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Productivity Committee Employee Benefits Subcommittee Minutes 10/18/2004 Employee Benefits Sub-Committee Minutes October 18,2004 Helen Philbin opened the meeting at 2 p.m. Committee members present were Celia Fellows, Joe Swaja, Dex Groose. Excused: Syd Blum Staff present were Jeff Walker, Risk Management; Len Price,Administrative Services Division; Amy Lyberg, Human Resources and Debbie Wight,Assistant to the County Manager. The minutes of March 31, 2004 were reviewed. The spelling of Alice Toppe's name was corrected. A motion to accept was made by Dex and seconded by Celia. Approved unanimously. The minutes of July 7,2004 were reviewed. The spelling of Alice Toppe's name was corrected. A motion to accept was made by Dex and seconded by Celia. Approved unanimously. The minutes of August 18, 2004 were reviewed. The spelling of Alice Toppe's name was corrected. A motion to accept was made by Dex and seconded by Helen. Approved unanimously. The minutes of September 9, 2004 were reviewed. The spelling of Alice Toppe's name was corrected. A motion to accept was made by Celia and seconded by Helen. Approved unanimously. Jeff Walker was asked about the differences between the plan the County now has to administer health benefits and what a group such as Blue Cross/Blue Shield could offer. He explained that we work with Douglas Ley, and Actuarial for Willis, a firm that does consulting and conducts studies in the health field. They are also a brokerage firm and negotiate the fees with our doctors and also with firms such as Blue Cross. They are on a set annual fee with the County. No additional commissions are paid. If Blue Cross/Blue Shield were to administer our program their fees would be 80 to 100% higher than they are now. Health Reimbursement Accounts (HRA) and Health Savings Accounts(HSA)were discussed. They are similar in concept. Funds are deposited in an employee's account by either the employee or employer, which may be used to pay for non-covered services such as deductibles. These funds are pretax which provides an advantage to the user. The deductible is lower in an HRA but the monies not expended during the year do not roll over to the following year. There is no requirement for a drug plan to be included which gives the employer more flexibility in providing or not providing such services to employees. It was noted that in the plan the County has the employee contributions are not pretaxed and are eligible to be rolled over. In an HSA a high deductible is mandatory and the funds not expended during the year roll over to the next year. When an employee leaves a firm the account is portable and can be added to an account at a new employer. Upon retirement unexpended monies can be rolled over into an IRA. HSAs require a drug component be built into the plan. Collier County offers HRAs to its employees. However,most employees do not benefit. The average age of employees in Collier County is 47 and this group is not likely to change to an HSA. They are the group that avails itself of medical services the most and by and large prefers the fee for service plan. The County offers a drug plan paying a percentage of the cost, which is dependent on whether a prescription is for a brand name or a generic. As an example,the county offers to cover over the counter medicines Prilosec and Clariton,which are identical to Nexium and Clarinex that require prescriptions and are far more expensive. They offer and encourage generic substitutes. There is also a mail order plan for maintenance drugs that is 20 to 30% less expensive. Another effort by the County to reduce costs is to join the Central Coalition of Florida, which monitors the quality of doctors and rewards doctors who have a high performance record with a higher fee. Doctors who under perform are cautioned and can be dropped from the plan until they improve services. Jeff Walker was asked to set up a meeting with Douglas Ley and the committee. A possible date is November 3, 2004 at 9:30 a.m. Jeff will let Debbie know if this is an acceptable arrangement with Mr. Ley. Meeting adjourned at 3:10 p.m. Respectfully submitted, Helen Philbin