Travis County Commissioners Court
Tuesday, September 27, 2011 (Agenda)
Item 43
43, consider and take appropriate action on long-term care insurance.
>> good morning, judge, Commissioners.
Travis County human resources.
we have before you today a proposal for employee long-term care.
we've had a lot of requests from our employees over the last couple of years when were we going to implement a long-term care program.
we brought this to court earlier in the year, got the go-ahead to go out for bid and did that.
reviewed all the bids, did our negotiation, and we are bringing to you the results of that.
we have found a long-term care program that we think would be excellent for our employees.
also our retirees and family members of employees are eligible to enroll in this as well.
one of the issues on long-term care is that little not a regular annual type benefit.
once you enroll in a long-term care program, it's almost a lifetime commitment.
it's not something you jump on one year and jump off the next year and jump on again, so it's not that type of an annual benefit.
you enroll and you start paying premiums at the age you are when you enroll, and then you carry it with you if you leave the county, as you go into retirement, you have this protection, this insurance with you along the way.
so we negotiated that we would not make it a payroll deduction.
we wanted it to be direct bill to the employees and any retirees or dependents.
that way it don't roll through payroll.
so there's a lot -- it's a complex product.
our plan is to have it effective March 1st to hold our enrollment in January.
we will have a team of enrollers in the county and we'll have as many meetings as humanly possible in all of our usual sites and probably some of our more unusual sites because it's a complex product and people have to understand whatter enrolling in.
there's several options they can chew from.
we want to make sure that people understand what they are enrolling in and that they have enough information to make an intelligent decision on what's right for their particular situation.
for employees at our first enrollment the enrollment will be guarantee issue.
and what that means is for employees that they will not have to be underwritten or answer any health questions if they enroll in the three or six-year options.
if they choose the ten-year option they will have to go under underwriting, but for the normal three or six-year option active employees will not have to undergo underwriting.
any family members or retirees will have to be underwritten.
all retirees that are under the age of 80, their dependents and family members are eligible to enroll, again, with underwriting.
we negotiated the direct billing process to make it more of a portable type product.
when someone leaves the county this goes with them because they are getting billed already.
it's not a payroll deduction.
there are several option as far as duration.
we're proposing a three, six or ten-year duration.
and different coverage amounts depending on your age.
it's an age rated product.
so you enroll at the age you are when you enroll and that's the amount you pay as you are going forward.
one critical item to put out is that there is an enrollment minimum that we must meet in order to offer this product.
so in our January enrollment, we have to have 10% of eligible employees enroll in this product to offer it.
if we fall short of that number, they will not offer the product.
try as we might, we negotiated mightly to make that come down but that was a firm number with them.
so it's important that the employees understand that if this is something that you asked for, if you are interested in enrolling in this product, January will be your opportunity to do so.
we will be in the department with unit personnel trainers explaining exactly what this looks like and how it all works.
>> so from today's presentation that you are giving to the court until what -- the decision must be made in January, that's what I'm understanding?
>> what we're doing today is trying to get the plan approved.
again, the contract will be brought back by purchasing.
we want to get the plan approved so we can start the implementation process and get everything set up during the fall.
>> but I guess what I'm trying to get to, what I'm trying to say is that: is that if this requires 10% of the employees to be enrolled in this program for this particular long-term plan, have we already assessed that we have 10% of the -- of the employee population on board at this point?
>> no, sir.
>> all right, all right, that's where I'm getting confused and you will have to help me out.
because what I'm trying to say, if we are bringing -- if you bring this to the court for a plan, for us to look at the plan, per se, and go forward, I have no problem with it.
>> from the interest expressed by the employees, we believe there is 10% but we don't know for sure, but we believe there is.
>> okay.
>> this plan is one that covers individuals who may be placed in a nursing home or convalescent home or in-home care so there's two ways you can take advantage of benefits in this plan.
if you are in a nursing home or if you are at home, you can have benefits.
as cindy says, there's four plans to choose from.
it's strictly voluntary.
>> okay.
>> and it can be taken with you when you leave the county or you retire.
so it's a portable plan.
>> all right.
>> it's based on a group foundation, but it is an individual plan.
benefits are very generous and it's on a reimbursement, it's on a direct pay, not a reimbursement which means you get each month the benefit comes to you, you don't have to file claims. So it's an easy plan to have and to seek benefits on.
it's one of the few that are out there that are sold on a group basis.
most of them are sold individually.
and at a much higher premium.
>> is there any model that exists somewhere that has the same type of concept for a public entity?
>> no, actually when we went out for bid, this was the only responder.
a lot of the larger companies that currently offer long-term products have gotten out of the market so the market has really narrowed in the long-term care field.
this was the most appropriate one we could find for our entity.
>> and state of Texas does offer long-term care.
>> the state of Texas?
>> uh-huh.
>> but it's 100% employee paid.
>> it is.
>> and how would we determine whether 10% of our employees are interested enough to enroll?
>> well, we give them a number of our eligible employees, employees that are eligible for benefits and 10% of that number.
we will keep track of who even roles and we'll know by the end of the enrollment if we've met that goal or not and we'll be able to let everybody know this is definitely going forward.
we only have that number on the first year.
that's the minimum that we can have to start the program.
>> would it make sense for us to try to survey employees before we start enrollment?
>> we did ask a question in one of our surveys previously if they were interested in long-term care, and we did get an affirmative answer from a lot of employees.
again, it's hard for someone to say what they will do until they see the actual plan because there's so many variables so it's hard for them to say I definitely will commit to this until they see what it cost them for their individual situation.
>> were they left with the impression the county would pay for it or they would have to?
>> no, it was plainly stated it was voluntary.
>> that makes a big difference.
>> we never intended this to be an employer paid benefit, but we have had a lot of requests to offer it to our employees and they are getting the advantage of a group rate.
where if you go out and get it from your insurance agent individually, will you pay a little more.
>> so the county's involvement is that if we do the group plan, we can basically get a better interest rate -- better cost --
>> for the employees.
>> for employees.
>> since we're not administering it through our payroll, we really won't have any administrative cost to speak of, although we will help with the company if they have any issues reaching our employees or anything like that.
but since employees' relatives and retirees and their dependents can enroll, we don't have a connection with those folks so it's better it's going to be handled on an individual basis.
>> so today you seek a motion to proceed.
>> to approve the plan and proceed with the implementation process.
>> which largely is the educational program that cindy mentioned.
>> so moved.
>> I second that and I have no problem with it, per se, it's just the fact that when we sometimes come up with things and we move forward with things, sometimes we get phone calls.
and I'm not that familiar overall with some of the terms. I haven't been introduced thoroughly to what the plan actually does.
and I guess my concern is -- I thought about the nursing situation, nursing home, there are some things that are required in nursing homes, an example, maybe some type of apparatus for better breathing or special type of bed, those type of supplies that may be made available for the comfort of those particular persons in confines, I don't know if it covers those type of things.
I really didn't know.
>> it k the way this works is you pick a payouter per month.
once you've met the 90 day waiting period and you are confined in a nursing home and you are at the $2,000 a month payout, you get the $2,000 a month.
it doesn't tell what you you have to spend it on so you could spend it on things that you needed at the nursing home or let's say you were at home and you had either skilled -- there's a plan that it has to be a skilled caregiver and there's a plan it could be a family member and you still get the plan which we thought was popular with a lot of employees because they have extended family that could make that work.
the money is yours to apply to what you think is best.
you don't have to submit a bill for the facility receipt and have it go towards that receipt.
it's up to you what you think is the most important thing to spend it on.
>> and I they it's very important that you said that and that's why I flushed out out because it makes things a little clearer what you can do with the proceeds.
if you are restricted, that's one thing.
but then if you have a wide variety of what you can do with the proceeds, that's a whole different story.
so I'm glad you laid it out the way you did.
thank you.
>> any more discussion?
all in favor?
that passes by unanimous vote.
>> number 10 fairly quick?
>> 10?
>> is it quick?
>> this is a purchasing item.
this is the --
>> is it quick?
>> yes, sir, it will be.
>> we have people we told to come at 10:45.
we want the county judge to keep his word.
I have a good reputation.
this pretty quick?
>> yes, sir.
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