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HomeMy WebLinkAboutResolution 130-1999 . RESOLUTION NO. 130-99 ESTABLISHING MEDICAL INSURANCE MONTHLY CONTRIBUTION RATES FOR THE CITY OF BROOKINGS HEALTH INSURANCE PROGRAM WHEREAS Resolution No. 109-96 established a self-funded program for the provision of health insurance; and WHEREAS the Brookings City Council intends to establish the levels of employee and employer contribution to fund the program; NOW,THEREFORE, BE IT RESOLVED,that the 2000 employee and employer contributions to the self-funded health insurance program be established as follows: Employer's Employee's Public Safety Share(�5%) Share(25%) Employer Share(100%) Single $145.80 $48.60 $194.40 Employee/Minor $250.26 $83.42 $333.68 Dependents Employee/Spouse $311.75 $103.91 $415.66 Family $386.93 $128.97 $515.90 Passed and approved this 20`�'day of December, 99. � Mayor ATT�T:; � �� U(,(:.I'1 I� Ci - �. r�,.. � � I - CITY OF BROOKINGS Tracy Dah/-Webb, SPHR Human Resourc�019�rc�e� 311 3rd Avenue, PO Box 270 Brookings, SD 57006 605/697-8668 To: AI Thelen — City Manager From: Tracy Dahl-Webb — Human Resources Offi er, ti¢c��� � Date: December 15, 1999 �. RE: Review of Health Care Plan — Year 2000 Premiums I feel that some history may be of help in reviewing my suggestions regarding our Employee Health Plan. In late 1996, a decision was made to change the City of Brookings Employee Health Benefit program from a fully insured contract to a self-funded plan with specific and aggregate stop-loss insurance coverages. The decision to begin a self-funded plan was prompted by the receipt of another substantial rate increase from Blue Cross/Blue Shield for the coming year of 1997 in the amount of 39.9%. An RFP was sent out and proposals for third party administrators and stop-loss carriers were obtained. The Segal Company from Colorado was contracted to assist in obtaining and evaluating the proposals received. First American Administrators of Rapid City, SD, was contracted to act as our third party administrator and Pacific Life was selected as our stop-loss carrier. At the inception of our plan, we contracted with Segal Company to assist us in setting our self-funded rate projections. The projections included the components of Stop-Loss Premium Cost, Expected Claims, Administration Costs, and the building of the Claims Reserve. One of the goals that we set at the inception of our plan was to have 20% of maximum claims in our reserve by the end of the first year, 32% by the end of 1998, and 35% thereafter. It should also be noted that, at the inception of our plan, an agreement was established Review of Health Care Plan—Year 2000 ' December 15, 1999 • Page 2 of 3 between the Municipal Utilities and the City of Brookings to continue maintaining our health plan together with premium contributions being held in trust and accounted for separately. I have attached the initial resolutions for your reference. Claims and administration expenses are also accounted for separately as well as the building of the reserve. Therefore, the Utilities sets its premiums on an annual basis as does City General. For the past two years, City General has maintained higher premiums than the Municipal Utilities due to our higher claims expense. On the City General side of our plan, the first year we were unsuccessful in building any reserves. The plan had a number of specific stop-loss claims and the plan as a whole hit the aggregate claim limit within that first plan year with City General being responsible for the majority of the claims. City General ended 1997 with a balance of ($305.00). Shortly after the first of the year, we collected on a claim that had been subrogated against another carrier and also received our aggregate stop-loss claim for the year. Therefore, we had a positive balance shortly after the first of the year. Obviously, we did not end 1997 with the 20% reserve as we had hoped. While we had received a rate increase from Blue Cross/Blue Shield for the year of 1997 in the amount of 39.9%, a decision was made jointly between the Commission and Utility Board to increase the premiums a minimal amount of 12.45%. Since City General had poor claims experience in that first plan year, a decision was made to increase the premiums by 20% for 1998 and an additional 20% for 1999. Therefore, it was not until 1999 that the City surpassed the premium increase that would have been in place with Blue Cross/Blue Shield in 1997. I have attached a spreadsheet called "History of Insurance Costs". This spreadsheet shows the history of the changes that were made to the fixed cost and aggregate accumulation factors used for our plan. The costs listed in the year 2000 column are firm numbers from our stop-loss reinsurer and from First American Administrators. Our Third Parly Administrator explained that there is a current trend of at least 12% to aggregate accumulation factors industry-wide and the increase that we incurred was 15%. This slightly higher increase is due to our claims being higher than expected in 1999. Along with the review of the quote received from Pacific Mutual for our stop-loss coverages, competitive quotes were requested from four stop-loss carriers. Pacific Mutual presented the most competitive bid using our current stop-loss coverage amounts. In addition, requests were made for the cost of coverage increasing our individual stop-loss coverage from $25,000 to $30,000. Four bids were received for that coverage and Pacific Mutual, again, had the most • Review of Health Care Plan —Year 2000 ' December 15, 1999 ' Page 3 of 3 competitive bid. In reviewing whether it would be cost effective to make the change from $25,000-$30,000, we noted that the premium savings was approximately $15,000. At this point in 1999, we have had four (4) individual stop-loss claims, three of which have already surpassed the $30,000 mark. Therefore, it is my feeling that the savings that we would incur would be diminished or completely erased by claims and the savings is further outweighed by the increased risk we would be taking in potentially having more than three stop-loss claims. Another issue is the building of the claims reserve. As I previously mentioned, a goal of our plan was to reach a 35% claims reserve by Plan Year 3. We have not met that goal but continue to work toward it. The Claims Reserve % is calculated by dividing Reserves by Maximum Claims. Our estimated Claims Reserve at year end will be 24.4% (approximately $103,000). I am recommending that we increase our current premiums by 15% for 2000. If we were to incur the maximum claims figure for 2000 and raise premiums by 15%, our claims reserve would increase to approximately 26.9%. Please note that our exposure is greater than the maximum claims figure due to the nature of our relationship with the Utilities. By this I mean we (City General) could incur more than our"Maximum Claims"for the plan year and not hit the aggregate stop-loss coverage. "Maximum claims" is calculated by multiplying the aggregate factor (set by the stop-loss carrier) times the number of participants times 12 months. Since we account for the Utility and City General dollars separately, claims could be more heavily weighted to one entity within the plan year. This, in fact, did happen in the first two years of the plan and could happen again in 1999. Our employee population simply incurs more and higher claims. Therefore, building an adequate reserve is important to our plan. I am recommending that the City accept the renewal presented to us from Pacific Life, with continued service from First American Administrators. Please note that First American did not increase their claims administration expenses this contract year. Using the figures presented in that renewal, plus calculating Maximum Claims, I feel that we should increase the premium amounts by the full 15% budgeted within the 2000 budget which totals approximately $450,000 for the year. Actual costs to the City in 1999 were 398,656. With the premium increase recommended and if we would reach the maximum claims costs in Year 2000, our ending Reserve would be approximately 27%. . � RESOLUTION N0. 109-96 RESOLUTION APPROVING HEALTH INSURANCE PROGRAM WHEREAS an e�amination has been made of the City's health insurance program by the Segal Company, an insurance consultin� company from Englewood, Colorado; and WI�REAS said examination identified the costs of the current program in relation to other alternatives; and WHEREAS it has been found that cost savings can be realized by changing from a fully insured pro�ram to a self-funded program; and WHEREAS the City has realized benefits by maintaining a common insurance program for City General and Municipal Utility employees; and WHEREAS it is the desire of the City Cominission to continue this relationship with the Utility to the extent pernussible under a self-funded arrangement; and WHEREAS a self-funded program requires the City Commission and the Utility Board to make certain decisions, particularly with respect to reserve levels and City General employee/employer contribution rates; and WHEREAS it is desired that the City Commission and the Utility Board each be allowed to establish their own reserve levels and employee/employer contribution rates. NOW, THEREFORE, BE IT RESOLVED by the Brookings City Commission that the self-fundin� health insurance program as presented in the analysis of proposals prepared by the Segal Company dated November 18, 1996, be hereby approved. BE IT FURTHER RFSOLVED that the Brookin�s City Commission establish its own health insurance reserve fund and that monies be transferred into said fund according to prudent fiscal policy. BE IT FURTHER RESOLVED for purposes of establishing City General employee/employer contribution rates under the health insurance program, it is hereby established that the following costs be authorized for inclusion in the rate setting computation: Administrative Services Utilization Review Individual Stop Loss Aggregate Stop Loss Expected Claims (Including Attachment Point computed as 125% of Expected Claims) . Appropriate Reserve � , r BE IT FURTHER RESOLVED that the health insurance program costs be identified on the basis of common costs and individual costs identified as follows: City General shall be responsible for common costs apportioned on the basis of equitable actuarial standards. Such costs are hereby defined to include the following costs: ' r ive Services Adrrurust at Utilization Review Individual Stop Loss Aggregate Stop Loss City General shall be responsible for individual costs on the basis of actual claims made by City General employees. Such costs are hereby defined to include the following costs: Expected Claims (Including Attachment Point computed as 125% of Expected Claims) Appropriate Reserve Passed and approved this 26th day of November, 1996. '' /',c - ,,u.� �,. ,Z G Mayor AT aook��, �y`���Reo'r,'.iiF�,.cs rn�.�.� G S c. . `. IJ.J !� • .. _. �i � `� -S ` ��C'''�� �— Finance Officer RESOLUTION N0. 110-96 RESOLUTION APPROVING LIFE INSURANCE PROGRAM WI�REAS an examination has been made of the City's life insurance program by the Segal Company, an insurance consulting company from Englewood, Colorado; and WHEREAS said examination identified the costs of the current life insurance vendor in relation to other vendor costs; and WI�REAS it has been found that cost savings can be realized by changing to a different life insurance vendor; and �VVI-�REAS the City has realized benefits by maintaining a common insurance program for City General and Municipal Utility employees; and WHEREAS it is the desire of the City Commission to continue this relationship with the Utility; and NOW, THEREFORE, BE IT RESOLVED by the Brookings City Commission that the life insurance program provided by Madison National (Schools Insurance Fund) as presented in the analysis of proposals prepared by the Sega1 Company dated November 18, 1996, be hereby approved. Passed and approved this 26th day of November, 1996. 'I � r � �• � ' Mayor �� ATTEST: ci�y�'�VC;nr♦'�'%� . ��� ' / G�� Fin � �icer . • ° � History of Insurance Costs . 1997 1998 1999 2000 *Premium dollars listed are costs % % % per employee per month Increase Increase Increase Specific Stop-Loss Limit Premium 529.87 14.0% 534.05 8.0% 536.77 24.0% 545.59 Aggregate Stop-Loss Limit Premium $2.48 18.1% $2.93 0.0% $2.93 15.0% $3.37 Conversion Premium 50.50 0.0% $0.50 0.0% $0.50 0.0% 50.50 Claims Administration-FAA $9.95 0.0% $9.95 5.0% $10.45 0.0% $10.45 Utilization Review Intracorp $1.65 0.0% $1.65 0.0% $1.65 0.0% $1.65 Total Fixed Costs 544.45 10.4% $49.08 6.6% $52.30 17.7% $61.56 Aggregate Accumulate Factors $156.24 32.0% 5206.25 32.5% $273.30 15.0% $314.30 Total Risk per employee per month $200.69 272% $255.33 27.5% $325.60 15.4% $375.86 Insratel.�ds