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HEALTH INSURANCE / PERSONNEL - Personnel Director Coral Ferrin
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Requested Action(s)
recommendation
a) Request approval of the following recommendations from the Tehama County Health Insurance Advisory Committee:
1) Increase the health insurance premiums by 4.62% for the renewal period of January 1, 2025, through December 31, 2025 for the EPO and PPO plans - services through Live Health Online will continue to be no cost for employees
2) Decrease the Delta Dental plan by -2.19% with no change to benefits
3) Decrease the Vision Service Plan (VSP) by -7.94% with no change to benefits
4) Schedule the 2025 Open Enrollment period for October 1-31, 2024
b) Request authorization for the Personnel Director and/or the Auditor to take the necessary steps to notify Alliant Insurance Services (broker), PrismHealth, and the third-party administrator, WorkTerra
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Financial Impact:
The full County contribution per employee for calendar year 2025 will be $1,934.16 per month; $23,209.92 annually. This represents an increase of $80.50 per employee per month for approximately 660 County participants. The increase to the General Fund is approximately $64,997.04, and $101,761.78 to Public Safety Fund, for a total of $166,758.82 for January through June 2025.
Background Information:
Tehama County participates in the Public Risk Innovation, Solutions, and Management (PRISM) Health Insurance Program, formerly CSAC-EIA. By participating in the PRISM Health Insurance Program, the cost of claims is pooled between the participating members. Pooling claims help to provide stability and reduces the chance of large premium increases. Tehama County joined the CSAC EIA Health Insurance Program in 2003. In 2006, the EIA Health Program joined with Self Insured Schools of California (SISC), which further increased the pool size and therefore, provided more stability.
The Tehama County Health Insurance Advisory Committee (TCHIAC) meets annually, prior to the open enrollment period, to discuss the County's plans and premiums for the following year. The Committee is comprised of one or more representatives from each bargaining unit, plus a representative from the appointed Department Heads, a representative for retirees, a representative for unrepresented employees, and the Personnel Director. The Committee met on August 12, 2024 to discuss benefits for 2025. Representatives from Alliant Insurance Services attended the meeting and gave a presentation to the Committee on the program renewal.
PRISM recommended an overall increase to premiums for the pool of 4.66% for the plan year 2025. Based on the County’s claims experience over the past two years, PRISM Health Committee recommended an overall pool increase of 4.62% to the Tehama County health benefit plan structure for the plan year 2025. This rate increase is 3.38% less than the California PPO Trend.
The Committee is recommending continuing to include LiveHealth Online to the health plan, without the $15 copay. The goal is to bring down the overall cost of claims by encouraging more telemedicine, and less visits to urgent care and the emergency room. This benefit is available to employees for medical and psychological visits. Telemedicine utilization in Tehama County has increased significantly in the last several calendar years with a total of 352 visits in 2023.
As a reminder, the EPO plan is the only option available during open enrollment. The EPO plan moved to a non-grandfathered status in 2022. Advantages of having a non-grandfathered EPO plan include removing the co-pay and co-insurance for preventative care, as well as member benefits for participation in cost saving programs, such as Livongo, Hinge, Carrum Health, and SaveOn SP.
Tehama County’s dental plan is self-funded. For plan year 2025, Tehama County received a recommended net rate increase of 25.77%. The County had steadily built a reserve over the last several years. Meaning, the amount collected for premiums is greater than the amount paid in claims. The State Controller is requiring the County buy down the remaining reserve by $133,943. The Health Committee is recommending the buy down occur over the next two years, at a rate of $66,971 in the first year and $66,971 in the second year. Therefore, the Committee recommended an overall rate decrease to the dental plan of -2.19% for the benefit year 2025 or $60.30 per employee per month.
Tehama County’s vision plan is also self-funded. The proposed funding change percentage for the vision plan is a decrease of -7.94%. Committee members agreed with the rate decrease recommendation for the benefit plan year 2025. There were no changes to the vision plan structure.
Tehama County has a rate guarantee for the VOYA life and AD&D plans from January 1, 2024 through December 31, 2027. There will be no change to basic Life/AD&D for the benefit plan year 2025.
In 2019, the County began offering a voluntary supplemental life insurance option at no additional cost to Tehama County. There is a rate guarantee from January 1, 2024 through December 31, 2027, so there will be no change to the voluntary life plan for the benefit year 2025.
2025 Premiums for all Full-Time County Employees/Impact:
EPO Monthly Premium County Cont/Mo Employee Cost/Mo
2025 $2168.70 $1934.16 $234.54
Rate Chng. $89.62 $80.50 $9.12
Net Impact 4.31% 4.34% 4.05%
PPO Monthly Premium County Cont/Mo Employee Cost/Mo
2025 $2666.70 $1934.16 $732.54
Rate Chng. $111.62 $80.50 $31.12
Net Impact 4.37% 4.34% 4.44%
All rates shown are monthly and include medical, prescription, dental, vision and $30,000 life/AD&D. Part-time employees receive a pro-rated premium amount based on the number of hours worked.
The County has approximately $1,047,397.98 in a reserve/dividend account which is held by PRISM. The account is interest-bearing and can only be used for health insurance purposes. In the years of 2008 through 2011, the County utilized a portion of the funds in the dividend account to partially offset premium increases. In 2019, dividend funds were used to pay third party administrator fees. TCHIAC reviewed the funds held in the reserve/dividend account during the renewal meeting and did not propose to offset premium increases.
The Open Enrollment period is October 1 through October 31, 2024. Changes made during open enrollment will become effective January 1, 2025. Employees will receive information with the first September paycheck regarding changes to premiums and open enrollment processes. Information will be mailed to all retirees, COBRA participants, and Special District employees who participate in the County’s plan.
Tehama County employees will continue to participate in the WorkTerra self-service on-line enrollment process. Employees will be provided with more information about this process with open enrollment notices.
The Colonial Supplemental Insurance open enrollment period does not run concurrently with the health plan open enrollment. Employees will receive a Colonial flyer with a November paycheck with open enrollment dates and directions on how to schedule an appointment with the Colonial representative.