Travis County Commssioners Court
June 15, 2004
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Item 25
25. A. Discuss and take appropriate action on recommendations from employee benefits committee on county fy 2005 employee, dependent and retiree health care benefits, including: 1. Establishing a wellness health clinic; 2. Renewal of contract with safeguard dental; 3. Extending the supplemental dependent and retiree life insurance contract with unum; and. 4. Extending the short term and long term disability contract with unum. And, b, consider employee compensation considerations and funding. Norman? Alicia? Cindy? And gang. Start working through these.
>> okay.
>> yes, ma'am. Alicia perez, executive manager for the administrative operations and -- and we will be using the background that we had for you last week. And in that backup, you had a list of recommendations that went one through 11. Where he can go through each of the recommendations, all of them, field any questions that you may have. As the court is aware, we presented last Thursday, there is a committee of employees that works on health care on an annual basis. The community made a presentation, made their report to the court on Thursday. And the first recommendation of the committee was to retain the four options for employee health care, coverage and these are the same one that's we had last year -- one that's we had last year. They include an epo, exclusive provider organization, that pays 100% of major medical health care after $100 deductible for hospital admission. The ppo, perked provider organization, preferred provider organization, which is a 9010 plan with the fund, health care fund, paying 90% of major medical, costs and with a deductible and -- and that -- that particular option allows you also to go out of network with a 70/30 split in terms of payment. The ppo will be of no cost to compleep only. But there will be cost increases in each of the tiers. And then the co-insured epo, which is an 80/20 plan, again no cost to the employee, but -- but it is what we are calling savings plan for -- for employees who want to ensure dependents and -- insure dependents, rx only option for retirees over 65, we provided you with those rates. So that's recommendation number 1. Would you like me to go on?
>> well, question. How does it -- I think alicia is working off of the yellow sheet in terms of both of us for -- in terms of the 11 recommendations, that the security's pleasure to start working down item no. 1 on there, then we will pick up the a 1, 2, 3, 4, the b as we need to.
>> yes.
>> as we get to them.
>> melissa can keep track of this. Item no. 1 in terms of retaining the four options as was laid out by alicia related to the co-pays, deductibles, co-insurance, I would need approval of item 1.
>> second.
>> that's with the understanding that next year we might have to make a change.
>> yes, ma'am.
>> this is for this year.
>> this is for this year. Say for fy '05.
>> next fiscal year.
>> maybe in 2006 there might be a change.
>> yes, ma'am.
>> these are all of the items that are going to be rolled into the hearing that we will have with our employees, so they will then have notice as to what it is that we are considering related to our rates, et cetera. So when I say number 1, I知 meaning recommendation number 1 on the list. Any further discussion? All righty. All in favor? That passes unanimously. On this meeting as well, show judge Biscoe gone until he gets back from his tceq meeting.
>> committee recommendation number 2 is approval of option 3 at the -- as the health care plan for fy '05. If -- if the court recalls, we had several options that had different -- different premiums for both active employees and retirees. Option 3 had an increase in the epo from $40 to -- to $60 and -- and then added $20 for each tier that had an adult in the epo and $10 for each tier has that had a dependent adult and ppo and co-insured epo.
>> that's the one that I would like to move approval.
>> okay.
>> option 2.
>> option 3.
>> option 3. I would second that. I think Commissioner Daugherty you had the most questions about 3. Are you at a comfort zone there? As comfortable as you are going to get.
>> it won by 5-4, it was overwhelming. I mean --
>> it was a landslide, Commissioner.
>> [inaudible - no mic] number 3 is a co-insured epo.
>> option 3 is all of them, just the rate schedule.
>> the rate schedule. Option 3. We will be getting to that one momentarily. So in terms of the rate plan on -- on option 3. There --
>> further discussion? All in favor? That passes unanimously.
>> move approval of that one.
>> all right.
>> to clarify, there was one caveat or proviso by the committee and you may want to -- to address that now or table it. And that is if option 3 is adopted the committee recommends that the difference in funding between one and 3 of approximately $600,000 plus be applied to the employee compensation funds for salary increases.
>> I move approval.
>> well, I would -- I would second that with a different way of saying we take note of their recommendation to the Commissioners court but that would be rolled into their discussions on budget when we get to budget. I think that we would take official note of their recommendation. But no action on it. Is that friendly to the maker? Okay. Moved and seconded related to taking official note of the recommendation related to any savings on option 3. Further discussion? All in favor? Passes unanimously. I will second that the default provision is the co-insured eop, any further discussion? I would like to say, one more time, for anyone that's listening is that all employees need to do open enrollment. They need to complete all 10 steps of the open enrollment process or they will be defaulted to the co-insured epo, employee only coverage and basic life. If anyone needs help with their open enrollment, they need to contact h.r. And we will be glad to help them.
>> also that statement that if we do fall into the default category, referring to the Travis County employees, jeopardizing coverage from the family, you may be covered. However your family members will not be covered if you end up not enrolling in -- falling into default category.
>> that's a very important point.
>> very important. Default coverage is for employee only.
>> right.
>> with all of those provisions, it's been moved and seconded any further discussion?
>> will we get something the -- obviously I know, cindy, how good you are about letting people know this about open enrollment. Did we put something in the payroll?
>> we do a lot of things, Commissioner. Traditionally we do a payroll stuffer. They inundate the workforce with e-mails, we have hard copies, we have announcements, the h.r. Liaisons work with the people in their departments to make sure that the information is given to every employee. We do everything that we can think of -- we do voice mail on the phone system as well. We really want to reach out and touch every single person, know everyone is exempt from this, even if you are a decliner you need to go through all 10 steps of the process.
>> I think when we were going over in the room, that we found that -- I mean you would assume that t.n.r., Because they are people that are out in the field, but -- but I think that we identified that -- that the area that had the largest --
>> [indiscernible]
>> so. , I think we do a good job by getting the word out f. You don't do it, you have really got to be somewhere else.
>> all right. With all of that advice, all of those in favor of the default? That passes by unanimous vote. Okay. Number 4, I think that was kind of getting to where Margaret was.
>> yes, the committee also recommends that employees be informed that the epo plan is not a sound long-term option and may not be an option for health care coverage in the future and the -- the epo, the exclusive provider organization is the insurance that provides 100% major medical costs or pays for 100% major medical costs. All people have to pay is for hospital add make it stance. That particular plan has gotten expensive so it may not be feasible for organizations like Travis County to be able to provide those sorts of plans, rich plans in the future. This is just to inform --
>> that's just information.
>> in the form of a motion, alicia or how do we want to handle this in terms of the --
>> if you would act on it, that would be. Good. We include it in the flier that we send out to employees.
>> > for purposes -- i'd second that for inclusion in the flier related to the long-term future of the epo plan. Further discussion on this item? All in favor? That passes unanimously. Number 5. The.
>> committee recommends approval of a 30 day waiting period for all new hires beginning October 1st, 2004. And that means that individuals coming on board, if they are hired after the first, they would have to -- they would have to then wait for 30 days and then the first of the next month is when they would be eligible. So it would be up to 45 days or more. When they will be eligible for health care [multiple voices]
>> health of the health land.
>> yes.
>> I would second that.
>> is there any further discussion on item no. 5, barbara?
>> to clarify that, the wording would be 30 days after the first of the month after you were hired. So if you were hired on -- on June 2nd, it would be 30 days after the first of July, which means that you would have had 59 days. So the maximum --
>> 59.
>> okay.
>> motion related to the clarification that it's the 30 days following the first of the month after you are hired. Any further discussion? All those in favor? That passes by unanimous vote. The committee recommended establishing a wellness and health clinic within the downtown campus, also provides services to employees in the outlying facilities.
>> on this one it's going to be the same kind of thing that we just discussed on the other one, should the appropriate motion be that we take note of the recommendation to establish the health and wellness clinic, but it actually be -- will be rolled into our budget process and not have a preapproval related to pbo, is that correct?
>> second.
>> my note would be that we take note of the recommendation to wellness and health. Look forward to it at an appropriate discussion. Seconded by Margaret. Gerald, did you have a question?
>> what percentage of -- of the -- somebody covered this I知 sure, the percentage of people that work for the county that would be considered downtown? I would have to get that information for you. I don't have it off the top of my head.
>> my fear on this is that -- is that -- that we are -- we are maybe opening something here that -- that's -- that we are going to have a hard time backing away from. I mean, like -- I expressed my apprehension about -- about the new program that we don't really have much of an exit strategy on this thing, other than just coming up and saying, not doing it anymore, we have got equipment, capital costs that we do. And I -- and I -- I really fear that I -- that I see people coming to us and saying, well, we're not convenient to downtown. So you know what? I mean, we really need to have one, you know, somewhere else. And -- and fighting that fight is -- is something that -- I mean we are going to get into some, we could get into some real expense here at -- I mean, I guess that I didn't hear that there was really no way to -- to limit our -- for -- I mean, if we feel like that this is not working like we thought and that's going to be difficult at best because -- most likely, our health care costs are going to continue to go up and -- unless we drastically change our plan and go to something else because we just can't afford it. I mean, I think that it's -- I think it was nicely laid out by dan. If you read the report, I mean, you know, it's not a bad return on the investment. If -- if we really hit all of these things, then I知 -- I知 very nervous about -- about doing -- doing this program. I mean, adding, we are -- we are adding nurses, we are -- we are adding all sorts of personnel that even though we are somewhere in that with -- with our -- with our health clinics, it's -- to me I mean we really need to -- if we are going to go into this thing, we really need to go into it with our eyes open, with some attention to what happens if we really identify that it's not and if it's -- if we see something, ratchet up, with continued cost.
>> sure.
>> incurred. And I -- I can only hope -- I mean, if I vote for this, here in the next five seconds, I really -- I really want to know that -- that we are going to -- going to be very honest with ourselves and if we find out that we are incurring more cost in this thing that what we think we potentially are getting out of it, that we would have the opportunity -- I know that it's just another vote again, but I would like to at least be on record. I mean I think that people can see that i've got some real apprehension about this thing. I知 willing to look at it because I do think that -- that the basic design of it is something that we ought to offer. You know, our employees and especially given that we know that the health care is just one of those things that -- where we are having a hard time holding on to it.
>> we are not proving it -- approving it today.
>> no. By going through the budget process [multiple voices]
>> our intention is to address your concerns, we will look at the demographics, we will also establish benchmarks at a three to five year period according to the direction of the court. That -- that we will be able to measure on an annual basis the -- the success of -- of the -- of the program. And in indeed during, say, three year period or four year period, five year period, whatever that is, you do not see a substantial return on your investment. That in the plan that we present to you, there is indeed a -- a -- a funding out clause or a -- a decrease, an exit and this -- providing this particular service.
>> I know that what this -- means. I mean it means whenever we do get to vote on it -- if somebody wouldn't mind taking the tape on my excerpt for the last minute and a half so we can replay that again [laughter]
>> slightly different take on that. Because what we have traditionally done related to brand new initiatives, you kind of have to get ill call it preclearance to be able to bring that toward to the actual formal budget hearings that we have in August and September. And there have been a lot of times when we said you know that has merit to discuss that further. Because if we took everybody's great ideas, there just isn't enough money in the worldment but if something interests you enough to say I want to vet that one some more. But we've had some things that have gotten preclearance, they still don't make it, simply because we run out of money or other kinds of things happen. At least for my vote here, this is to say I take note of the recommendation, it is preauthorized to move forward in the budgetary process where we will once again have a very vigorous discussion about the merits and whether there is money to do this and whether that is a priority.
>> the onus is on us to develop those benchmarks of the performance.
>> that's essentially what I was saying.
>> okay. I knew that [laughter] one other thing that I would like to add about that, too, the plan is to do some outreach into the outlying areas, even though the -- maybe the main clinic would be downtown. The plan is to develop sites in -- in some of the outlying areas that the -- that the personnel could visit and deal with things in that area. Such as flu shots or whatever. The schedule hasn't been worked out yet. But we are cognizant that we can't just keep it in downtown campus. So I know that -- that that's part of the plan.
>> do we have a motion yet?
>> okay.
>> looking at examples of this model that is now taking place in other counties. There has been a lot of success using this particular concept. I really don't know the merit of all of this. How do you measure all of it, but if it's to -- to bring about wellness to Travis County employees, I think that it's something that we can visit and go to the budget process and look at. Just not close the door on it if we have an opportunity to -- to have persons to a staff who actually go out and -- and qualified staff, medical staff, to go out and visit with the folks in Travis County as far as employees are concerned. So I just think that it's an opportunity that we can maybe look at in the future.
>> do we have clarity on the motion that this is one of taking note of the recommendation and for it to be moved forward through the budgetary process for yet another view. Is there any further discussion on this.
>> all those if favor, that passes unanimously. This would also probably take care of item a 1, trying to mark off things on the judge's agenda. Item no. 7, please?
>> yes. On item no. 7, the committee is recommending added -- adding some benefits. And one of them would be a nurse line, which is a 24/7 service where a nurse or medical assistant would be able to provide the employees information on acute illness or reaction to medication or any of those questions that would pertain to illness, medication or treatment. That they would have, they could call a 1-800 number and get a nurse on the other -- on the other side that would answer the questions. And those -- so that would be at -- a value added benefit so the nurse line. The second item would be a vision plan that is fully insured vision plan, free to employees. If they wanted to add their dependents, they would be able to do that. I believe that we have a new -- is it a new rate sheet or --
>> yes. Since we presented last Thursday the -- the vision carrier has come in with further reduced rates for the depend departments. I have copies of those that -- i'll pass them around.
>> is there a motion on item no. 7.
>> yeah, I move approval of item no. 7. Thank you.
>> moved and seconded related to the adding a nurse line in the option 2 of the vision plan, any further discussion? All in favor? That passes unanimously. Number 8 which I think is also going to be item a 2 that's on our list here. Okay.
>> number 8, the committee recommends renewal of safeguard dental with a 3% rate increase and a contract extension to September of '06 and that's 3% rate increase on the other -- two plans, the pdp and indem nitty plan, premier dental and indem nitty plan.
>> actually on this it would be to September 07. Make it a three-year rate extension instead of a two.
>> seconding that? So item no. 8, the change on that is until September of 2007. Is this a 3% rate increase or 3% cap.
>> it's a 3% rate increase for the pdp and the indemnity plans. Not for the dhmo.
>> okay. That clarification, any other further questions? Barbara?
>> 3% or all three years or 3% per year?
>> it is -- one second. All plans will only increase 3% for -- I think it's for all three years, not per year. But we can clarify that if you like.
>> I think that was --
>> that was my understanding.
>> right. [multiple voices]
>> it was 3% was now, that will carry us through the next three years, not a 3% per year increase.
>> exactly.
>> but we will make sure that's very have clear before we enter into any contract knowledge.
>> in terms of the months right now, clarity is it's September of 2007, we are doing this with that is the understanding that it's a 3% increase for the entirety of that contract. If that is any different you will bring this item back to the Commissioners court so we can do the appropriate changes. Any further discussion? All in favor? That passes unanimously.
>> on the umum life insurance, I知 going to talk about recommendations 9, 10 and 11 which are represented to the life insurance short-term disability and long-term disability. As most people know, the basic life coverage is offered by the county is 25,000. For retirees it is 5,000. If eligible they can purchase another 5,000 for a maximum of 10,000. That will be a change, we are proposing a change for next year that -- that the initial amount for retiree life is 10,000, they will be able to, if eligible, purchase additional 10,000 for maximum of $20,000 of life insurance. The short-term disability and the long-term disability on the long-term disability the -- the contract would be extended through fy 2007. Which provides an opportunity for the -- for the long-term disability --
>> before you discuss this any further, could we take this into executive session?
>> 9, 10 and 11.
>> later, not right now.
>> that's fine if it's later. Let's not discuss it now then.
>> that's 9, 10 and 11.
>> we have the wording that -- that was provided by the county attorney to owe for this item.
>> you are reading it as it's here. You need to read it as I gave you the wording.
>> this is the -- -- she will say yes. She printed it, I didn't. The green doesn't --
>> when we get to that point, there was actually a suggested language related to for us dealing with the unm contracts ... Long-term disability and the item on the elementnating the waiver of premium. I am happy to lay that out right now to give us a context so that alicia can fill in the planks, barbara tell me if this is okay. That is I move approval, this would be related to items 9, 10, 11, on our agenda, 25 a, 3, 4 to authorize the county attorney to prepare a three year contract with umn coverages and rates for the following coverages. Supplemental life, independent life and retiree, short term disability, long term disability and to authorize the county attorney to prepare an amendment to the unum contract to eliminate the waiver of premium from the basic left coverage and extend the contract for that coverage only for the last option year. Now does that lay the context for us to have the discussion without needing to go into executive session? We are not actually approving it. It is authorizing the work to begin to bring back the appropriate --
>> the key thing in there is that current contract will only be extended for basic life, the remainder of the coverages, you will -- you will terminate the current contract, but new contract [inaudible - no mic] same terms and conditions set for [indiscernible] contract rates [inaudible - no mic] waiver of life premium, waiver of premium in the life coverages.
>> but wouldn't that be happening the day that we actually approve the contracts, we will be terminating the others, or is there necessary to put on notice that we are intending to terminate the others with the approval of these new contracts.
>> what I don't want you to be saying in your motion or in anything that you are talking about is that you are extending the current unum contract for those other coverages. You will not be extending that contract. You will be entering into a new contract.
>> entering into a new contract.
>> okay. So words that I think that we need to make sure that we have clarity on is help me through this, barbara. Authorizing the county attorney to prepare an amendment to the unum contract to eliminate the waiver of premium from the basic life coverage. Okay so far. What was given to us is and extend the contract for that coverage only for the last option year. If that's not correct --
>> that is correct. That is correct. For basic life only.
>> for basic life only. Do we now understand --
>> for the remainder of the coverages you will have a brand new contract.
>> is there a second to the green motion.
>> I have already moved this wording.
>> again with barbara helping us out in terms of understanding exactly what it is we are doing or not doing, this will be coming back to Commissioners court when the appropriate contracts are ready? Contract? Everybody understand it? Okay. All those in favor? That passes unanimously. Melissa we will get this to you to help.
>> okay.
>> that covers all of the recommendations from the committee on that particular item.
>> did we have one or thing represented to the time on the public hearings? I got an e-mail saying -- that may come under the -- the [multiple voices]
>> an appropriate action.
>> appropriate action on the main a.
>> yes.
>> I -- so you are -- your suggestion is what is the date of that?
>> it is June the 23rd and I think we have it scheduled for 4:30.
>> it can be 4:00. Last year we did 4:00. We looked back at what we did last year, it was 4:00 is what we did last year.
>> for the pleasure of the court, 4:00 or 4:30. We scheduled it earlier for employees to be able to -- those that get off at 3:00 or earlier than 5:00 they would be able to come by if they needed to. It's either 4:00 or 4:30 at the pleasure of the court. We had it at 4:00 last year starting.
>> that was fine with me, 4:00.
>> this is what we would also do in having the employee public hearing. The June 23rd public hearing I would move to begin at 4:00 p.m. Moved and seconded. To make everybody understand you don't have to be here at 4:00, but that's when we would get started. Certainly when folks get off later they can come later.
>> and the -- the only other information to the court that in -- in accordance with your vote, we will send out all of the information, all of the items that you voted for, tomorrow. And we will try to get those in the mail tomorrow, especially to the retirees. And it would include the consideration, also, of the -- of the retired policy committee which is an item later on that you'll deal -- that you will vote on.
>> clarity on the motion about the June 23rd public hearing, 4:00 p.m. Start. All in favor? That passes by unanimous vote. Thank you. Have we finished all of the items under 25 then.
>> yes, ma'am. I believe that we have.
>> got it. My question is, is it appropriate to us to skip over to 27 since it is kind of a subset of that? And then we will come back and hit the job analysis and do everything associated with that.
Last Modified: Wednesday, June 16, 2004 1:30 PM