HomeMy WebLinkAboutAgenda - 03-19-2019 6-c - Recommendations for Employee Health Insurance and Other Benefits 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: March 19, 2019
Action Agenda
Item No. 6-c
SUBJECT: Recommendations for Employee Health Insurance and Other Benefits
DEPARTMENT: Human Resources
ATTACHMENT(S): INFORMATION CONTACT:
1. Breakdown of County and Brenda Bartholomew, Human Resources
Employee Contribution for Health Director, (919) 245-2552
and Dental Coverage
PURPOSE: To approve the Manager's recommendations regarding employee health and
dental insurance and other employee benefits effective July 1, 2019 through June 30, 2020.
The Manager is recommending no increase in appropriations for the FY2019/2020 Health and
Dental budget and is also recommending that the County continue to participate as a member of
the North Carolina Health Insurance Pool (NCHIP).
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 Employee's Retirement System and a supplemental
retirement plan.
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 also 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 the benefit programs, which
include health, dental, vision, and other voluntary programs for employees and retirees.
In FY2016/2017, the Board of County Commissioners approved the County Manager's
recommendation to continue with UnitedHealth Care (UHC) as the County's Third Party
Administrator for health insurance programs and granted authority to the County Manager to
renew the Third Party Administrator contract with UnitedHealth Care. UnitedHealth Care also
provided $25,000 for wellness programs.
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In FY2017/2018, the Board of County Commissioners approved "carving out" pharmacy
coverage from UnitedHealth Care and contracted with Envision Rx as the County's Pharmacy
Benefit Manager (PBM). This resulted in an expenditure reduction of $141,000 annually for
FY2017/2018. The FY2017/2018 total County budget for health insurance for employees and
pre-65 retirees was approximately $11.6 million dollars.
For FY2018/2019, the Board of County Commissioners approved the County's participation in
the North Carolina Health Insurance Pool (NCHIP), which included Blue Cross Blue Shield as
the health care provider, and approved increasing Health Insurance funding (County share) by
$750,000 and the Dental Insurance funding (County share) by $125,521. The County
maintained current premium equivalent rates for health insurance and dental coverage for
employees and pre-65 retirees. The total FY2018/2019 budget was projected to be
approximately $13.3 million (including health savings account contributions) based on increases
to current enrollment of 1,068 employees and pre-65 retirees. The County contribution was
projected at $11.9 million; representing a 5.9 percent increase.
Health Insurance
The total FY2019/2020 budget is projected to be approximately $13.3 million (including health
savings account contributions) based on current enrollments for employees and pre-65 retirees.
The County contribution is projected at $11.9 million assuming that no changes are made to the
current employee contribution structure. This represents no increase to the FY2019/2020
budget.
Through December 2018, Orange County is in a very good position from a reserve perspective
with NCHIP. Reserve levels are recommended at 1.25 times total monthly claims; $6.4 million
has been funded by Orange County through December 2018; $819,000 has been paid in fixed
costs; and $3.9 million paid in claims which results in a $1.7 million reserve. This is well over
the recommended reserve level.
Comparatively, $21.4 million has been funded by all participants of NCHIP through December
2018. A total of $16.9 million has been paid for claims resulting in a $4.5 million reserve. Of
these reserves, $1.7 million is tied to Orange County.
The following represents total health care appropriations over the last five years (County and
Employee shares):
2015-16 2016-17 2017-18 2018-19 2019-20
Health Insurance $11,082,953 $11,784,305 $12,585,606 $13,333,299 $13,333,299
Budget
Health Budget% 6.33% 6.80% 5.94% 0.00%
Increase
It is recommended that the premium equivalent for the high-deductible plan be decreased by
$118 per month for each plan tier. The $118 per month represents 1/12th of the Health Savings
Account County funding of $1,416 annually. A total of $363,912 is funded for Health Savings
Accounts for FY2018/2019 and is 100% paid by the County. These funds are currently not paid
to NCHIP and therefore not necessary to include as part of the high-deductible premium
equivalent. The Health Savings Account funding is budgeted separately in the Health Insurance
70 Fund.
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Attachment 1 demonstrates further the breakdown of the County and employee contribution
relationship for health insurance based on current enrollment without health savings account
equivalents. Monthly/Semi-Monthly rates are listed as follows:
Current PPO Plan Premium Equivalent Monthly County Monthly Employee Semi Monthly County Semi Monthly Employee
FY2019/2020 Cost Share Cost Share Cost Share Cost Share
Employee Only $806.59 $806.59 $0.00 $403.30 $0.00
Employee+Child(ren) $1,267.24 $1,037.34 $229.90 $518.67 $114.95
Employee+Spouse $1,631.71 $1,222.51 $409.20 $611.26 $204.60
Employee+Family $2,293.71 $1,558.87 $734.84 $779.44 $367.42
Current HDP Plan Premium Equivalent Monthly County Monthly Employee Semi Monthly County Semi Monthly Employee
FY2019/2020 Cost Share Cost Share Cost Share Cost Share
Employee Only $680.51 $680.51 $0.00 $340.26 $0.00
Employee+Child(ren) $1,065.16 $916.04 $149.12 $458.02 $74.56
Employee+Spouse $1,369.49 $1,109.29 $260.20 $554.64 $130.10
Employee+Family $1,922.26 $1,441.70 $480.57 $720.85 $240.28
Dental and Vision Insurance
Delta Dental is the County's Dental provider and Community Eye Care provides the County's
vision plan. The County will continue to provide coverage with Delta Dental and Community
Eye Care. Vision premiums are paid 100 percent by employees and to date no increase has
been proposed by Community Eye Care.
There is no recommended increase to the FY2019/2020 Dental budget and the funding is
proposed as follows:
Projected 2019-20 Dental Costs
$594,604
Proposed EE Contributions $227,532
Proposed OC Cost $367,073
Monthly rates for dental coverage are listed below:
Monthly Premium Monthly Orange Monthly Employee Semi Monthly
W I Premium Tier Equivalent County Cost Share Cost Share Employee Cost Share
Employee only $30.49 $30.49 $0.00 $0.00
Employee children $82.32 $34.58 $47.74 $23.87
Employee spouse $73.17 $33.85 $39.32 $19.66
Family $106.71 $36.51 $70.20 $35.10
FINANCIAL IMPACT: No financial impact, there are no additional appropriations for Health or
Dental Insurance for FY2019/2020.
SOCIAL JUSTICE IMPACT: The following two Orange County Social Justice Goals are
applicable to this item:
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• 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 approve no increase to
the Health Insurance 70 Fund for FY2019/2020, maintaining the County's current level of health,
dental, and other employee benefits, and approve the County's continued participation as a
member in the North Carolina Health Insurance Pool (NCHIP).
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ATTACHMENT 1- Breakdown of County and Employee Contribution for Health Insurance Premium Equivalents
Premium Premium BUDGET
Equivalent Equivalent TOTAL COST EMPLOYEE EMPLOYER TOTAL COST EMPLOYEE EMPLOYER CHANGE
Current PPO Plan FY2018/2019 FY2019/2020 Enrollment FY2018/2019 CONTRIBUTION CONTRIBUTION FY2019/2020 CONTRIBUTION CONTRIBUTION FY2018/2019
Employee Only $806.59 $806.59 570 $5,517,076 $0 $5,517,076 $5,517,076 $0 $5,517,076 $0
Employee+Child(ren) $1,267.24 $1,267.24 164 $2,493,928 $411,821 $2,082,107 $2,493,928 $411,821 $2,082,107 $0
Employee+Spouse $1,631.71 $1,631.71 48 $939,865 $279,456 $660,409 $939,865 $279,456 $660,409 $0
Employee+Family $2,293.71 $2,293.71 40 $1,100,981 $362,176 $738,805 $1,100,981 $362,176 $738,805 $0
822
$10,051,850 $1,053,453 $12,780,611 $10,051,850 $1,053,453 $8,998,397 $0
Premium Premium BUDGET
Equivalent Equivalent TOTAL COST EMPLOYEE EMPLOYER TOTAL COST EMPLOYEE EMPLOYER CHANGE
Current HDP Plan FY2018/2019 FY2019/2020 Enrollment FY2018/2019 CONTRIBUTION CONTRIBUTION FY2019/2020 CONTRIBUTION CONTRIBUTION FY2018/2019
Employee Only $798.51 $680.51 133 $1,274,422 $0 $1,274,422 $1,086,094 $0 $1,086,094 (188,328.00)
Employee+Child(ren) $1,183.16 $1,065.16 55 $780,886 $91,936 $688,950 $703,006 $91,936 $611,070 (77,880.00)
Employee+Spouse $1,487.49 $1,369.49 25 $446,247 $64,026 $382,221 $410,847 $64,026 $346,821 (35,400.00)
Employee4amily $2,040.26 $1,922.26 29 $710,010 $196,437 $513,574 $668,946 $196,437 $472,510 (41,064.00)
242
$3,211,565 $352,399 $2,859,166 $2,868,893 $352,399 $2,516,494 (342,672.00)
1064 $13,263,415 $1,405,851 $15,639,777 $12,920,743 $1,405,851 $11,514,891 (342,672.00)
*Decrease in funds represents funding separately for Health Savings Account.