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HomeMy WebLinkAbout2023/06/06 WORKSHOP SESSION 1:30PMDATE � 3 w--- ..9 BY BRAZOS COUNTY BRYAN, TEXAS NOTICE OF MEETING AND AGENDA WORKSHOP SESSION BRAZOS COUNTY COMMISSIONERS COURT BRAZOS COUNTY COMMISSIONERS WILL MEET IN A WORKSHOP SESSION AS FOLLOWS: MEETING DATE: June 6, 2023 MEETING TIME: 1:30 PM MEETING PLACE: Brazos County Administration Building, 200 S. Texas Avenue, Suite 106, Bryan, TX 77803 1. Call to Order 2. FY23-24 Budget Discussion Regarding Insurance Premiums and Contributions. 3. Adjourn The Brazos County Administration Building, 200 S. Texas Avenue, Suite 106, Bryan, TX 77803 is wheelchair accessible. Handicap parking spaces are available. Any request for sign Interpretive services must be made two working days before the meeting. To make arrangements, please call (979) 361-4102. The foregoing minutes of the Commissioners Court Workshop Session held June 6, 2023, have been examined and are approved in open Court this the 1 lth day of Jules, in Bryan, Brazos County, Texas. Duane Peters County Judge Steve Aldrich Commissioner, Precinct 1 Chuck Konderla Nancy Berry Commissioner, Precinct 2 Commissioner, Precinct 3 Attest: Karen McQueen County Clerk MINUTES J U N E 6, 2023 BRAZOS COUNTY COMMISSIONERS COURT WORKSHOP SESSION Call to Order The Commissioners' Court of Brazos County, Texas met in a Workshop Session in the Commissioners Courtroom in the Brazos County Administration Building, 200 South Texas Avenue, in Bryan, Brazos County, Texas, beginning at 1:30 p.m. on Tuesday, June 6, 2023 with the following members of the Court present: Duane Peters, County Judge, Presiding; Steve Aldrich, Commissioner of Precinct 1; Chuck Konderla, Commissioner of Precinct 2; Nancy Berry, Commissioner of Precinct 3; Wanda J. Watson, Commissioner of Precinct 4; Karen McQueen, County Clerk, Absent. The attached sheets contain the names of the citizens and officials that were in attendance. Judge Peters called the meeting to order and invited Brenda Cos and Bobby Anderson from US I Insurance Services to speak. 2. FY23-24 Budget Discussion Regarding Insurance Premiums and Contributions. Mr. Anderson walked the Court through the budget for 2023, looking at total, and per employee costs. He discussed the number of claims, and noted that they are currently lower than 2022. Mr. Anderson stated that the plan was trending favorably for the County and further detailed the claims, giving exact numbers for medical claims, Rx claims, stop loss claims, and finally the total. Mr. Anderson moved into dental experience, giving the 2023 cost summary. He stated that he expects the 2024 Budget to decrease by 9.4% based on current data. Mr. Anderson recommended keeping the employee and employer contributions the same. Additionally, he recommended that the rates for the dental plan also stay the same in the 2024.year. Nina Payne,. Budget Analyst, discussed the National Benchmark Data, specifically regarding contributions of our plan compared to other County's plans of similar size. Ms. Payne asked if the Court had any questions or concerns. Commissioner Berry asked if her recommendation is to keep the same contribution rate as the 2023 Budget. Ms. Payne stated it is her recommendation to keep the rate the same. Commissioner Aldrich asked for further information on the percentage of gross cost to the County in relation to health claims. Ms. Payne assured she could get that data sent to him. Ms. Payne discussed concerns regarding increased health needs following the COVI D-19 pandemic, potentially affecting the projections. Mr. Anderson proposed either a 3% increase to the budget as protection or to wait a couple of months to decide based on the additional data. Commissioner Aid rich questioned where the surplus of health and life funds go. County Auditor Katie Conner explained that typically it is used, and if it is not, it is retained. She stated that they would continue watching the claims experience over the next couple of months and make a decision based off that. Jennifer Salazar, Director of Human Resources, shared that Human Resources goal is to increase the wellness rewards program. Commissioner Konderla explained that many people put off elective procedures and routine checkups during the pandemic. He urged everyone to consider the potential increase in. health claims as people -are catching up on their healthcare. Mr. Anderson agreed that this was a good point. A copy of the presentation is attached. 3. Adjourn Pg i of BRAZOS COUNTY COMMISSIONER'S COURT (.o DAY i : 36 Name OF 2'vou c , 20 AM ' ,v����-�� (PLEASE PRINT) Me-,L,�55A 6OULs A u, a-t5\t L ecoGev-- P-cz.!� 4rk Avi oi�y <o C�-r,e C.3 obbL/ CVA Organization (PLEASE PRINT) Cor J1 �l--1>G E Ci()h/lr\ - C0 a Ge. -TL-�C)GI .L� s (ks-T- &6-�4 .49 Aa- Co . suV co t Pga-of BRAZOS COUNTY COMMISSIONER'S COURT (� DAY OF , 20 Q� 1 r� A /P Name Organization (PLEASE PRINT) (PLEASE PRINT) V-1 vn 9 car cy\ C' M , a c6zk ac ' I. Health Plan Experience II. Budget Review ➢ Medical ➢ Dental III. Addendum a. Plan Historical b. 2024 COBRA Rates 91 Table of Contents Experience Dashb. Experience Summary 2022 April YTD d from 2022 T _ Observations For the 2023 Plan Year Budget $18,344,193 $6,278,796 3% Plan Overview: Net Costs $16,526,715 $5,166,558 -6% Net Position to Budget 90% 82% The Budget is 3% higher from prior year due to the 3.5% increase to premium rates. Net Costs PEPY $16,864 $15,688 -7% YTD the plan is under budget by $1,112,238. • The Net Position to Budget is 82%. Net Claims $13,667,738 $4,336,883 -5% Gross Rx Claims made up 39% of total paid claims, which is above the industry standards (20%-30%). Net Claims PEPY $13,947 $13,169 -6% • Average monthly enrollment is 1% higher than prior plan year. Average Employees 980 988 1% • Overall, net cost on a PEPY basis is 7% lower from prior year. • Large Claimants: Large Claimants 2022 April YTD o There are two Large Claimants over the SSL with $489,010 in claims and $89,010 Number of Large Claimants 22 9 over the SSL. Total Paid for Large Claimants $5,588,790 $1,368,195 o Large Claimants make 26%of gross claims. Claimants Over SSL 9 2 Total Paid Over SSL $1,793,893 $89,010 $2,000,000. $1,500,000 $1,000,000 $500,000 $0 2023 Budget vs. Net Costs Jan-23 Feb-23 Mar-23 Apr-23 v Budget ® Net Cost Historic Budget vs. Net Costs $25,000 ---- - — -- --- - $20,000 -- - - ---- - _.. -_ ---- - $10,000 I i l m $5,000 ! m - " ° .w 2021 2022 2023 u Budget PEPY m Net Costs PEPY 1 74� 2023 YTD > $100,000 Large Claimants as a % of Total Claims o Large Claimants u Other Claims © 2020 USI Insurance Services. All rights reserved. W. 1 2 Cost Summary- Medica Budget vs. Net Costs $2,000.000 $1,800,000 $1,600,000 .......... - - - - 77 77 $1,400,000 4 - --------- $1,200,000 $1,000,000 . ..... $800,000 $60 0�00' $400000) $200,OOD $0 Jan-23 Feb-23 Mar-23 Apr-23 ri Budget m Net Cost • ExpectedFixed Cost, Total Total Admin Stop Total % Paid by Budget Minus Medical Rx Loss 0,L,SSL Net Total Budget Net Cost EE I Contributions: ER Expense Employees Members Fees Pre Claims Claims Reimbursements ements Claims Employer Actual Wellness Rates Jan-23 982 1,720 $48,422 $201,082 $249,504 $845,591 $523,670 ($308,558) $0 $1,060,702 $1,560,580 $1,310,206 $212,294 $1,097,912 .84% $250,374 Feb-23 986 1,723 $48,620 $201,598 $250,218 $670,073 $455,299 ($228,820) $0 $896,552 $1,566,324 $1,146,770 $212,546 $934,224 81% $419,554 Mar-23 988 1,725 $48,718 $202,057 '$250,776 $1,021,256 $530,303 ($85,990) $10,457 $1,471,569 $1,570,016 $1,722,345 $213,492 $1,508,853 88% ($152,329) Apr-23 996 1,734 $49,113 $203,091 $252,203 $670,545 $514,745 ($277,230) $78,553 $908,059 $1,581,876 $1,160,263 $214,369 $945,895 82% $421,613 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Rx Rebates ($173,027)1 ($173,027) $173,027 , Totals 3,9521 6,902 $194,873 $807,828 $829,675 1 $3,213,465 $2,024,017 ($900,599) $89,010 $4,336,883 $6,278,796 $5,166,558 $852,700 $4,486,884 87% ?$1,112�,238 Notes 1. Aggregate corridor is 125%. Specific stop loss is $200,000. Q 2020 USI Insurance Services. All rights reserved. 2022 Cost Summary Budget vs. Net Costs $2,000,000 $1,600,000 - ----------- - - ---- --- ------ $1,400,000 71 $ 1,200,000 $1,000,000 $600,000 _J $400,000 $200,000 $0 L _J Jon-22 Feb-22 Mar-22 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 = Budget in Net Cost • 'E=66fi d Fixbd.Cost �0111 , cicinnspipmV i"AICMW:� w N 920"" Total Total Admin Stop Loss Medical Ri x Stop Loss OverSSL Net Total Net Claims / Budget Net Cost 'E Contrib. tions: ER Expense % Paid by Budget minus Employees Members Fees Premium Claims s Claims Reimbursements Claims EE Employer Actual I Wellness Rates Jan-22 ' 998 1,726 $49,241 $239,898 $289,139 $633,311 $379,656 ($87,025) $o $925,942 928 $1,552,232 $1,215,082 $230,210 $984,872 810% $337,150 Feb-22 992 1,722 $48,945 $239,469, $288,414 $562,732 i $385,120 ($227,279) $0, $720,573 726 $1,544,904 $1,008,987 $230,838 f $778,149 i 77% $535,917 Mar-22 989 1,726 $48,797 $239,255 $288,052 $630,017 $552,147 ($74,465) $1,374 $1,107,699 1,120 $1,541,912 $1,395,751 $231,824 $1,163,927 83% $146,161 Apr-22 980 1,716 $48,353, $237,891 $286,244 $650,888 $493,953, $0. $105,890. $1,144,841 1,168 $1,529,276 $1,431,085 $231,122 $1,199,963 84% $98,192 May-22 976 1,708 $48,156 $237,765 $285,921 $684,454 $516,888 $0 $97,085 $1,201,343 1,231 $1,523,640 $1,487,263 $230,790 $1,256,473 84Y. $315,377• Jun-22 976 1,701 $48,156, $237,284 $285,440 $689,355 $437,815 ($46,956): $94,217 $1,080,214 1,107 $1,523,432 $1,365,654 $230,582 , $1,135,072 83% $157,778 Jul-22 969 1,694 $47,810 $236,464 $284,274' $677,411 $520,701 ($97,393) $110,576 $1,100,719 1,136 $1,513,880 $1,394,993 $230,312 $1,154,681 83% $128,887. Aug-22 972 1,696 $47,958 + $236,678 $284,637 $794,884 $601,170 ($94,217) $169,297 $1,301,836 1,339 $1,516,700 $1,586,473 $229,154 $1,357,319 i 861% ($69,773) Se p-22 971 1,697 $47,909 $236,767 $284,676 $596,912 $636,174 ($110,576) $268,505 $1,122,511 1,156 $1,515,372 $1,407,187 $227,826 $1,179,361 84% $108,185 Oct-22 975 1,692 $48,107, $236,652 $284,759 $769,448 $537,332 ($289,270) $239,989 $1,017,510 1,044 $1,519,816 $1,302,269 $226,966 $1,075,303 83% $217,547 Nov-22 980 1,701 $48,353 $237,891 $286,244 $961,986 $501,747 ($96,882) $171,002 $1,366,851 1,395 $1,527,216 $1,653,095 $227,736 $1,425,359 86% ($125,879) Dec-22 986 11708 $48,649 � $238,800' $287,449 $1,117,098. $558,604 ($98,001), $535,957 $1,577,701 1,600, $1,535,812 $1,865,151 $228,376 $1,636,775 88% ($329,339) Rx Rebates ($576,272)1 ($576,272) $576,272 Totals 11,7641 20,487 $580,436 1 $2,854,813 i $2,858,977 1 $8,768,495 $6,121,307 ($1,222,063), $1,793,893 $13,667,738 $1,162 F$18,344,193 $16,526,715 $2,755,737 1$14,347,251 8 (D 2020 USI Insurance Services. All rights reserved. W.1 4 Enrol Claims Per'Et. Total '. Medical Rx Total Gross OverSSL RxRebates Net Total •. Monthly Net Claims/ Annual Net Claims/ 1 Employees • Claims Claims Claims Claims EE1 EE1 .) Dec-21 994 11,817 $706,079 $474,034 $1,180,113 $172,337 $0 $1,007,776 $12,200,566 $1,032 $12,385 Jan-22 998 11,817 $633,311 $379,656 $1,012,967 $0 �0 $1,012,967 $12,028,230 $1,018 $12,221 Feb-22 992 11,818 $562,732 $385,120 $947,852 $0 ($117,323) $830,529 $12,075,891 $1,022 $12,263 Mar-22 989 11,815 $630,017 $552,147 $1,182,164 $1,374 $0 $1,180,790 $11,932,943 $1,010 $12,118 Apr-22 980 11,810 $650,888 $493,953 $1,144,841 $105,890 $0 $1,038,951 $11,692,839 $989 $11,873 May-22 976 11,800 $684,454 $516,888 $1,201,343 $97,085 ($148,896) `$955,361 $11,683,014 $989 $11,866 Jun-22 976 11,795 $689,355 $437,815 $1,127,170 $94,217 $0 $1,032,953 $11,819,970 $1,001 $12,010 Jul-22 969 11,786 $677,411 $520,701 $1,198,112 $110,576 $0 $1,087,536 $11,711,691 $993 $11,910 Aug-22 972 11,785 $794,884 $601,170 $1,396,053 $169,297 ($143,361) $1,083,395 $11,941,678 $1,012 $12,149 Sep-22 971 11,782- $596,912 $636,174 $1,233,086 $268,505 $0 $964,581 $11,996,845 $1;018 $12,215 Oct-22 975 11,780 $769,448 $537,332 $1,306,780 $239,989 $0 $1,066,791 $12,069,218 $1,024 $12,289 Nov-22 980 11,772 $961,986 $501,747 $1,463,732 $171,002 ($166,692) $1,126,038 $12,387,668 $1,051 $12,617 Dec-22 986 11,764 $1,117,098 $558,604 $1,675,702 $535,957 $0 $1,139,745 $12,519,636 $1,063 $12,753 3.0% Jan-23 982 11,748 $845,591 $523,670 $1,369,260 $0 $0 $1,369,260 $12,875,929 $1,094 $13,125 7.4% Feb-23 986 11,742 $670,073 $455,299 $1,125,372 $0 ($173,027) $952,346 $12,997,746 $1,105 $13,258 8.1% Mar-23 988 11,741 $1,027,256 $530,303 $1,557,559 $10,457 $0 $1,547,102 $13,364,059 $1,138 $13,651 12.7% Apr-23 996 11,757 $670,545 $514,745 $1,185,289 $78,553 $0 $1,106,737 $13,431,845 $1,144 $13,727 15.6% May-23 Jun-23 Ju I-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Historical Budget vs. Net Costs $25,000 ___-.-,___.________ $20,000 $15,000 $10,000 $5,000 $0 2021 PEPY 2022 PEPY 2023 PEPY Annualized a Budget s Net Costs Average Medical SSL Net Total Fixed Time Period Employees Budget Claims Rx Claims Reimbursements Net Claims Costs/Bud Costs Net Costs 2021 Plan Year 985 $17,687,116 $8,499;476 $5,493,604 ($981,466) $13;011,614 91.7% $3,210,394 $16,222,008 2022 Plan Year 980 $18,344,193 $8,768,495 $6,121,307 ($1,222,063) $13,667,738 90.1% $2,858,977 $16,526,715 2023Annualized 988 $18,836,388 $9,640,394 $6,072,050 ($2,701,796) $13,010,648 82.3% $2,489,024 $15,499,673 Change from Change from Change from Time Period Budget Prior Year Net Claims Prior Year Net Costs Prior Year 2021 PEPY $17,956 N/A $13,210 N/A $16,469 N/A 2022 PEPY $18,719 4.2% $13,947 5.6% $16,864 2.4% 2023 PEPY Annual! $19,065 1.9% $13,169 -5.6% o 0 2020 USI Insurance Services. All rights reserved. W, 1 6 Enrollment by Member Type Enrollment by Month and Tier 1,200 1,000 1 t »v ra A— Ee+Fam ® Ee+Ch (ren) 400 ' - - -- - - - - -- - - -- a Ee+Sp 200 ------ ® Ee Only Oy(L O1� O`cry O`c� O`o, O`1ry O1ry O`1ry O1� O`f� O1� O1ry O1� O`1O O1� O`1n' �\ �\ '\ h\ h\ Average Enrollment by Year by Tier 700 r -- — -- ---- ---- — — .... 609 618 600__.- 500 i ____.__ _.-•-- ------ _.____-_.__...__-------- ____....._.____.__...----- --___._.._... 400 - 300 200 176 180--_—.—..— — { 116 100 0.- r IML i - Ee Only Ee+Sp Ee+Ch(ren) Ee+Fam ■ Prior Year: 1 /2022 - 12/2022 o Current Year To Date: 1 /2023 - 4/2023 2020 US[ Insurance Services. All rights reserved. Year To Date Enrollment Distribution 8% 11% 63% ® Ee Only Ee+Sp ■ Ee+Ch(ren) ❑ Ee+Fam u�Y Multi -Year Trend Net Costs PEPY versus Trend $25,000— $20,090 $21,275 $20,000 _......: _._.._�____.___.___.__._18,776 $17,29 $15,000_.___---.___,._.._._._._.___._..___..._—__-_-__.-___-------_.___._--------.--------__._--. _--------_.__..__-____._ _----- ----- $16,469 $16�864 $15,688 $5,000 -- $0 2020 2021 2022 2023 -Net Costs PEPY Trended Costs PEPY Actual Costs 2020 2021 2022 2023 Net Costs $17,140,700 $16,222,008 $16,526,715 $15;499;673. Average Enrollment 991 985 980 988 Net Costs PEPY $17,296 $16,469 $16,864 $15,688 % Change from Prior Year -0.6% -4.8% 2.4% -7.0% Trended Costs 2020 2021 2022 2023 Trended Costs PEPY $17,433 $18,776 $20,090 $21,275 Observed Blended Trend (80% med/20% rx) 0.2% 7.7% 7.0% 5.9% Medical -1.9% 7.8% 6.5% 5.5% - Prescription 8.5% 7.3% 9.0% 7.5% c0 2020 USI Insurance Services. All rights reserved. 8 2023 YTD >_ $100,000 Large Claimants as a % of Total Claims 74, ■ Large Claimants - Other Clams 26% Category Total % of Total Claims>$200,000 $489,010 9.3% iclaims $150,000-$199,999 $197,8111 3.8%!. Claims $100,000 - $149,999 $681,375 13.0% ,Other Claims i $3,869,286' 73.9%1 Total $5,237,481 10o.040 Paid Claims> $100,000 Amount' Claims OverSSL; Reimbursements, Relationship Diagnosis) Plan Claimant 1 $264,842 $64,842 SPS Quadraplegia, Fracture of Neck, Respiratory Failure PPO Claimant 2 $224,168; $24,168 DEP ' N201- Calculus of ureter • PPO; Claimant $197,811 SUB R300-Dysuria PPO Claimant4 $130,564; SUB; 12720- Pulmonary hypertension, unspecified PPO Clalmant5 $112,953 DEP E849- Cystic fibrosis, unspecified PPO Claimant 6 $111,518 SUB=oplasm of overlapping sites of right female breast PPO Claimant $109,440 SUB •-Non-STelevation (NSTEMI) myocardial infarction PPO Claimant8 $109,325' SUB R531-Weakness PPO ,Claimant9 $107,575 SUB sis, lumbar region without neurogenic claudication PPO Total $1,368,195 $89,010 $0 © 2020 USI Insurance Services. All rights reserved. �, 1 9 i ummary- Denta Budget vs. Actual Net Cost $60,000 ---- - $50,000 _-____.___...._..-----_-_._. _.._.- _. --------.__ ..-.-- r 4 0 i I _ _ n Jan-23 Feb-23 Mar-23 Apr-23 c7 Budget n Actual Cost o Actu61,Fixed Claims PEPM m • ' Cost Total Employees Admin Fees Dental Claims Claims / EE Budget Actual Cost EE Contributions ER Expense % Paid by Budget Minus Employer Actual Jan-23 916 3,184 $40,184 $43.87 $49,497 $43,369 49,497 (6,129) -14.1% $6,128.72 Feb-23 921 3,202 $47,962 $52.08 $49,688 $51,164 49,688 1,476 2.9% ($1,475.68) Mar-23 919 3,195 $46,661 $50.77 $49,634 $49,856 49,634 222 0.4% ($221.54) Apr-23 927 3,222 $45,698 $49.30 $49,939 $48,921 49,939 (1,018) -2.1% $1,018.37 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Totals 3,683 $12,803 $180,505 $49.01 $198,758 $193,308 198,758 (5,450) -2.8% < $5,450 0 2020 USI Insurance Services. All rights reserved. , 1n Q $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $0 ost Summary- Denta Jon-22 Feb-22 Mar-22 Apr-22 Budget vs. Actual Net Cost i i a � r t � I i _4. J ' May-22 Jun-22 Jul-22 Aug-22 a Budget ® Actual Cost Sep-22 Oct-22 Nov-22 Dec-22 • Expected Claims PEPMjjjjj��� (eds i n° Fixed Cost Total Employees Admin Fees Dental Claims Claims / EE Budget Actual Cost EE Contributions ER Expense •� Paid by Budget Minus Employer Actual Jan-22 934 $3,633 $40,735' $43.61 $50,156 $44,368.62 $50,156 ($5,787) -13.00/. $5,787.38 Feb-22 929 $3,614 $37,727 $40.61 $50,112 $41,340.70 $50,112 ($8,771) -21.2% $8,771.30 Mar-22 927 $3,606 $47,415 $51.15 $50,246 $51,020.53 $50,246 $775 1.5% ($774.53) Apr-22 918 $3,571 $52,010 $56.66 $49,803 $55,580.80 $49,803 $5,778 10.4% ($5,777.80) May-22 914 $3,555 $39,688 $43.42 $49,677 $43,243.89 $49,677 ($6,433) -14.9% $6,433.11 Jun-22 913 $3,552 $37,832 $41.44 $49,492 $41,383.14 $49,492 ($8,109) -19.6% $8,108.86 Jul-22 905 $3,520 $39,647 $43.81 $49,211 $43,167.84 $4%211 ($6,043)-14.0%' $6,043.16 Aug-22 907 $3,528 $45,477 $50.14 $49,030 $49,005.06 $49,030 ($25) -0.1% $24.94 Sep-22 903 $3,513 $39,566 $43.82 $49,016 $43,078.97 $49,016 ($5,937) -13.8% $5,937.03 Oct-22 905 $3,520 $45,241 $49.99 $49,038 $48,761.34 $49,038 ($277) -0.6% $276.66 Nov-22 907 $3,528 $39,316 $43.35 $49,089 $42,844.07 $49,089 ($6,245) -14.6% $6,244.93 Dec-22 916 $3,563 $30,214 $32.99 $49,359 $33,777.55 $49,359 ($15,581) -46.1% $15,581.45 Totals 10,978 $42,704 $494,868 $45.08 $594,229 $537,573 $594,229 ($56,656) -30.5% $56,656 © 2020 USI Insurance Services. All rights reserved. 11 rime Periods Current -ALL PLANS Prior - ALL PLANS Renewal Period: Janua -24 December-24 Janua -24 December-24 Experience Period: Ma -22 Aril-23 Ma -21 Aril-22 Enrollment Period: Aril-22 March-23 Aril-21 March-22 Current Enrolled Employees: 996 Current Enrolled Members: 1,734 ,Claim DevelopmentRenewal Calculation PEPM Paid Claims $9,505,012. $5,702,472 $7,823,517 $5,267771 Total Large Claims in Excess of ISL ($200k) ($1,478,788) ($2,547,580) ($869,767) ($2,196,466) Benefit Adjustment $0 $0 $0 $0 Adjusted Paid Claims $8,026,224 $3,154,892 $6,953,750 $3,065,690 Annual Trend 5.0% 7.5% 5.0% 7.5% Midpoint Months 21.0 20.0 33.0 32.0 Applied Trend 8.9% 12.8% 14.4% 21.3% Trended Claims $8,741,632. $3,559,032 $7,952,243 $3,717,784 Portion of Large Claims up to ISL $1,056,253 $1,143,747 $690,263 $909,737 Adjusted Trended Claims $9,797,885 $4,702,779 $8,642,506 $4,627,520 Total Subscribers 11,741 11,757 11,815 11,810 Adjusted Trended Claims (PEPM) — $834.50 $400.00 $731.49 $391.83 Current Employees 996 996 996 996 Total Projected Trended Claims $9,973,965 1 $4,780,779 $8,742,720 $4,683,160 Total Projected Trended Claims(PEPM) $1,234.50 $1,123.32 Claim Period Weighting 100% 0% Total Experience Projection $14,754,744 $1,234.50 ASO Fee (PEPM) $607 034 $50.79 $1 740,641 ISL Rate (PEPM) $145.64 - ASL Rate (PEPM) $31 374 $2.63 5 769 PCORI Fee (PEPM) 0.48 A re atin S ecific Deductible $60 000 $5.02 Total Fixed Costs $2 444 818 204.55 17 199 562 $1439.05 $18 982 512 $1 588.23 9.4% 12 c Employee Only `61$ ; 618 , Employee+Spouse 111 111 - Em_ployee + Child_ren 18Q, . 180 Employee + Family 80 80 - 'Totall - � , s r- 1, •989; , � , � _ 989 Employee Only $63:00` Employee +Spouse $511a00. $511 00 Employee +Children '' $339:00' $33900 Employee+ Family $711.00 - $711.00 TQ,rAL 4_NNOALEE CONRIB,UTIONS' ., $2;562;660 . ' $2,562,660: ` Difference {$,/ /) °"„ $ / 0:0 Empl oyee Only $1,373.00 $1,37100 to Employee+Spouse $1;373'00 $1;37300 � Employee +_Children $137,3:00 $1;37300 , Employee + Family .' $1, 373.00 $1;373.00 TOTALANNUAL ERCONRIBUTIONS $16,294,764- $16;294,164 / 0 0% * Non -wellness employee contributions are additional 75 per month © 2020 USI Insurance Services. All rights reserved. `USX Underwriting- DentalPro-iection Time Periods Current -ALL PLANS Renewal Period: January-24 December-24 Experience Period: May-22 Aril-23 Enrollment Period: April-22 March-23 Current Enrolled Employees: 927 Renewal Calculation PEPIVI Claim Development Paid Claims Benefit Adjustment Adjusted Paid Claims Annual Trend Midpoint Months Applied Trend Adjusted Trended Claims Total Subscribers Adjusted Trended Claims (PEPM) Current Employees Total Projected Trended Claims Claim Period Weighting $497,487 $0 $497,487 4.0% 20.0 - 6.8% $531,093 10,944 $48.53 927 $539,828 100% Total Experience Projection $539,828 $48.53 Fixed Costs ASO Fee (PEPM) $39,873 $3.58 • - - - $579,701 $52.11 Current • • $599,268 $53.87 HE - . Kai 14 2024 Dental Renewal Projections Employee Only 543- 543 Employee +Spouse 137 137 Employee + Children,-�55 155_ Employee + Family - 92- - �92` Totals 927 , 927 Employee Only $30:00' Employee +Spouse $80;00 $80:00 Employee + Children $71:00 $71:00 Employee +Family $127:00`- $1,27'00 TOTALANNUAL EE-CONRIBUTIONS .-' , .,..,, , 9 68 $59 6$ 9,2 © 2020 USI Insurance Services. All rights reserved. @ 2019 US1 insurance Services. All rights reserved. 1 16 Plan Historical Indlvlduai Do ectihle 1711 11,500 $750 $1,SW $750 $1,5m $1,000 i $1,50U $1,W0' $1,5m $1,000 $1,5W $1,000 $1,500 Family Deductible $1,5m $3,000 $1,SW $3,000 $1,SW $3,000 , $2;OD0 _-_ $3,m0 $2,0m $3,m0 $2,000 $3,W0 $2,000 $3,000 Individual Out of Pocket $3,000 $9,0W $3,Om $91000 $3,m0 $9,000 $9,WO $3,5W $9,m0 $3,500 $9,000 $3,500 $9,000 Family Out of Packet $6,000 $18,0m $6,W0 $18,m0 $6;W0 $18,OW _ _ $7,000 $28,000 $7,0m $18,WD $7,000 $18,000 $7,000 $18,0m peduNGle Notlnduded Coinsurance 80% 30% 8l% 30% 80% 30% 80% 30% 80% 30% 80% 30% 80% 30% OffixeVisits $25/$35 Co pay Deductihle+70% $25/$35Copay Deductible + 70% $25/$35Copay Deductible +7P% $25/$35Copay Deductihle+70% $25/$35Copay Deduct! ble+70% $25/$35Copay Deducti bl e+70% $25/$35 Capay Deduaible + 70% URG ENTCARE $50 Deducible + 70% $50 Deducible + 70A $50 Deducible + 70% $50 Oedudhle+]0% $50 Deducible +]0% $50 Dedudble +70% $50 Deducible +70'% ERCapay $100 Copay then 20% $Im Capay then 20% $100 Capay then 20% �5150 Capaythen 20% $150 Copay then 20% $150 Copay then 20% $150 Capay then 2D91 Capay.1wdifndmitrod Capay—wxIi)adouMd Copay waived i)adoun,d Copay—rdiif.con ed Copay waiveddiof incd Copaywaived iif—ited Coppywufvedppdmdted Generic $7 $15 $7 $ss $7 $is -_$30 _ _ _ $11s $30 $15 SID $15 $10 $15 Brand Formulary 20% 2096 (Minimum 2l% 20% 2091 (Minimum 20% IMinimum 20% (Minimum 20% (Minimum 20% (Minimum 20'A (Minimum 20% [Minimum 209G (Minimum (Minimum$25, $50, Maximum (Minimum$25, 20% (Minimum$50, (Minimum$25, 20% (Mimmum$50, $25,Maximum $50, Maximum $25, Maximum $50, Maximum $25, Maximum $50, Maximum $25, Maximum $50, Maximum maximum $100) $200) _ Maximum $100) Maximum $200) Maximum$]%) Maximum $200) $1m) $200) Sim) $200) $100) $200) Sim) — $2W) Brand Non -Formulary 209A 20% Minimum ( 7D% 2l% 20% (Minimum 20% (Minimum 20% (Minimum 20% (Minimum 20% (Minimum 20% (Minimum 20% (Minimum 20% (Minimum (Minimum $40, $80, Maximum (Minlmum$40, 20% (Mmimum$80, (Mlnlmum$40, 20% (Minimum $80, $40, Maximum $80, Maximum $40, Maximum $80, Maximum $40, Maximum $80, Maximum $40, Maximum $80, Maximum Maximum $100) SOW) Maximum $100) Maximum $200) Maximum $100) Maximum $200) $Im) $2W) $1m) $2W) $1m) $20D) $100) $200) RKOUT-OF-POCKET $3850/$7700 $3850/$77W $3850/$77m $3850/$77m $3850/SPOO $3850/$7700 $3850/$77m Other Non-Grandfathered Non-Grandfathered Non-Grandfathered Non-Grandfathered Non-Grandfathered Non-Grandfathered Non-Grandf.1ho ed C.—Umiai Trials Cover Climcal Trials Cover Clinical Trials Cover Clinical Idais Corer Clinial Trials Cover Ciinice Trials Cover Cimiai Trials Cover Preventive withno coshare Cover Preventive with no Wshate Cover Preven five wi th no Wshare Cover Preventive wnh no coshare Cove r Preventive with no coshare Cover Preventive with no coshare Cove r Preventive with no Wshere Women's contrite ptwes no coshare Wome o's Wntraceptives no cash are Women's Wntmceptrves no coshare Women's contraceptives no coshare Women's. contraceptives no coshare Wome o's contraceptives no coshare Women's contraceptives no coshare Deductibles/Coinsurance/copays all Deductibles/Coinsurance/Wpaysall DeduRibles/Coinsurance/copays all Deifuctlbie>/Coinsurance/cppays all Deductibles/Coinsurance/copays all DeduRibles/Coinsurance/Wpays all Deductibles/Coinsurance/copays all apply toward the medical out-,f. apply toward the medical a ut-of-pocket, apply toward theinedical out-of-pocket. applytoward the medical out -of- apply toward themedicel out -of. apply towardthemedical out -of- apply towardthe medical out-of- ocket. For has a se arm, DOM. Flux has, separate OOM. Rx has a separate DOM. ockel. Fox has a se anal, OOM. pockct. Rx has, se ,rate DOM rocket. R. has a separate OOM. pocket R. has a separate DOM. Humana+added ST&PA&Ezcusions Humana -added ST&PA&Exclusions lolned TAC. Joined TAC Joined TAC Joined TAC lamed TAC Joined TAC Moved 1. CVS/Caremark R. with CVS/Caremark R. with CVSICaremark R. wnh CVS/Caremark Rx with CVS/Caremark Rx with CVS/Caremark I ,dfie Deducts 1WK 1WK _ _ _ _175K _ - _ 200 2WK 2mK 2WK API, gating SpeclAic OeduRihle mK mK mK 60K 60K 60K WK Employee Only ,, ,$860D $96,DO tY. $124.00 .$]4.m $124.W - $74.W $138.0$78.0 $138.m ] 563.m 7$62.00 Employee+Spouse $456.00 _ $507.00 - $527.00 $551.00 $SO1.W $SSl.m $501.W $586,00 $526.00 $586.00 ,. Employee+ Children $3W.m $345.m - $356.W $388.m $338.00 1388.00 $338.W $414.W ,5354.W f ,$511.00' 1414.01 $339.OD' Emplayee+Famil $634.00 $696.00 $706.00 - $741DO $692.00 $742.00 $02,m $786.00 . $726.00 $786.W $71100 $30 Discount on EE premium for $50 Discount on EE premium for $50 Discount on EE premium for $50 Discount on EE premium for $50Discounton EEpremium for $20 Discount for EE&SP Annual Exam Wellness Wellness Wellness Wellness Wellness Employee Only % 17 $976.00 $1,041.W $1,073.W $1,274.m $1,2]4.m $1,326.00 $1.373.00 Employee+5pouse $977.00 $1,042.W $1;073.m $1;274.m $1,274.m $1,326.00 $1' 73.00 Employee+ children $97&m` $1,043.00 $1073.m $1;274.W $1,274.W $1,326.00 $1,373.00, EmPlnyec+ Family $979.W $1,044.00 $1,073,00 $1,274,m $1,274.00 $1,326,01 $1,373.00 Wellness Di—ol$W Wellness Discount$75 7777 2024 COBRA Rates Includes 2% Employee Only $1,327.04' . Employee + Spouse Employee + Children1,582.09 Employee + Family $1,925:87"° Employee Only $30.00 rv' � Employee + Spouse Employee + Children $72:42 Employee + Family--^ - - $129.54 © 2020 USI Insurance Services. All rights reserved. ,Q C) rH N O z 1 Lubbock County (Self -Funded) Team Choice EPO Employee % County % Employee Only 260.00 3% 7,480.98 97% Employee + Child(ren) 3,380.00 14% 13,969.02 86% Employee + Spouse 2,340.00 22% 11,657.10 78% Employee + Family 4,420.00 20% 17,742.92 80% Aetna PPO Employee % County % Employee Only 1,950.00 22% 7,079.02 78% Employee + Child(ren) 3,250.00 20% 13,022.88 80% Employee + Spouse 4,810.00 32% 10,058.88 68% Employee + Family 6,240.00 27% 16,534.96 73% McClennan County (Self -Funded) Base Health Plan Employee % County % Employee Only 337.08 5% 6,756.60 95% Employee + Child(ren) 3,419.64 34% 6,756.60 66% Employee + Spouse 6,668.64 50% 6,756.60 50% Employee + Family 9,350.16 58% 6,756.60 42% County contributes $563.05 to total cost of plans' monthly premium Consumer Driven Plan Employee % County % Employee Only - 0% 6,234.12 100% Employee + Child(ren) 2,672.28 30% 6,234.12 70% Employee + Spouse 5,488.80 47% 6,234.12 53% Employee + Family 7,813.56 56% 6,234.12 44% Health Savings Account* 600.00 County contributes $519.51 to total cost of plans' monthly premium *County Contributes $600 to employee HSA Brazos County (Self -Funded) Employee % County % Employee Only 1,656.00 9% 16,476.00 91% Employee + Child(ren) 4,968.00 23% 16,476.00 77% Employee + Spouse 8,688.00 35% 16,476.00 65% Employee + Family 9,432.00 36% 16,476.00 64% *County contributes $75 for Wellness Discount County contributes $1,373 to total cost of plans' monthly premium Hood County (Self -Funded) Plan 1 Employee % County % Employee Only - 0% 11,731.20 100% Employee+ Spouse 6,027.58 34% 11,731.20 66% Employee + I Child 3,536.78 23% 11,731.20 77% Employee + 2 Children 3,536.78 23% 11,731.20 77% Employee + 3 Children 4,087.20 26% 11,731.20 74% Employee +`4Children 4,642.30 28% 11,731.20 72% Employee +5 Children 5,195.06 31% 11,731.20 69% Employee + 6 Children 5,747.82 33% 11,731.20 67% Employee + Spouse + 6 Children 11,775.40 50% 11,731.20 50% County contributes $977.60 to total cost of plans' monthly premium Johnson County HMO Employee % County % Employee Only - 0% 11,060.64 100% Employee + Spouse 12,194.64 52% 11,060.64 48% Employee +lChild 2,722.08 20% 11,060.64 80% Employee + Children 5,988.96 35% 11,060.64 65% Family 14,916.48 57% 11,060.64 43% County contributes $921.72 to total cost of plans' monthly premium PPO Employee % County % Employee Only - 0% 11,060.64 100% Employee + Spouse 14,922.96 57% 11,060.64 43% Employee+ 1 Child 3,858.96 26% 11,060.64 74% Employee + Children 7,989.12 42% 11,060.64 58% Family 17,964.00 62% 11,060.64 38% County contributes $921.72 to total cost of plans' monthly premium Comal County (Self -Funded) Employee % County % Employee Only - 0% 9,715.32 100% Employee + Spouse 4,991.74 34% 9,715.32 66% Employee +lChild 2,471.04 20% 9,715.32 80% Employee + 2 Children 2,928.64 23% 9,715.32 77% Employee +3 Children 3,386.24 26% 9,715.32 74% Employee + 4 Children 3,843.84 28% 9,715.32 72% Employee +5 Children 4,301.44 31% 9,715.32 69% Employee + 6 Children 4,759.04 33% 9,715.32 67% Employee + Spouse + 6 Children 9,749.74 50% 9,715.32 50% County contributes $809.61 to total cost of plans' monthly premium Galveston County (Self -Fund) Non -Nicotine Rate: Base Plan Employee % County % Employee Only 1,248.00 12% 9,540.00 88% Employee + Child(ren) 2,448.00 20% 9,540.00 80% Employee + Spouse 3,012.00 24% 9,540.00 76% Employee + Family 4,020.00 30% 9,540.00 70% Nicotine Rate: Base Plan Employee % County % Employee Only 2,853.60 23% 9,540.00 77% Employee + Child(ren) 4,053.60 30% 9,540.00 70% Employee + Spouse 4,617.60 33% 9,540.00 67% Employee + Family 5,625.60 37% 9,540.00 63% No Annual Health Assessment: Base Plan Employee % County % Employee Only 3,656.40 28% 9,540.00 72% Employee + Child(ren) 4,856.40 34% 9,540.00 66% Employee + Spouse 5,420.40 36% 9,540.00 64% Employee + Family 6,428.40 40% 9,540.00 60% County contributes $795 to total cost of plans' monthly premium County has 3 rates with 3 different plan (HDHP, Base Plan, Buy -up Plan) Victoria County (Self -Funded) Plan 1 Employee % County % Employee Only 2,100.00 32% 4,392.00 68% Employee + Spouse 5,100.00 50% 5,136.00 50% Employee + Child 4,920.00 49% 5,136.00 51% Employee + Family 6,300.00 55% 5,136.00 45% Plan 2 Employee % County % Employee Only 3,300.00 43% 4,392.00 57% Employee + Spouse 6,300.00 55% 5,136.00 45% Employee + Child 6,120.00 54% 5,136.00 46% Employee + Family 7,500.00 59% 5,136.00 41% _ Profit or Loss by Coverage Type $4,000,00 $2,000,000 � $(2,000,000) $(E,000,000) M Employee Dependents 0 Employees 13 Retirees M Employee Dependents 0 Employees 13 Retirees County Contributions Year $ Change * Change 2008 $484.50 2009 $547.50 13.0% 2010 $547.50 0.0% Brazos County Contributions Percent Change 2011 $646.00 18.0% 20.00% 2012 $682.00 5.6% 15.00% 2013 $700.00 2.6% 2014 $745.00- 6.4% 10.00% ......... 2015 $861.00 15.6% ................... ............. ............. 2016 $916.00 6.4% 5-00% .. ........ ............ .................. 2017 $976.00 6.6% 0.00% 2018 $1,041.00 6.7% 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2019 $1,073.00 3.1% — County Contributions % Change ......... Yearly Trend 2020 $1,274.00 18.7% --- — ---- 2021 $1,274.00 0.0% 2022 $1,326.00 4.1% 2023 $1,373.00 3.5% Average 7% * Based on monthly Brazos County, Texas Historical Emplovee and Dependent Health Insurance Contributions '20212 2023 County Contribution n Contribution ty Co tr 0 M -P4 $X, 4�,OQ' ,$1,Q73.00- $L274.00 $1,274,.06' `$I,�267'0p.�' '$1373.0 011 Employee Only 0 ly n bb 74. $6 -3 00 Employee + Spouse Employee e ee +Spouse �;001 -'$487 ob,,,,,- t '$501.00 $501.w �-,'$526.bo' 511 -00 Employee + Children $326.00 $338.00 $338.r00"$354.00 $339. 06, Employee + Family $676.00, $676.00"-" $691.00 $692.0,0 $126'.00,,, $7,11.00 l6clud6s$20 Wellness, ,Includes'$30: fncludes�$50.'Wellness ,` InC1'U'dbs,55Q Wellness Indddes,$6006Kine'ss udes"�,7' Piscount Wef1'hess,Dist6ufit' Discount. , I . ,Discount Discount� �W616E!si, 6 3ro6nf County Contribution Employee Only Employee + Children Year % Change Year % Change Year % Change_ 2015' -1�-65/6- 2015 '-6.1bo% 2015 4.80% 2016 6.4% 2016 9.43% 2016 9.92% -2017 6.6% 2017- 6.90% 2017 6.25% 2018 6.7% 2018 6.45% 2018 6.54% r',2019 �,3`1% 201,9-, change; —', No ange, 2019 No Change 2020 18.7% 2020 12.12% 2020 3.68% 2021 0.6% 2021: No change! 2021 No Change 2022 4.1% 2022 5.41% 2022 4.73% .59/c 2023 -4.24% Employee + Spouse Employee + Family Year %Change Year %Change 2015 4.84% 2015 5.08% 2016 10.00% 2016 10.595/.' 2017 6.29% 2017 6.55% 2018 6.80% 2018 6.62% 2019 No Change 2019 No Change 2020 2.87% 2020 2.37% 2021 No Change 2021 No Change 2022 4.99% 2022 4.91% 2023 -2.85% 2023 -2.07% Benchmork-i'm-4 Table 6. Traditional National Network Plans' Funding,, Premiums, and: Contributions c y", F- Per#Pnfdq'6bf'tjyct,p:zfhqf d.ff&z,thIz type of'p,lah 83% 94% 81%, 5elf-ln su red 6 38a 7 5% 28% 00--cf-network-cNered", -100% 90% E 6% nthly PreMiuM Family $1,-.855 $1,855 $2 '7283 $1;954 $7815 57,11 54910, $603- $896 Monthly -Eirployer,'Confeibuffon Percdfifaqw 7 Family 581011c, 62'3S 79% 7 15S 54%: Monthly: Pre'mi,ums;- Sing IeAhen Family" j Monthly Pdyroll Cohtdbs, ShQle,then Farnily Employer,S)AX icty as", ;angle 773 20. WYA Employer..Sk�sidy--6s %-of. PreMIM;" i& :7 `- L u 40_ tv W-wx) 1,51w f Q to-yg.