TITLE
Title
APPROVE CALENDAR YEAR 2025 OPEN ENROLLMENT BENEFITS CONTRACTS AND PREMIUM AND DISCOUNT RATES
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SPONSOR
Sponsor
Jaime Joyner & Mirna Simaan
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BACKGROUND
Background
Guilford County provides a comprehensive and competitive benefits package as a part of our total rewards. Staff proposes to continue our existing benefit options as described below. There are no changes in employer or employee contribution rates across the various benefit offerings. Some supplemental benefits, if elected, will have rates that vary based on age and income. The County's cost is estimated to remain approximately the same for calendar year 2025.
UNUM
The County has an existing carrier relationship with UNUM for these benefits.
*Basic Life and Accidental Death & Dismemberment (AD&D) - The County pays the full cost for Basic Life and AD&D. If approved, the County's cost is estimated to remain approximately the same for 2025.
*Supplemental Life Insurance - This is a voluntary insurance that employees may elect to provide additional life insurance coverage. For employees that elect this coverage, the County pays up to a maximum of $5.33 per employee per pay period. If approved, the County's cost is estimated to remain approximately the same for 2025.
*Short Term Disability - This is a voluntary insurance that employees may elect at full cost to the employee. The County makes no contribution towards this voluntary benefit.
*Long Term Disability - This is a voluntary insurance that employees may elect at full cost to the employee. The County makes no contribution towards this voluntary benefit.
*Hospital Indemnity Insurance - This is a voluntary insurance that employees may elect at full cost to the employee. The County makes no contribution towards this voluntary benefit.
*Critical Illness & Emergency Care Insurance - This is a voluntary insurance that employees may elect at full cost to the employee. The County makes no contribution towards this voluntary benefit.
*Accident Insurance - This is a voluntary insurance that employees may elect at full cost to the employee. The County makes no contribution towards this voluntary benefit.
DELTA DENTAL
The County has an existing carrier relationship with Delta Dental for our Basic and Enhanced Dental Insurance. The County pays a portion of the total premium ranging from 18% to 84% depending on the plan and coverage selected. If approved, the County's cost is estimated to remain approximately the same for 2025.
UNITED HEALTHCARE (UHC)
UHC currently provides administrative services related to the County's self funded medical plan at a cost of $28.77 per member per month. For 2025, UHC will continue to provide these services at the same cost per member per month.
The final total cost will fluctuate depending on the total number of insured members throughout the year which will change with instances such as new hires, resignations, retirements, qualifying life events and open enrollment. We currently have 2904 members insured with UHC. If that number remains approximately constant, it will translate to an estimated annual total cost of 1,002,577. (2904 members multiplied by $28.77 per member per month for 12 months).
Health Plan Design Change
With this overall request for approval of our calendar year 2025 open enrollment contracts, staff are additionally recommending one health plan design change for Board consideration and approval specific to established visit caps for both occupational/physical/speech therapy and for spinal/chiropractic treatment. An analysis of this plan design change was provided to the Board back in January of this year and is attached to this agenda item for quick reference.
Currently under our health plan we have a covered visit cap established for both occupational/physical/speech therapy and for spinal/chiropractic treatment. The visit cap for occupational/physical/speech therapy is sixty (60) combined visits per calendar year. The visit cap for spinal/chiropractic treatment is twenty-four (24) visits per calendar year. Our plan provides coverage up to those established visit caps and then any visits beyond the cap become the full responsibility of the member. There is currently no way for a member to exceed the cap for covered visits.
Staff are recommending that the Board consider and approve an increase to both occupational/physical/speech therapy and spinal/chiropractic treatment visit caps. Staff recommend that we adjust our covered visit caps upward by 50% to ninety (90) combined visits for Occupational/Physical/Speech therapy and thirty-six (36) visits for Chiropractic treatment.
Initial estimates of this plan design change show a 0.05% cost impact on total medical claims. This scenario would carry an estimated cost impact of $13,766 or approximately $275 per one (1) percent change in the visit caps.
HEALTH, DENTAL, AND VISION INSURANCE PLAN PREMIUM RATES AND WELLNESS STRATEGY DISCOUNT
The employee and employer biweekly premiums for the County’s health, dental, and vision insurance premiums are included in the attached file. There are no changes to the non-discounted premiums.
Staff recommends that the County continues to offer a biweekly premium discount of $20 for an employee and $20 for a covered spouse, if applicable, upon completion of a specified wellness activity or activities. Previously, the Board of Commissioners approved discount amounts and specific wellness activities to receive the discounts, such as completing biometric screening or attesting to no tobacco use. This recommendation continues Board approval of the discount amounts and authorizes the County Manager to determine and adjust as necessary the annual wellness activity/activities to be completed to receive the discounts based on an annual review of health plan performance and population health and wellness strategy recommendations to maintain the financial integrity of the County's self-funded plan.
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BUDGET IMPACT
Budget Impact
NO ADDITIONAL COUNTY FUNDS REQUIRED
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REQUESTED ACTION
Requested Action
1. Approve seven (7) contracts for calendar year 2025 benefits, in substantial form with UNUM for Basic Life and Accidental Death & Dismemberment, Supplemental Life, Short-Term Disability, Long-Term Disability, Hospital Indemnity, Critical Illness & Emergency Care and Accident Insurances to be effective January 1, 2025, for a term of one (1) year.
2. Approve one (1) contract for calendar year 2025 benefits, in substantial form, with Delta Dental for dental insurance to be effective January 1, 2025, for a term of one (1) year.
3. Approve a price only contract, in substantial form, with United Healthcare (UHC) to provide health insurance administrative services for the self funded medical plan at a rate of $28.77 per covered member per month to be effective January 1, 2025 for a term of one (1) year.
4. Approve a health plan design change to increase the visit cap for occupational/physical/speech therapy to ninety (90) combined visits and to increase the visit cap for chiropractic treatment to thirty-six (36) visits.
5. Rescind all prior premium rates and wellness strategy discounts and approve the attached health, dental and vision insurance plan premium rates; approve $20 employee and $20 covered spouse, if applicable, wellness strategy discounts; and authorize the County Manager to determine and adjust as necessary the annual wellness activity/activities to be completed to receive the applicable discount(s) based on an annual review of health plan performance and population health and wellness strategy recommendations to maintain the financial integrity of the County's self-funded plan.
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