Loading...
HomeMy WebLinkAboutAppropriation of Funds for Close Out of the Point-of-Service J16k) L-, M194p-J-)ti M/y1./N y CITY OF HUNTINGTON B'EA�CH MEETING DATE: August 2, 2004 DEPARTMENT ID NUMBER: AS-04-025 Council/Agency Meeting Held: 0 _ ^' C Deferred/Continued to: =� Approved ❑ Conditionally Approved ❑ Denied C y ler 'st1ature Council Meeting Date: August 2, 2004 Departmen ID Number: AS-04-025 CITY OF HUNTINGTON BEACH REQUEST FOR ACTION N D SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL SUBMITTED BY: PENELOPE CULB TA H-G� T&ITYIN�� R� S TOR PREPARED BY: CLAY MARTIN, DIRECTOR OF ADMINISTRATIVE SERVICES SUBJECT: CLOSE OUT OF THE POINT-OF-SERVICE CITY MEDICAL PLAN Statement of Issue,Funding Source,Recommended Action,Alternative Action(s),Analysis,Environmental Status,Attachment(s) Statement of Issue: Representatives of the city and all seven full-time employee associations have completed the meet and confer process on health insurance rates and plans for the 2004 calendar year. Effective July 1, 2004 the Point-of-Service City Medical Plan ceased providing insurance coverage and must now be closed out. Funding Source: General Fund Unreserved Fund Balance in the amount of $775,700. Recommended Action: 1. Approve appropriation of $775,700 from the General Fund unreserved fund balance for the purpose of closing out the Point-of-Service City Medical Plan. 2. Authorize the implementation of the layoff process with employees affected by the close out of the Point-of-Service City Medical Plan. 3. Authorize the use of funded frozen positions for the placement of employees during the layoff process, August 3, 2004 through October 29, 2004. Alternative Action(s): Reject the recommended action and provide staff with alternative direction. H:\RCA's\Clsoe Out of City Plan POS.doc 4 7/20/2004 7:37 AM REQUEST FOR ACTION MEETING DATE: August 2, 2004 DEPARTMENT ID NUMBER: AS-04-025 Background: In June, 2003 the city's medical insurance broker, Driver Alliant, commissioned an actuarial study of the self-insured Point-of-Service (POS) City Medical Plan. With the completion of the actuarial study by Demsey, Filliger & Associates, LLC it was determined that to maintain the POS City Medical Plan it was necessary to increase health insurance premiums by 54.83% in 2004. Realizing that this cost was too great of a burden to place on either the city or the employees, the City Council directed that staff begin negotiations with the seven full- time employee associations to seek a fully-insured health insurance plan. The city and the seven full-time employee associations recently completed the meet and confer process on new health insurance plans for the 2004 calendar year. Starting April 1, 2004 all Huntington Beach Municipal Employees' Association (MEA), Huntington Beach Management Employees' Organization (MEO), and Non-Represented employees were transitioned to either a Blue Shield Preferred Plan Organization (PPO), a Blue Shield Health Maintenance Organization (HMO) or a Kaiser Permanente HMO. This package of health insurance plans is referred to as the "Stand Alone Plan" by staff and the employee associations. The Huntington Beach Firefighters' Association (HBFA) began using the same health insurance plans on July 1, 2004. Starting July 1, 2004 the Huntington Beach Police Officers' Association (POA), Huntington Beach Police Management Association (PMA), Huntington Beach Fire Management Association (FMA), and the Huntington Beach Marine Safety Officers' Assocation (MSOA) represented employees began utilizing the Public Employees' Medical and Hospital Care Act (PEMHCA) for health insurance. The California Public Employees' Retirement System (CaIPERS) administers the PEMHCA health insurance programs. Close Out of POS City Medical Plan With the transition of all employees to fully insured health insurance plans now complete, it becomes necessary to close out the POS City Medical Plan. The self-insured POS City Medical Plan had an adopted budget of $10,013,000 in fiscal year 2003/2004 and five positions assigned to the plan. Two positions were assigned to the management and supervision of the POS City Medical Plan: the Risk Manager and a Senior Personnel Analyst. Three positions were assigned to maintaining the day-to-day operations of the POS City Medical Plan: two Medical Claims Examiners and an Office Specialist II (vacant). When the City Council authorized the new fully insured health insurance plans it also transferred the adopted budget of the POS City.Medical Plan to the new fully insured health insurance plans. The POS City Medical Plan had operated with no reserve for many years. With the transfer of all budgeted funds to the new fully insured health insurance plans it is necessary to request that the City Council appropriate enough salary and operating funds to close out the POS City Medical Plan. The plan document that established the POS City Medical Plan allows health insurance providers one year from the date of service to bill the POS City Medical Plan. The final close out of the POS City Medical Plan will not officially occur until June 30, 2005. H:\RCA's\Clsoe Out of City Plan POS.doc -3- 7/21/2004 4:25 PM a2 REQUEST FOR ACTION MEETING DATE: August 2, 2004 DEPARTMENT ID NUMBER: AS-04-025 Medical Claims The largest single cost to the POS City Medical Plan had been the weekly payment of medical claims. The average weekly payment to health insurance providers was $62,500 for the months of April and May, 2004. A health insurance provider typically submits a claim for payment to the POS City Medical Plan within 4 to 6 weeks after a service is provided. Based on this average it is recommended that the City Council appropriate 10 weeks of medical claim payments using the April/May weekly average, to cover all costs incurred by POS City Medical Plan enrollees. Medical Claims (Cost Incurred through June 30, 2004) $625,000 Total Recommended Appropriation for Medical Claims $625,000 The appropriation of 10 weeks of the April/May average should cover all costs incurred through June 30, 2004 and submitted through June 30, 2005. Any health insurance provider that submits a claim after one-year from the date of service or June 30, 2005 will receive a letter informing them that their invoice has been denied. This is the same process for claims submitted more than one-year from the date of service that was used when the POS City Medical Plan was fully operational. Prescription Drugs Claims The fastest growing cost to the POS City Medical Plan was prescription drugs. The POS City Medical Plan contracted with PCS to pay the various pharmacies and handle mail order prescriptions. PCS would then bill the POS City Medical Plan monthly for the cost of the prescription drugs purchased by the enrollees. This billing runs two months in arrears, to close out the POS City Medical Plan and the contract with PCS, it is recommended that the City Council appropriate two months of prescription drug billings. The average payment to PCS in April and May, 2004 was $60,000 per month. Prescription Drugs (Cost Incurred through June 30, 2004) $120,000 Total Recommended Appropriation for Prescription Drugs $120,000 It is expected that once the August payment is completed all prescription drug payment should be closed out. Management and Supervisory Staff The Risk Manager, who manages the POS City Medical Plan, will continue to manage the POS City Medical Plan until the close out. Until the close, the Risk Manager will continue to manage both the POS City Medical Plan and the fully insured health insurance programs, in addition to the Workers' Compensation and Liability programs. The Risk Manger's salary is and will continue to be budgeted in the General Fund under the Liability Program business unit within the Administrative Services Department. The Senior Personnel Analyst will administer the day-to-day operations of the health insurance contacts, as well as all other employee benefits. The Senior Personnel Analyst's salary is and will continue to be budgeted in the General Fund under Employee Benefits business unit of the Administrative Services Department. H:\RCA's\Clsoe Out of City Plan POS.doc 4 7/21/2004 4:25 PM 3 REQUEST FOR ACTION MEETING DATE: August 2, 2004 DEPARTMENT ID NUMBER: AS-04-025 Operations Staff On August 3, 2004, in accordance with the Personnel Rules and the Memorandum-of- Understanding (MOU) between the city and the Huntington Beach Municipal Employees' Association, the layoff process will begin with one Medical Claims Examiner. The effective date of the layoff is August 18, 2004. It is expected by that time, that the workload in medical claims will only require one Medical Claims Examiner. On September 15, 2004, the layoff process will begin for the remaining Medical Claims Examiner. This effective date of layoff is September 30, 2004. From thereon, the Senior Personnel Analyst will process outstanding medical claims received from October 1, 2004 through June 30, 2005. As with the budget reductions last year that resulted in layoffs, it is recommended that the City Council authorize staff to utilize vacant positions designated as "frozen" to place the two employees impacted by layoff. In addition to other placement alternatives in accordance with the Personnel Rules or the MOU, an employee may be placed in a fully funded "frozen" position that is at or below their current pay range provided the employee meets the qualifications for the position. This authorization is requested for the period of August 3, 2004 through October 29, 2004. Recommended Funding for Staff It is recommended that the City Council appropriate $30,700 to fully fund the two Medical Claims Examiners until the close out the POS City Medical Plan, as described above. The additional $10,000 is requested to allow for the possibility of a delayed transition or bridge until an employee affected by a layoff notice can be placed into a new position. Medical Claims Examiner(July 1, 2004 through August 4, 2004) $6,900 Medical Claims Examiner (July 1, 2004 through September 30, 2004) $13,800 Bridge Funds to allow for the possibility of transition time $10,000 Total Recommended Appropriation for Staffing $30,700 Since the Risk Manager and Senior Personnel Analyst are budgeted in different business units there is not need to appropriate additional funds. Total Recommended Funding Staff is recommending that the City Council appropriate $775,700 from the General Fund unreserved fund balance to close out the POS City Medical Plan. Upon City Council approval, staff will only appropriate the total funds necessary to close out the POS City Medical Plan, with a maximum authorized appropriation of $775,700. Staff will use budgetary savings in the benefit accounts to achieve minimal use of the City Council authorized appropriation. H:\RCA's\Clsoe Out of City Plan POS.doc +µ- 7/21/2004 4:25 PM REQUEST FOR ACTION MEETING DATE: August 2, 2004 DEPARTMENT ID NUMBER: AS-04-025 Council Policy Regarding Requests for an Appropriation of Funds: As adopted by the City Council in March 1998, all requests for appropriation of funds must meet one of the following criteria: 1) The request is an unanticipated emergency, 2) The request is required to implement labor negotiations, or 3) The request will be offset by related new revenues. The new appropriation being requested falls under the labor negotiations criteria and will complete the labor negotiations process regarding health insurance with all seven full-time employee associations. Attachment(s): City Clerk's , . - Number No. Description , , ..,,� 1. Fiscal Impact Report RCA Author: William McReynolds H:\RCA's\Clsoe Out of City Plan POS.doc -6- 7/21/2004 4:25 PM ATTACHMENT # 1 � CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICA TION TO: Penelope Culbreth-Graft, City Administrator FROM: Clay Martin, Director of Administrative Services SUBJECT: FIS 2004-26 Close Out of POS City Medical Plan DATE: July 12, 2004 As required by Resolution 4832, this Fiscal Impact Statement has been prepared for "Close out of POS City Medical Plan." If the City Council approves this action (total appropriation $775,700), the estimated unreserved General Fund Balance at September 30, 2004 will be reduced to $4,254,000. Cla M�a* DirectAdministrative Services RCA ROUTING SHEET INITIATING DEPARTMENT: ADMINISTRATIVE SERVICES SUBJECT: CLOSE OUT OF THE POINT-OF-SERVICE CITY MEDICAL PLAN COUNCIL MEETING DATE: AUGUST 2, 2004 RCA ATTACHMENTS -STATUS_ .. Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Not Applicable Tract Map, Location Map and/or other Exhibits Not Applicable Contract/Agreement (w/exhibits if applicable) (Signed in full by the City Attorney) Not Applicable Subleases, Third Party Agreements, etc. (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Not Applicable Financial Impact Statement (Unbudget, over $5,000) Attached Bonds (If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial Not Applicable w,. t EXPLANATION "FOR MLSSINGATTQCIHMENTS r , REVIEWEDr �: ,.y RETURNED`. FORWARDED;: Administrative Staff Assistant City Administrator Initial City Administrator (initial) City Clerk ( ) EXPLANATION FOR RETURN OF ITEM g Only)(Below Space For City Clerk's Use RCA Author: William McReynolds �ECE! CH" Y CLERK CITY or HUNTINGft N BEACH, CA 1114 AUG -2 P 2: 38 Out --- f the Po 'lnt-of- L.,o bq= U bervice City Medical Plan x� a � x Clay Martin, Director of Administrative Services August 2, 2004 Item F- 1 � City ed ca I Pl a n . Representatives of the city and all seven full- time employee associations have completed the meet and confer process on health insurance rates and plans for the 2004 calendar year. . Effective July 1, 2004 the Point-of-Service City Medical Plan ceased providing insurance coverage and must now be closed out. . The final close out of the POS City Medical Plan will not officially occur until June 30, 20050 4" lose Out Costs k Medical Claims (Cost Incurred through June 30, 2004) $625,000 Prescription Drugs (Cost Incurred through June 30, 2004) $120,000 Medical Claims Examiner (July 1, 2004 through August 18, 2004) $6,900 Medical Claims Examiner (July 1, 2004 through September 30, 2004) $13,800 Bridge Funds to allow for the possibility of transition time $10,000 Total Recommended Appropriation $775,700 LaYOTT Process Wo • On August 3,, 2004, in accordance with the Personnel Rules and the MOU between the city and MEA, the layoff process will begin with one Medical Claims Examiner. • On September 15, 2004, the layoff process will begin for the remaining Medical Claims Examiner. . The layoff process will be the same as the one used in July 2003 . Recommended Actions Li . Approve appropriation of $775,700 from the General Fund unreserved fund balance for the purpose of closing out the Point-of- Service City Medical Plan . . Authorize the implementation of the layoff process with employees affected by the close out of the Point-of-Service City Medical Plan . . Authorize the use of funded frozen positions for the placement of employees during the layoff process, August 3, 2004 through October 29, 20040