Travis County Commissioners Court
February 20, 2007
Items 26 and 27
Ms. Perez the is is here, and so, item number 26 is to consider and take appropriate action on fy 2008 healthcare issues, employee benefits committee membership, and b, charge for the employee benefit committee.
>> good morning. Executive manager for administrative operations. We have several committees that the court has authoriz authorized me to put together, and we're here to discuss a couple of them together. The first one will deal with healthcare issues.
>> can I call up 27 too ?
>> yes, sir. We can jump right into that after the discussion.
>> 27 is to consider a take appropriate action on Travis County wellness committee issues. A, committee membership, b, charge and guidance.
>> we will start with the health benefits committee or employee benefit committee. And this committee has been deliberating or assisting the court with really making recommendations on our health benefits and other insurance related issues for about seven years now, since the beginning of our self- self-funded healthcare. And what we would like to do is talk about the charges to the committee and then also the make-up of the committee committee. And I think first is the committee membership. We have about 17, we ended up with about 17 representatives. And you have in your backup the list of original members and then a list of departments that would be represented. We have a couple of slots that would be open, and then we ask the court to confirm the rest of the membership. For example, we do not have a member for hhs or one for records management. Right now, like I said, a 17 member committee. We tried to be representative of a large department and small departments also. And it's been very, very beneficial to have this committee. We debate, we argue, we laugh and really take into consideration the needs of the employees and the county in making the recommendation recommendationrecommendation s. We realize all recommendations we make are preliminary and ultimately the court's decision. What the court will do is take the recommendations, have the employee public hearing, and finally set the rate or make any programmatic decisions after you hear from all the employees.
>> so our goal was to try to get the big departments represented on the committee committee? Is that what I am hearing ?
>> really to have a diverse membership on the committee.
>> have we touched base with these individuals to make sure that they are in a position to commit the time necessary to serve ?
>> yes, we have.
>> can we discuss the charge a little bit, that will help us determine whether we have the right people on there, won't it sph.
>> yes, sir.
>> okay.
>> if you look, we put a one one-page charge together, really an agenda for this year, fy '07 and '08. These decisions lead into the budget for fy '08, but it is the continuation or discontinuation of the epo, and that is one of the options that we offer that provides 100 percent, really hospitalization coverage. Attention the only option where employees pay a premium for employee-only health benefits. And it is more expensive than any of the other plans, more expensive for the employee, but also the claims are more expensive for the county. So there have been some discussions of whether you wanted to continue the program another year or eliminate it and go just to the ppo, the coinsured ppo, and then perhaps look at another healthcare plan. The second item on there is retiree healthcare benefits and premiums. Retiree healthcare is cat cat--categorized in our plan under 65 and over. And over 65 people are eligible for medicare. Under 65 most of them tot totally rely on health insurance provided by the county. We find that those claims are higher than your normal pop lake and and--population and certainly higher than over 65. The premiums have been higher and also the claims the number of retirees will increase every year also because have you a lot of people that are eligible for retirement. So this item will just look at the whole program. The benefits that we offer and the premium and then the cost of retirees to the plan plan. That's what would be under that particular item. Adding another option, you want to take that? You're more familiar with that.
>> the other option being looked at is the high deductible or consumer driven health plan that would have with it a health savings account. The health savings account is very much like a fsa except the funds roll over year to year. That's the major advantage. That the something that we would be looking at in discussing in our committee meetings.
>> and see if it's an appropriate option to add to our healthcare benefits plan plan. For setting rates on fy '08 on an annual basis the committee considers rates for individuals, for families, for spouses and any other dependent. And so we will be looking at that and bringing a preliminary recommendation to the court. We work are the actuary on setting those rates. For prescription options, it's really prescription and medication options. Right now we have mail order and of course people can go to their local pharmacy and get prescriptions filled. This is an item that we added at your request, Commissioner Davis, to kind of take a look at other options that may cost less or be more convenient for our employees in terms of providing them the medications that they need.
>> would that be listed on attachment a, description descriptiondescription-- prescription options? It's not on mine, that's why I ask.
>> on b.
>> beg your pardon ?
>> yes.
>> on attachment a ?
>> yes.
>> it's not.
>> okay. Yeah, no no. Sorry, it's listed on mine. Clearly, it's not on yours. Then the last item on here is just setting an appropriate health fund reserve. Just the committee taking a look at that and working with the actuary on preliminary recommendations, again to the court, on what an appropriate amount of reserve should be for the sort of plan that we are, that we have, and also I think taking a look at the ultimate goals for the reserve, which will determine how much we are bring to those those.
>> are we defining those as healthcare as benefits? There are other benefits.
>> yes, from time to time we review long-term and short-term disability and supplemental life am I think two years ago we added the accidental death and des memberment feature and that I was an outcome of the discussions among committee members. So we do review all benefits benefits. I think the focus is on healthcare, but at first, pardon me, but we do review the dental and other benefits as well.
>> no major issues, judge, unless there's some that you have to ask, that we know of for this year.
>> if I?m an employee, I guess I?d be real concerned about retirement benefits. I mean, we haven't changed that much but, I mean.
>> yeah. Tcrs usually does the retirement. Are you talking about specifically members for vesting or exactly what issues issues--what issues ?
>> any and all. I?m shage there are benefits owner healthcare that somebody needs the look atat.
>> for retirees ?
>> normally retirement benefits, after retirement, it's too late to worry. I mean--
>> that's right.
>> what, 12, 15 years ago we reduced the county contribution to retirement from I think 250 to 225, and the 225 still left us as being super competitive. I don't know whether that the true today or not, nobody has said otherwise so it may well be. My question is, I don't know if there's anything here to indicate to the committee that we expect you to look at employee benefits, not just employee healthcare issues. Right? .
>> this is the charge. And that's I guess the issue issue. If there's other things that you would like us to look at we would be glad to do itlve if you want us to look at the entire retirement--
>> I think this committee ought to look at all of the benefits.
>> that's more complex.
>> I think this committee should look at all of the benefits. And health is just one of them.
>> that's right.
>> healthcare. Because the next item we talk about wellness, which again is healthcare. But hopefully a different perspective. Instead of, what can you do besides going to the doctor, for your own health. I think the committee has a good start because there are a number of people that contacted us during the last six to nine months. Somebody needs to listen to them because my thinking is, of the eight to ten recommendations that I have heard, probably one or two are pretty good but I know that I?m the one to make that call. We need a committee in place to evaluate those. But employee benefits is more than money for healthcare. . That's mew only point. So even if the we put non nonhealthcare issues, because the other benefit options really are healthcare too. Right? Number three is healthcare.
>> yes. And usually when we come back, we do do a cursory look at life insurance, disability insurance insurancedisability, but some of those if there are not major issues we come back and recommend that you continue the program as it is.
>> the committee does look at all benefits. And some of the life insurance has been tweaked over the years, I think, the amount that can you take out at any one time in open enrollment has been add adjusted. As I said earlier, we brought the accidental death and dismemberment plan forward. So all benefits are reviewed reviewed. Are you directing that they be reviewed in more depth?
>> if I were to make a list of employee benefits at Travis County and put them in different categories, one category would be healthcare healthcare.
>> correct.
>> but there would be other categories. Right ?
>> that's correct.
>> during employee orientation, I mean, I know we cover more categories than healthcare.
>> vacation, sick leave, health insurance, and then disability, dental, and life.
>> the added pay issue is surfacing.
>> it's a policy issue.
>> all of this healthcare stuff is policy issues, with a compensation attachment. Or with a funding attach the thement. So compensation related stuff would not be looked at by the employee benefits committee ?
>> not generally.
>> who looks at that ?
>> hr with recommendations to the court.
>> that the kind of my point point. We have a public hearing for employees once a year. But an employee normally lines up to talk about compensation, but there are other issues that probably surface throughout the year and they really have nowhere to go except coming down here during citizens communication. Then their supervisors will know had a they are not at their job I mean, that's what I have heard. Anyway, my only request, I think that employee benefits committee ought too deal with employee benefits. One way to start on that will be to look at employee orientation and see what's covered there and what this committee should look at, if anything. I would just hate for us to acquiesce into healthcare benefits becoming employee benefits and exclusively.
>> right.
>> what we have done in the past, for example, we have a deferred comp committee, we have a wellness committee. For example, we do market salary survey, we don't run that through a committee first before we bring it to the court.
>> why not ?
>> there's not enough time, I guess, in the day. If you want to do that, perhaps another committee. Because healthcare takes up a significant amount of time just going through these issues. If you wanted a committee for each of those issues, maybe we should develop one.
>> I don't think we ought to have one for each of the issues, but I do think if we think this committee will spend all of its time on healthcare, this ought to be the healthcare committee. Doesn't that make sense? I have no problem with that.
>> that's the way that we had it before.
>> perhaps there should be subcommittees on healthcare, on wellness, on--
>> compensation issues.
>> --compensation issues. And then the committee as a whole can pick up the other items as they come up, like dental or vision plan or deferred comp.
>> I agree with you, judge. I had this as a healthcare committee. It was broadened only because of the other insurance issuesissues-- issuesissues--issues. I don't think the committee had in mind either looking at everything from vacation to retirement.
>> let's put all that out and have this healthcare committee have I no problem. I do think we ought to see what the other employee benefits are and try to figure out how to put that in one committee. If we take action on the next item that's positive, then we will have a wellness committee too. My thinking on separating them is that healthcare really is, our focus is Travis County Commissioners court funding. How do we take steps, pre prescrigs, et cetera-- cetera--prescriptions, to reduce reduce funding for Travis County, the whole, united healthcare, dental I would put in. And on wellness my thing was what steps can employees take on their own that doesn't cost them, cost them very little and the county zero or mex to nothing, that would fall under the well wellness umbrella. To be honest, my first request under the wellness committee was, pass on the list of people who say they have incredible programs and plans for county employees and give them an audience. If they can't convince the wellness committee, I?m some some--i'm assuming they won't be able to convince the Commissioners court. Those are the ones that employees have to decide on their own they want to participate there there's a wide range of vendors that we have talked with but we certainly can frame that in more of an approach to the wellness committee and have them come back to the Commissioners court with recommendations.
>> I felt real uncomfortable saying employees should want this. I feel uncomfortable saying that the employees at the county should want this. The charge looks fine to me and certainly there's enough work here. I would change it to the healthcare issues committee.
>> okay.
>> any issues that involve employee healthcare and county funding, this would pick up.
>> including life insurance, judge, and dealt and disability, I mean not disability, but insurance.
>> okay.
>> when are we going to make this, look at the healthcare participation? Is that scheduled any time this year ?
>> yesyes.
>> when is that coming up ?
>> take will be April either 6 or 16. Around the 16th of April, 6 6th through 16.
>> okay it will be good to see what they are also saying as over overseeing a lot of this stuff and where they are it will be good to have that at that time also. Thank you.
>> you have in mind this committee working the same as employee benefits committee has worked in the past, but with expanded membership and expanded charge too, pretty much the same charge it's been operat operating under, just more formal.
>> yeah, it's pretty much the same charge we have been dealing with, primarily healthcare. We have gotten into issues of other insurance, life insurance, death and disability. And then other, I guess, providers that have come and offered, for example, the legal assistance. They have taken a look at it and have said, not sure we want to deal with that given our charge on healthcare, but we can certainly narrow it to just healthcare. It just becomes very cumbersome because of the issues they have to deal with in one year, setting rates and looking at actuarial analysis and the four or five tiers, six tier tiers, that we have to deal with and thedisis for the dependents, all those are issues that -- the sub si disfor depend , all those issues. We have to have, from now to April, we have to have recommendations. Kind of a short time frame.
>> yes.
>> I?m sure the perception is a lot of the time is spent on healthcare, and it probably is because it's such a high ticket tell. We do look at all the other benefits. We will roll in the vacation.
>> you want to roll those in or pull those out ?
>> I?m not sure how broad you want the charge to be. I?ll say that the membership on this committee, I?m not sure has the expertise to bring compensation to the court with any degree of expertise.
>> why don't we pull that out then, and the other that I mentioned.
>> okay.
>> my intent is not to overwhelm this committee. If you expand the number, I mean, lord knows there are enough healthcare related issues to keep them busy. When you start talking about the county budget, that really adds to the load.
>> on an annual basis, does the court have a particular charge, like you want to us look at retirement benefit or vacation, then I think they would do it and just know it up front that's something to look at. On compensation, because we do the market salary survey, I would be a little hesitant to bring that in. I think it would, we have tried that before, and it has not been fully, with the special interests, everybody wants to look at that. That's why we deferred to the court to bring that information and leave it to your judgment. There's an opportunity here from all the dents and not just members of a particular committee, but it's open to all dents--departments.
>> what's open ?
>> when we talk about compensation or market salary survey.
>> what's open though? The court ?
>> the court.
>> employees complain about communicating with us. They can send us all the e-mails in the world. You get 50 to 200 a day, that's just another e-mail. Then we have the public hearing and typically that it's on a colan or performance pay in the next next--cola or performance pay in the next budget. And so, if we gave them more structured forum, maybe they would take advantage of it, maybe not. But at least we would be able to say, hey, share this with the wellness or healthcare committee. They are set up.
>> yeah, and on market salary survey, we work with the department heads and get their buy in. For there's not, then the forum is to present that to the court at the time that the study is presented to the court.
>> any objections to changing this to the healthcare committee? Let's just take time on the others. Okay? So on 26 a and b, I move approval of what you have recommended with a name change to employee healthcare committee. The charge is roughly what you all have been doing. Our goal would be to try to figure out what to pull out of what you sort of have informally addressed in the past, if it makes sense to do so. And at some point we'll get together on this and address that, hopefully within the next couple weeks. That's the motion seconded by Commissioner Gomez.
>> tell me what we are doing.
>> healthcare issues.
>> the healthcare committee. Okay.
>> we have defined healthcare as being dental. Any part of the human body really, I guess. Let's keep on doing it. All in favor. That passes by unanimous vote. That passes by unanimous vote unless there is option, we will postpone the well wellness committee and maybe take a look at what's left. Dan, you have received a lot of wellness recommendations too ?
>> yes, sir, and a lot of them have been referrals from the court. We try the look at each of them to a certain degree but some just aren't a good fit others that are, we meet with the folks, I mean with legal aid. We met with a couple of different fitness centers, 24 hour is working with us to be able to bring something back to the court. I do get those.
>> well, what I heard really made all the sense in the world. I wondered, why aren't a whole lot more people doing that including me. The other half, I said that's kind of way out there there. But if there were a small committee to look at that, we can figure out, here is something employees should be interested in. If so, we could help get on you the word, maybe help put them in touch with others. Some folks, there are some miracle products out there if you use them, a lot of this came sort of after we looked at bariatric surgery. A lot of people have been saying instead of looking at that, you ought to look at that. After looking at the discovery health channel, I mean.
>> well, judge, I don't want us to get too carried away on this wellness stuff. I mean, these committees are really designed, if we can give somebody some ideas and some help, then fine. But I mean, committees can bog you down quite a bit. These are people that are working for the county that are on these committees and I?m much more concerned about them doing the job that they are being paid to do versus being on a committee, coming up with every, I mean, it's your responsibility as an individual to take care of yourself. I mean, now, if we can help, and think we've gong a long ways. We are a pretty good organization with regards to just with what we have done with our wellness clinics. The truth of the matter is, is that all of this stuff that you get into with health clubs and all of these programs, you know, people get energized to do them but get energizes to do them about that long. That's just what happens with us. So I think that we ought to promote it. I mean, as much as we can, but I?m not, you know, all right, let's spend four hours a week on coming up with things that we need to be telling our people that they need to be doing. You know, you don't need to get out and get liquored up every night and go out and eat everything that you see, and by the way, you need to get some exercise. You need to have some mod ration. That is something that you need to do you know why? Because you have a job here and we expect you to show up and expect you to be productive. I mean, people just ought to know that.
>> and we have the case that we have a large number of employees who have healthcare issues related to weight and we have an environment where we don't have showers in the building to encourage people to ride bikes or to walk over their lunch breaks, we have an in house cafeteria that is fat salt and sugar, and on Fridays the building is filled with sweets. There are things that we can do. I think the employees are looking for an outlet, for instance a committee or subcommittee, where they can bring their own ideas in order to encourage or create a workplace that encourages a healthier lifestyle, which will run down the cost of our health insurance, and I think all of that would be productive. I think that having been an eight-year employee here, I never felt that there was an outlet where I could come and say, you know, we get a basket of fruit in the foyer things as ample as that. Can I use the tcso gym facility to show for I ride my bike to work? These are things I think are the kind of good ideas that bubble up through a committee on wellness.
>> a fascinating discussion. Next time this them is on in a couple weeks. Maybe have a little backup. Maybe we can kind of define what we have in mind. I?ll work with danny and we'll try to do that. That is okay? Two weeks from today is March 6. That way we can maybe try to define what we need to did.
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Last Modified:
Wednesday, February 21, 2007 8:00 AM