HomeMy WebLinkAboutIR 8397 INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 8397
psi&% Date: 04/09/02
To the Mayor and Members of the City Council
Page 1 of 3
SUBJECT: HEALTH BENEFITS FUND UPDATE —INTERIM REPORT
Purpose: The first Quarterly Report to the City Council concerning Health Benefits was issued
February 26, 2002. At that time, staff noted that the claims costs for the period October 1-December
31, 2001, were consistent with expectations and resulted in an adequate position for the status of the
fund.
After two additional months of claims data (January and February, 2002), it appears that claims costs
are higher than expected. This interim report is intended to notify the City Council of that status and to
identify actions being considered to control the costs.
Claims Costs:
A summary of the paid claims for the first five months of the fiscal year (October 2001—February 2002)
is shown below:
Total Paid Expected Total Paid Self-Funded Funding
Claims Paid Claims Plus Equivalent Surplus
Claims Admin. Fees Premium (Deficit)
OCT'01 $ 494,006 $ 2,360,200 $ 812,212 $ 3,262,120 $2,449,908
NOV'01 $ 2,184,562 $ 2,358,248 $ 2,503,154 $ 3,187,473 $ 684,319
DEC '01 $ 2,447,025 $ 2,349,021 $ 2,764,988 $ 3,171,512 $ 406,525
JAN '02 $ 2,941,554 $ 2,340,955 $ 3,258,507 $ 3,166,829 ($ 91,679)
FEB '02 $ 2,892,862 $ 2,338,976 $ 3,209,822 $ 3,167,438 ($ 42,384)
TOTAL $10,960,009 $11,747,400 $12,548,682 $15,955,371 $3,406,689
The total paid health claims costs for December, January and February have exceeded the expected
claims cost each month. Moreover, January and February total paid claims were approximately 25%
above the expected paid claims level. As you'll recall the plan is funded at 125% of expected claims
costs. The 25% corridor between expected paid claims and the aggregate limit is anticipated to
provide for reserves.
As of February, the reserves accumulated through the plan year are $3.4 million. Continued claims
expenditures 25% above the expected claims level will result in no additional reserves (beyond the
$3.4 million already accumulated) being added to the fund balance this fiscal year. Claims
expenditures greater than 25% above the expected claims cost level will erode the $3.4 million. It
should be noted that the "available" fund balance at the beginning of FY 2001-02 was $8.3 million.
Staff initially anticipated an additional funding surplus of $7.2 million by the end of FY 2001-02. If the
monthly claims costs continue at or around 125% of expected claims costs, the end of year fund
balance will be$3.8 million less than projected.
Allowing such cost trends to continue without developing contingency plans is not fiscally prudent.
ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS
INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 8397
APAT-A, Date: 04/09/02
14aft To the Mayor and Members of the City Council
Paae 2 of 3
SUBJECT: HEALTH BENEFITS FUND UPDATE —INTERIM REPORT
Contingency Plans:
Staff and the Health Benefit Advisory Committee are reviewing measures that could be implemented
prior to the end of the current fiscal year, with very little administrative costs. Such measures include:
1. Raising Employee and Retiree Contributions
Increasing the contribution rates for employees and retirees has the immediate effect
of bringing more revenue into the fund. This action would increase the "Self-Funded
Equivalent Premium" column in the chart, which would offset the costs, thereby
keeping the current year fund in a surplus condition.
This approach has little or no impact on decisions to access health benefits and
theoretically would not impact the claims costs. All members (employees and
retirees)would pay more no matter what their usage rate of the benefits is.
2. Changing the Plan Design
Changing the plan design to shift costs to those who use their health benefits, by
increasing the members' share of the costs for services provided, would.shift costs to
the "users" of the plan. This strategy is similar to "fee for service" methodology
utilized for funding some City services.
Current literature indicates the move toward "consumer-driven" health benefits, so
that those receiving the medical services become more like consumers by sharing
more of the cost.
The plan design changes being reviewed are those that would be administratively
easy to change and those where the benefit appears to be significantly greater in
Fort Worth's plan than in other comparable plans.
Such plan design changes include increased deductibles for various services,
increased maximum out of pocket limits before the plan pays for all costs for the
members, coinsurance, and cancellation of the application of member's prescription
costs to the attainment of their maximum out of pocket limit.
These plan design changes will impact employees and retirees: they will pay more for the
services provided by physicians and facilities. They will therefore be more likely to take on
the role of consumers, making decisions based on affordability and need.
11/001"
ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS
INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 8397
PAT Date: 04/09/02
To the Mayor and Members of the City Council
Paae 3 of 3
s^rs SUBJECT: HEALTH BENEFITS FUND UPDATE —INTERIM REPORT
Options and Recommendations:
Several options are available:
• Make no changes to the current plan design or contribution rates;
• Increase City contributions;
Increase employee/retiree contributions;
* Increase City and employee/retiree contributions; and/or
• Change the plan design.
It is staff's position that the first option is not viable. Even though it appears that a year-end surplus will
result, due to carry-over of the prior years' surplus, failure to take revenue-generating and/or cost-
containment measures is simply"putting our heads in the sand" and ignoring the potential future impact
both on costs and on the ultimate ability of the City to provide health benefits to employees and
retirees.
Staff and the Health Benefits Advisory Committee recommend that contingency plans to increase
employee/retiree contributions and/or to change the plan design be developed and be ready for
implementation immediately. "Immediate implementation" is about 60-90 days after the decision is
made to make the changes, in order to communicate the changes effectively to employees and
retirees.
Following an analysis of March claims data, which should be available by the middle of April, staff will
provide the City Council with the second quarterly report on the health benefits fund. At that time, staff
will recommend appropriate options to increase health fund revenues and/or control health claims
costs.
Gary W. Jackson
City Manager
ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS