Joint Insurance Committee

By The City of Oklahoma City Office of the City Clerk at 10:38 am, Feb 26, 2025 THE CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE Joanna McSpadden Isaac Locke Jeff Cooper Donna Skidmore Larry Slaff Phil Smith 420 W Main Ste 110, Oklahoma City, OK 73102 Basement Conference Room March 5, 2025 8:30 a.m. It is the policy of the City to ensure that communications with participants and members of the public with disabilities are as effective as communications with others. Anyone with a disability who requires an accommodation, a modification of policies or procedures, or an auxiliary aid or service in order to participate in this meeting should contact the ADA Personnel Department Coordinator at 297-2861 or TDD 297-2020 as soon as possible but not later than 48 hours (not including weekends or holidays) before the scheduled meeting. The department will give primary consideration to the choice of auxiliary aid or service requested by the individual with disability. If you need an alternate format of the agenda or any information provided at said meeting, please contact the ADA department coordinator listed above 48 hours prior to the scheduled meeting.  CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE AGENDA and MEETING NOTICE DATE: March 5, 2025 TIME: 8:30 a.m. PLACE: 420 W Main Ste 110, Oklahoma City, OK 73102 Basement Conference Room AGENDA: I. Call to Order II. Approval of Minutes A. September 4, 2024 III. Information from Vendors IV. Information from Employee Benefits Division A. Plan Performance  AGENDA ITEM II. Approval of September 4, 2024 Minutes  CITY OF OKLAHOMA CITY JOINT INSURANCE COMMITTEE MINUTES September 4, 2024 The Joint Insurance Committee meeting was held on September 4, 2024 at 8:30 a.m. in the City Municipal Building, 420 W Main, Ste 110 Basement Large Conference Room Those in attendance were: Members Present: Donna Skidmore, Retiree Member Isaac Locke, AFSCME Representative Jeff Cooper, FOP Lodge 123 Member Phil Smith, Citizen Member Larry Slaff, Citizen Member George Fina, Citizen Member Members Absent: Joanna McSpadden, City Manager Designee Staff Present: Jason Long, Total Rewards Manager Richard Mahoney, Asst Municipal Counselor III Taylor Atherton, Benefits Systems Specialist Lolly Landgraf, Sr. Human Resources Analyst I. Call to Order Jason Long, called to order the Joint Insurance Committee Meeting at 8:33 AM II. Approval of Minutes The minutes of the June 5, 2024 meeting was approved with no objection.  III. Information From Vendors IV. Information from Employee Benefits Division Lockton presented plan performance through June 2024. Review minutes from previous meeting Motion to approve minutes- Donna Skidmore & Second - Phil Smith Mr. Long asked if there were any questions - none were asked. Ms. Young reviewed plan performance materials. Ms. Young indicated the EPO and PPO combined loss ratio is at 91% Mr. Long stated one of the claimants over $300k are on COBRA and should fall off in a couple months. Mr. Long indicated the "old" HMO was fully insured. The 2024 EPO plan is self funded - which in turn means the City is no longer paying United Healthcare profits. Ms. Young indicated that the medical and pharmacy cost details are right in line with the 50/50 split Mr. Fina asked if prescription savings are out there yet. Ms. Young Yes, but are a wash as rebates are going away. Yet, still cost savings on diabetic prescriptions. Ms. Young shared the rolling (paid plans by month) 12 month trend analysis for actives. Ms. Young stated we are seeing the annual cost per employee decrease with implementation of the EPO plan Mr. Slaff asked what is the monthly premiums plan cost share by the City. Mr. Long replied, the PPO is a 80/20 split and the EPO plan is 85/15 split. Mr. Slaff asked what is the timeline to qualify for benefits. Mr. Long stated if hired after 2017 NO health benefits are offered as a retiree. Ms. Young reviewed the Individual Stop Loss Renewal for 2025 slides. Mr. Long stated that our Stop Loss at $300k is significantly lower than other competitors in the market. Mr. Mahoney as what are our reserves and what other cities are self-funded? Ms. Young stated she does not have the numbers with her, but can bring what our reserves are and what other cities are self-funded to the next meeting. Mr. Mahoney said he would like that. Mr. Long mentioned he would like the JIC to be involved in the Stop Loss discussions or definitely have a voice. Mr. Long spoke of 2025 Open Enrollment and asked the committee if they wanted to see anything for the December meeting and there was no responses. V. Citizens to be heard VI. Items from Committee Members VII. Adjournment Mr. Long adjourned the meeting at 9:11 A.M.  AGENDA ITEM III. Information from Vendors  AGENDA ITEM IV. Information From Employee Benefits Division A. Plan Performance City of Oklahoma City Joint Insurance Committee March 2025 LOCKTON COMPANIES | 1 Agenda 01 Health Plan Performance 02 Pharmacy Trends 03 Clinic and EAP Performance & Utilization 04 Wellness and Plan Perks 05 Current Developments LOCKTON COMPANIES | 2 Health Plan Performance 2024 Plan Year (January – December) Executive Summary • On an all-plans combined basis; the plan is running at 94.2% loss ratio (funding vs. expenses). • The Active EPO plan is running with YTD expenses to budget/accrual ratios of 82% while the PPO Plan is running at 114.9%. The Retiree plans are running at 124.7%. • Projected Per Employee Per Year (PEPY) cost is $18,706 (in December 2023, it was $18,352). • Enrollment increased 2% from the prior plan year. • Plan had 129 claimants over $100k year to date, 11 of those claimants were in excess of the $300k stop loss level. • City of Oklahoma City will receive an estimated $1,792,897 in stop loss reimbursements LOCKTON COMPANIES | 4 Enrollment Overview – All Active and Retirees LOCKTON COMPANIES | 5  Rolling 12 Month Trend Analysis - All Plans Rolling 12 Enrollment Enrolled Paid Claims Gross Medical SL Gross Rx Total Net Rolling 12 Total Net Claims Enrolled Month (1) Employees Month Claims Paid Reimbursement Claims Paid Claims Net Claims PEPY Employees(1) Dec-23 4,822 57,286 Jan-24 $2,528,917 $0 $2,239,205 $4,768,156 $87,491,198 $18,327 Jan-24 4,834 57,403 Feb-24 $3,572,855 $0 $2,675,145 $6,248,249 $87,109,797 $18,209 Feb-24 4,836 57,537 Mar-24 $3,755,898 $0 $3,222,262 $6,978,667 $86,228,354 $17,983 Mar-24 4,866 57,666 Apr-24 $4,795,566 $0 $2,969,205 $7,764,916 $86,737,401 $18,048 Apr-24 4,878 57,808 May-24 $4,111,277 $81,259 $3,709,899 $7,741,515 $86,799,386 $18,016 May-24 4,890 57,945 Jun-24 $3,928,479 $131,454 $3,067,282 $6,865,473 $86,335,266 $17,878 Jun-24 4,889 58,078 Jul-24 $4,158,574 $88,884 $3,049,804 $7,119,895 $86,152,948 $17,800 Jul-24 4,875 58,180 Aug-24 $7,678,944 $270,146 $3,902,399 $11,311,234 $89,053,298 $18,365 Aug-24 4,873 58,247 Sep-24 $4,913,895 $331,962 $3,158,818 $7,741,032 $89,297,285 $18,397 Sep-24 4,896 58,325 Oct-24 $5,723,245 $148,382 $3,109,649 $8,684,966 $90,430,849 $18,603 Oct-24 4,926 58,417 Nov-24 $4,308,158 $321,291 $4,076,525 $8,064,724 $90,661,594 $18,620 Nov-24 4,941 58,526 Dec-24 $5,300,163 $419,519 $3,076,288 $7,957,074 $91,245,902 $18,706 (1) Enrollment is set back 1 month to reflect claim lag. • City received an estimated $1,792,897 in stop loss reimbursements for 2024 $23,372,291 25% • City’s average per employee per year (PEPY) over the last 12 months is $18,246 $69,666,508 75% Paid claims over $100,000 All other paid claims LOCKTON COMPANIES | 6 Per Employee Per Year (PEPY) Year Over Year Comparison Prior PEPY Current PEPY Jan $17,924 $18,327 Feb $18,106 $18,209 Mar $18,256 $17,983 Apr $18,417 $18,048 May $18,674 $18,016 Jun $18,961 $17,878 Jul $18,911 $17,800 Aug $18,675 $18,365 Sep $18,756 $18,397 Oct $18,747 $18,603 Nov $18,876 $18,620 Dec $18,868 $18,706 LOCKTON COMPANIES | 7 Performance Overview – All Active and Retirees LOCKTON COMPANIES | 8 Performance Overview – Actives Only LOCKTON COMPANIES | 9 Performance Overview – Retirees Only LOCKTON COMPANIES | 10  Pharmacy Trends Data through Q3 (January - September 2024) Executive Summary Pharmacy Plan • Membership and plan costs are up, but total cost Per Member Per Month (PMPM) is down 20% • This is primarily due to a significant increase in membership following the discontinuation of the fully insured HMO plan, which led to increased enrollment in the self-funded plans • The highest PMPM expenditure is on diabetes medication, with a cost of $89 PMPM • Pharmacy Services Performed • Quarterly reporting • Rebate Reconciliation • RFP support and negotiations LOCKTON COMPANIES | 12 Pharmacy Plan Overview Average Membership Total Cost PMPM Specialty Total PMPM Total Plan Cost per Month $28.5M $297 $124 10,678* -$73 -$17 +$14,269k +6,397* -20% change -12% change 100% change +149% change* Lockton Norm: $152 Lockton Norm: $77 * 1/1/2024 there was an increase in members due to the transition of the fully insured HMO plan population moving to the self-funded plans. LOCKTON COMPANIES | 13 Pharmacy Trend Factors LOCKTON COMPANIES | 14  Clinic and EAP Performance & Utilization  Q3 Clinic Metrics Clinic Performance (July – September 2024) 873* 41%* Members Members with OBSERVATIONS & OPPORTUNITIES Engaged 1+ Visits 1,403* 93.3%* MEMBER EXPERIENCE Primary Care Provider Utilized • 15.4% Canceled Appointments (exceeds Visits Available Capacity benchmark 10%) • 5.6% no shows (exceeds benchmark 5%) • 53.3% Same Day Availability (3% 87* 2.6 min* reduction from prior period due to clinic operating above optimal capacity) Net Promoter Wait Time Score 129* 5,144* CLINICAL QUALITY Prescriptions Prescriptions Sent • Anxiety Disorders were in the top diagnosis by member with 167. dispensed Onsite to Homes 1,425 CARE MANAGEMENT Total Visits • Open Position in Q3 - lost CM candidate 9% decrease from prior period in Oct due to part time role. This is due to a decrease in Care Management RN visits, PCP visits are up 1% *Exceeds or improved from prior period stats LOCKTON COMPANIES | 16 Q3 Clinic Summary LOCKTON COMPANIES | 17 Q3 Clinic Pharmacy Summary LOCKTON COMPANIES | 18 EAP Engagement LOCKTON COMPANIES | 19 Wellness and Plan Perks UHC Medicare ADT Plan Perks Gym & Fitness Let’s Move by UHC Memberships UHC Renew Rewards Let’s Move by UHC is a health and wellness program designed to help keep you active. Silver Sneakers is a UHC fitness benefit that Simple resources include: Earn rewards on a reloadable Visa reward includes: • Recipes, cooking events, and meal prep card at the completion of certain wellness • Free membership and access to group support activities such as: exercise classes • Free access to at-home workouts, online • Classes to get active outside of classes and local fitness events • Annual wellness visit traditional gyms • Financial wellbeing support • Breast cancer screening • Virtual resources to support through • Online Mental Health resources • Colorectal cancer screening SilverSneakers LIVE, SilverSneakers On- • Online events, classes and volunteering • Osteoporosis screening Demand, and SilverSneakers GO Fitness • Caregiver resources and referrals • House Calls visit App Value Adds Recovery Vision & Hearing House Calls Virtual Visits Assistance Benefits • No cost annual vision • Meal delivery • Medical care visits to treat exam • One-way rides to minor illnesses and Annual in-home visit from • Annual eyeglasses or medically related ailments one of UHC’s licensed health contacts allowance appointments and to the • Behavioral Health visits to care practitioners at no • 50% off hearing exam pharmacy treat addiction, additional cost. • Hearing aid allowance • Non-medical personal depression, trauma and every 3 years care loss, stress or anxiety LOCKTON COMPANIES | 21 BCBS Plan Perks Well OnTarget Wellbeing Management Women’s & Family Health Well OnTarget is a fitness program that BCBS provides the following tools as part of BCBS provides women’s and family health offers flexible options and access to a the health plan: support at no extra cost. Program includes network of fitness locations. Other features • Mental health digital programs for stress, access to: include: depression, panic, resiliency and more • Ovia Health – for tracking your cycle and • Online enrollment tracking • Help managing diabetes, high blood menopause support • Choice of gym networks and studio pressure, or joint and spine pain • Ovia – Predict when you are more likely classes • Weight loss and metabolic health to get pregnant • Mobile app programs • Ovia Pregnancy – Monitor your • Access to thousands of digital fitness • Support with fertility, menopause, pregnancy and baby’s growth week by resources and live classes pregnancy and parenting week leading up to your baby’s due date. • Weekly Blue Points for regular visits • 24/7 Nurse Line • Ovia Parenting – Keep up with your • Low monthly fee child's growth and milestones. Virtual Visits Blue Access for Members BCBS Mobile App for Rx • Available online and through the • Compare drug costs at different • Medical care visits to treat minor mobile app pharmacies illnesses and ailments • Check coverage • Find available lower-cost drug • Behavioral Health visits to treat • View claims options addiction, depression, trauma and • Find a network provider • Chat with a pharmacy customer loss, stress or anxiety • View EOB’s service representative • Access your ID Card LOCKTON COMPANIES | 22 Current Developments Current Developments On the Calendar STRATEGIC AND FINANCIAL ENGAGEMENTS Quarterly updates with BCBS WITH KEY PARTNERS Quarterly pharmacy plan review with Excelsior Quarterly JIC Meetings Annual strategy and financial meeting with Lockton 2025 Meetings are ongoing Weekly touch points with Lockton’s core team RFPs MARKETING Near Site Clinic Target date for release is late March In 2025 the City of Oklahoma City implemented Bidnet, a new electronic bidding system that replaces Dental Plan Bidsync. 2026 marketing prep is in progress. Target date for release is late March Exploring opportunities to improve current benefits or add an enhanced plan option ENHANCING EMPLOYEE EXPERIENCE Opportunities BCBS wellness perks for enrolled population Explore engagement opportunities with carrier partners UHC wellness perks for enrolled Medicare ADT population Create an education campaign for employee wellness AWP resources for active population LOCKTON COMPANIES | 24 Appendix MAPD Retiree Plan Information Register for your secure personal online account at retiree.uhc.com Follow these easy steps to register for your secure and personal online account: Visit the website and click on the Sign In or register After you sign up, button and then click Register Now you can: Enter your information (first and last name, date of birth, • Look up your latest claim information ZIP code, UnitedHealthcare member ID number) and click Continue • Review benefit information and plan materials Create your username and password, enter your email • Print a temporary member ID card address, and click Create my ID and request a new one For security purposes, you will need to verify your • Look up drugs and how much they account by email, call or text cost under your plan • Search for network doctors • Sign up to get your Explanation of Benefits online LOCKTON COMPANIES | 27  UnitedHealthcare mobile app With the UnitedHealthcare mobile app, you can stay on top of your benefits 24/7 anywhere you go. Find care • Find network care options for providers, clinics and hospitals in your area • Talk to a provider 24/7 Manage your health plan details To download the app, • Generate and share digital health plan ID cards scan the QR code with the camera on a • View claims and rewards smartphone or tablet Stay on top of costs • View your copay, annual deductible and out-of-pocket expenses Fitness • Find a gym location Apple and the Apple logo are trademarks of Apple Inc. registered in the U.S. and other countries. App Store is a service mark of Apple Inc.. Google Play and the Google Play logo are trademarks of Google LLC. LOCKTON COMPANIES | 28 MAPD - Renew Rewards Reward Activity Annual Wellness Visit • Rewards are available at the completion of certain Breast Cancer Screening wellness activities on a Colorectal Cancer Screening reloadable Visa® Reward Card. Osteoporosis Screening • If retiree received HouseCalls Visit a Reloadable Visa® Reward Card previously, they should continue using this card in 2025. Reloadable Visa® Reward Card Restrictions: To align with CMS guidelines, members will have some card restrictions. Restrictions include but are not limited to: • Alcohol, Tobacco, and Firearms • Bookstores and Computer Services, including Amazon • Drug Stores, Pharmacies and Wholesale Distributors of Prescription Drugs • Medical Services, Equipment, and Health Care Providers • Insurance Providers LOCKTON COMPANIES | 29 0 Gym and fitness membership SilverSneakers® is a fitness benefit that includes: A free membership and access to group exercise classes* at participating fitness locations** Classes to get active outside of traditional gyms Virtual resources and a support network through SilverSneakers LIVETM, SilverSneakers On-Demand and the SilverSneakers GOTM fitness app SilverSneakers Steps for members 15 miles or more from a participating fitness center. Choose the kit that works best for you: general fitness, strength, walking or yoga. *Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer members additional classes. Classes vary by location. **Participating locations (“PL”) are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities are limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL. Availability of the SilverSneakers program varies by plan/market. Refer to your Evidence of Coverage for more details. Consult a health care professional before beginning any exercise program. SilverSneakers and SilverSneakers FLEX are registered trademarks of Tivity Health, Inc. SilverSneakers LIVE, SilverSneakers On-Demand and SilverSneakers GO are trademarks of Tivity Health, Inc. ©2024 Tivity Health, Inc. All rights reserved. LOCKTON COMPANIES | 30  House Calls brings yearly check-in care to you* Get a yearly in-home visit from one of our licensed health care practitioners at no additional cost to you. The visit includes: Up to an hour of 1:1 time with the health care practitioner Health screenings tailored to you A medication review A chance to get advice and ask questions to help you manage your health A visit summary that is sent to you and your primary care provider Prefer a video visit? House Calls offers a video visit using a computer, tablet or smartphone to connect plan members with a health care practitioner. They will review your health history and current medications, discuss important health screenings, identify health risks and provide health education. *HouseCalls may not be available in all areas. LOCKTON COMPANIES | 31  Extra help recovering with UnitedHealthcare Healthy at Home With UnitedHealthcare Healthy at Home you are eligible for the following benefits up to 30 days following all inpatient and skilled nursing facility discharges*: 28 home-delivered meals when referred by a UnitedHealthcare Engagement Specialist 12 one-way rides to medically related appointments and to the pharmacy when referred by a UnitedHealthcare Engagement Specialist 6 hours of non-medical personal care provided through a professional caregiver to perform tasks such as preparing meals, bathing, medication reminders and more. A referral is not required. *A new referral is required after every discharge to access your meal and transportation benefit. LOCKTON COMPANIES | 32  Get care anywhere with Virtual Visits With Virtual Visits, you can live Virtual Provider Visits may be best for: video chat* with a medical Allergies, bronchitis, cold/cough provider or behavioral health specialist from your computer, Fever, seasonal flu, sore throat tablet or smartphone anytime, Migraines/headaches, sinus problems, stomachaches day or night.** Ask questions, get a diagnosis, or even Virtual Behavioral Health Visits may be best for: get medication prescribed*** and sent Initial evaluation to your pharmacy. All you need is a strong internet connection. Behavioral health medication management Addiction Depression Find participating Virtual Visit providers by logging Trauma and loss in to your member website Stress or anxiety *The device you use must be webcam-enabled. Data rates may apply. This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. **Benefits and availability may vary by plan and location. ***Providers cannot prescribe medications in all states. LOCKTON COMPANIES | 33  Keep your health on track with a $0 Annual Wellness Visit* Combine visits Save time by combining your wellness visit What’s the difference between your and physical into a single office visit. annual physical and wellness visit? A physical exam includes a head-to-toe Schedule early exam, blood sugar test and cholesterol test. Schedule your appointment early in the year to This visit is a good time to review your medications and/or health concerns. Your get any other preventive care you may need. plan covers this visit once per calendar year. A wellness visit includes a blood pressure Follow recommendations check, height and weight measurement and Make sure you follow through with your body mass index (BMI) test. Your plan provider’s recommendations for screenings, covers this visit once per calendar year. exams and other care. Schedule anytime — you don’t have to wait 12 months *A copay or coinsurance may apply if you receive services that are not part of the Annual Wellness Visit and physical. LOCKTON COMPANIES | 34  Vision exam and eyewear* With the vision benefit, you’ll have access to a nationwide network of providers with the freedom to see any participating vision provider. You will have access to an annual routine eye exam through a vision provider and an allowance toward eyeglasses (frame and lenses) or contacts for vision correction not related to cataract surgery. A routine eye exam once every 12 months with a $0 copay $130 allowance toward eyeglasses (frames and lenses), every 12 months $175 allowance toward contact lenses instead of eyeglasses, every 12 months Out-of-network providers may require you to pay upfront and submit a reimbursement claim to UnitedHealthcare The network is UnitedHealthcare Medical Network with information on your UnitedHealthcare member ID card When scheduling your appointment, make sure your vision and eyewear provider(s) will bill the UnitedHealthcare medical plan before receiving routine vision services (routine eye exam and eyeglasses or contact lenses) *Please refer to your Summary of Benefits for details on your benefit coverage. LOCKTON COMPANIES | 35  Well-tuned care for your hearing With UnitedHealthcare Hearing, you can receive a hearing exam and access to one of the widest Save up to selections of prescription and non-prescription hearing aids at significant savings. Plus, you’ll receive personalized care and follow-up support 50% from experienced hearing providers, helping you to hear better and live life to the fullest. To get started and save up to 50% off standard Receive friendly expert advice through our national network industry prices^ with of 6,500+ hearing providers* — or try virtual appointments** exclusive pricing, go online or call Get personalized support to help you adjust to your new UnitedHealthcare hearing aids Hearing. Choose from the latest technology from popular brands including Phonak, Starkey®, Signia, ReSound, Widex® and Unitron Your place includes a $500 hearing aid allowance every 3 years when you use a UnitedHealthcare Hearing provider *Please refer to your Summary of Benefits for details on your benefit coverage. **Select products and providers. ^Based on suggested manufacturer pricing. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider. Provider network size may vary by local market. LOCKTON COMPANIES | 36 Clinic Testimonials Clinic Success Stories LOCKTON COMPANIES | 38 Clinic Member Testimonials LOCKTON COMPANIES | 39 Independence changes everything. © 2024 Lockton Companies. All rights reserved. D: 2859452