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HomeMy WebLinkAboutCity of Huntington Beach Self Insurance Issues - 1979-84 . . �/�, I- -F%N- REQUE� FOR CITY COUNCIL ACTT N Date June 12, 1984 Submitted to: Honorable Mayor and City Council P.O Submitted by: Charles W. Thompson, City Administrator Prepared by: Robert J. Franz, Chief of Administrative Serv' es Subject: Appropriation Increase in the Self Insurance Fun p►� Statement of Issue, Recommendation,Analysis, Funding Source,Alternative Actio s, achments: ? STATEMENT OF ISSUE: Appropriation increase in the Self Insurance Health Division adjusting the--accounting system to meet employee medical claims for Fiscal Year 1983/84. RECOMMENDATION: Council authorize appropriation from the unappropriated fund balance of the Self Insurance Fund of $280,000 to the Employee Medical Claims account in the Self Insurance Fund. ANALYSIS: The resolution adopting the Fiscal Year 1983/84 budget was understated by $280,000 in the Self Insurance Fund. This was due to an error in the budget detail of the Self Insurance Fund in which the medical claims payments amount should have been $280,000 higher than shown. Projected medical costs for 1983/84 are approximately the same as audited costs for 1982/83. The revenue from premiums for medical insurance to the Self Insurance Fund also will be $280,000 higher than shown in the budget. The net effect to the Self Insurance Fund is that both expenditures and revenues will be $280,000 higher than shown in the budget with no net change in the Self Insurance Fund balance in the Health Insurance area. FUNDING SOURCE: Self Insurance Fund Balance ATTACHMENTS: Financial Impact Statement Appropriation Revision 0534j PIO 4/81 CITY OF HUNTINGTON BEACH REQUEST FOR BUDGET APPROPRIATION REVISION DEPARTMENT REQUESTING TRANSFER Administrative Services DATE 6-12-84 DIVISION Self Insurance FUNDS TRANSFER FUNDS TRANSFER FROM INTO Account Account Account No. Description Amount Account No. Description Amount Unappropriated Reimbursements 110"-301 Fund Balance $280,000 867419 Empl .Med.Claims $280,000 Total$280,000 Total$280,000 Justification: To meet employee medical claims expenses for Fiscal Year 1983-84, projected to be $280,000 higher than budgeted. *Approvals/Dates: 1. Department Hea Date l ?/1;1 2. Director of Financ r`� Date /Z 3. City Administrator Date k/1 4. Mayor Date * If between departments, requires Approval 1-4. If within department, requires Approval 1-3. FISCAL IMPACT STATEMENT Budget Status: Current budget projects to exceed appropriation for employee medical claims expense by $280.000. Cost: $280,000 for claims payments with no additional indirect costs other than loss of interest on expenditure of funds. Revenues for medical claims payments projected to be over budget estimate by $280,000. Funding Source: Self Insurance Unappropriated Fund Balance Revenue Source: Premiums from health insurance (adjusted 12/1/83) to provide needed revenues to meet cost of Self Insurance Health Plan. Alternative Sources: None History: Rates for health insurance have been adjusted to meet medical claims costs. t REQUES f FOR CITY COUNCIL ACTION' s`f Date January 26, 1983 Submitted to: Honorable Mayor and City Council BY G17Y GwNCYL Submitted by.. Charles W. Thompson, City Administrator Dyad 19. Prepared by: F. B. Arguello, Chief of Administrative S rvices Subject: Consolidation Consolidation of City's Insurance Programs cxrY cs-F Statement of Issue, Recommendation,Analysis, Funding Source,Alternative Actions,Attachments:` STATEMENT OF ISSUE: The City's insurance programs have grown both in size and cost to the extent that it is felt that centralization of these programs is the most efficient way to administer them. In order to accomplish this, it is necessary to consolidate all self insurance funds into one, create the position of Insurance and Benefits Manager, and transfer all existing insurance personnel . Although this will entail the transfer of considerable funds, the total City budget will be increased by $42,600. RECOMMENDATION: Approve the consolidation of the City's insurance programs, the creation of the Self Insurance Fund, the establishment of the position of Insurance and Benefits Manager with salary and benefits at $36,616 and operating expense of $5,984, and transfer of existing insurance personnel to the Self insurance Fund. ANALYSIS: The new Self Insurance Fund will be: a. established by consolidating the Self Insurance Medical (H) and Self Insurance Liability (G) with the Self Insurance Workers Compensation Fund (0) . b. administered by the Insurance and Benefits Manager. In addition, the existing personnel in the Risk Management section of the City Tr6asurer's Department will be transferred to the new division. FUNDING SOURCE: The Self Insurance Fund unappropriated fund balance. f PIO 4/81 t H , 4 CITY OF HUNTINGTON BEACH INTER-DEPARTMENT COMMUNICATION HUNTINGTON BEACH To Charles W. Thompson From F. B. Arguello City Administrator Chief of Administrative Services Subject Consolidation of City's Insurance Date January 27, 1983 Programs FIR # 83-31 In response to the recommendation of the Administrative Services Department, a Financial Impact Report has been prepared and submitted relative to the centralization of the City's self insurance programs as well as the requested appropriation for the proposed establishment of the Insurance and Benefits Manager position plus related operating expenses. It has been estimated that an appropriation of $42,600 would be adequate to fully fund the latter expense for the time span of December 13, 1982 through June 30, 1983. Sufficient monies are available in the proposed unappropriated Self Insurance Fund for this purpose. An affirmative response by the City Council will reduce the unappropriated balance in that fund to $1 ,122,385.48. F. B. Arguello Chief of Administrative Services FBA/AR/cg / CITY OF HUNTINGTON BEACH FINANCIAL IMPACT REPORT Project Name Consolidation of City's Insurance Programs Description Funding for this project 1 . DIRECT PROJECT COSTS 1 . 1 One-Time Costs Land Furn. , ac - Current Acquisition Construction ties, Equipment Fiscal Year Total Cost 4260 1 .2 Recurring Annual Costs Additional Materials S utside Payroll Personnel supplies S rvices Revenues Total Cost 67,598 11 ,002 78,6o0 IN 1 .3 Replacement/Renewal Costs N/A 2. INDIRECT COSTS Loss of interest earning capability due .to expenditure of funds. Financial Impact Report Page 2 3. NON-DOLLAR COSTS N/A 4. BENEFITS TO BE DERIVED FROM THE PROJECT Approval of this appropriation will allow for the rentralizatinn nf the soli - funded City insurance prograr�swh i ch has been felt ,to be the m ,,t- eft i r i cr�r mznn� in providing adequate administration thereof. 5. PROJECT USAGE Daily. 6. EXPENDITURE TIMING Subsequent to City Council approval . 7. COST OF NOT IMPLEMENTING THE PROJECT Status quo will prevail . CITY OF HUNTINGTON BEACH INTER-DEPARTMENT COMMUNICATION HUNTINGTON BEACH To Charles W. Thompson From Robert J. Franz City Administrator Chief of Administrative Svcs. Subject Appropriation Increase In The Date June 12, 1984 Self Insurance Medical Claims Account For FY1983/84 FIS # 84-2 As required under the authority of Resolution 4832, a Fiscal Impact Statement has been prepared and submitted by the Administrative Services Department relative to the need for additional funding to accommodate the projected medical claims payments deficit over the balance of the current fiscal year. Estimates are that an appropriation of $280,000 would be adequate for this purpose. An affirmative response by the City Council will reduce the balance of the Self Insurance unappropriated fund balance - Health to $464Chief . F anz Administrativ RJF/AR/cg 0535j REQUE� 1" FOR CITY COUNCiL- TION' Date January 26, 1983 Submitted to: Honorable Mayor and City Council Submitted by: Charles W. Thompson, City Administrator �YGp GTL't 8Y F. B. Arguello, Chief of Administrative Ser D Prepared by: g � Subject: Insurance Claims Administration (Medical ) C ITS c K Statement of Issue, Recommendation,Analysis, Funding Source,Alternative Actions,Attachments: ( % STATEMENT OF ISSUE: The City is currently paying an annual fee of $81 ,304 to Blue Cross for our medical plan claims .administration. The attached letter from Jerry Bramlett dated December 29, 1982 shows an analysis of how to save substantial money by purchasing computer software and hiring two persons to administer our own claims. After the one-time purchase, the annual cost should be only $38,000, the cost of two employees to administer the claims. The City Council has previously directed staff to pursue the concept of in-house claims administration. RECOMMENDATION: City Council to authorize the purchase of the necessary equipment, hiring of Clerk Typist, Range 193-A; Insurance Claims Processor, Range 226-A, to perform in-house claims administra- tion. Total appropriation necessary for Fiscal Year 1982-83 of $119,304.00. ANALYSIS: As costs of outside claims administration continue to increase, the City can save con- siderable money and provide better claim service by doing this work in-house. This applies to the group medical insurance plan and workers compensation as well . Administra- tion of both programs can be done in-house at substantially less cost than purchasing the service outside. This concept of in-house administration is also recommended as a cost savings measure by the consultant hired to study the City's overall risk manage- ment program. FUNDING SOURCE: Self Insurance Unappropriated Fund Balance. ALTERNATIVE ACTIONS: 1 . Continue to purchase claims administration services from outside contractor. 2. Lease on a time share basis outside claims administration service. ATTACHMENTS: F. B. Arguello letter, January 6, 1983 Jerry Bramlett letter, December 29, 1982 Jerry Bramlett letter, October 22, 1982 Appropriation Revision Pt0 4/81 rp, CITY OF I UM' "INGTON BEACH INTER-DEPARTMEilT COMMUNICATION HUNiINGTON KACII To Charles W. Thompson From F. B. Arguello City Administrator Chief of Administrative Services Subject Insurance System Cost Date January 6, 1983 I have had Jerry Bramlett, Data Processing Manager, review the system in Santa Barbara which we thought might be usable in our operation. I concur with Mr. Bramlett's findings (see attached 10/22/82 memo) in that the system is precisely what we need in this city to ensure proper operation of our insurance function. In addition, I had Mr. Bramlett work with Ed Thompson, our Insurance and Benefits Manager, in an attempt to determine our requirements relative to such a system. I feel that the system will respond to all of our reporting needs in all three areas , i .e. employee medical , worker' s compensation and liability. As noted in the attached 12/29/82 memo, we can acquire the system, pay for conversion costs , hire a claims examiner and a clerk typist for $119,900 total cost - $81 ,900 of which is a one-time cost. Our current annual cost is $114,304. We can create a workable system and at the same time save a considerable amount of money over the next fey, years as the new system will be completely compatible with our current Burroughs equipment. I recommend that we be authorized to enter into an agreement to purchase the needed software, contract with the present owner to assist us in the necessary conversion, purchase the display terminal required, and to be authorized to recruit the necessary two new people. We would also move to eliminate our current outside administrative agreements as soon as full conversion could be made. -,, Gc F. B. Arguello Chief of Administrative Services FBA/cg CITY OF HUI JTINGTON BEACH INTER-DEPARTMENT COMMUNICATION HUNTINGTON BEACH To Frank B. Arguello From Jerry Bramlett Chief of Administrative Services Data Process' nager Subject AUTOMATED CLAIMS HANDLING COST STUDY Date December 29, 1982 As per our previous conversation, shown below is a cost analysis of claims administration costs for medical and workers compensation handling. Shown first is the current costs, using third-party claims administrator, followed by the costs associated with in-house handling via a proposed automated software package. The personal services expense of the "Public Liability Claims Coordinator" and the "Clerk Insurance Senior" are not included in this analysis as I understand their duties will continue regardless of automation and the majority of their duties are related to liability claims as opposed to medical and workers compensation. Current Administration/Handling Cost: Workers compensation, approximately (varies) �. $2,750/month x 12 = 33,000 Medical Insurance Blue Cross (FHP and Health Net not included) $13.27 - 2.70 (stop loss) _ $10.57/month, per .641 subscriber x 12 = 81,304 Annual Cost $114,304 Automated In-House Administration%Handling Cost: Option I, Modified Time-Share; - $1,750/month flat rate, software $21,000 times 12 - Claims Examiner, new position $22,000 - Clerk Typist, new position $16,000 - Leased telephone data line $ 7,200 Approximate Annual Cost $66,200 i AUTOMATED CLAIMS HANDLING COST STUDY -2- December 29, 1982 Option II, Total In-House - Claims Examiner, new position $22,000 - Clerk Typist, new position $16,000 Approximate Annual Cost $38,000 Option I and II above both have clear cost advantages over the current procedure but both approaches have one-time capital outlay costs; Option I, - DCP line adapter $3,300 - Display terminal, 1 each 1,900 - Modems (2,400 baud) , 2 each ' 1,600 $6,800 Option II, - Display terminal, 1 each $ 11900 - Conversion cost,, software 10,000 - Purchase cost, proprietary software 70,000 $8 900 . I highly recommend the in-house approach Option II, which appears to be cost justifiable within less than 13 months. The vendor who markets the automated claims handling application software has stated a willingness to allow the City to pay the flat rate lease time-share rate through the fiscal year (which is considerably less than Blue Cross) until 83-84 monies can be budgeted for purchase and to allow a 50% lease credit to apply to the purchase price even though total in-house implementation could begin as soon as approved and converted. I do not recommend the in-house approach, Option I, aside from being $22,000/year more expensive than Option II, this approach introduces very clumsy logistical and control problems. J3:dp ` cc: E. Thompson File e CITY OF 1-IMITINGTON BEACH *-- INTER-DEPARTMENT COMMUNICATION MlNIIN(JON BFAC" To Frank B. Arguello From Jerry Bramle Chief of Administrative Services Data Proce g Manager Subject AUTOMATED CLAIMS ADMINISTRATION Date October 22, 1982 This memorandum is to report on the result of my visit to SWIv1D Systems and the Foundation for Health Care in Santa Barbara. I visited with Mr. William Whitmore viewing the subject system from a data processing point-of-view. As you are aware, this system is currently running (and has been now for approximately two years) on a Burroughs small systems processor (81955, 500 KB) and could be run on our computer following a conversion effort. My visit was to answer two questions. 1. How involved would a conversion effort be, and how willing would the vendor be to make this conversion? 2. How well constructed is the system; design and programming? I found the following: 1. The conversion effort appeared to be a minimal task and easily feasible, the vendor was clearly interested in the conversion with the assistance of the city's •' staff. 2. I found the system well constructed with the following desirable attributes: a. written in COBOL (our native language), b. uses the state-of-the-art data base management software tool "DMSII", C. running under the data communication software tool "NDL". 4 The system is a large, very involved application with approximately 100,000 lines of code. As well as being an on-line system for the daily input of subscribers and providers for claims adjudication, the system generates such output as: 1. statements for the subscribers (patients), 2. checks to the providers (doctors), 3. check register, 4. form letters to the providers for additional and proper claim handling, 5. form letters to the subscri!,.-rs, 6. plus a number of management i epm ts. NeN t i sage ;abase . . . r' Automated Claims Administration -2- October 22, 1982 The system can also handle Worker's Compensation claims as well as health care claims, and plans are in effect to also implement the handling of liability claims. The only drawback with this system appears to be the $80,000 price tag although it appears that this cost could be offset in less than two years at which time the city should experience a sizeable cost reduction in claims administration costs, maybe$50,000 to $60,000 a year depending on claims staffing. I highly recommend the implementation of this system. JB:ms cc: Edward Thompson Rich Barnard YO a r CITY OF HUNTINGTON BEACH REQUEST FOR BUDGET APPROPRIATION REVISION DEPARTMENT REQUESTING TRANSFER ADMINISTRATIVE SERVICES DATE 1/28/83 DIVISION INSURANCE & BENEFITS FUNDS TRANSFER FUNDS TRANSFER FROM INTO Account Account Account No. Description Amount Account No. Description Ammunt Unappropriated 0302 F 30,397.00 86 161 Retirement 4 4 .o0 86 162 Workers Comp. 2 .00 867163 Ins. Employee 2 6o6.00 867165 Jnemployment 27.00 867662 ui /Data Proc. 81 900.00 T I Total 119,900.00 Total119 900. Justification: Transfer needed to establish the' Claims Processing section of the Insurance and Benefits Division. *Approvals/Dates: 1. Department Head Date 2. Director of Finance Date 3. City Administrator Date 4. Mayor Date * If between departments, requires Approval 1-4. If within department, requires Approval 1-3. FH CITY OF HUNTINGTON BEACH INTER-DEPARTMENT COMMUNICATION HUNTINGTON BEACH To Charles W. Thompson From F. B. Arguello City Administrator Chief of Administrative Services Subject Funding for Conversion to In-House Date January 20, 1983 Administration of City Funded Medical/ Workers Compensation Claims FIR # 83-30 In response to the recommendation of the Administrative Services Department, a Financial Impact Report has been prepared and submitted relative to the requested appropriation for purposes of acquiring the necessary equipment and hiring adequate personnel thus enabling the City to assume in-house administrative capability over the self insured medical/workers compensation programs. It has been estimated that the annual expense of the two employees will be $38,000 while the one-time purchase acquisition of computer software would cost out at $81 ,900. Adequate funding is available in the unappropriated Self Insurance Employees Medical Fund. An affirmative response by the City Council will reduce the unappropriated balance in that fund to $1 ,113,016. '�X-44JA&4C/_ZX F. B. Argueliq Chief of Administrative Services FBA/AR/cg CITY OF HUNTINGTON BEACH FINANCIAL IMPACT REPORT Project Name In-House Admi istration for W,nrkers ropencatiop Claims Description Requested funding for this proiect 1 . DIRECT PROJECT COSTS 1 . 1 One-Time Costs Land Furn. , MITI- Acquisition Construction ties, E ui ment. Other Total Cost 81 o0 81 0 1 .2 Recurring Annual Costs —Additional Materials OulFside Payroll Personnel supplies Services Revenues Total Cost 38,000 -o- 38,000 1 .3 Replacement/Renewal Costs N/A 2. INDIRECT COSTS Loss of interest earnin2 capability due to expenditure of funds. Financial Impact Report Page 2 3. NON-DOLLAR COSTS N/A 4. BENEFITS TO BE DERIVED FROM THE PROJECT As advanced by the requesting department and reaffirmed by the consultant engaged to study the City's overall risk management program, it is possible 'to save con- siderable money and provide better claim service by converting to an in-house claims administrative capability as opposed to the present practice of contracting out for such services. 5. PROJECT USAGE Daily. 6. EXPENDITURE TIMING �SubSPquPnt to r i tu, CQuncil anlaroyal . 7. COST OF NOT IMPLEMENTING THE PROJECT The City would retain the option of continuing its long term policy of contracting out for this function, or may choose to lease outside claims administrative service on a time share basis. ' REQUES f FOR CITY COUNCIL ACTION Date April 8, 1982 Submitted to: Honorable Mayor and City Council Members GGtl 1vZ, Submitted by: Charles W. Thompson, City Administrat Prepared by: Frank B. Arguello, Chief - Administrative Ser e's Subject: Appropriation to the Self Insured Employee Me Plan. Statement of Issue, Recommendation,Analysis, Funding Source, Alternative Actions, Attachments: STATEMEW OF ISSUE The Self Insured Employee Medical Account is in need of approximately $260,000 to satisfy incurred liability and expected expenses through the end of the fiscal year 1981-82. RECON VINDATION Appropriate $260,000 from the Fund Balance (H301) into the self insured employee medical expense budget. ANALYSIS For the fiscal year 1981-82, $810,000 was budgeted for the employee medical plan which was broken down into $750,000 for medical claims and $60,000 for Blue Cross administrative costs and stop loss insurance. On 11/1/81, the second anniversary of self insuring employee medical benefits, Blue Cross prepared a report which projected that the City would spend $926,203 in expected paid claim. Additionally it should be noted that the 1981-82 self insured employee medical account budget is 6% lower than the 1980-81 actual expenditures. As all employee medical claims are submitted in the strictest confidence, there are no specific examples available to cite which would attribute to the drain of funds other than the ever escalating medical and hospital costs. FUNDING SOURCE Self Insurance - Employee Medical Fund balance ALTERNATIVE ACTION Do not approve the appropriation. All present liabilities and incurred expenses will not be paid until the start of the new fiscal year. Another alternative is to explore and research the feasibility of self administering the employee health plan in attempts to reduce the administrative service costs. /I. PIO 4/81 0 Fjfl CITY OF HUNTINGTON BEACH INTER-DEPARTMENT COMMUNICATION HUNTINGTON BEACH To From Charles W. Thompson F. B. Arguello City Administrator Chief of Administrative Services Subject Date Request for increased April 8, 1982 appropriation to the Self Insured Medical Fund for FY 1981-82 FIR # 82-17 In response to the Administrative Services Department, a Financial Impact Report has been prepared and submitted relative to the necessity of increasing the appropriation in the City's Self Insured Employee Medical Fund for FY 1981-82 to accommondate the unexpected drain of funds through paid claims. It has been suggested that an increased appropriation of $260,000.00 would be adequate for this purpose. Adequate monies are available in the Self Insured Employee Medical Fund balance. Shoul.d the City Council approve this appropriation, the balance in the fund will be reduced to $119,228.00 F. B. Arguello Chief of Administrative Services FBA/AR/sm Z CITY OF HUNTINGTON BEACH FINANCIAL IMPACT REPORT Project Name Appropriation to the Self Insured Employee Medical Fund Description Request for increased appropriations to adequately fund the unexpected extent of medical claims through the end of Fiscal year 1981-82. 1 . DIRECT PROJECT COSTS 1 . 1 One-Time Costs Land urn. , aci i- Acquisition Construction ties, Equipment Other Total Cost 260 000 260 On 1 .2 Recurring Annual Costs Additional Materials r; - -Out-side .Payroll Personnel Su lies Services Revenues Total Cost L .L 21 -0- 1 . 3 Replacement/Renewal Costs N/A 2. INDIRECT COSTS Loss of interest earning potential due to expenditure of funds. Financial Impact Report Page 2 3. NON-DOLLAR COSTS N/A 4. BENEFITS TO BE DERIVED FROM THE PROJECT Allow for the timely payment of present liabilities and incurred PxnPncac and notjeopat41ize the City's positive credit rating with Blue Cross . 5. PROJECT USAGE Daily 6. EXPENDITURE TIMING Upon the approval of the Council , the funds would be immediately available to satisfy all respective claims. I 7. COST OF NOT IMPLEMENTING THE PROJECT In that present liabilities/incurred expenses would not be paid until the next fiscal year, City employees utilizing the Blue Cross umbrella might be required to advance full payment for current medical coverage. 0 h c•es REQUEST FOR CITY COUNCIL ACTION Submitted by warren G. Hall Department Treasurer Date Prepared September 21 , 1979 Backup Material Attached X© Yes No Subject APPROVAL FOR ISSUANCE OF CERTIFICATE OF SELF INSURANCE AND INnFMNIFIC',ATION City Administrator's Comments PP OVE AS R COMMENDED ` CITY LBR Statement of Issue, Recommendation, Analysis, Funding Source, Alternative Actions: Statement of Issue: In the past, the City's Insurance Broker was called upon to issue to entities.that the City wished to indemnify a Certificate of Insurance. Since we are self insured for one million dollars, this task must be accomplished by the City. Recommendation: The Recommendation is two fold: I. That City Council approve the two indemnifications attached. a. Coast Community College District, Certificate of Insurance for $1,000,000 :See including indemnification and hold harmless for City function on District Ndi✓,Lv-�l properties. b. State of California, General Liability Insurance Certificate regarding the , " lease/use of Office Emergency Services Engine 127 (State Fire Truck.) 2. That the City Council approve the attached resolution regarding self insurance to authorize the Risk Manager to issue such Certificates of Self Insurance under his approval with City Attorney approving the certificate as to form and the City Clerk attest the signatures. Analysis: The recommendation is made to relieve the Council Agenda of ministerial acts, such as approving miscellaneous insurance coverages, and causing delay in the execution of normal City business to require each item to be prepared and wait for the next Council Meeting which is often a period of three weeks including agenda lead time. Funding: No funding is required as all insurance amounts issued would be "normal business" items. Any unusual requirement would administratively be submitted for City Council approval. Alternative Actions: Submit each item as an agenda item for City Council approval. Per City Attorney's letter (dated August 9, 1979) attached, all indemnification will be submitted individually. CITY OF HUNTINGTON BEACH INTER-DEPARTMENT COMMUNICATION HUNTINGTON BEACH To City Treasurer/Risk Manager From City Attorney Subject Risk Manager' s Approval of Date 9 August 1979 Certificates of Self-insurance and Indemnity Agreements--Resolution There is no problem in your being authorized to issue certificates of self-insurance. However, as we read Charter Section 613, there is no way in which the Council can delegate the power to you to bind the city without its approval (see Charter Section 613) by issuing indemnifi- cations. The attached resolution is approved as to form, as written, but the language of the RCA should be modified to delete reference to indemni- fication agreement authority. A GAIL HUTT N City Attorney GH:WSA:ahb -1'S Attachments