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AGENDA ITEM REVIEW FORM |
3.D.
Special Employee Benefit Trust Board Meeting
- Meeting Date:
- 04/13/2022
- Department Head:
- Maria Munoz
- Submitted By:
- Mary Barajas Gutierrez, Human Resources Coordinator, Human Resources Department
ITEM:
Discussion and possible action on any and all matters regarding the employee benefit plans proposals starting July 1, 2022, for the third-party administrator, the employee assistance program, network fees, prescription management provider, and the wellness program. (Susan Posada, Broker and Consultant, and Maria Muñoz, HR Coordinator)
SUMMARY:
Broker/Consultant Susan Posada will provide more information regarding the following changes:
Third-Party Administrator
90 Degrees, formerly EBSO,
Employee Assistance Program
Integrated Behavioral Health, Inc., doing business as Uprise Health, increased its fee from $2.28 to $2.39 (11¢ more) per employee per month (PEPM)
Network
Blue Cross Blue Shield increased its fee from $19.25 to $21.00 ($1.75 more) per employee per month (PEPM).
Prescription Medicine Management
Change of provider from Magellan Health to Southern Scripts. Costs for the first year are $10.00 per claim (second year $10.25, third-year $10.50).
Telemedicine
The Healthiest You contract for telemedicine continues without change.
HR Coordinator Maria Muñoz will review the activities of the Wellness Program.
Wellness Program
HR is requesting the same $18,000 budget as last year.
The below motions are recommended. The Trustees are free to approve, deny or modify the recommendations within their fiduciary duty.
Third-Party Administrator
90 Degrees, formerly EBSO,
- increased its fee to administer the plans from $24.50 to $25.50 ($1 more) per employee per month (PEPM),
- increased its claim management fee from $113 per hour to $140 per hour, and
- its contract is up for renewal.
Employee Assistance Program
Integrated Behavioral Health, Inc., doing business as Uprise Health, increased its fee from $2.28 to $2.39 (11¢ more) per employee per month (PEPM)
Network
Blue Cross Blue Shield increased its fee from $19.25 to $21.00 ($1.75 more) per employee per month (PEPM).
Prescription Medicine Management
Change of provider from Magellan Health to Southern Scripts. Costs for the first year are $10.00 per claim (second year $10.25, third-year $10.50).
Telemedicine
The Healthiest You contract for telemedicine continues without change.
HR Coordinator Maria Muñoz will review the activities of the Wellness Program.
Wellness Program
HR is requesting the same $18,000 budget as last year.
The below motions are recommended. The Trustees are free to approve, deny or modify the recommendations within their fiduciary duty.
RECOMMENDATION / SUGGESTED MOTION:
(1) I MOVE TO APPROVE THE INCREASES PROPOSED BY 90 DEGREES, UPRISE HEALTH, AND BLUE CROSS BLUE SHIELD AS PRESENTED.
(2) I MOVE TO RENEW THE 90 DEGREES CONTRACT PROPOSAL AND DIRECT THE EXECUTIVE ADVISORS AND CONSULTANT TO TAKE ALL FURTHER STEPS NECESSARY TO FINALIZE IT.
(3) I MOVE TO APPROVE THE PROPOSED CONTRACT WITH SOUTHERN SCRIPTS AND DIRECT THE EXECUTIVE ADVISORS AND CONSULTANT TO TAKE ALL FURTHER STEPS NECESSARY TO FINALIZE IT.
(4) I MOVE TO APPROVE A $18,000 BUDGET FOR THE WELLNESS PROGRAM FROM THE TRUST RESERVES.
(2) I MOVE TO RENEW THE 90 DEGREES CONTRACT PROPOSAL AND DIRECT THE EXECUTIVE ADVISORS AND CONSULTANT TO TAKE ALL FURTHER STEPS NECESSARY TO FINALIZE IT.
(3) I MOVE TO APPROVE THE PROPOSED CONTRACT WITH SOUTHERN SCRIPTS AND DIRECT THE EXECUTIVE ADVISORS AND CONSULTANT TO TAKE ALL FURTHER STEPS NECESSARY TO FINALIZE IT.
(4) I MOVE TO APPROVE A $18,000 BUDGET FOR THE WELLNESS PROGRAM FROM THE TRUST RESERVES.
Fiscal Impact
Fiscal Impact:
90 Degrees, TPA Services:
- Increase in administrative fees from $24.50 to $25.50 PEPM.
- Increase in Claims Management fee from $113 per hour to $140 per hour.
Fiscal Impact:
Uprise Health (employee assistance program ("EAP") fee increase from $2.28 to $2.39 PEPM.
Fiscal Impact:
Increase in Blue Cross Blue Shield Network fees from $19.25 to $21.00 PEPM (In second year of 2yr agreement).
Fiscal Impact:
Southern Scripts administrative fees
- Year 1: $10.00 Fee Per Paid Claim
- Year 2: $10.25 Fee Per Paid Claim
- Year 3: $10.50 Fee Per Paid Claim