Loading...
Minutes 07-07-10 MINUTES OF THE BOYNTON BEACH INSURANCE COMMITTEE MEETING HELD ON JULY 7, 2010, AT 2 P.M. IN LIBRARY CONFERENCE ROOM A, BOYNTON BEACH, FLORIDA MEMBERS PRESENT: Pat Sholos, Benefits Administrator Sharyn Goebelt, Director Marylee Coyle, Assistant Director Hanna Matras, Economic Research Analyst Mike Osborn, Blue Collar Union Representative Pete Mazzella, Deputy Director Scott Blasie, Administrator Philip Svehla, Intern Henry Diehl, Union Representative, Police Catherine Cherry, Recording Secretary Tim Howard, Assistant Finance Director Danielle Crissinger, Administrative Assistant Human Resources Human Resources Human Resources Planning and Development Utilities Utilities Code Compliance Human Resources Police Department City Clerk's Office Finance Golf Course Willis Representatives: Renee Schindler, Willis Ms. Goebelt opened the meeting at 2:07 p.m. At the last meeting, Willis was given authorization to negotiate with Cigna. The purpose of this meeting was to disclose what was accomplished. A handout reflecting the revised plan was distributed. Renee Schindler, Willis representative, announced they negotiated removing the in network deductible completely. The $15 co-pay for primary care visits would remain, as would the $25 co-pay for the Cigna Condensed Network (CCN) in-network specialist providers and the $30 co-pay for the out-of-network specialty providers. Wellness and preventive care was covered 100% after the applicable physician co- pays. Tests such as mammograms, colonoscopies, PSAs for men, and well-women exams would be covered as long as they were taken for wellness and not diagnostic purposes. Since Cigna eliminated the plan deductible for the hospital services, if a participant was admitted they would not have to pay the deductible and they would eliminate the separate co-pay. If admitted to an in-network hospital, the employee would only be responsible to pay 20% of the contracted amount, capped by the $2,500 maximum. The plan would run on a plan year commencing October 1, 2010, not a calendar year. 1 Meeting Minutes Insurance Committee Boynton Beach, FL July 7, 2010 Although employees were encouraged to use an in-network hospital, if they were admitted to a non-contracted hospital, there was still the $500 deducible, but employees would not have the additional co-pay. Outpatient hospital services were now a $100 co-pay plus the 20% co-insurance. There were some outpatient facilities that would be less expensive. Ms. Schindler explained to the committee that if employees had to go to a hospital outpatient facility for services, it would be processed as a hospital visit, and not an outpatient visit. The employee should ensure the facility was contracted for outpatient services. Ms. Goebelt agreed to put the information on the shared drive. Emergency Room visits had a $100 co-pay in or out-of-network and there was no deductible that applied. Urgent care facilities, in or out-of-network had a $50 co-pay, but if an out-of-network center was used, the employee would be responsible for the deductible. Diagnostic lab and x-ray tests done in the physician's office would be no charge and was covered under the office visit co-pay. The diagnostic lab and x-rays done at a participating free-standing facility (not a hospital) were no charge. If an employee went to the hospital for the diagnostic tests, the employee would be responsible for 20% of the contracted amount and it would be a great deal more money. The major services, such as Pet Scans, CT scans, and MRls would have a $50 co-pay regardless of whether it was at a hospital or freestanding facility, plus 20%. Ms. Schindler strongly urged the employees to check the various facilities because the co- insurance could vary significantly from facility to facility. Ms. Goebelt explained the plan would be presented to the City Commission on July 20, 2010. She also explained there would be mandatory open enrollment and employees would have to sign a form acknowledging the change to Cigna. The following comments were received: :;... Emergency Room visit co-pays covered all the services for both the in and out- of-network visit. It was clarified Emergency Room visits were for a life threatening emergency. If an employee used the Emergency Room for very minor non- emergencies, when the claim comes through, the carrier has the right to not pay that claim. :;... The Gap plan was off the table. :;... Co-insurance was the cost sharing with the insurance company and the employee. In-network, Cigna would pay 80% and the employee would pay 20% 2 Meeting Minutes Insurance Committee Boynton Beach, FL July 7, 2010 with no deductible. Out-of-network would have a deductible and could also allow for balance billing. :;... The plan was the Cigna Open Access plan. The key phrase to use when determining where to go for service was to ask "Are you contracted with Cigna?" not, "Do you accept Cigna?" It was noted the Employee Assistance Plan was a contracted provider with Cigna. :;... Participating physicians could be located online. Directories were available but Ms. Schindler pointed out that by the time they go to print, they were outdated. :;... If an employee uses a contracted doctor from a group practice and was seen by another non-contracted doctor from the group because their doctor was unavailable, the doctor's office should file the insurance paperwork from the employee's contracted doctor. :;... There were some specialists on the plan what were contracted by area based on need. :;... The City had originally budgeted for a 30% increase and Cigna only required a 10% increase. Ms. Schindler also announced in addition to the better plan benefits, Cigna set aside $35,000 in a fund for the City of Boynton Beach to use towards wellness whether it was towards incentives or education. There was discussion that perhaps the committee could develop some type of a plan to motivate employees or reward them. One example of an incentive could be for everyone to complete a health-risk assessment. Another example was the City of West Palm Beach has a group of doctors that speak to the employees. The Commit2BFit@Phase II series was beginning on July 13, 2010. All were encouraged to attend; it is an hour long and was free. The speaker would be a nutritionist. There was discussion there were employees or dependents having health issues that were continuous such as a pregnancy, employees with a chronic long-term malady that were in treatment and must continue treatment, or those undergoing treatment for cancer that could be affected by the change in carriers. There was discussion that often, the employee is required to redo the tests; however, Cigna offered "continuation of care" if the requirements were the same as the other carrier. The employees would have to file a form which would be available at open enrollment. The records would be provided and the form would be assessed by the carrier to avoid duplication of services. Similarly, for employees in the STEP Therapy program, if the requirements were the same with Cigna, they would be grandfathered in. If there was a Cigna contracted provider who could continue the care, Cigna, most likely, would require the employee continue the care with their provider. 3 Meeting Minutes Insurance Committee Boynton Beach, FL July 7, 2010 Ms. Goebelt explained staff was looking to the Committee for help with the changeover. She acknowledged change was difficult and not all employees would be happy. She requested the members discuss it with the employees and let the City know the best way to roll out the plan. It was noted the plan was a one-year plan, not a multi-year plan. The dental and vision plans would not change. The City received a 10% discount for Life Insurance and Accidental Death and Disability and a 5% discount for long-term disability. Ms. Goebelt explained all of the bargaining agreements indicate the City would pay for the insurance. The only issue was from the Firefighters' Union. Ms. Goebelt met with them and they would provide their answer prior to July 20th. The members were polled regarding their recommendation for health Insurance. There was unanimous agreement to go with the Cigna revised Option 2 plan. Ms. Schindler would contact Cigna regarding the exact percentage increase as there appeared to be a miscalculation on the figure, which was thought to be a rounding issue. Ms. Goebelt would meet with the Fire and Police Departments regarding the best way to roll out the plan. There being no further business to discuss, the meeting ended at 2:54 p.m. {! Catherine Cherry Recording Secretary 071210 4