From
Lisa Norris, Human Resources Director
Title
Employee Insurance Fund Monthly Review - Lisa Norris, Human Resources Director
Presenter
Lisa Norris, Human Resources Director
Recommended Action
Review Only
Analysis
This analysis covers the experience in the Employee Insurance Fund through March 2019:
Employee Insurance Fund (Attachment 1):
The insurance fund is performing very well as we complete March 2019, producing our lowest month of the fiscal year reaching only $599,321 for active claims (row 30, column 7) and the second lowest month of the fiscal year for retirees reaching $159,572 (row 31, column 7). Both of these are well beneath the fiscal and running 12-month categories. Revenues continue to remain consistent. With half of the fiscal year now under our belt, year end projections (blue column, rows 30 and 31) are projecting well beneath budget with actives projected at only $12,678,056 versus the $15.7 million budgeted and retirees projected at $2,419,452 versus the $3.2 budgeted. This continued positive trend overall creates a projected operating balance at year-end of $4,894,548 (row 39, column 13).
Life Insurance and Long-Term Disability insurance reflected on rows 28 and 36 are showing no premiums paid from Janaury through March on each of them as the contract has not yet been executed. We have been engaging heavily with them to get that to us and I believe we are close to getting it executed by the end of May. They are very clear on my displeasure at this point; however, we have had 3 claims and they were very prompt in handling those even without receipt of premiums, so the contractual issue is not impacting our employees which is positive.
On a side note, we are in finalist review of our Third-Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) that went out to bid in January. We had 9 responses for the TPA services and 8 responses for the PBM. We have narrowed the finalists down (in no particular order) to Aetna, BlueCross BlueShield, Cigna, and Aetna. HSA services and Pet Insurance will be solicited next.
UHC Slides:
Slide 1 of the UHC Deck:
UHC has provided slides reviewing January to March in 2018 versus the same period in 2019. That slide indicates we are trending higher in several areas on Slide 1 of the UHC slides, including (2nd row) Medical and Pharmacy per member per month (PMPM), Emergency Room (ER) paid per visit and inpatient days in the hospital. However, the number of visits to the ER is down and our network discount has improved. The network discount is the amount of discount agreed upon to recieve from a provider off of the full "billed" amount.
Slide 2 of the UHC Deck:
The number of claimants with claims greater than $50,000 are higher this quarter at 5, versus the same quarter in 2018 (January through March) which only reflected 2 claimants. However, we also have no claimants currently exceeding $100,000 in claims like we did this same time last year.
Slide 3 of the UHC Deck:
The last slide is just interesting information on how the claims are falling in this quarter by range of cost.
Financial Consideration
The current budget is approved and no financial consideration is necessary at this time until additional claims data based on future months can be reviewed.