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Home My WebLink AboutMINUTES - 02051991 - 2.4 '_`0llnn 4 TO: BOARD OF SUPERVISORS Contra FROM: Phil Batchelor, County Administrator Costa January 31 County 1991 �\``='° 4o DATE: REVIEW OF THE STATUS OF HEALTH CARE BENEFITS FOR COUNTY SUBJECT: EMPLOYEES SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1 . Accept the. report of the County Administrator outlining some of the positive things that have been done to stabilize the health care benefits of County employees and insure the integrity and the availability of these benefits. 2. Approve the distribution of the attached letter to all First Choice Health Plan enrollees, identifying some of the important features which make the First Choice Health Plan a source of quality health care. BACKGROUND: Over the past several months there has been adverse publicity about the County' s self-insured First Choice Health Plan. Questions have been raised regarding the management, administration and financial solvency of First Choice. It is time to stop for a moment and take stock of what steps are being taken to insure that the County' s First Choice Health Plan is financially sound, well administered and readily available to all those employees and their families who have chosen to join it. CONTINUED ON ATTACHMENT:YeS YES SIGNATURE: X RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON February 5, 1991APPROVED AS RECOMMENDED OTHER The Board heard comments from Jim Hicks, AFSCME, Henry Clarke, Contra Costa Employees Association, Local 1, and Benjamin Russell, retiree, relative to the work of the Health Coalition in developing the First Choice Health Plan. Following discussion, the Board ACCEPTED the report of the County Administrator and amended Recommendation No.- 2 to require inclusion in the referenced letter to solicitation of input from First Choice members as to their perception of the management and operation of the Plan and suggestions for improvement. The County Administrator was AUTHORIZED to coordinate with labor representatives and to have i the letter sent out as soon as possible. i VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. CC: ATTESTED Please see Page 3 . PHIL BATCHELOR,CL RK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY DEPUTY M382 (10/88) ly �� "✓ A number of recommendations have been made to the Board of Supervisors in recent weeks to help insure the viability of the Plan. These include having: 1. Completed an outside audit which reviewed administrative and contractual relationships and asked for recommendations to increase the efficiency of the First Choice Health Plan. 2. Established several labor-management committees to review the audit findings and recommended actions. 3 . Referred to the District Attorney all documents and information with a request for his assistance in investigating any items which, in his opinion, might involve inappropriate relationships. 4. Assigned the County Medical Director to assume overall policy and oversight of the First Choice Health Plan and dental plans for 90 days. 5. Assigned the County' s Risk Manager to handle the day-to-day administrative responsibilities for the First Choice Health Plan and dental plans during the review period. 6. Transferred the Employee Benefits Manager and the responsibility for all employee benefits to the Risk Management Division. 7 . Agreed to work with a labor-management committee on a Request for Proposal (RFP) to seek a benefits advisor to assist the County in the management of the First Choice Health Plan. 8. Agreed to work with a labor-management committee to review the First Choice Health Plan reserves and the necessity for stop-loss insurance. 9. Agreed to work with a labor-management committee to prepare and distribute an RFP to insure the most cost-effective and efficient delivery of claims administration services for the First Choice Health Plan. 10. Endorsed the concept of working with a labor-management committee to develop a "joint trust" organization that could serve as overseer of the First Choice Health Plan. 11. Negotiated a 33% reduction in the First Choice Health Plan administrative fee. 12. Noted an increase in the membership of the First Choice Health Plan from 600 ''members to 2700 members in a three year period, a 350% increase. 13 . Approved the attached letter to First Choice Health Plan enrollees highlighting the commendable features of the First Choice Health Plan. It is important to recognize some of the measures taken by the Board to assure that County employees are provided a viable, solvent, well-managed and reasonably priced medical indemnity plan. In addition, it is important to recognize that the First Choice Health Plan has a number of features which make it an important . benefit for ' both employees and retirees: * , The Plan provides worldwide coverage for employees and retirees and is the only health care coverage offered by the County which retirees can use outside of the immediate geographic area. -2- * The Plan provides for freedom of choice among medical care providers. * The Plan also has available a statewide network of preferred providers. Use of these preferred providers means the employee or retiree has no out-of-pocket cost for health care. * If an employee or retiree chooses to use other than a preferred provider there is a maximum $1000 annual out-of-pocket cost for non-preferred providers. * The Plan also includes a preferred provider pharmacy network where prescriptions can be obtained at a modest co-pay. * Coverage under the Plan includes unlimited hospitalization, an incentive for use of outpatient rather than inpatient ; care when appropriate, well baby care, and school or sports physicals up to age 17 . * The preferred provider network discounts have remained at the same level for three years. cc: County Administrator William Walker, M.D. , County Medical Director Joe Tonda, Director of Risk Management County Counsel Director of Personnel All County Department Heads (Via Risk Management) All Employee Organizations (Via Risk Management) -3- FEB-..: 4-491 , MON 1 6 44 HSD •AI]M IN .. P . 02 ;! s£ L Contra Costa County . . f: ' Health Services Department William B. Walker, M.D. x, Medical Director and •,, .•�tv County Health Officer osTA,coc�'�' February 5, 1991 Dear First Choice Health Plan Member: As you are no doubt aware, there has been some adverse publicity recently regarding allegations of problems with the First Choice Health Plan. We want you to know that a number of steps have been taken by the Board of Supervisors and the, County Administrator' s Office to insure that First Choice remains the strong, viable, quality health care pian you have a right to expect it to be. On February 5, 1991, the County Administrator presented -a report to the Board of Supervisors outlining these steps. These include the following: 1 . I have been assigned overall policy and oversight responsibility for the First Choice Health Plan and Dental Plans for the next ninety days (90) . 2. The County Risk Manager, Joe Tonda, has been assigned the day- to-day administrative responsibilities for the First Choice Health Plan and Dental Plans during the review period. 3 . We are working with several Labor-Management Committees to review. the findings of the recent audit and the recommended actions . 4 . I am chairing a committee representative of management and the union coalition. to develop the concept of an "Employer/employee Joint Trust" to serve as overseer of the .First Choice Health Plan.. We are sending out a Request for Proposal (RFP) this week to seek a Benefits Advisor to assist us in establishing a trust' as well in helping with some of the analysis necessary to assure the .viability and strength of the plan. 5 . A separate Labor-management Committee is reviewing First Choice Health Plzen reserves and the issue of stop/loss insurance. 4-<911 M O N 16 : 4r> H S D ADMIN . P . 0:5 6. A thirty-three percent ( 33%) reduction in the First Choice Health Plan administrative contract has been negotiated effective January 1, 1991 . We will be preparing an RFP to . ensure the most cost effective and efficient delivery of claims administration services for the First Choice Health Plan. You know there has been an increase in the membership of the First Choice Health Plan from 600 to 2,700 members in a three year period, a Three hundred fifty percent. (350%) increase. There is every reason to believe that, if properly administered, a viable health plan can be maintained with such a membership base. You are all aware of the desirable features offered by First Choice Health Plan including world-wide coverage for employees and retirees, freedom of choice of medical care providers,- state-wide network of preferred providers, and a whole list of other desirable benefits. I give you my commitment to work with your employee organizations in ensuring quality and stability of the plan. First Choice is honoring all claims presented to it for payment and will continue to do so. If you have any further questions, please contact the Benefits Division at (415) 646-4940 . Very truly yours, William B. Walker, M. D. County Medical Director County Health Officer first.ww. WW-.no