Travis County Commissioners Court
Tuesday, February 1, 2011,
Item 12
>> item 12?
the independent -- employee independent audit.
receive final report and take appropriate action on the Travis County employee hospital and insurance fund dependent audit including authorization to terminate coverage for all unverified dependents effective back to October 1, 2010.
good morning.
>> gr morning, Commissioners -- good morning, Commissioners.
last week we gave a very quick and brief update on the independent audit.
we're here today to give you a final report.
the audit started back in November.
the official audit -- I’m sorry, back in September.
the final audit was November 19th, but we asked for reconciliation period to reach out to employees who had not yet provided all the documentation they were supposed to.
and that ended on January 21st.
we asked for assistance and were able to bring patty marshon on board to work with us during that reconciliation period.
I would like to begin, though, with cindy perkington who oversaw the dependent audit from its inception and she will give a little background and can get you up to date with where we are today.
>> good morning, court.
benefit administrator for Travis County.
I’ll keep this brief because we've talked about this several times recently, but as you know back in may the court approved a dependent audit on the health plan.
we started talking to the employees and started letting them know what they would need during the dependent audit.
we stressed the fact that during open enrollment was going to be their chance to do a self-audit if you will to make sure that all of the dependents on the health plan were what they intended to be and that they had the documentation to go bieng loing with all the dependents that he had listed.
after the end of open enrollment the plan was to start dependent audit, which we did.
we had the dependent audit go for 60 days.
e-mailing and contacting the employees the entire time.
sage brush solutions handled the dependent audit.
they were contracted, outside third-party.
the dependent audit had some problematic areas.
it was our first one that we had ever done and there was a little bit after learning curve there.
I think if we did another one today that we would do things a little bit differently.
but you always have to have the first one to figure all of that out.
so when we ended the dependent audit on November 19th, there was still a significant number of employees that had not responded with their dependent information.
rather than just cut all of those people off the plan, we wanted to give them some more opportunities to bring in their information because it was new to the employees as well as us.
so we did that and then that brings us up to where we are today with the final results of the dependent audit.
patty's done a wonderful job trying to reach out and physically talk and touch these people to try to get this information in.
so I’m going to let her tell you exactly where we're at today.
>> when I began the reconciliation period there was still 870 dependents that we needed documentation for.
as of today the number of employees who remain incomplete are down to 11.
only one of those has health insurance for a dependent.
the rest are some sort of either dependent life or perhaps vision or dental.
during the audit period there have been 324 drops, 151 of those were during this reconciliation period.
the 35 that have been dropped during the entire period have health insurance.
so as of this morning only 11 remain.
remain unresolved.
>> so what we'd like to do is ask the court for their authorization to go ahead and drop the dependents that are remaining that have not provided the documentation needed to be on the plan.
and go forward, put an end to the dependent audit.
I think that we do have one or two that are still actively trying to get their documentation from out of state and we would also request a caveat that we would be able to continue to work with those people to get their dependent documentation in place.
>> before the court takes action, though, when -- I know there's the first one we've done as far as this type of audit.
in the future, when would we feel that it's necessary to do it again?
how do you measure that, the use and the services of this type of audit?
>> what we have in place now, thanks to some hard work on cindy's part and barbara wilson's, a method of verifying the eligibility at the time of enrollment, but an audit may be required every three, four, five years.
the procedure in place now requires the documentation be provided at the time of enrollment.
so the gap that existed for the last 10 years has been removed.
it's no longer as big an issue as it has been.
>> right.
>> but the verification still needs to take place.
I don't think a future audit would be as expansive as this one.
>> random sampling may get us there?
>> yes.
>> and the follow-up during the enrollment, I guess we can still do that.
and I know y'all send e-mails out about that.
and so I guess some additional follow-up needs to be done just to make sure --
>> we probably need to change our procedures for open enrollment when people are adding.
in the past at open enrollment you just put someone on there and there was no documentation provided during open enrollment, which was part of the problem.
we always have done midyear adds like if you got married or had a baby or something like that, we always required documentation, but at open enrollment it was just wide open.
so our procedures will change for open enrollment going forward so that we can maintain this baseline and know who is on our plan.
we learned several lessons during this process.
we learned that a lot more of our people don't have access or don't use their e-mail than we anticipated.
we had identified probably 3 to 500 people that were not active e-mail or didn't have access to e-mail users.
before the audit was over we identified several problem areas with that, either certain areas didn't have access to outside internet.
they just had access to the county wide internet.
they couldn't receive e-mails from the outside in.
and we had an outside third-party sending these e-mails out.
that was something we learned that we didn't anticipate.
we also learned that people -- that we need to have the important information on the first page.
there was a lot of information that went out from sage brush on the audit, and we found that a lot of people didn't get to the third or fourth page of the instructions where the meat of the matter was.
on so as always the meat of the matter needs to be on the first page so people that are busy can just jump to the important stuff.
we also learned that maybe our employees didn't think we really meant it.
and so we want to -- we want them to know that we have a really good health plan and part of the reason we have a really good health plan is that we need to know who is on the health plan.
the people that are on there need to be eligible.
they need to be paying their way and they need to be eligible.
so a lot of people were actually quite angry that we asked for documentation, but I think going forward that we may not get that reaction again because we did try to take the time to explain to people exactly why we were doing this and how important it was.
and I think that that made a difference.
people just didn't think about how important it was.
how important it was who was on the plan.
>> do y'all cover this during orientation for new employees?
>> well, we've always -- we probably are now a little bit more than we ever have.
have in the past because of the documentation.
when they come to work at the county they're told they will need to have this documentation on hand when they do come to enroll.
>> nut employee packet will have that information.
>> good.
>> as cindy said, we learned a lot.
>> sure.
that's great.
>> we intend to put it in practice.
>> and this is an efficiency measure, that is a cost savings of $188,000.
that is an ongoing cost savings.
thank you for doing it.
>> thank you.
>> other comments?
>> can I just ask one question?
the impact of going back to October 1st, are there expectations that staff has to follow-up with reimbursement for claims that have been paid?
and is there going to be a follow-up action that court will have to consider?
>> yes.
we'll be identifying the next phase of action is to identify claims that have been paid on ineligible dependents.
and we will be putting into effect recovery steps.
>> and those will come back as agenda items for us to look at?
>> yes.
>> okay.
but today we should just accept the final report?
is that --
>> yes.
and authorize us to terminate those who failed to provide justification.
>> and authorize to terminate coverage of all unverified dependents.
I move approval.
>> second.
>> all in favor?
unanimous support.
>> thank y'all.
>> thank you.
>> no, thank y'all.
>> thank y'all.
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:
Tuesday, February, 2011 2:19 PM
