4.5. SR 07-25-1994
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Ill< River
ITEM 4.5.
MEMORANDUM
TO:
MAYOR & CITY COUNCIL 0_.5\
LORI JOHNSON, FINANCE DIRECTOR '"(Y:J'fV
FROM:
DATE:
JULY 21,1994
SUBJECT: PRESENTATION ON EMPLOYEE
HEALTH INSURANCE
.
Due to a substantial rate increase from HealthPartners for the City's group
health insurance contract, the contract was re-bid for the 1994-95 contract
year. The bid information was provided to seven companies in the hope that
they would provide a quote to the City. Unfortunately, each of the seven
companies declined to quote. This means that the City must choose between
either HealthPartners or the Public Employees Insurance Plan (PEIP).
There are numerous issues regarding the insurance issue to be discussed
prior to deciding on which proposal to accept. I will try to address as many of
those issues as possible in this memo. Those issues include the following:
. Insurance cost to employees and the City
. Type of coverage
. The need for Union approval if the aggregate value of the coverage
is decreased
. Possibility of employees electing to obtain coverage elsewhere
. Options available to the City Council
. Review of PEIP and the related contract requirements
. Planning ahead for the 1995-96 renewal and beyond
Cost to Emplovees and Citv
.
The insurance costs will increase for both the City and employees no matter
whether the HealthPartners contract continues or the City changes to PEIP.
First, lets look at the costs associated with the HealthPartners contract. For
each single coverage employee, the City would pay an additional $57.04 per
month. The annual City cost for the 39 employees currently electing single
coverage is $26,694.74. Of this, $11,122.81 will come from the 1994 budget
year and the remainder from the 1995 budget year. The increased cost for
P.O. Box 490 · 13065 Orono Parkway · Elk River, MN 55330 · (612) 441-7420 · Fax: (612) 441-7425
.
employees electing family coverage is $180.59 per month. That means that
the 17 employees will pay an additional $36,840.36 for the upcoming contract
year. These employees will see a net pay reduction of approximately $90 per
paycheck (for employees pre taxing their premium, this amount will be
approximately $65).
If the City were to change to the PEIP contract, each employee would be
allowed to choose one of the four programs that would best fit his or her
needs. For purposes of calculating the cost to the City and employees, the
most expensive single plan will be used and an average family premium will
be used. The most expensive single premium is $172.75. Changing to this
plan would cost the City $6,486.48 annually. Of this, $2,702.70 would come
from the 1994 budget and the remainder from the 1995 budget. The average
family premium would be $535.61. However, it is likely that many
employees would select coverage with a premium of either $567.62 or
$584.79. Based on the average premium, the monthly increase per employee
would be $32.56, meaning that the employees would pay an additional
$6,642.24 annually excluding co-pays and de ductibles. With the PEIP Plan,
both the single and family coverage employees would incur out of pocket costs
for co-pays and deductibles. For the most part, the out of pocket maximum is
$1,000 per individual and $2,000 per family.
. Type of Covera!!e
The current contract with HealthPartners is for comprehensive medical
coverage. HealthPartners has also provided quotes for a co-pay and an 80/20
plan. The co-pay plan results in a premium reduction of 3.2 percent and an
80/20 plan results in an additional reduction of approximately 5 percent.
Taking into consideration both of these reductions, the single premium would
be $202.43 and the family premium would be $640.89. Any of the plans
provided by HealthPartners would be more comprehensive than the plans
under the PEIP program. The PEIP coverage is more restrictive and, of
course, less comprehensive.
Union Issues
Any time there is a reduction in the aggregate value of benefits, the Union
must vote to approve the change in benefits. The City Council can decrease
the non-union employees benefits without employee approval. If the Council
elects to contract with PEIP and the Police Union does not approve the
reduction in benefits, the Police Union and non-union employees would each
be covered under different health insurance contracts. Although this is
certainly possible, it does limit options for either group due to the size of the
. groups and it may cause friction between the employee groups.
. Emplovees Opting: to Obtain Familv Coverag:e Elsewhere
It is very likely, given the amount that employees pay for family coverage,
that many employees will choose to obtain coverage elsewhere; either
through a spouse or an individual plan. Many employees have already gotten
quotes on individual plans and some have already been approved for coverage
under those plans. Although the coverage includes co-pays and deductibles,
in many instances the savings exceed the maximum out of pocket expense.
.
If employees do elect to get coverage elsewhere, the City will suffer through
increased premiums in the next contract year. Both the single and family
premiums would increase substantially to offset the loss of premium revenue.
Of the seventeen employees with family coverage, it is estimated that ten or
more of those may drop the City's coverage a get coverage elsewhere. This
will force premiums up substantially for the employees remaining on the
City's group health contract as there will be fewer premium dollars to pay for
the high utilization and large ongoing claims. This will mean that employees
with family coverage will pay even more in the future as will the City
because single premiums will also increase substantially. It is obvious that it
is in the group's best interest to try to retain as many family premiums as
possible.
Options Available to the Citv Council
During our earlier discussion on health insurance, several employer options
were presented. In addition, the Employee Health Insurance Advisory
Committee (members include Mark Thompson, Cheryll Edinger, Steve
Miller, Gary Schmitz, Darrell Mack and Lori Johnson) also discussed various
options available to the City in order to deal with the insurance issue.
Because the City did not receive as many quotes as it had hoped, some of
those options no longer apply. The items discussed by the Committee
include:
.
. Offer a cafeteria plan to all employees - The main reason for
discussing this option was to provide an incentive for employees
with single coverage to agree to lesser coverage, thereby reducing
the premiums for employees with family coverage. If the City
approves the HealthPartners contract for 1994-95, a cafeteria plan
based on the current mix of single and family coverage would cost
the City $16,936.92. If the City were to change to the PEIP Plan,
this program would cost $37,145.16. This option would benefit the
single employees by allowing them to select from a menu of
benefits, but would benefit the employees with family coverage only
if this allows for a change from comprehensive to an 80/20 plan.
.
Based on quotes we have received, this option will likely not benefit
family coverage employees.
. Employees could find their own coverage - The Committee agreed
that this was not a workable solution since not all employees with
family coverage would qualify for insurance elsewhere and also
because it would drastically increase the premiums paid by the City
and the remainder of the employees with family coverage under the
City's contract.
. The City would reimburse employees if proof of coverage is provided
- This would benefit employees who are covered under the City's
plan in addition to another plan. It would also benefit employees
who are able to get family coverage elsewhere. This also would
allow employees to submit proof of payment for coverage and
receive reimbursement for that if the employee had not spent
his/her City provided insurance dollars. This option may cause
problems with the City's group contract as most group contracts
require that at least 75 percent of the eligible employees are
covered under the contract.
. Increase the City's insurance contribution - The City currently
contributes up to $280.00 for health, dental, and life insurance.
The cap has increased approximately $15.00 each year in the last
several years. This increase has not come close to covering the
increase in insurance premiums. Based on the current 17
employees electing family coverage, each $10.00 increase in the
insurance cap costs $2,040.00 per year.
. Time the increase in the City's insurance contribution to coincide
with the premium increase - Each January, the insurance
contribution has increased. However, the insurance contract is
renewed on August 1. If the increase in the City's contribution was
timed such that it offset the increase in the premium, employees
would be more likely to see the benefit of this additional City
contribution.
. Set a percentage of the premium to be paid by the City Council - It
was agreed that this option would be too expensive for the City and
that it would be too hard to budget for premium increases.
. Co-pays and deductibles for employees on single coverage would be
reimbursed by the City up to a maximum of the annual difference
between the cap and the amount paid for single coverage - It was
agreed that this would be too labor intensive and difficult to
administer.
. Apply unused single insurance cap dollars to family coverage -
There are 39 employees currently on single coverage. The cost for
the City to supply insurance to those employees is $36.19 less than
the $280.00 cap. This would mean that an additional $16,936.92
would be available for the employees with family coverage. This
.
.
.
would equal an added contribution of $41.51 per paycheck, bringing
the family contribution down to $174.25 per paycheck. This option
would cost the same as providing a cafeteria plan for all employees.
The difference would be that this plan would benefit employees
with family coverage versus employees with single coverage.
. Accept one of the quotes and make no changes to the current
benefit plan - The Council could approve either the PEIP or the
HealthPartners proposal and make no changes to the insurance
benefit package. If the HealthPartners quote is accepted, this
would mean that employees with family coverage would pay
$431.52 per month for family coverage if they did not elect to get
coverage elsewhere. If those employees elect to get coverage
elsewhere, the City's premiums will increase substantially in future
years to make up for the loss of revenue. If the City were to
approve the PEIP Plan, all employees would incur out of pocket
costs. Additionally, the Union would need to approve this decrease
in benefits. If the Union did not approve, the City may need to
enter into group insurance contracts.
Review of PEIP Contract
.
There are several items of concern relating to the PEIP contract. First,
PEIP requires a two year contract. As I have already mentioned, the PEIP
coverage is lesser and more restrictive than the HealthPartners coverage
and, as a result, the premiums are somewhat lower. However, the premiums
can increase up to 50 percent in the second contract year and the City cannot
get out of the contract. In other words, those premiums could increase to
approximately $259.00 for single coverage and $877.00 for family coverage
before the City could get out of its second year contract. Given the City's
experience history, it would not be unreasonable to assume that this may
happen; especially given the quality of the risk pool we would be joining. In
contrast, the HealthPartners could increase by 130 percent in 1995 and the
premiums would be only slightly more ($280.00 for single and $888.00 for
family) than the PEIP premiums, even though the PEIP Plan would require
substantial out of pocket costs while the HealthPartners plan would not.
Planning: Ahead for the 1995-96 Renewal and Bevond
.
When making a decision regarding the contract renewal effective August 1,
1994, it is very important that not only this contract year but future contract
years be considered. Continuity is very important to employees when it
comes to health insurance so that they do not need to continue changing
clinics and doctors. In addition, it takes a tremendous amount of staff time to
go through the bidding, evaluation, and change over process. It is probably
not prudent to enter into a contract with low premiums that will not cover
.
claims because the shortfall will need to be recaptured by way of a rate
increase the next year.
In conclusion, due to the City's experience history, the City did not receive
any bids through the open bidding process. As a result, the City has the
option of renewing its contract with HealthPartners or changing to PEIP. In
addition, the Council has the option of reviewing the benefits provided to the
employees. As requested by Council, this memo contains only facts and no
recommendation. I would like to advise the Council, however, that it is in the
employees and the City's best interest to look beyond the 1994-95 contract
renewal and be concerned with premium increases in future years. I have
attached several pieces of information for your review. I also have additional
information which I will provide verbally on Monday. This is obviously an
issue of great concern to the employees. In that regard, the employees are
anticipating some sort of decision from the City Council so that they can plan
accordingly.
.
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~ ~ HealthPartners
8100 34th ^ venue Sooth
PO flux IlO~
Mlnne.polll,!\iN 554.0-1309
.
Revised
HealthPartners Proposal for
City of Elk Rive.r
Rlltes effectilJe August 1, 1994
He/llthPartrlers Choice (no copay)
(35.9% incm~e)
Single Family
$215.93 S6B3.64
.
He/llthPartners Choice ($10.00 office copay)
(32,4% Incre~se)
Single Family
$210.37 $666.04
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