taking advantage of out-of-network benefits today,
270 on the hybrid plan. That is not
a cross-accumulation issue, but the 357 individuals
on the consumer choice ICE plan would be impacted if
we were to move forward with removing that cross-accumulation,
which is the recommendation of MJ.
Not seeing any questions. We can keep going. Okay. Thank you,
Jamie. And I think just to put a bow on this one, the The
plan would still have out-of-network coverage. Members can still
go out of network just like they do today. The only change is
that they have to satisfy separate deductibles and separate out-of-pocket maximums,
whereas today they get— they can kind of blend the two.
Honestly, it's about equity between the plans more than anything else.
There's a lot of risk and a lot of exposure that Jamie touched on,
but it's really about, in our isolated MJ opinion,
treating the same— treating members on both plans the same. But that's
my takeaway. All right,
one more final BAB recommendation before we move on to
premiums, and this one's over to Andrea. Yes, thank you.
This is Andrea Crone again from the MJ Companies. So, as I noted
earlier, the MindCo utilization— so, again,
to Commissioner Stoltzman's question earlier, really utilization,
who's actually using the program and engaging in it.
Using the app is, is far below what is needed for those programs to
really have a meaningful impact for your employees. I will add really quickly,
and I should have said this before, the BAB members did also seek
feedback from each of their departments on MindCo, if they
had used it, what their feedback was. And, and to your point exactly,
Commissioner Stoltzman, there was feedback around, I've used it,
but I was dissatisfied with the app, or the headset didn't work, or it was
uncomfortable, or I didn't want another app. So there was some, some relevant
feedback there. Um, the county does have alternative
stress relief and tobacco cessation support that's already available through
programs that you have in place. So, for example, through your employee assistance
program with CareLink, um, your medical and pharmacy plans can help treat
mental health and stress disorders as well as prescribe medications as
needed. And then you also do have a wellness program that's already in
place that that offer support for these specific types of services.
So with that information in mind, both the BAB and MJ recommend terminating
this program for 2027. This will result in about $110,000
per year in savings for the county. And really where that comes in is MindCo
charges a per employee per month fee for every eligible
employee, regardless of whether they are using the program. And so
again, with such low utilization maybe around 8 or so people
per year using each of these programs, but you're still paying for
the full population to have access. And for your consideration,
we have included some additional information about this recommendation in
the appendix.
Thank you. All right,
Kyle. All right, Kyle Sullivan here to talk a little bit about
what the employee premiums might look like. So as Andrea mentioned, we did have— the
BAB did survey their members
and the members they represented, and one of the things they came back with
is they wanted to ensure that there's a balanced approach to managing costs. So not
only looking at changing the benefit design, but also considering changes to
the employee premium premiums that come out of their paychecks.
During the BAB session, they recommended shifting an additional
1% of employee premium cost share to employees
in a way— or in an effort to help manage
and reduce the cost increase to the county.
Both of the scenarios that we'll look at here will show a status quo scenario,
and then we'll discuss the two proposed scenarios. So just to set the
baseline, the status quo scenario based on our current cost share has the
$36.9 million total broken
into the county portion and the employee portion. So the employee portion
is currently 13.3% of the total annual
plan spend, and the county portion is 86.7%.
If we look at what that cost shift looks like, like combined
with the plan design savings in each scenario,
the 14.3% with the BABB recommended
scenario has the total costs that have been reduced by $600,000.
So the $36.3 million split into 14.3%
of the total covered by employees,
that would be an increase of about $300,000
from an employee cost basis.
With the additional savings and the additional $400,000
savings in the MJ recommended scenario, that cost increase is
reduced by about $60,000 to employees,
and the employee cost share again is the 14.3%.
I want to note that these cost shares of either 13%
or 14% are very competitive among municipalities and
employers in general. And we'll note on the next slide what
that actual dollar amount to people's paycheck, the change
looks like. But I just wanted to comment that it's been important for
us to ensure that we're aligning with benchmark and ensuring
that the full benefit package, both from a plan design perspective and
a payroll deduction perspective, is robust.
Can we stay on this slide for just a minute? Commissioner Litschman, do you have
any questions? I do. I just am getting one other piece of information before before
I can ask mine. Thank you.
I'm waiting for the slide that shows the breakdown of
what that costs with the different employees. So, okay.
Thank you for asking. Are you breaking this down further on the next slide,
Kyle? Yeah. Yes. The next slide will show the monthly rate. So it will
absolutely address or help address that. Let's see
that, and I might have you go back to that last slide also. Sure.
Perfect. So we want to start on the left here with our current plan design
offering and our current payroll deduction. So on the top, just orienting,
we have the Consumer Choice Plan. These are all monthly employee
deductions based on the plan election and the coverage
tier election. If we're looking at the middle column,
this represents the change on a monthly basis based on each scenario.
As I mentioned, a balanced approach with less plan design changes.
There is an additional increase, or a slightly higher increase,
to employee rates. On the Consumer Choice Plan, the monthly
change is between $16 for employee only and $69 for
family coverage. In total, we're still looking at a
little bit over $350 per month for family coverage, which is extremely
competitive, especially in the current healthcare market
space and considering
how much your plan design
covers is very competitive. From a hybrid plan perspective,
that increase is higher, so it's $22
for an employee per month in addition to our current amount and an additional
$89 for family coverage. Still,
we're our total family per employee
per month rate would be less than $500 for your
buy-up plan offering.
Do you have a question at this point or do we want to talk?
Yeah. No, I think I do. So if you could go back to
the last slide, I think it's a little cleaner of a question on that slide.
So on the— I
see that you've tried And the BAB recommendation and your recommendation,
you're trying to show a similar cost share between the county and
the employee of the county. And so going back to the plan design that
drives that, you're essentially trying to
drive down that cost to the employees and county by increasing the out-of-pocket
max and reducing the risk. Is that right, Kyle? For the total, yeah.
So the total amount reduces due to that. And I
honestly probably should have highlighted the county's portion here because that's one of the really
key considerations. If we look at the county status quo, we're looking
at $32.0 million. In the middle column
with the recommended change in cost sharing and plan design, we're looking at $31.1
million. So a $900,000 difference. And then in the MJ recommendation,
we're looking at the $30.8 million. So that's
a piece I should have mentioned earlier. No, I see that. I'm really focused
on the employee row, actually. And so it looks like you've tried to keep that
14.3 to 85. fixed while using
the plan design to reduce the risk basically on
your side. So the risk is essentially getting shifted to employees that may
experience more sickness, like right in their out-of-pocket max,
that's where it's made up for. Is that right? Correct. That's what's driving the
change in the total. All right. So like as far as like who
benefits and who burdens between the raspberry color and the purple color,
like the employees that are experiencing more chronic illness or maybe hitting
their out-of-pocket max are who are being burdened with the purple design?
Correct. There would be— and then healthier employees are benefiting
in the raspberry, or I guess healthier employees are benefiting in the purple.
Yes, from a plan design perspective.
One of the considerations discussed during the BAB was that there's this interplay
between if the county is paying more in benefits, that that also might
reduce the amount of compensation that could be passed on. And so that
was one of the considerations in the purple is if
we're able to mitigate cost there, that it might help ensure
that employee increases are not burdened by additional increases
from the benefit plan.
I mean, but you're just positing that because we've not talked about that. So I
don't have any other questions. Thank you. Thank you.
Kyle, it's Courtney again. If I could just chime in, I really appreciate Commissioner
Stoltzman's comments. One analogy I like to use is if you focus
first on the total, that number gets smaller as we move
into raspberry and into purple, so that the entire pie gets
smaller when you change plan design because the dollars, you know,
the dollars, the cost of the dollars go down. Obviously, the employees have
to pay more at the time they use care. So that's decision point number 1,
which was driven by Marathon and the plan design changes, obviously, we've been talking
about. Step 2 is to then determine how does that pie get divided
into 2 pieces, the piece the county pays for in premiums versus the piece the
employee pays for in premiums. And that's driven by this cost share.
So it's, you know, you'll notice this 1% shift.
It's 13.3% today. The proposal is for the employees
to pick up an additional point of the total.
The total is smaller in these two scenarios,
and you're absolutely right that it's a bit of a balance between,
you know, if we've got this pie to split in half,
you know, raspberry gets you a lower number through,
gets you lower on plan design. Purple gets you even lower
on plan design, but you're absolutely right that people who would feel that would be
the people who use care the most, i.e., being the
sicker or the folks that just use more care. And that was exactly the
conversation during the BAB and all that is outlined on the readout in the back.
So you articulated that perfectly.
Thank you. Any other questions on the plan design?
At this time, thank you. Thank you.
So let's see, next topic.
Any questions on the rates and the change to the employees either?
Just in regards to the rates, for me, I think my questions are going
to come later when we're talking about the actual figures and numbers.
So I'm holding on to thinking about this
one. Okay.
Dental premiums. Dental premiums are very exciting
this year. There are no changes to dental premiums as we're in
a rate guarantee. So I'm pleased to present the current
and 2027 dental premiums and employee deductions.
Thank you. Vision premiums. Very similar to dental, one of my favorite subjects.
We're in a great spot for having these rates locked in for another year.
So no changes to vision premiums.
Thank you. All right,
this is Andrea Crone again. Just a quick renewal summary here for
you. Really, this is highlighting when your programs
are up for the next round of RFPs. Just wanted
to highlight that we did complete RFPs this year for life,
disability, FMLA, and leave administration
earlier this year, so those have been completed.
And the RFP panels of course voted to move those
programs from Lincoln Financial over to Unum for life and
disability, and then to bring the leave administration
in-house with a software called PulpStream. We do have
the stop-loss RFP coming up. That is something that we typically market
every year just to ensure you're getting the most competitive rates. So that is
upcoming. And then, of course, the virtual mental health and tobacco
cessation through MindCo that we do recommend terminating that on
December 31st, '26.
And then after that, we do have some additional RFPs coming up next
year, really high-level, just flexible spending accounts, COBRA administration,
and identity theft. And then we're, we're good for a little while after that
on the need for RFPs for these programs.
Thank you. Before we go to the discussion
on those topics, just are there any other topics commissioners have that weren't covered
in the presentation or ready for discussion?
For me, Commissioner Salzman, I'm really— I
want to have a discussion with you around the
recommendations and what I'm wanting to look
at more specifically what happens if we don't make a change
on the benefits. What does that mean to our members?
So if this is the right time to talk about that, that's great. If it's
later, that's fine too.
That's great. We will— we can do that right now. I think that I
wonder if MJ or Budget has any,
you know, sometimes we see a slide that shows like
the overall cost of like status quo, overall cost of the BAB recommendation, overall cost
of the MJ recommendation. I wonder if we have something like that you could take
us through. Yep. Let me go back to that. Thanks, Courtney. That was 23,
I think. Oh, nope.
Oh, boy. Trying to go backwards. This one.
This is specific to medical because that's the only piece that's changing in cost.
Everything else is staying the same. So, we're— if you do
nothing, it's a 36.9% $1 million total
county spend, which is a $2 million increase over where we anticipate
you ending this year. And then if you do the BAB recommendation,
it reduces that by— it reduces that by $600,000. If you
lean towards the more encompassing plan design changes being recommended
by us, that takes it a little bit close, a little
bit further. And then the secondary recommendation after that is is
how that cost is then shared with employees via
their premiums, which was that 1% additional cost share that the BAB has
recommended.
Thank you. I think for me, I'm— what
I'm trying to understand, and included in the recommendations of
those different line items at the beginning of the presentation, first slides or
so, but what I'm wanting to understand I would
like to see a world for this next
year that we're talking about in no increase to deductibles and no increase
to out-of-pocket max. So I'm
thinking I might be interested in some of the
recommendations, but I'm trying to really look at how
it might not impact employers. And I understand there's a—
cost of us as the county.
Courtney or Kyle, do you want to talk a little bit about which— that would—
yep, if I may comment, that would be this number right here. This is if
you change nothing, if you leave everything the same, all your plan designs, all your
deductibles, all your coinsurance, etc.
That would be— that's what we're referring to as status quo, for lack of a
better word, and that would be the dollar amount that would then result
in higher premiums to employees
versus what we've shown here. Because as a reminder— well, actually,
no, let me go back. Sorry. What page is the— what page are the premiums
on, MJ? Team, help me since I'm sharing my screen.
Sorry, I need to come off here. 29 and 30, Courtney. Okay.
So here are your 2026
rates that employees are paying right now. If we don't
change the plan design, these numbers would all go
up by even more than what you see over here.
We don't have a slide for that, but that just directionally So
if it weren't— the total cost was going up higher, therefore the employee
cost is— their plan design would stay the same, but their premiums would go up
And it's— some of it hinges on that cost share
piece that we talked about, that additional 1%. So if
they were to keep the current cost share, it would be different than the
two— the two impacts we're showing here have that higher,
that 1% higher cost share. Or 10.3%
currently. Yep. And for reference,
the BAB did vote on that scenario, leaving the— and
that was not the prevailing recommendation.
Okay. So I hear that, and I'm looking at this, and to
me, an $89 or an $83 or state $60,000 or
$65,000 is a significant amount of money,
just taking into account all of the other costs. What I'm looking for is
if we didn't have that increase, what is that number?
What's that cost? Like, it was a $4 million number.
And then I also think maybe— so those are some of my questions,
Commissioner Soltzman. And then we need to go the different line
items that are being asked, plan design. Happy to look at that because
I may help.
May I clarify? So I believe what you're asking for are two things.
One, leave the plan design exactly the same, and also
two, leave premiums exactly the same as they are today
in 2026. So essentially no increases at all to employees either in
either bucket. Is that what I'm hearing, or did I misunderstand? I'm actually—
I'm not looking at the plan design right now. So there is some of
the plan design that I will be supportive of in the recommendation.
So it might impact this piece, but what I'm trying to— what I would
like to see is what would it cost the
county to not have an increase to the employees' premiums?
On premiums. Okay.
I don't know that we have that modeled since that was not a scenario contemplated
by BAB, unless Kyle or Paige,
you know otherwise.
We did not explore that scenario. The current employee contributions
represent about $4.2 million. So that would be—
from the status quo scenario, that would be an additional $700,000 shift
from employees to the county.
And then the other scenarios would follow similarly. So at $4.2
million in the middle scenario, the difference there is
about $1 million. So the county cost would increase by $1 million.
And that would be pretty close to that in the far right as well.
To not have a change in the premium. Premiums for this next year.
Correct. Okay, thank you. Thank you, Kyle.
Thank you. The question I have that we just haven't covered yet before we get
into the 5 decision points that we need to make today, um, is just really
around GLP-1 coverage. I've had a number of employees from
different departments talk about, you know, previously we were covering GLP-1s and
it was really helping folks with cholesterol and weight loss and working,
and many people now are having to pay $500 or more a month to continue
that coverage since it's no longer covered and just wondered if there was discussion or
if there are approaches that we could take looking at next
year in our conversation to try to get some of that
coverage back for folks. I think the state bulk purchased two particular
GLP-1 products and I think some other employers are
taking some innovative approaches. So I wonder if there's any discussion or
if there's anything we could look at around that space.
Jamie, may I ask you to chime in on the discussion with, with BAB,
if any, regarding GLP-1s?
Yeah, so we have not had any discussion with BAB
regarding bringing back
GLP-1 coverage. We did have some general conversations
around state of the market and what is happening
in the GLP-1 space. There are some
non-plan-sponsored options that are available,
which include direct-to-consumer programs that offer
the drugs at a lower cost than if they were to just pay a
cash price at the pharmacy counter.
And that typically runs $400
or less. Depending on the dosing and which drug they're picking up, if it's in
pill form or injectable. But we did
not explore anything specifically for this year, knowing that we just
eliminated the coverage in 2020— for 1/1/2026.
Okay. I do think that's something that's important to talk about at BAB in 2027
in the discussion, just understanding where people are and getting a pulse on employee
feedback on that. Um, just because that's something that consistently
comes up for me when I talk to employees in different departments. I also
have a question on the same topic, if that is something,
you know, when you're working on your contracts and sales
pitches and things with Marathon Health, if that's something that they would consider offering at
a rate, like at a fee, um, like if that is an expansion
of services that they'd be interested in providing. I think that may make it more
likely that people would use the service. Yeah,
they absolutely have. Go ahead, Courtney, I'll let you speak to it.
I think you're a little more familiar with the specific program.
Yes, I was going to say I've made a note to bring up,
to request that the BAP speak about GLP-1 coverage again next
year. I won't go to it in the interest of time, but in the appendix
of this presentation, there is some data on the
impact of that change and, you know, the amount
of money that the county is saving as a result of that
change. And we did review all that information with the BAB as well, and there
was not a recommendation to bring the coverage back. So, but we will, we will
add that to the list. You are, your question is
a fantastic one. I know we don't have anyone from Marathon on the line
today, but I do know that they are exploring ways in which they can
add dispensing of certain GLP-1s for certain
reasons. At their clinics as well.
That's an active business strategy of Marathon,
and I agree with you wholeheartedly that if they're able to do that, it would
certainly increase foot traffic into Marathon clinics if that were the
only place to obtain your medication for GLP-1s.
Okay, if they want to talk to a county commissioner, I'm happy to meet with
them. I'm sure they would love that. We will pass that along. Alright.
Okay, so I think that brings us to the 5 decision points that we need
to talk through this afternoon in discussion. You've formatted
them a little bit different here than they are in our packet.
Okay, happy to pull the screen down if you'd rather. I think it
gets us to the same place. I just wonder if Commissioner Lauchman, if your notes
are in line with what was written in the text of the packet, or if
you want to go through them in the order they are here. It's slightly different.
I'm really okay either way. Okay. On this
slide is totally fine. It makes— so the difference
I'll just note that I'm noting, and maybe I'm reading it wrong, in the way
that it was designed in the text of the packet, there are like two differences
where MJ has a different recommendation than BAB, and I
think that the way they've been presented here, you've combined both of those into the
fifth point. Is that right?
Right? I apologize. I don't have the packet that
you're looking at in front of us, but I think what you're maybe alluding to
is the additional plan design changes. Again, it would
be either 2 or 5. 5 includes those
additional changes Jamie went through and the out-of-network cross-accumulation
item. Right. So, like, those are just separated slightly differently.
Oh, okay. My apologies. I didn't realize it was presented that way. Presented to you
that way. Okay, so we'll start with Marathon Health. Commissioner Lutchman,
how do you feel about the BAB recommendation on Marathon Health?
Do you want to tell me, if you don't mind, which page in the packet
that you're looking at the decision points? Sure. I just
flipped to there. Sorry, I'm switching back. So the decision points are actually on
I'm on one screen, so I'm not,
but I've got it up in front of me.
Great.
Well, maybe I've got the whole packet, so that's—
just a second. I have
the 60-page packet up, and it's page 2 is what I have with it on
there.
All right, I won't worry about of that piece. Um, let's see here.
On number 1, introducing the marathon pill.
Yeah, I'm, I'm in support of it. I, I had
a lot of questions. I have some concerns that I think are just kind of
the what-ifs in the world of healthcare and if we get people
really using this particular addition
to what's offered and in those 14 start
to pull back the same way the brick and mortar has in the healthcare space.
I've got those types of concerns. And just
seems like there's— it could create another alternative.
I had a similar question on the JLP as well, Commissioner Sullivan,
because I thought that was something that was going to be continued.
I mean, again, what these two events, you know, additional options inside the decision was
turned back from policy. So I'm glad you brought that back up. And it seems
like that might be an advocacy piece.
And there may be some other things that had to remove with the changes that
I haven't thought about, but I think that makes sense to do
some advocacy and hopefully with that program. What are
you thinking on number 1? I think that it is a good thing
to do with how it's described this year, but similar to you, like I do
concerns of the what-ifs in the future of like, well, it makes a ton of
sense as it is now, but is this really just a way to hook people
in and then it'll be a cost increase or it will, you know, compare differently
in the future. So I do think we'll have to continue to evaluate it,
but as it is presented and funded in the, in this decision,
I think it's a positive choice for employees at no cost that can
reduce their costs and reduce county costs and give another option. So for
what it is now, I think it's great and we'll have to just keep a
close eye on the future for like all the reasons you described.
Described. Okay, so the second thing we have to talk about is
the medical plan design changes. So this is where the BAB
was recommending changing the deductibles and out-of-pockets on both medical
plans, and they were trying to— it looked like essentially reduce
the out-of-pocket max compared to the
MJ Team recommendation on that one. And just MJ Team,
if you're listening, we're going to talk about the cross-accumulation separately.
So we're just talking about the— on this particular discussion that
we're having, we're just talking about the changing the deductibles and out-of-pocket maximums
on both plans. And I don't know for the discussion if it's helpful to put
that slide back up or not, or if we can just discuss it. I think
that we might be trying to find it on the packet.
This one here, yeah.
Thank you.
So this is— thank you. For me,
what I'm worried about right now is the addition of cost
period. So when I'm looking at this, it seems like,
as an example, the current hybrid,
just on that first line, from $1,500 $1,500 to
$1,750 or $3,000 to $3,500, that is
just, that's a significant amount. So I
would really like us to figure out what we might be able to do to
reduce, you know, the premium costs,
whether it's the monthly premium or the visit premium
or the collective deductible. It's just a lot of money
for employees. I think that's why we're seeing
the difference in the BAB recommendation versus the MJ recommendation.
I think MJ is trying to present something that contains the cost overall and
the risk overall between the employees and the county. But the BAB, I think,
tried to land at, you know, we see these costs going up over
time, we know they're going to increase year on year, and if we can reduce
that burden on the employees, that has a significant benefit.
And then I think that when I look at what the BAB's looking at,
it's just distributing it it, it's talking
about healthcare is always rotten because it's like, well, obviously no one wants
to get sick, but if you get sick, you hope that collectively society is going
to like pitch in and we're gonna help cover the costs together. So I,
I just, I see the BAB recommendation. Um, and I
think I would lean toward what the BAB is recommend— recommending
on this over MJ because I think it's trying to get at addressing
what you're trying to address, but recognizing that the costs are accelerating so
much and in this medical space?
I think when I look at this, I'm reading this as
something in the chat here. Is that something you want to share,
Courtney? Well, I just— I— Sure,
go ahead, Courtney.
So I didn't know if that data point would be helpful or if it was
appropriate for us to chime in that the virtual setting is difficult. I apologize,
but just, wanted to make sure that the data point was shared that the
out-of-pocket maximum is generally not applicable to most members.
It is very— it is reached by only a subset of the population.
Sure. That was all. Thank you. I think
what I'd like to just explore a little bit is I appreciate
Fab's work and, of course, MJ's work as well. And if
there's a way for us to decrease that cost
even to the amount that the BAF is
recommended, I think you're right that they're acknowledging that there
is most likely going to be a change. But I think the BAF ability
as well to look at what would that cost be and what could we consider.
And I know that probably makes it complicated from, you know,
OFM sitting there trying to run numbers. But I,
if there's interest, Commissioner Salzman, I would like us to see if we could add
something in there to reduce the third item.
Sorry, will you just repeat reduce which item? The burden
of the,
just the, the actual cost to employees. And so if
that's premium, if that's the deductible, if that's wherever that is,
I think I would like to see us add something into both
of those. Um, so I don't think we have all of
the information we would need to be able to do that today, because I think
the piece that's missing is like that essentially creates what I was hearing from Kyle
is an additional million dollars, um, in funding
gap from the county side per year. So like, as far as our structural debt
goes, like that actually makes us have to find another million dollars And so
I think we would need OFM to do some additional work on
that. So I guess the question I have for— I would normally send
it toward Emily Cooper, so I'm sort of wondering who's with us in the room
that can help us, but about the necessity of having
this decision made today. Is there someone from
HR on this call?
Hi, Ashley. It's Stephanie Hyatt. Yes, I can work with the
MJ team and finance, OFM,
and they can crunch the numbers to see what
that would look like. Do we have time for that, Stephanie? That's what— that's the
question that I was wondering is like, is this like, do we need to have
this locked in? Is it time sensitive for today, or do we have time
to get that info back? I do think
we have a little bit of time.
If, you know, if that's something that you want to see before you're
comfortable making a decision,
I don't think that the BAB is planning to be
meeting again. So as long as you're okay with just
getting those numbers and making the decision with,
you know, what OFM provides
and the MJ team with kind of revising and
adding to, Yeah, so I think what we need
is sort of a fourth, basically a fourth option presented here that would show the
in-out-of-pocket maxes and the deductibles
staying the same essentially, right, Commissioner Lochaman, and shifting that
percentage. So instead of the, I forget what the actual presents were,
but it was something like 84% to
the county, shifting that county share and then showing what that does. Does for
the recurring expenditure from OFM side. Does that make sense, Kyle, what we're
asking to look at? Yeah, I just wanted— this is Kyle Sullivan— I just wanted
to confirm. So we're talking about the same, so basically it would
take our status quo scenario that we showed, but we would be combining
that with the current 2026 employee cost share, and then
what does that mean to the county from absorbing
those additional costs. Yeah, the current
employee payment, not cost share, because the share would shift to the county,
right? Yeah, so employees would pay the same in payroll
deductions and have as close to possible the current plan design.
And that's the reason I mentioned that is there's a bullet at the bottom of
this page that the IRS requires a $50 and $100 increase
to the deductible to remain compliant. So there will be some change,
but that's as close to no changes as possible.
So yes, that is the design we're hoping to see more detail on.
Okay. Yeah, that— thank you for that, everyone. I just want to add
a response for— I'm sorry,
I think it was Stephanie, maybe. Yes. Thank you.
I would feel comfortable with out because I feel like
this would be more favorable. So just, just in regards
to the— just say, I think that would be okay.
Want to check in on Commissioner Sullivan. If it was going the other direction,
maybe I would want to have conversation, additional meetings.
I actually— sorry, could you just say that again? I, I wasn't understanding.
Oh yeah, um, I, I thought I heard
a question from Stephanie or a comment about if the board would feel
comfortable, um, seeing changes without
having the— a board member present.
And for me, what I'm asking would be more favorable for
staff, and so it doesn't concern me about not having an additional meeting. Is that
clear? Yes. Yeah, thank you for clarifying. Yeah,
I'm The part
of it that would be very nice to have Bob weigh in on, of course,
is like what the effect of the structural deficit
is. I think that was in some of the notes of the conversation, but I
think they have contributed quite a lot of feedback. So seeing
that other scenario, I think builds on the feedback we've gotten, and then we can
compare the 4 scenarios that we have and have that discussion.
That's great. Thanks. All right. The next topic
is the medical premium contribution changes. Is. And I
don't know if you all want to change slides back again, but I think
the medical premium contribution changes, it looked like MJ and Bab
were in alignment on. But do we need
to put a pause in this discussion if we're waiting for that other information?
Yes. Okay. So we'll put a pause on that.
And then the next discussion is termination of the MindCo benefits.
Benefit, and it looked like Bab and MJ were in agreement that we
would recommend terminating
the MindCo benefit and save the $110,000 a year.
Any discussion on that one? I'm supportive of those recommendations and
having some of that additional information just to
understand the context because I had heard something different as well last year. So it's
helpful again for evaluation, just review.
Great. And then the last topic is the cross-accumulation on the consumer
choice plan. Any discussion on that? If I can just
ask Commissioner Solzman, I'm guessing you were fine with my recommendation. I just
didn't hear— Oh, sorry. Yes, I support also. Sorry about that.
Support the plan. The last one is this cross-accumulation of the
consumer choice plan. And so Bab was recommending that
we go ahead and leave it like it is designed now where the consumer choice
plan is a little bit different out of network than the other plan. And MJ
was recommending making them both the same.
That— this one concerned me when I see the amount
of people who will be impacted. Me too.
And so I just feel like there's so much changes going on with so many
different processes, certainly depending on where we're going in regards to a
change in premiums for people. I would rather
not make that change at this point. All right.
So I think what we would be doing today is it sounds like
we agree to direct staff to adopt the BABB recommendation
on Marathon Health, adopt the BABB recommendation
on the MindCo benefit, and adopt the BABB recommendation on
the cost accumulation, which is to not make a change in that space. So those
would be the 3 BAB changes that we're giving direction to move forward
with today. And then we're going to come back at a future meeting and continue
to discuss the medical plan design changes and the medical
premium contribution changes.
Is that right? Well, help me if the
first 3 part— first 3 pieces, Yes, the one that you
just said about coming back for plan design. I guess I was
interpreting all of these changes as plan design, so I just want to make
sure that the group knows what we're asking. What I read in the
packet is plan design. It says BABB recommends changing the
deductibles and out-of-pocket maximums on both medical plans and some small
changes to prescription copay tiers on the hybrid plan. These changes
will help lower the 16% increase increase in premiums
to 14.6, and then the MJ team recommended further bringing
it down to 13.4%. That was the thing that was described as medical
plan design changes, and that's what I think we have to come
back and talk more about with the additional scenario that you've described
that we'll look at. And then in concert with that, they called medical
premium contribution changes in the packet. The BABB recommended shifting 1% of the
premium contribution split from the county employees, making it
an 85.7% county paid and 14.3% employee paid.
And in that one, Bab and MJ had agreed, but I think we can't decide
on that without the additional information that you had put together too. So that's what
I'm talking about when I talk about the coming back to talk about medical plan
design changes and medical premium contribution changes. I think
that's a great clarifier. Okay, and so we can go ahead
and move forward with direction to staff on the Bab recommendation
on those other 3 items, and we'll come back at a future meeting on those
remaining 2. I'll turn back over to
Stephanie to see if there was anything else she needs us to answer today.
I don't have anything else. I'll work with everyone involved, and we'll
get that future meeting scheduled.
Excellent. Thank you all very much for being here today,
and just another thanks from the board, Kelly and BAB members,
for all the time and energy you've put into it and helping us understand how
this will affect each of your departments. It is a tremendous amount of time and
work you put in talking to everybody, going to all the meetings, understanding all the
actuarial data, and it is really helpful. So thank
you very much. And with that, we'll be adjourned for the day. Thank you all.
Thank you. Thank you. Bye-bye. Thank you,