Travis County Commissioners Court
July 8, 2008
Item 21
Number 21 is to discuss and take appropriate action on recommendation for fiscal year 2009 dental insurance plan.
>> judge, Commissioners.
>> how you doing?
>> we're here to discuss with the court the outcome of an r.f.p. That we released for dental benefits earlier in the year in March or April. We received seven responses. They were evaluated. The top three responses -- respondents were interviewed and we've narrowed the choice down to save guard and met life. For dental benefits. There are three separate plans that they proposed, and the enhanced benefits in the premiums were in line it with what we felt would be beneficial to employees. Cindy has an outline that she's going to discuss briefly with you to indicate what those benefits are and what the premium rates would be.
>> cindy perkington, human resources. On page 3 of your backup, there's a one page side by side comparison of the three plans. And if you are familiar with the current plans, you'll think that this looks almost identical, and it is almost identical. The actual basic plan structure, they met the structure that we have in place now. The dhmo is going to continue to be with safeguard, so there won't be any changes on the dhmo and that's where we have the bulk of our employees, so it will be seamless to them. The dhmo network will remain the same, the cost will remain the same. On the other two plans, the indemnity and the pdp, those are the plans that you can go to any dentist. Those rates have been reduced, the benefits have remained in place, plus we've enhanced the benefits. For example, implants are going to be covered under the pdp and the indemnity plan. The maximum, the 1,500-dollar maximum on those plans remains the same. Both of these plans have a network. You can go in network or out of network f you go in network, the dentist cannot balance bill you. If you go out of network, then you can get balance billed up to the full charge of the dentist. So it's always in your best interest to stay in network for the lowest out of pocket expense. We negotiated anybody that has treatment in progress at this time, such as orthodontic treatment or if you're in the middle of a crown or something like that, they're going to do no loss, no gain, which means that they will coordinate the payment that safeguard has made already perhaps to the payment then that met life will make in the future. So you shouldn't have a problem you have stuff in progress. Dental work is a little bit different than medical insurance because for one thing it doesn't pay for everything, and there are schedules that they pay against. But you can may be midway in something and we didn't want to leave our employees hanging midway in the middle of their treatment. Only thing that our employees will notice different, even on the pdp and the indemnity plan, is that they'll now be using a metlife network instead of a safeguard network on the plans. And the metlife network is much larger, so it was an advantage to the employees to do it this way. I think that most of our employees will not even notice the difference in the contract other than they would maybe want to double-check their providers and make sure that their providers are still participating. If anyone has any suggestions for providers, please let us know and we'll pass them along on the carrier. Dental is 100% employee paid, so there is no county funding going toward this contract.
>> the dhmo will stay with safeguard, as cindy indicated and that is a requirement to stay in benefits in that particular plan.
>> metlife recently bought safeguard, so we're basically getting the best of both worlds. We're getting an expanded network with expanded benefits for a little bit lesser cost and we're able to keep our dhmo like it was.
>> we're asking the court to approve this new contract so that -- new carrier so that the contract can be written and brought back before the court, but we're asking for approval now so that we can prepare to notify employees of what the benefits are for open enrollment that begins July 21st.
>> we only have about a week and a half before open enrollment begins so we need to give its time to get this into the open enrollment system.
>> so someone on the dhmo to say the other plan, the indemnity, and also the pdp plan, when would that go into effect? Would that come into effect in October 1? Would that go into effect at that time?
>> yes, sir. October 1 would be the start of this contract.
>> okay. And if an employee wanted to stay put, this metlife would still be able to carry out the same services as if it was safeguard? In other words, under that particular plan?
>> if someone is in the middle of treatment, they will coordinate the payment of the treatment between the two carriers. They may want to double-check to see if their dentist is a participating dentist under met life. If not, I'm sure that we can work around any serious issues that might come up. But met life's network is larger, so what we're thinking is that most people will be more than covered under their existing providers.
>> if you have ongoing treatment on October 1st, that's going to be covered. No loss, no gain. You will still get the same benefits you had under the prior carrier.
>> where are we on the letter to metlife clarifying Travis County's position as to the situation with metlife and mr. Mitchell?
>> at this point I had referred the letter to barbara wilson, who in turn I think was going to show it to david escamilla for review. And I don't know where we're at at this point.
>> and I have a proposed letter. David's suggestion was that it go to cid for a is suggestion about where to go out for a letter. And if the court wants the letter to go out, we have a letter that explains the provision that mr. Mitchell claims was misinterpreted and limits the letter to just that explanation.
>> judge? I mean, with me being out last week and having gotten several e-mails, I'm sure the rest of the court probably got the same e-mails, I am going to request another week on this thing because I do -- I do want to understand the e-mails. I want to understand -- there obviously is something amiss here or at least with somebody involved in all this. Another week puts us in eight bit shorter time line, but I'm going to ask that.
>> and we would request really advice from attorney on this issue. I know -- I don't really understand the hesitancy on that because this contract is so essential. It hinges on whether we are able to provide these services to the employees or not. My understanding is that the dispute between mr. Mitchell and metlife is theirs, not ours.
>> and this is a purchasing office issue. I think that the resolution can be made by our office in response to metlife and their breaker. The rates issue that y'all are requesting for approval is a separate issue and takes place during the open enrollment period.
>> that was my point. That's why I asked about the time, the effectiveness of this. And then also the time that you have available to get this information out to our employees. I'm concerned about that. And it is in my opinion two separate issues. What we have here now and of course that others is something else. I don't think there ought to be in my opinion folded into what we're doing here.
>> it's very clear in the r.f.p. That -- I believe page 16 states that we don't cover any broker fees, any agent fees, any commission. That's between the agents and the insurance carrier, the dental carrier who is submitting their proposal. Those issue are not any part of Travis County's responsibility to bill between the agent and the carrier. It's always been that way. I understand there are questions that mr. Mitchell has, but those are something that is separate and distinction what we're asking for it to approve, that is the benefits and the --
>> open enrollment begins when?
>> July 21st.
>> I almost said open season.
>> [ laughter ]
>> but you have a month, right? You effectively have a month to open enroll.
>> open enrollment is open for a month.
>> it's not like anybody is pushed for time.
>> well, we really are. It takes a full month to enroll all of our people and get word out to retirees and for them to respond because some have to do it by mail.
>> the issues have been raised that I can discuss in executive session with the court in relation to this matter. And it might be best if we did that whenever y'all are ready to take everything back to executive session. The other thing is that legally we are required to have open enrollment for an entire month. And when we start open enrollment, we have to know everything that we're going to have available for people to enroll on, and it takes a certain amount of time and you will have to get the specifics from them about -- for the programming to be done for -- by its to list an item as an option. And what they've said is if we wait another week, its won't have the time to do that. I'm assuming it's right. I don't know what the exact time frames are on that. They do.
>> that's what I'm understanding also. I think it's pretty significant and important. And if that is the case, there are two separate issues, as I've stated before, but this here is on a time line. And if we need to do something, we need to do it today. But again, I'm hearing what you're saying.
>> I have a question in regards to the two separate issues. One is what's before us today in regard to this agenda item. Is how we vote on this agenda item today or any other day that we decide to vote on it, does it have any bearing -- will it change the status quo ante between mr. Mitchell and metlife?
>> no.
>> well, wait a minute. I don't know that.
>> I understand that. And that's why it would be valuable to take it into executive session.
>> that's not a definitive because it could --
>> I'm asking from a legal perspective does it change the ante between mr. Mitchell and his contractual relationship?
>> two separate deals.
>> let's talk about it in executive session. To my way of thinking when I read something that gives me a conclusory statement, I'm never as convinced as when I get the story behind it. And I think that would --
>> good point.
>> would it be okay with the court -- I'd like for him to come down here. At lunch I'm going to call and say you're asking for this. I want you to come down. I'd like to understand. I'd like for everybody to understand because perhaps there is no relationship.
>> I think after barbara talks to you in executive session, I think it might be clearer.
>> well, it may be, but until I talk to him, I'd like to know really what the issue is there.
>> him being air mitchell?
>> yes.
>> I believe he lives out of state now. That's my understanding.
>> what?
>> lives out of state in georgia, I believe. He has indicated to me in our conversations --
>> he will have to get on a quick flight then.
>> [ laughter ]
>> and then metlife representatives prosecutor dallas. That's where the proposal originated from, from dallas.
>> we consider this very similar to a lot of our other agreements, although the law is a little bit different. But we normally do not get involved between contractors and their subcontractors except on public works they're required to have a payment bond in case they don't get paid, and then we give the surety information to help get paid. Fanned our project is not getting done. But this comes under a different section of the law, but we're treating it in a similar manner. It's between mr. Mitchell and met life. Whatever agreement they had in advance, the r.f.p. Stated clearly that we would not be paying broker fees.
>> well, I have three things to say. One is that whether we like it or not, we have been put into the middle of that dispute. Because I understand that metlife basically said we excluded you because the county didn't want you in there. Now, I know what's in our r.f.p., but I think a letter is necessary in order for us to clear the air to say what our position is. Secondly, it's not like we have 10 proposals and we have to chose one. We only have one. And it's the company that bought the company that provided this service previously. We have known about this situation for months, if not years, that we will need to do this. So we're here at the 11th hour because of our own doing. So my plan would be if we need another week, we take another week. And if we need to direct its to go ahead and start preparing as though met life has the contract, I don't have any problem with that because we have no choice. It will be metlife or no dental coverage.
>> well, we did receive seven proposal responses. Metlife happened to be the highest ranking of the scoring.
>> metlife is the only one before us, right?
>> it's the best proposal.
>> they're the only ones who can start immediately. And they're already here if they bought out the old company.
>> I think a letter needs to go out clarifying our position based on what I've heard from legal and others, and we need the letter to be received by metlife before we take final action on the contract. Whatever influence, leverage, ethical pressure we have, we have to exert it and apply it before we take final action.
>> I want to make it clear for the record that the purchasing office never did advise metlife of them to pull anything from their broker, so whatever metlife has advised -- whatever they have stated --
>> [overlapping speakers].
>> I'm sure the metlife people have their position on it. I'm just saying that I think we have a responsibility to try to clear the air as to what the county policy and positions are. And it's probably clearly worded in the r.f.p., but it's susceptible to different interpretations. It is real simple where we stand and where metlife allegedly represented. And I think we owe it to -- I suggested on the day before July fourth that we ought to do this. And I guess it takes some time to generate the letter. We're talking about a letter with three or four sentences to clarify this.
>> I did prepare it, and -- with your advice you wanted barbara to review it, and she did. And then she --
>> I'm not blaming anybody.
>> I'm not either. I'm just saying that the letter was prepared.
>> we rant and rave about (indiscernible) participation all the time. At some point in time it seems that our actions have to be consistent with what we give.
>> with all due respect, judge, I understand that mr. Mitchell might be a hud firm, but this is not in relationship to our hub policy as far as them using subcontractors. So it's really not a hub issue in a sense either. It's more a broker issue than a hub issue from my point of view.
>> we may well have clean hands as I'm hearing. But we have been dragged into the middle of a messy situation whether we like it or not. And I'm saying that one letter at least as to where we stand with metlife will clear the air.
>> I agree, judge.
>> and that one letter after the fact, though, has a whole lot less influence an that one letter while we're sitting here contemplating when action to take. As to open enrollment, though, I mean, I don't know that we have much choice but to give the word, if we haven't done it already, to use metlife for this dental or no. And I don't see us basically just eliminating all the dental stuff. This one letter would make a whole lot of difference and met life needs to know what our position is and what we'd like to think about situations like this in the future. Maybe it will be a good working relationship, maybe it won't be in the future. But I think we should clarify our position and this letter will do it. We ought to get that letter out today or tomorrow in my view and take action next Tuesday.
>> judge, again, I've had a family emergency. I'm just getting here. We will get this letter signed today. Have y'all -- does the court need to approve this letter?
>> let me suggest that we go ahead and try to go into executive session today, get the letter and then if we can act on it today, if not, we can wait until next week. Are there any comments on the particular prices or services that we are providing? One of the best things about this particular plan, I will tell you, is the ability for employees to get now dental implants partially covered. A dental implant can cost $4,000 each. So it's covered up to $1,500. It's a wonderful benefit. We have not had that benefit before.
>> those implants are both covered by the indemnity and the pdp, correct?
>> right.
>> but it would not be covered by the current plan.
>> so don't go out and have one before October 1st.
>> just be real clear about what is covered by each of the plans so that you choose the right one.
>> right. And staff at hr will be available to sit down with anyone if they're confused because we don't want someone to make the wrong decision.
>> as I stated earlier we're really talking about two separate issues here. There's no doubt I hear what everyone is saying, but we're talking about two different issues. One, we're talking about increasing the coverage for our employees that basically they don't have at this point. And that deals with the pdp plan and the indemnity. Those two options we've never had before. What we need to do is expose the employees to the two new features, two new plans that have not been available to Travis County employees before.
>> actually, we have them available right now --
>> go ahead, I'm sorry.
>> some of the benefits are a little expanded and the rates are less.
>> but the benefit portion of it. And even going into the point of (indiscernible) and a whole lot of other things, 50% costs of the out of pocket costs that would be to the employees. So it has a lot of good features. And I think that the employees of Travis County should be exposed to it in a timely manner to make some optimal decisions. That's my opinion. And of course we did it with two separate issues here, but at the end of the day we need to look at the additional services that the county employees should be available to them.
>> I don't think anybody has any problem with the benefits offer. We do have a problem with them being brought in at one minute before the shootout. The benefits are the proposal. The county lost because of this other issue situation. And it doesn't help that we're set sitting here really on the eve of the beginning of the open enrollment when we're faced with this decision. We have been criticized for that in the past. And so I really think that we should have gotten this earlier. It would help us, I think. So this added pressure doesn't help.
>> I agree.
>> we have to deal with it.
>> we will take this into executive session this afternoon.
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Last Modified:
Tuesday, July 8, 2008 1:51 PM