier as
appropriate;
4. Maintain current premium equivalent rates for FY2016-2017 health coverage renewal;
5. Approve the recommended changes to the Dental program of removing diagnostic and
preventative services from the annual maximum; and
6. Approve aligning all dental services to a fiscal year verses a calendar year.
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ATTACHMENT 1
Benefits Participation
New employees enroll in plans effective with the first of the month after hire, and
terminating employees' coverage ends on the last day of the month employed (unless a
retiree under age 65). Participation is shown as of March 2016.
Health Coverage 2011 2012 2013 2014 2015 2016
Traditional Plan n/a 610 605 624 646 661
High Deductible Plan n/a 187 197 198 182 209
Total Health Plan Participation n/a 797 802 822 828 870
Health Savings Account(employee n/a 81 89 73 64 69
contribution) (37%) (33%) (33%)
Waived Health Insurance 20 22 21 29 31 32
Participation in Voluntary Benefits as of March 2016
Benefit # of Participants
As of March 2015 As of March 2016
Delta Dental 838 885
Medical Flexible Spending Account 134 177
Dependent Care Spending Account 13 16
Community Eye Care 477 538
Accident Insurance 204 431
Critical Illness 179 254
Disability 231 305
Whole Life (2015)/Universal Life (2016) 113 242
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Wellness Events/Activities July 2015 through March 2016
Annual Employee Flu Shot Clinic Participants
2010 2011 2012 2013 2014 2015
204 169 225 207 196 218
Sponsored Health Screenings
Orange County Breast Cancer Awareness Day Mammograms Promoted to employees in October, but numbers
unavailable
Biometric Screenings (blood pressure, cholesterol, &glucose) 98
held June 2015
Results of Health Screenings:
Employees by Risk Category
% of Total % of Total
Risk Category 2014 2015
Low 48% 60%
Moderate 36% 32%
High 16% 8%
Orange County Sportsplex Membership
Sportsplex Membership remains consistent with the past few years. Approximately 245
employees are members, receiving a total 75% discount on membership.
Employee Wellness Activities
Maintain, Don't Gain Holiday Challenge 28 participants
Fit in 15!
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ATTACHMENT 2
Current Medical Monthly Premium Equivalent Cost Share
Traditional Choice Plus Orange County Cost Employee
MONTHLY Medical Plan Premium Share Cost Share
Equivalent
Employee Only $726 $726 $0
Employee/Child(ren) $1,160 $930 $230
Employee/Spouse $1,449 $1,040 $409
Family $2,028 $1,294 $734
Health Savings Account
MONTHLY Choice Plus Plan (High Orange County Cost Employee
Deductible Plan) Premium Share Cost Share
Equivalent
Employee Only $712 $712 $0
Employee/Child(ren) $1,070 $918 $152
Employee/Spouse $1,306 $1,034 $272
Family $1,784 $1,294 $490
Current Dental and Vision Monthly Premiums Cost Share
Delta Dental Eye Care
MONTHLY
Employee Cost Share Employee Cost Share
Employee Only $0 $9.74
Employee/Child(ren)
Employee/Child $47.74 $18.54*
(Vision)
Employee/Spouse $39.30 $18.54*
Family $70.18 $27.30
*coverage for employee plus 1 only, an employee with more than one child, pays a family rate.