Kane County Board met April 2.
Here is the minutes provided by the board:
1. CALL TO ORDER
The Adjourned Meeting of the Kane County Board was held at the Kane County Government Center, 719 S. Batavia Ave., Bldg. A, Geneva, IL 60134 on April 2, 2019.
Chairman Lauzen called the meeting to order at 4:00 PM.
2. ROLL CALL
Present: Co. Bd. staff Figliozzi, Nagel; County Clerk staff Weilandt; Finance Exec. Dir. Onzick; Human Resources Exec. Dir. Wetzel & staff Young; Bldg. Mgmt. Exec. Dir. Sparks; Asst. State's Attys. Lulves, Niermann; ITD Exec. Dir. Fahnestock & staff Peters; Sheriff's Dpty. Collins; members of the press & public.
3. PLEDGE OF ALLEGIANCE
Mr. Mike Baker with Group Alternatives was called to the podium to lead in the recital of the Pledge of Allegiance.
4. SPEAKERS (Agenda & Non-Agenda Items)
Chairman Lauzen read the protocol for the special board meeting. (Hanson arrives 4:02 p.m.) No speakers came forward.
5. DISCUSSION AND POTENTIAL ACTION REGARDING HEALTHCARE INSURANCE PROVIDER SELECTION
Human Services Committee Chairman, Cliff Surges, recalled the board's decision to leave the IPBC (Barreiro arrives 4:04 p.m.), explaining today’s focus would include the following key decisions: 1) group healthcare/prescription drug packages; 2) employment/employee assistance programs; and 3) group life and accidental death disability/dismemberment. He referenced Member Iqbal’s email sent to him on whether the recommendation was received from the committee. Member Surges closed by summarizing that Aetna was the best choice financially. Blue Cross/Blue Shield (“BCBS”), he reported, was more rigid (Starrett & Hernandez arrive 4:06 p.m.) in its pricing with 64% of the county’s members in the HMO program. Obtaining the information from BCBS to insert into the Springbuck program was difficult. (Allan arrives 4:08 p.m.) Further changes were described by Member Surges.
Mr. Baker, from Group Alternatives, referenced his revised presentation, noting some of the changes that were made to the packet. Mr. Baker estimated the expected savings to the county if it went with Aetna was $1.2M dollars; with United Healthcare was $1.1M dollars; and with BCBS was $780,000 dollars. Wellness Services as well as the various technology benefits for each of the three companies were reviewed. Questions followed on clarifying what Wellness Coaching was (offered by BCBS), how an employee would utilize such funds, how the employee health risk assessments worked under all three providers.
Addressing the county’s current prescription drug program with the IPBC/ Xpress Scripts, Mr. Baker indicated the county had a closed formulary (drugs that are excluded), while Aetna and United Healthcare were providing an open formulary. Details followed.
Asked why there was so much disruption from BCBS leaving the co-op, Mr. Jim Sherman, Director of Sales with BCBS of Illinois, stated he could not comment on the subject analysis because he was not aware of it nor could he add to it today but offered to review it.
Mr. George Popododos (phonetic) with BCBS, confirmed he was asked to provide an open formulary but due to the nuances of the HMO program, he could not provide the information due to the model and design the formulary was built under, i.e., a closed formulary. Mr. Baker proceeded to clarify he did not show BCBS the exact summary but did receive the data from BCBS as far as where their drugs fell on the county’s utilization from the Xpress Scrips report. Member Thomas recommended that Mr. Baker and H.R. Exec. Dir. Wetzel get together to have BCBS contribute, validate or refute the information being presented to the board.
Mr. Baker proceeded to explain how he was able to obtain employee prescription information from a large claim file (Excel file) through Xpress Scripts. The same file was sent to BCBS, United Healthcare, and Aetna. Details followed with Mr. Baker stating, again, that BCBS could not provide all of its information due to the HMO. (Scheflow arrives 4:35 p.m.)
Continuation of the presentation followed. Member Hoscheit confirmed that Aetna had made two changes, but inquired whether the other companies knew they could change their process and whether actual changes were made, wherein Mr. Baker explained that after the vote to leave IPBC was taken, the other companies were sent a spreadsheet and offered the opportunity to change their pricing. Mr. Baker recalled the county’s Human Services Committee was provided an appendix in an email from Mr. Sherman (BCBS) indicating they would not be changing their financial pricing but would include $25,000 for the EAP towards the Empyrean program. United Healthcare also increased funding for its EAP services.
A short dialog followed from Member Barreiro on why Rush Copley was not included in the HMO choices, wherein Mr. Popododos with BCBS offered to look into. Further clarification followed. Mr. Baker explained how the HMO process worked under the three insurance companies, while Mr. Popododos clarified even further.
Lastly, Mr. Baker referenced the financial comparison chart for the Life/Accidental Death insurance policy the county carries for non-union employees. Sun Life was able to match the county’s rate with a 30-month rate guarantee to get the county’s renewal on a calendar basis.
Asked if BCBS could provide any additional information to the board in the next day or so, outside of what was presented by Mr. Baker and staff, Mr. Popododos explained that referring to the drugs that were disrupted, the chart was referring to unit cost and lines on a spreadsheet and was not relative to the actual drug. He provided an example. Following up to the other question, Mr. Popododos explained that from a data perspective and a risk stratification in determining the cost impact from moving out of the IPBC, his company had the best line of sight, from a data perspective. As he explained, this was not an opportunity for the county to move out of the IPBC only to get hit with a high renewal. When the data was reviewed internally by his company, Mr. Popododos said the determination was to help the county as much as possible from a financial perspective, which was where the credits came from.
Other board questions followed as to what the capitation figure meant under BCBS (page 1 of chart), why the Springbuck program could not provide the HMO data, whether feedback from the employees had been received or whether a survey had been sent to the employees. H.R. Exec. Dir. Wetzel relayed she did not receive employee feedback and no formal survey was sent out. Member Surges summarized there was not much feedback in general; however, Members Starrett and Silva reported that employees had contacted them expressing concerns about changing the insurance but were not willing to provide their names due to retaliation.
Member Hoscheit provided a financial perspective on the figures before the board and summarized the county was basically considering a $484,000 savings with an uncertain future. He posed the question of whether the county wanted to disrupt the current insurance for that savings with the hope of future savings accruals or stay with the current insurance company with the hope that the increase in future years would not be as significant. Member Allan suggested speaking to the employees and explain to them that in order for the county to get money for their raises, they should speak to their physicians on how a change in insurance would affect them.
Other comments/concerns followed that: 1) it was not a question of leverage to the employees; 2) the 15 bargaining units had not been invited to the negotiating table again; 3) the maximum out-of-pocket costs for each insurance carrier was a worst-case-scenario; and 4) the $484,000 was a bit over 3% difference in costs.
Since there were concerns about doctors not being in the new network, Member Lenert suggested an idea to the board summarizing that if the county decided to change insurance carriers, that it agree to pay an additional out-of-pocket expense ($3,000) for every employee that has additional expenses so they could continue to see their doctors/providers. Lenert estimated the maximum exposure to the county would be at $300,000 and exposure in claims would be reduced by $4.0M dollars. Allan queried on how the logistics would work.
Mr. Baker cautioned the board regarding those employees receiving transitional care and the proper administration of same. He also confirmed where the disruption could occur -- with the employees’ specialists -- and not necessarily their primary care doctors, but again, Mr. Baker cautioned Surges regarding the details.
Board dialog proceeded back and forth on the administration process and regulation of Lenert's suggestion, the need for a legal opinion on such a matter, and the fact that while the county was saving $485,000, it was giving back $300,000 to cover those employees’ doctors not in the network. Member Sanchez provided ideas to promote wellness to avoid the maximum liability figures. Additional comments followed on researching Lenert’s suggestion further, staying with Blue Cross until results could be measured before changing to another carrier, consider the burden placed on the H.R. department to administer the program, and whether the county would increase the employees’ salaries above the 2% increase to afford paying for their co-pay, deductible, co-insurance and/or out-of-pocket stop loss.
Chairman Lauzen recommended setting this matter aside for now, possibly having it as a discussion item for the Human Services Committee. Frasz asked members whether there was a consensus to explore Member Lenert's option, or vote on the matter, wherein the Chairman explained Member Lenert’s option was not being considered today but could in the future.
Chairman Lauzen entertained a motion to select one of the companies as the County’s healthcare provider and to direct him to work with the State’s Attorney’s office to prepare the appropriate resolution(s) to bring to the April 9, 2019 County Board meeting.
Motion by Silva, second by Starrett to select Blue Cross Blue Shield as the county's healthcare provider and direct the Chairman to work with the State's Attorney's Office to prepare the appropriate resolution(s) to bring to the April 9, 2019 County Board meeting. Roll call followed:
1. Motion to Select County's Healthcare Provider
RESULT: APPROVED BY ROLL CALL [16 TO 5]
MOVER: Monica Silva, Board Member
SECONDER: Susan Starrett, Board Member
AYES: Deborah Allan, Theresa Barreiro, Drew Frasz, Matt Hanson, Barbara Hernandez, John Hoscheit, Michael Kenyon, Chris Kious, Tom Koppie, John Martin, Myrna Molina, Jarett Sanchez, Monica Silva, Susan Starrett, Angela C Thomas, Barbara Wojnicki
NAYS: Bill Lenert, Anita Lewis, Douglas Scheflow, Clifford Surges, Steve Weber
ABSENT: Mark Davoust, Penny Wegman
PRESENT: Mo Iqbal
6. EXECUTIVE SESSION (if needed)
None.
This meeting was adjourned at 5:57 AM.
https://www.countyofkane.org/MeetingMinutes/5270/19-04-02%20COB%20Special%20minutes.pdf
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