HomeMy WebLinkAboutMINUTES - 09302008 - SM TO: BOARD OF SUPERVISORS 5 E L °� Contra
FROM: JOHN CULLEN, County Administrator
Costa
DAVID TWA, County Administrator
40
CountyDATE: SEPTEMBER 25, 2008 � i srA_coux
SUBJECT: CALPERS PROPOSAL MT6
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION
1. ACKNOWLEDGE Board of Supervisors adopted goals for the County's Other Post Employment Benefit
liability;
2. ACKNOWLEDGE receipt of proposal from Doug Pipes (Retired Senior Deputy District Attorney)
regarding"Proposed Changes in Health Care Benefits Affecting Retired County Employees"; and
3. RECEIVE report from the County Administrator analyzing the proposal.
FINANCIAL IMPACT:
Other Post Employment Benefits (OPEB) do and will have significant future impact on the County's
overall fiscal stability and service delivery viability.
BACKGROUND
In the fall of 2006, the County Administrator established a task force to manage the County's long-term
liability for Other Post-Employment Benefits. On June 26, 2007, the Board established the following
OPEB goals: 1) fully comply with Governmental Accounting Standards Board (GASB) Statement 45; 2)
adopt an OPEB financing plan, which preserves a balance between providing sound, competitive health care
coverage for our employees and retirees and maintaining vital county programs and services; and 3) adopt an
OPEB funding target of 100% of the potential liability for the retiree population(this target currently equates
to approximately 40% of the total liability).
CONTINUED ON ATTACHMENT: L YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR ❑ RECOMMENDATION OF BOARD COMMITTEE ❑
❑ APPROVE ❑ OTHER
SIGNATURE(S):
ACTION OF BOARD ON
❑ APPROVED AS RECOMMENDED ❑ OTHER
VOTE OF SUPERVISORS: I HEREBY CERTIFY THAT THIS IS A TRUE AND
CORRECT COPY OF AN ACTION TAKEN AND
UNANIMOUS (ABSENT ) ENTERED ON THE MINUTES OF THE BOARD OF
SUPERVISORS ON THE DATE SHOWN.
AYES: NOES:
ABSENT: ABSTAIN: ATTESTED: SEPTEMBER 30, 2008
Contact: LISA DRISCOLL (925) 335-1023 DAVID TWA, CLERK OF THE BOARD OF
cc: County Administrator's Office SUPERVISORS AND COUNTY ADMINISTRATOR
By: Deputy
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To achieve the Board's goals,the OPEB Task Force utilized the breadth of expertise available within the
county and through professional contracts in each of the-following areas: financial, audit,budgetary,
personnel, labor relations,benefits, and legal. The importance of incorporating the perspective of all
stakeholders was recognized. The Board of Supervisors,through the work of the Task Force,has
accomplished the following tasks.
• Received OPEB Task Force presentation on OPEB challenge, focusing on the magnitude and possible
changes to the liability(March 2007).
• Directed OPEB Task Force to report on funding targets including evaluating and calculating different
targeted funding scenarios and the fiscal,budgetary, reporting, and programmatic impact scenarios under
those funding levels (June 2007).
• Adopted an OPEB funding target of 40%of the liability(June 2007) and allocated$588+million in future
resources towards the OPEB liability(June 2007).
• Researching benefit plan designs including: detailed demographics of the current active employee
population as well as retirees;best practices; making comparisons to other municipalities,public sector,
and corporations in the area; and considering changes to benefit plan design, administration, cost sharing,
funding mechanisms, and providers such as Ca1PERS (May 2007-ongoing).
• Conducted pre-negotiation meetings with county labor representatives regarding the development of
possible plans and models for benefit reform(June 2007) and developed and delivered `brown bag'
education campaign for county employees, labor organizations, and the public (September 2007-December
2007);
• Approved an irrevocable trust(Internal Revenue Code Section 115) for OPEB funding for Contra Costa
County(January 2008). The purpose of establishing the Trust is to comply with GASB to establish a
mechanism for 1) saving OPEB funds, 2) earning interest, and 3) discounting our liability.
• Directed the County Administrator to begin the application process to prefund other post employment
benefits through the California Employer's Retiree Benefit Trust Program ("CERBT") and to return to the
Board, to execute an agreement with Ca1PERS upon successful conclusion of application process.
• Ordered and received the second GASB 45 required comprehensive calculation of liability(spring 2008).
• Adopted changes to the Management Resolution and Fire Management Resolution regarding
compensation and benefits that will begin the process of reducing our OPEB liability,reducing overall
health care cost growth, and specifically reducing health care cost growth for the County(May and July
2008). The County's goal is to reduce the overall cost growth of benefits prior to 2010 through Benefit
Plan design changes that counteract medical cost growth in order to preserve a balance between providing
sound health care coverage for our employees and retirees and maintaining vital county programs and
services.
• Selected a Benefit Design Consultant—Buck Consultants to help in identifying cost control options.
• Implemented a Health Care Benefit Design Task force. The job of the Task Force is to: become familiar
with the County's existing healthcare benefit structure,budgetary costs, and eligibility provisions;
determine healthcare needs of County employees; explore cost effective alternative plans that reduce our
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OPEB liability; and, submit recommendations for the design of competitive, cost effective and customized
healthcare benefit plans.
• Adopted a FY 2008/09 budget including$20 million in OPEB pre-funding dollars, $10 million of which
came from program/service reductions.
These changes have had a significant impact on the County's original 2006 OPEB liability of$2.6 billion,
annually required contribution(ARC)of$216 million, and funding gap of$139 million. As reported to the
Board in April 2008, the projected valuation was reduced to $1.7 billion total liability and the ARC to
$129.4 million.
At the Board's adopted 40% funding target, the County's remaining OPEB liability funding `gap' is
approximately$53.7 million. This means that we must either reduce benefits or cut programs permanently
by$53.7 million in addition to resources already allocated in order to reach the goal of 40%. Continued
work on countywide health care cost containment strategies and the redirection of designated future
resources are key to resolving the OPEB dilemma. The Board of Supervisors continues to make progress
towards a solution for one of the biggest fiscal challenges the County is likely to face.
CaIPERS Proposal
On June 2, 2008, Doug Pipes(a retired Senior Deputy District Attorney), submitted a proposal (Attachment
A)to the Board of Supervisors regarding"Proposed Changes in Health Care Benefits Affecting Retired
County Employees"(Proposal). Mr. Pipes personally has researched CalPERS, developed the transfer
assumptions, and calculated the costs behind this Proposal. At the Board of Supervisors June 24, 2008
meeting, Board members requested that staff analyze the Proposal and return to the Board with a written
response.
CalPERS is the third largest purchaser of health care in the nation,providing benefits to more than 1.2 million
public employees,retirees, and their families. The program covers State employees by law, and local public
agencies and school employers can contract to have CalPERS provide these benefits to their employees
(whether or not they contract for the CalPERS retirement program). CalPERS offers three types of health
plans: Preferred Provider Organizations (PPOs); Health Maintenance Organizations(HMOs); and Exclusive
Provider Organizations(EPOs) (limited to members in certain California counties).
More than two-thirds of CalPERS members are enrolled in HMO plans,which offer a standard benefit design.
All HMO,PPO, and EPO plans offer separate Medicare supplemental plans for those members eligible for
Medicare. Health plans offered, covered benefits,monthly rates, and co-payments are determined by the
CalPERS Board, which reviews health plan contracts annually. Employers make a contribution(subsidy)
towards the member's monthly premiums,with members covering the difference between the employer's
contribution and the actual premium amount. The employer contribution rate is normally established through
collective bargaining agreements—as would be the case in Contra Costa County. Contra Costa County's
public safety employees are members of the CalPERS program.
Mr. Pipes' Proposal states that transferring County active employees and retirees to CalPERS health insurance
plans would save"millions of dollars each year in the County' share of health insurance premiums and in
costs for administering health insurance plans for its employees and retirees." The Proposal does not include a
transfer of all active employees and retirees; it specifically excludes CCHP members (approximately 30%of
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our total health care program and 46%of our non-PERS active employees). Mr. Pipes acknowledges that
transferring CCH? active and retired members to CalPERS would cause a significant cost shift to those
members due to the current very high County CCHP subsidy. The basic premise behind the Proposal is that
Ca1PERS health plans are less expensive than the County's current plans and that transferring most of our
employees and retirees to CalPERS will cost the County less.
In considering a reply three areas need to be addressed. The first is the cost of health plans and the impact of
the proposed transfer on employees,retirees (living in and out of California), and the County. The second is
our current County policy of tiering our plans to benefit families. And finally(and most importantly), the
issue of CalPERS reduction of the County's OPEB liability must be addressed.
County staff met on multiple occasions with Mr. Pipes and representatives from the Retiree Support Group of
Contra Costa County. Although County staff does not agree that all of the migration and cost assumptions
made by Mr. Pipes will come true,basic agreement was reached on many issues.
Staff would like to point out that Ca1PERS offers excellent health care plans available to agencies by contract.
There is nothing inherently wrong with CalPERS or the health care plans it offers. The issue is whether or
not moving to CalPERS helps the County to reduce its OEPB liability. There are, of course, advantages and
disadvantages of moving employees and retirees to CalPERS:
Advantages
• Initially provides pay-go (County premium subsidy) savings.
• Arguably removes the premium subsidy of retirees by actives in the GASB 45 valuation due to
community rating of CalPERS plans. This potential decrease in the County's OPEB liability is almost
entirely offset by the guaranteed. addition to the County's OPEB liability for surviving spouse coverage.
• Saves the County in the form of a lower County premium share for active employees and retirees by
transferring those costs to active employees with families and to retirees.
• Although it adds costs for employees and retirees, CaIPERS does include survivor coverage which is
an advantage to retirees.
• Offers more plans for out of area retirees.
Disadvantages
• Does not reduce the County OPEB liability.
• Requires that County subsidies for actives and retirees must be equal and that County subsidies must
be the same for current employees and new hires. These restrictions offer very little flexibility in
medical plan design and eliminate the possibility of reducing future liability through establishing a new
tier for new hires.
• Limited input on eligibility requirements for postretirement medical coverage. CalPERS dictates most
benefit design options including co pays, deductibles, and coinsurance, which reduces the County's
flexibility in benefit design.
• Inability to have a local 15 year vesting requirement. CalPERS dictates form of vesting requirements
and allows only two options.
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• Higher overall premiums, not just based on going to three tiers, but on a unit cost, per-employee-per-
month basis. This is due to community rating and does not take into account our own positive
experience or any local health improvement initiatives.
• No flexibility in tier structure, we must go to three tiers; right now if we wanted to, we could change
our tier structure, but are not required to do so.
• Added cost of survivor coverage.
• Under the current scenario, working families will pay more for health coverage under CalPERS than
they do in County plans.
• Medicare eligible retirees must enroll in Medicare, requiring on-going very large penalties for some of
our older retirees.
• CalPERS only allows same sex domestic partners that are State registered—this would be a health care
take-away for a portion of our employees/retirees.
Analysis
Attached is a PowerPoint presentation(Attachment B) analyzing the methodology used in Mr. Pipes'
proposal and the County's, along with our calculation of the savings associated with the proposal.
It should be noted that the County's current CalPERS subsidy and Mr. Pipes' proposed CalPERS subsidy
are tied to the Bar Area Kaiser rate. The Bay Area Kaiser rate includes many higher cost county areas such
as San Francisco, Marin, and San Mateo. The County's current Kaiser rate is experience rated based on
the majority of costs arising in Contra Costa County. The listing of State Agencies (Counties, Districts,
Cities, and School Districts) included in the Proposal shows that mainly smaller groups that can not benefit
from experience rating when seeking health insurance participate in the CalPERS pool. Large Counties
and Cities are better off working directly with insurance carriers to get the best rates based on their own
claim experience. Contra Costa County is a large group and benefits from a lower cost stricture on a per
employee per month basis by not fully participating in CalPERS pooling. The County's calculations show
that Contra Costa County's current per-employee-per-month rates are better than CalPERS.
Staff and Mr. Pipes have had a lively debate regarding which plans cost more in total—County plans or
CalPERS plans. Because the County has a two-tier family subsidized system and CalPERS has a three-tier
straight subsidy system, it has been difficult to `prove' that one plan is more expensive than another. What
is very clear and easy to `prove' is that CalPERS health plan costs are increasing more annually than
County health plan costs. Between 2001 and 2009, County Kaiser plans have increased by 128.33%. In
this same time period, CalPERS Kaiser plans increased by 151.37%. In the last year, County Kaiser single
plans increased by 5.52% and family by 6.43%. For that same time period, CalPERS Kaiser plans
increased by 8%. Attachment C shows rate increases annually and in total for each of the last 8 years.
Conclusion
The County must its reduce OPEB liability through management of benefits options and County cost
control,while providing competitive health care. Moving to CalPERS would not allow the County the
flexibility to do this. This Proposal does nothing to resolve the County's OPEB liability. At the 80%
County subsidy, the County might save up to $6.6 million annually(Pipes' Proposal) or might spend an
additional $1.6 million annually(County estimate of impact of Proposal); employees and retirees might
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save a net of$600,000 (Pipes' Proposal) or might pay an additional $4.3 million (County PEPM estimate)
in contributions annually. Even if the entire County savings identified by Mr. Pipes were realized and
were to be put in our OPEB trust, our liability would still continue to grow (we currently have a$54
million annual funding gap). Additionally, future liability valuations will be higher as we will no longer
have separate tiers for new hires and will continue to experience higher Ca1PERS rate increases.
The Ca1PERS disadvantages listed above severely limit local flexibility to define and negotiate health
care options and costs for not only our current active employees and retirees, but for our future
employees as well. Flexibility is absolutely essential if we are to continue to reduce the OPEB liability
while providing sound health care coverage for employees and maintaining vital county programs and
services. The potential pay-go savings to the County(the majority of which, if any, arguably will be
picked-up by our employees and retiree through increased share of health care premium) gained by
transferring some of our County employees/retirees to CalPERS Health Plans does not address the
County's OPEB liability goals and in fact severely limits the County's ability to reach those goals in the
future.
Attachments: Mr. Pipes' Proposal (Attachment A)
PowerPoint Presentation(Attachment B)
Health Care Rate Increase Comparison(Attachment C)
I
Attachment A
23201 N.E. 47th Avenue
Ridgefield, WA 98642
June 2, 2008
The Hon. Federal D. Glover, Chair
The Hon. John Goia, Supervisor, District I
The Hon. Gayle Uilkema, Supervisor, District 2
The Hon. Mary Piepho, Supervisor, District 3
The Hon. Susan Bonilla, Supervisor, District 4
Contra Costa County Board of Supervisors
651 Pine Street, 1st Floor
Martinez, CA 94553
Re: Proposed Changes in Health Care Benefits Affecting Retired County Employees
Dear Chairman Glover and Members of the Board:
I have been advised that following your meeting of May 6, 2008, several
members of the Board of Supervisors requested that I provide for your review the
evidence to which I referred in my letter of May 6th. You will recall that in that letter I
stated that transferring County active employees and retirees to CalPERS health
insurance plans would NOT cost an additional $26 million each year, as claimed by
County staff, and that any such claims are grossly inaccurate and false. To the
contrary, switching to PERS Health would save millions of dollars each year in the
County's share of health insurance premiums and in costs for administering health
insurance plans for its employees and retirees.
The attached analysis entitled "The Benefits to Contra Costa County From
Switching Its Employees/Retirees to PERS Health Plans" and its supporting charts
contain the evidence that proves that Contra Costa County could save its taxpayers
hundreds of millions of dollars by switching to PERS Health.
The conclusions I have reached are not the result of my own data or my own
interpretation of the data. These conclusions are the product of simple mathematics
applied to data provided to me by the County in response to my public records requests
and the use of the County's and PERS Health's insurance premium rate charts that are
a matter of public record. I have used the County's own statistics and records in
reaching these conclusions.
The decisions you are being called upon to make regarding health insurance for
County employees and retirees are momentous and will have long-reaching
consequences for Contra Costa County, its employees, its retirees, its taxpayers, and
you personally as members of the County's governing body. You deserve to have
May 30, 2008
Page 2
accurate data and information to guide your decision-making. If you make these
weighty decisions based upon grossly inaccurate data and false conclusions, you will
inflict irreparable, life-impacting harm upon the County's active and retired employees.
The consequences of that harm would then be visited upon the County's taxpayers, and
you would have done a disservice to your constituents whom you were elected to serve.
Accordingly, I believe that it would behoove you to personally invest the time necessary
to study the attached analysis and its supporting charts, and not simply rely upon a
report or analysis of them by others.
Adopting this proposal would save Contra Costa and its taxpayers as much as
$17.6 million in the first year in the County's share of health insurance premiums for
active employees and retirees. Over the next 30 years (the period of time covered by
the County's OPEB report) the savings to the County and its taxpayers would amount to
as much as $527.8 million calculated in 2008 dollars. This one-half billion dollar in
County savings will be even greater when the savings are calculated in "real dollars,"
which represents the future value of present-day dollars.
I am hopeful that you will agree to rneet with me individually to discuss my
proposal, the conclusions on which the proposal is based, and the evidentiary basis for
those conclusions. And I would be pleased upon request to explain this proposal and
my conclusions in a public session meeting of the Board.
Sincerely yours,
L. Douglas Pipes
Senior Deputy District Attorney (Ret.)
Contra Costa County
cc: John Cullen, County Administrator
Lisa Driscoll, County Finance Officer
2
I
THE BENEFITS TO CONTRA COSTA COUNTY
FROM SWITCHING ITS EMPLOYEES/RETIREES
TO PERS HEALTH PLANS
L. Douglas Pipes'
June 2, 2008
REDUCED HEALTH INSURANCE PREMIUM COSTS FOR
' CONTRA COSTA COUNTY: The County Would Save
Between $3.4 Million and $17.6 Million Each Year in
Reduced Premium Costs.
1 . PERS health insurance premium rates are lower than
the County's health insurance premium rates in 32 out of
38 of the most common rate categories.
2. The County's 87% subsidy of PERS health insurance
premiums would be lower than the existing County
subsidies of the County's health insurance premiums in
49 out of the 58 rate categories by which County
employees and retirees get their health insurance.
3. The County's 80% subsidy of PERS health insurance
premiums would be lower than the existing County
subsidies of the County's health insurance premiums in
51 out of the 58 rate categories by which County
employees and retirees get their health insurance.
4. The County's health insurance plans provide that once
an employee or retiree leaves a County-sponsored
health insurance plan, the employee or retiree may
never again receive a County subsidy for health
insurance under a County plan. In order to protect
This analysis and supporting its charts have been prepared by L. Douglas Pipes, Senior Deputy District
Attorney (Ret.), Contra Costa County, in his private capacity and not as a County employee.
2 There is one exception to this rule: An active employee who has left the County's health insurance
plans and who then experiences a "change of life" event, such as his or her spouse's loss of outside
health insurance coverage, may re-enter the County's health insurance plans. This exception is not
available to retired employees.
1
r-
their right to future County-subsidized health insurance
coverage, employees and retirees who do not need one
of the County's health insurance plans, because, for
example, they are covered by their spouse's health
insurance plan, thus sign up for CCHP, which costs
them only about $20.00 per month as their share of the
premiums. The County department for which they are
employed or from which they retired, however, must pay
more than $1 ,000.00 per month per person as the
employer's share of premiums for this health insurance
that is not needed and never used.3
5. PERS Health plans allow participants to leave and then
return to .coverage under its plans. Because employees
and retirees would not have to keep coverage in CCHP
to preserve their right to return to County-subsidized
health insurance plans in the future, transferring
employees and retirees to PERS Health would eliminate
this waste of taxpayers' tax dollars.
REDUCED HEALTH INSURANCE ADMINISTRATIVE
COSTS FOR CONTRA COSTA COUNTY: The County
could save as much as $1 .3 million each year in reduced
costs for administering its health insurance plans for
employees and retirees, and an undetermined additional
amount of reduced personnel costs. [See written analysis
entitled "AdministrCative Cost Savings to Contra Costa
County From Transferring Employees and Retirees to PERS
Health Insurance Plans. ,]4
3 In 2006 the Employee Benefits Unit of Human Resources Department reported that 58 out-of-state
retirees were participating in CCHP, whose non-emergency medical services may only be obtained in
Contra Costa County. The cost to Contra Costa County of the County's share of these unnecessary
premiums (at least$58,000.00 per month) has wasted $700,000.00 per year.
a Because surviving spouses would be entitled under PERS to County subsidy of their health insurance
premiums, and the annualized premium cost for the 231 surviving spouses now covered by the County's
health insurance plans is less than $1 million, the administrative cost savings from switching to PERS
would more than offset the increased premium costs paid by the County for surviving spouses. Many of
these surviving spouses are elderly widows living off small annual incomes. I can think of no finer use of
wasted administrative costs than to help these struggling widows afford health care.
2
IMPROVED NEGOTIATING POWER WITH HEALTH CARE
PROVIDERS.
1 . Contra Costa County now negotiates with health care
providers for a plan membership that is less than
10,000 persons. CalPERS Health negotiates with
health care providers for a plan membership that is 1 .2
million persons strong, the second or third largest
health insurance plan in the world.
2. PERS Health's size enables PERS to negotiate health
insurance plan designs, benefits, and premium rates
that are better than the County's plans. As in all other
aspects of life, the 800 pound gorilla commands a
stronger negotiating position than the 8 pound
Chihuahua.
• LITIGATION AVOIDANCE BENEFIT: Agreeing to transfer
County employees and retirees to CalPERS Health would
avoid expensive and time-consuming negotiations and
litigation with employee labor organizations and retiree
organizations, and would avoid the County's having to pay
the employees' and/or retirees' attorneys fees and costs as
prevailing parties in federal civil rights litigation to protect
their vested health insurance benefits.
1 . There is reason to be optimistic (for reasons discussed
below) that both active employees and retirees would
support a transfer of their health insurance plans from
the County's plans to PEMHCA plans, as long as the
County retained the CCHP-A and CCHP-B plans as
alternative plans to the PEMHCA plans.
2. Adopting a PERS proposal would help avoid a
disgruntled active workforce, and would obviate
expensive and protracted litigation with active employee
3
unions and retiree organizations which is certain to
occur if the County goes forward with the health
insurance plans the Board approved on May 6, 2008.
• BENEFITS TO ACTIVE EMPLOYEES AND RETIREES:
Transferring active employees and retirees to CalPERS
Health plans, with a CCHP alternative plan option, would
benefit those employees and retirees.
1 . Lower Employee and Retiree Premiums.
A. 88.6% of County plan participants (8,775
employees and retirees) would pay reduced
amounts for their health insurance than they are
now paying for County health plans.
B. 11 .4% of County employees and retirees (1 ,082
employees and 55 retirees covered by the County
Kaiser non Medicare family plan) would pay
$11 .89 higher premiums each month under PERS
Californka Kaiser with an 80% County subsidy.
C. .004 % of County plan participants (41 retirees
covered Iby the Health Net HMO 2-Party Medicare
plan with one party covered by Medicare and the
other party not covered by Medicare) would pay
$38.80 higher premiums each month for
comparable PERS Blue Shield coverage with an
80% Couinty subsidy.
D. The Kaiser family plan differential would be
eliminated were the County to ever agree to a
three-tier Kaiser rate plan.
4
E. The Blue Shield two-party (1 Medicare) $38.80
increased premium cost for retirees would become
a $52.69 reduced premium cost for retirees who
enrolled in the new PERS Blue Shield Net Value
plan. Instead of paying $82.50 per month, each
such retiree would pay only $29.81 per month for
the Blue Shield Net Value plan.
The Blue Shield Net Value plan is identical to the
standard Blue Shield HMO in its coverage and
benefits, but because its scope is limited to high
performance physicians and medical providers, its
premium rates are lower than the standard Blue
Shield HMO rates.
2. Greater Insurance Plan Selection.
A. Including the CCHP plans, the County offers 5
health insurance plans (CCHP-A, CCHP-B,
Kaiser, Health Net HMO, and Health Net PPO).
B. In addition to allowing the two CCHP plans to be
made available to County employees and retirees,
PERS Health offers 7 health insurance plans
(Kaiser, Blue Shield HMO, Blue Shield Net Value,
PERS Choice, PERS Select, PERS Care, and
PORAC), for a total of 9 plans.
C. The Blue Shield Net Value and PERS Select plans
were added by PERS in 2007. Contra Costa
County has not added a new health insurance
plan since January 1 , 2000, when Health Net
replaced Foundation Health Systems PPO.
3. Spousal Survivorship.
5
A. The County's health insurance plans provide that
a surviving spouse may continue to participate in a
County-sponsored health insurance plan, but the
spouse must pay the entire premium for that
coverage.
B. PERS plans provide spousal survivorship in which
the County continues to subsidize the premiums at
the same rate as prior to the member's death.
4. Portability of Kaiser.
A. Because its size makes it economically feasible to
do so, CalPERS has negotiated contracts with
Kaiser regions other than Kaiser of Northern
California. Thus, County retirees who have PERS
health insurance (County safety members) and
who move to other Kaiser regions in the United
States can become Kaiser members in these other
regions, and the County will subsidize their health
insurance premiums in these other regions.
B. The County has not negotiated any such
agreemE;nts for the County-sponsored Kaiser
health plan and does not subsidize premiums of
any Kaiser organization except Kaiser of Northern
California.
C. Thus, a County retiree who does not want to pay
the large premiums of Health Net National PPO is
precluded from moving to another part of the
country and having County-subsidized health
insurance for health care located near to his or her
home.
6
5. Improved Plan Designs. CalPERS health insurance
plans have better plan designs than do the County
health insurance plans.
A. Superior Lifetime Benefits Cap.
The Health Net PPO has a lifetime benefits cap of
$1 million, a total that is quickly reached when a
patient is hospitalized for any length of time.
Two of the PERS PPO plans (PERS Choice and
PERS Select) have lifetime benefits caps ($2
million) that are double the lifetime benefits cap of
Health Net PPO ($1 million). The PERS Care
plan has no lifetime benefits cap, and a participant
may transfer from PERS Choice or PERS Select
to PERS Care immediately upon reaching the $2
million lifetime benefits cap, thus obtaining
insurance coverage with no lifetime benefits cap.
B. Lower Kaiser Prescription Drug Co-Pays. PERS
Kaiser prescription drug co-pays are $5 for generic
drugs and $15 for brand name drugs. The
County Kaiser prescription drug co-pays are $10
for generic drugs and $20 for brand name drugs.
C. Cheaper Kaiser Chiropractic Visit Co-Pays. PERS
P P Y
Kaiser charges participants a $10 co-pay per visit
fir chiropractic treatment. The County Kaiser plan
}
charges a $15.00 co-pay per visit.
D. Kaiser Hearing Aid Reimbursement. CALPERS
Kaiser pays up to $1 ,000.00 per year for hearing
aids. The County's Kaiser plan doesn't list
hearing aids as a benefit at all.
E. Emergency Room Charges.
1 ) PERS Kaiser charges $50.00 for an
emergency room visit, while the County's
Kaiser plan charges $10.00 per visit.
2) If an employee or retiree is admitted to the
Kaiser hospital from the emergency room,
even just for observation, the emergency
room $50 charge under PERS Kaiser is
waived. The $50 charge is intended to
disc:.ourage excessive and needless ER visits
and to motivate members to use urgent care
F appointments for medical conditions that are
not true emergencies.
s:
3) Any ER visit that involves a true emergency
and a serious medical condition is FREE
under PERS Kaiser.
• CONFIRMATION OF SUPERIORITY OF PERS HEALTH
INSURANCE PLANS OVER COUNTY-SPONSORED
PLANS: The Actions of Scores of Non-State Agencies
Located or Operating in Contra Costa County in Joining
PERS Health and in Not Joining the County's Health Plans
Confirms the Superiority of PERS Health Insurance Plans.
1 . One thousand, one hundred forty (1 ,140) non state
agencies in California contract with CalPERS Health for
health insurance for their employees and retirees. (See
Chart 3-1 ) This number includes twenty-nine (29) California
counties, 302 California cities, 694 California districts and
other public agencies, and 115 California school districts.
8
2. Of particular significance, this number includes 40
governmental agencies located or operating in Contra Costa
County: 10 Contra Costa County cities, 21 Contra Costa
County districts and other public agencies, and 9 Contra
Costa County school districts.
3. These non County governmental entities located or
operating in Contra Costa County could have contracted with
the County for health insurance under the County's plans.
All of them have chosen to contract with PERS Health.
4. Although non-County public entities may contract with
Contra Costa County to have their employees and retirees
covered by the County's health insurance plans, only two
have done so (Contra Costa Housing Authority and the
Contra Costa Community College District), and their
coverage is limited to CCH p.5 In fact, the only outside
entities which have contracted to cover their employees in
the County's health insurance plan (CCHP) are a small
number of private employers with just several hundred
covered participants.
CONCLUSION
For the past several years those who claim that the County's
health insurance plans for its employees and retirees are overly
generous have engaged in an almost non-stop harangue against
the County, its active employees, and its retirees, arguing that the
County should cut back on health insurance plan benefits for
current employees and retirees. Such unilaterally-imposed cut-
backs would constitute an abridgement of the employees' and
retirees' vested employment and retirement rights for which they
have long worked and thus would violate the contracts clauses of
the United States and California Constitutions.
s Eight small local businesses also provide CCHP coverage for their employees.
9
Badgered by these critics, the County has adopted changes
to its health insurance plans which will go into effect against
unrepresented employees and retirees in the near future. These
changes will soon make County-sponsored health insurance
beyond the reach of thousands of the lowest-paid County
employees and retirees, and force them to obtain health care as
indigents at County medical facilities.
The County Adrninistrator has promised that a County
Benefit Design Task Force will identify "newer, more flexible, cost
conscious health plan captions" that will keep the County's health
insurance plans affordable to County employees and retirees.
While this rhetoric sounds lofty and noble, the truth is that the
health insurance plans produced by such changes would provide
scaled-back health inSUrance coverage, reduced benefits, higher
co-pays, and substantially greater premiums for employees and
retirees. The concept that the County can pay substantially less
to provide health insurance for its employees and retirees without
harming their health insurance runs contrary to the Law of
Business Balance artiCUlated by John Ruskin over a century ago:
"There is hardly anything in the world that someone cannot
make a little worse and sell a little cheaper, and the people
who consider price alone are that person's lawful prey.
It is unwise to pay, too much, but it is also unwise to pay too
little.
When you pay too much, you lose a little money, that is all.
When you pay too little, you sometimes lose everything
because the thing ,you bought is incapable of doing the thing
you bought it to do.
The common law of business balance prohibits paying a little
and getting a lot...
10
It can't be done.
If you deal with the lowest bidder it is well to add something
for the risk you run.
And if you do that you will have enough to pay for something
better. It
Instead of inflicting lifetime harm upon thousands of County
employees and retirees by implementing a massive scaling back
of their vested health insurance benefits, the County should heed
the analysis contained in this paper and transfer all or a
substantial part of its employees and retirees to PERS Health.
This proposal will produce real cost savings for the County and its
taxpayers and improved health insurance for its employees and
retirees in a lawful and constitutional manner.
11
INDEX OF CHARTS
HART 1-1 "2008 Contra Costa County Health Insurance Census"
rovides numbers of active and retired Contra Costa County employees by health plan
nd family unit as of January 1 , 2008.
HART 1-2 "2008 Contra Coosta County Health Insurance Plan Premium
ates & County Premium Subsidies"
rovides 2008 premium rates and County premium subsidies for County-sponsored
ealth insurance plans for active and retired Contra Costa County employees.
HART 1-3 "2008 PERS Health Insurance Plan Premium Rates & County
remium Subsidies"
rovides 2008 premium rates and potential County premium subsidies for PERS
ealth insurance plans for active and retired Contra Costa County employees_
CHART 1-4 "2008 PERS Health Insurance Premium Rates Compared to 2008
Contra Costa County Health Insurance Plan Premium Rates"
Provides side-by-side comparison of PERS Health and Contra Costa County
sponsored health insurance plan total premium rates.
CHART 1-5 "2008 Existing County Health Insurance Premium Costs"
Provides total County cost for County subsidies of existing County-sponsored health
insurance plans by plan and family unit based on January 1 , 2008, census of active
and retired Contra Costa County employees.
CHART 1-6 "2008 Yearly County Premium Costs For Active Employees
Under PEMHCA Health Insurance Plans Compared to County Health Insurance
Plans"
Provides side-by-side comparison of yearly County share of premium costs for active
employees under existing County-sponsored health insurance plans with projected
County share of premium costs for active employees under PERS health insurance
1
F laps (PEMHCA) based on January 1 , 2008, census figures, and itemized by health
nsurance plan and family unit.
HART 1-7 "2008 Yearly County Premium Costs for Retired Non Medicare
mployees Under PEMHCA Health Insurance Plans Compared to County Health
nsurance Plans"
Provides side-by-side comparison of yearly County share of premium costs for retired
yY non Medicare employees under existing County-sponsored health insurance plans with
projected County share of premium costs for retired non Medicare employees under
PERS health insurance plans (PEMHCA) based on January 1 , 2008, census figures,
and itemized by health insurance plan and family unit.
CHART 1-8 "2008 Yearly County Premium Costs for Retired Medicare
Employees Under PEMHCA Health Insurance Plans Compared to County Health
Insurance Plans"
Provides side-by-side comparison of yearly County share of premium costs for retired
Medicare employees under existing County-sponsored health insurance plans with
projected County share of premium costs for retired Medicare employees under PERS
health insurance plans (PEMHCA) based on January 1 , 2008, census figures, and
itemized by health insurance plan and family unit.
CHART 1-9 "Yearly/20-Year County Premium Savings for Transferring Active
Employees and Retirees to PERS Health Insurance Plans"
Provides total yearly and 20-year projected savings to Contra Costa County for
transferring active employees and retired employees, with and without a transfer of
CCHP participants, from County-sponsored health insurance plans to PERS health
insurance plans.
=4 CHART 2-1 "Employee/Retiree Shares of Monthly Premiums — County Health
r_ .
Insurance Plans Compared to PERS Health Insurance Plans"
Provides side-by-side comparison of active employees' and retired employees' shares
of health insurance premiums under County-sponsored health insurance plans and
under PERS health insurance plans.
CHART 3-1 "Non State Agencies Which Contract With PERS Health for
Health Insurance For Their Employees and Retirees"
2
a•
4
z-
ontains a list of the 29 California counties, the 10 Contra Costa cities, the 21 public
9encies which operate in Contra Costa County, and the 9 Contra Costa County
chool districts which participate in PERS Health.
3
ti
v CHART 1 -1
2008 CONTRA COSTA COUNTY
HEALTH INSURANCE CENSUS'
ACTIVE EMPLOYEES
JANUARY 1, 2008 CENSUS
FAMILY UNIT NUMBER
s=
CCHP — A - NON MEDICARE
- Single
765
,4
2-Party 389
Family 1 ,556
TOTAL 2,710
CCHP — B — NON MEDICARE
Single 108
2-Party 37
Family 147
TOTAL 292
KAISER — NON MEDICARE
Single 854 [1 employee full-pay]
2-Party 270
Family 1 ,082
TOTAL 2,206
'T b health Ian and family unit were provided by Contra Costa
The numbers in this chart of active and retired employees y p Y
f✓
County in response to a request under the California Public Records Act in a document entitled 'January 1, 2008
Enrollment Census, County Medical Plans."
1
FAMILY UNIT NUMBER
EALTH NET HMO/EPO — I14C1N MEDICARE
Single 482 [1 employee full-pay]
2-Party 157
Family 627
TOTAL 1 ,266
HEALTH NET PPO — NON MEDICARE
Single 34
2-Party 3
Family 12
TOTAL. 49
RETIRED EMPLOYEES
JANUARY 1, 2008 CENSUS
FAMILY UNIT NUMBER
CCHP — A - NON MEDICARE
Single 207
2-Party 213
Family 71
TOTAL 491
F
I
2
FAMILY UNIT NUMBER
CHP - B - NON MEDICARE
Single 12
4 2-Party 9
Family 3
TOTAL 24
ISER .- NON MEDICARE
} Single 222
2-Party 165
Family 55
TOTAL 442
HEALTH NET HMO/EPO - NON MEDICARE
Single 156
2-Party 86
Family 29
TOTAL 271
HEALTH NET PPO - NON MEDICARE
Single 38
2-Party 8
Family 3
TOTAL 49
3
4, FAMILY UNIT NUMBER
CHIP
— A - MEDICARE (COB)
Single 113
2-Party 100
Family 34
TOTAL
247
c�;HP — B — MEDICARE
Single 11
2-Party 6
Family
2
TOTAL. 19
KAISER SENIOR ADVANTAGE — MEDICARE
Single 465
2-Party — One Medicare 111
Family - Both Medicare 246
Family — Combinations 2
Family — Combinations 24
TOTAL. 848
KAISER COST — MEDICARE
Single 235
E
4
FAMILY UNIT NUMBER
KAISER COST — MEDICARE (cont.)
2-Party 15
Family 73
Kaiser Combination
2-Party 1
Family 1
TOTAL 325
HEALTH NET HMO/EPO COB - MEDICARE
Single 166
2-Party - One Medicare 41
Family - Both Medicare 92
TOTAL 299
HEALTH NET SENIORITY PLUS
Single 102
2-Party — One Medicare 15
Family - Two Medicare 47
Health Net Combination (Sr. Plus and HMO) 1
Health Net Combination (Sr. Plus and PPO) 2
Health Net Combination (Sr. Plus and PPO) 2
TOTAL 169
5
SURVIVING SPOUSES
JANUARY 1, 2008 CENSUS
FAMILY UNIT NUMBER
CCHP — A - NON MEDICARE 2
CCHP — A COB - MEDICARE 8
CCHP — B - COB - MEDICARE 2
KAISER - NON MEDICARE_ 23
KAISER SENIOR ADVANTAGE — MEDICARE 119
KAISER COST COB — MEDICARE 15
HEALTH NET HMO - NON MEDICARE
Single 4
2-Party/Family 1
HEALTH NET HMO - COB - MEDICARE 20
HEALTH NET PPO - NON MEDICARE 1
HEALTH NET PPO - COB -- MEDICARE 21
HEALTH NET SENIORITY Pli_US — MEDICARE 15
6
TOTAL NUMBER OF EMPLOYEES, RETIREES, AND SURVIVING SPOUSES IN
COUNTY HEALTH INSURANCE PLANS AND PEMHCA PLANS
JANUARY 1, 2008
Active Employees in County-sponsored plans 6,523
Active Employees in PEMHCA plans 1 ,109
Retired Employees in County-sponsored plans 3,430
Retired Employees in PEMHCA plans 774
Surviving Spouses in County-sponsored plans 231
Surviving Spouses in PEMHCA plans 74
TOTAL 12,141
Prepared May 15, 2008, by L. Douglas Pipes, Senior Deputy District Attorney (Ret.), Contra Costa County
7
CHART 1-2
2008 CONTRA COSTA COUNTY
HEALTH PLAN PREMIUM RATES & SUBSIDIES'
Family Unit Rate Existing County Subsidy
CCHP — A - NON MEDICARE
Single $516.42 $506.09
2-Party $1 ,230.38 $1 ,205.77
Family $1 ,230.38 $1 ,205.77
CCHP — B - NON MEDICARE
Single $569.72 $512.75
2 — Party $1 ,353.74 $1 ,218.37
Family $1 ,353.74 $1 ,218.37
CCHP — A - MEDICARE
Single $420.02 $420.01
2-Party - 2 Med $1,037.58 $1 ,037.57
2-Party - 1 Med $1 ,133.98 $1 ,133.97
Family $1 ,037.58 $1 ,037.57
CCHP — B - MEDICARE
Single $473.32 $473.31
2-Party - 2 Med $1,160.94 $1,160.93
' The rates and existing County subsidies in this chart are those listed in the 2008 Contra Costa County
Retiree/Survivor Information and Open Enrollment Guide.
1
Family Unit Rate Existing County Subsidy
CCHP — B - MEDICARE (cont.)
2-Party - 1 Med $1,257.34 $1 ,228.01
Family $1 ,160.94 $1 ,160.93
KAISER — NON MEDICARE
Single $499.70 $399.76
2-Party $1 ,160.29 $928.23
Family $1 ,160.29 $928.23
HEALTH NET HMO/EPO — NON MEDICARE
Single $598.09 $478.47
2-Party $1 ,467.14 $1 ,173.71
Family $1 ,467.14 $1 ,173.71
HEALTH NET PPO — NON MEDICARE
Single $832.24 $487.20
2-Party $1 ,977.04 $1 ,157.37
Family $1,977.04 $1 ,157.37
2 The rates and County subsidies for Kaiser Non Medicare 2-Party and Family status found in the 2008
Contra Costa County Retiree/Survivor Information and Open Enrollment Guide differ from the rates and
County subsidies for Kaiser Non Medicare 2-Party and Family status contained in the document"January
1, 2008 Enrollment Census—County Medical Plans" provided by the County in response to a public
records request under the California Public Records Act, which lists the rates and County subsidies as
$1,164.29 and $931.43.
2
Family Unit Rate Existing County Subsidy
KAISER — SENIOR ADVANTAGE (MEDICARE)
Single $226.97 $226.96
2-Party - 2 Med $618.83 $618.82
2-Party 1 Med $891 .56 $809.65
Family $1 ,010.69 $1 ,010.68
HEALTH NET HMO/EPO COB (MEDICARE)
Single $404.42 $404.41
2-Party — 2 Med $808.86 $808.85
2-Party — 1 Med $1 ,002.51 $898.41
HEALTH NET HMO/EP,O SENIORITY PLUS — MEDICARE
Single $296.40 $296.39
2-Party - 2 Med $592.80 $592.79
2-Party - 1 Med $894.49 $811 .99
Family - 2 Med $808.86 $808.85
HEALTH NET PPO /FLEA: NET COB/NATIONAL PPO COB -
MEDICARE
Single $642.48 $472.54
2-Party - 2 Med $1 ,284.97 $944.99
2-Party - 1 Med $1 ,474.72 $959.13
C
3
CHART 1-3
2008 PERS HEALTH PLAN
INSURANCE PREMIUM RATES
AND COUNTY SUBSIDIES'
Family Unit Rate 87% County 80% County
Subsidy Subsidy2
KAISER — NON MEDICARE
Single $470.67 $409.48 $376.59
2-Party $941 .34 $818.97 $753.07
Family $1 ,223.74 $1 ,064.65 $978.99
BLUE SHIELD HMO — NON MEDICARE
Single $478.22 $409.48 $376.59
2-Party $956.44 $818.97 $753.07
Family $1,243.37 $1 ,064.65 $978.99
PERS CHOICE - NON MEDICARE
Single $482.48 $409.48 $376.59
2-Party $964.96 $818.97 $753.07
Family $1 ,254.45 $1 ,064.65 $978.99
The rates and existing 87% County subsidies in this chart are those listed in the 2008 Contra Costa
County CalPERS Health Plan—County Retirees and Survivors, Information and Open Enrollment Guide.
2 The 80% County subsidies in this chart were calculated by multiplying the CalPERS Kaiser Health
Insurance non-Medicare premium rates by 80%. Where that figure exceeds the CalPERS Kaiser
Medicare premium rate, the County subsidy is reduced to the CalPERS Kaiser Medicare premium rate,
less one penny($.01), as provided in existing County rules.
1
Family Unit Rate 87% County 80% County
Subsidy Subsidy
KAISER - MEDICARE (SENIOR ADVANTAGE)
Single $273.36 $273.35 $273.35
2-Party - 2 Med $546.72 $546.71 $546.71
2-Party - 1 Med $744.03 $744.02 $744.02
Family $820.08 $820.07 $820.07
BLUE SHIELD HMO - MEDICARE
Single $341 .44 $341 .43 $341 .43
2-Party - 2 Med $682.88 $682.87 $682.87
2-Party - 1 Med $818.97 $818.97 $753.07
Family - 2 Med $1 ,024.32 $1 ,024.31 $978.99
PERS CHOICE - MEDICARE
Single 9 $349.11 $349.10 $349.10
2-Party - 2 Med $698.22 $698.21 $698.21
2-Party - 1 Med $831.59 $818.97 $753.07
Family - 2 Med $1 ,047.33 $1 ,047.32 $978.99
2
CHART 1-4
2008 PERS HEALTH PLAN INSURANCE PREMIUM RATES
COMPARED TO 2008 CONTRA COSTA COUNTY HEALTH
PLAN INSURANCE PREMIUM RATES'
Family Unit County Rate PERS Rate Lower Rate
CCHP — A NON MEDICARE vs. CaIPERS KAISER NON MEDICARE
Single $516.42 per month $470.67 per month PERS
2-Party $1 ,230.38 per month $941 .34 per month PERS
Family $1 ,230.38 per month $1 ,223.74 per month PERS
' CCHP — B NON MEDICARE vs. CaIPERS KAISER NON MEDICARE
Single $569.72 per month $470.67 per month PERS
2-Party $1 ,353.74 per month $941 .34 per month PERS
Family $1,353.74 per month $1,223.74 per month PERS
CCHP — A MEDICARE vs. CaIPERS KAISER MEDICARE
Single $420.02 per month $273.36 per month PERS
2-Party 2 Med $1 ,037.58 per month $744.03 per month PERS
2-Party 1 Med $1 ,133.98 per month $546.72 per month PERS
Family $1,037.58 per month $820.08 per month PERS
' The rates in this chart are those listed in the 2008 Contra Costa County Retiree/Survivor Information and Open
t Enrollment Guide, and in the 2008 Contra Costa County CalPERS Health Plan — County Retirees and Survivors -
Information and Open Enrollment Guide. If Contra Costa County implemented a three-tier rate structure, County premium
rates would change. But there is no way to calculate in advance changed rates under a three-tier premium structure.
� 1
tEF
I
Family Unit County Rate PERS Rate Lower Rate
CCHP — B MEDICARE vs. CaIPERS KAISER MEDICARE
Single $473.3-'. per month $273.36 per month PERS
2-Party 2 Med $1,160.94 per month $744.03 per month PERS
2-Party 1 Med $1 ,257.34 per month $546.72 per month PERS
Family $1 ,160.94 per month $820.08 per month PERS
KAISER — NON MEDICARE
Single $499.70, per month $470.67 per month PERS
2-Party $1 ,160-29 per month $941 .34 per month PERS
i
Family $1,160.29 per month $1 ,223.74 per month COUNTY
HEALTH NET HMO NON MEDICARE vs. BLUE SHIELD NON MEDICARE
Single $598.00 per month $478.22 per month PERS
2-Party $1 ,467.14 per month $956.44 per month PERS
Family $1 ,467.14 per month $1 ,243.37 per month PERS
HEALTH NET PPO NON MEDICARE vs. PERS CHOICE NON MEDICARE
Single $832.24 per month $482.48 per month PERS
2-Party $1 ,977.04 per month $964.96 per month PERS
Family $1 ,977.04 per month $1,254.45 per month PERS
2
Family Unit County Rate PERS Rate Lower Rate
KAISER MEDICARE (SENIOR ADVANTAGE)
Single $226.97 per month $273.36 per month COUNTY
2-Party - 2 Med $618.63 per month $546.72 per month PERS
2-Party - 1 Med $891 .56 per month $744.03 per month PERS
Family — 2 Med $1 ,010.69 per month $820.08 per month PERS
HEALTH NET HMO/EPO MEDICARE vs. BLUE SHIELD HMO MEDICARE
Single $404.42 per month $341 .44 per month PERS
2-Party — 2 Med $592.80 per month $682.88 per month COUNTY
2-Party - 1 Med $894.49 per month $818.97 per month PERS
Family — 2 Med $808.86 per month $1 ,024.32 per month COUNTY
HEALTH NET SENIORITY PLUS vs. BLUE SHIELD HMO MEDICARE
Single $296.40 per month $341 .44 per month COUNTY
2-Party - 2 Med $592.80 per month $682.88 per month COUNTY
2-Party —1 Med $894.49 per month $818.97 per month PERS
HEALTH NET PPO vs. PERS CHOICE - MEDICARE
Single $642.48 per month $349.11 per month PERS
2-Party - 2 Med $1,284.97 per month $698.22 per month PERS
2-Party - 1 Med $1,474.72 per month $831.59 per month PERS
3
F '
Family Unit County Rate PERS Rate Lower Rate
HEALTH NET PPO vs. PEF;;S CHOICE - MEDICARE (cont.)
Family $1,474.72 per month $1,047.33 per month PERS
SUMMARY: 38 RATE GROUPS - LOWER PREMIUMS
PERS - 32 Lower Premiums
COUNTY - 6 Lower Premiums
i
s
4
CHART 1-5
2008 EXISTING COUNTY HEALTH
INSURANCE PREMIUM COSTS'
ACTIVE EMPLOYEES
JANUARY 1, 2008 CENSUS
FAMILY UNIT NUMBER TOTAL COUNTY YEARLY COUNTY
MONTHLY MONTHLY COST
PREMIUM PER SHARE PER
EMPLOYEE EMPLOYEE
CCHP -- A - NON MEDICARE
Single 765 $516.49 $506.09 $4,645,906.00
2--Party 389 $1 ,230.88 $1 ,205.77 $5,628,534.00
Family 1 ,556 $1 ,230.88 $1 ,205.77 $22,514,137.00
TOTAL 2,710 $32,788,577.00
CCHP — B — NON MEDICARE
Single 108 $569.72 $512.75 $ 664,524.00
2.-Party 37 $1 ,353.74 $1,218.37 $ 540,956.00
Family 147 $1 ,353.74 $1,218.37 $2,149,204.00
TOTAL 292 $3,354,684.00
KAISER — NON MEDICARE
Single [1 employee 854 $499.70 $399.76 $4,091 ,943.00
full pay]
I 'The numbers, rates, and County subsidies in this chart were provided by Contra Costa County in response to a request
under the California Public Records Act in a document entitled "January 1, 2008 Enrollment Census, County Medical
Plans."
2 The rates and County subsidies for Kaiser Non Medicare 2-Party and Family status found in the document"January 1,
2008 Enrollment Census—County Medical Plans" differ from the rates and County subsidies for Kaiser Non Medicare 2-
Party and Family status contained in the 2008 Contra Costa County Retiree/Survivor Information and Open Enrollment
Guide, which lists the rates and County subsidies as $1,160.29 and $928.23.
1
FAMILY UNIT NUMBER TOTAL COUNTY YEARLY COUNTY
MONTHLY MONTHLY COST
PREMIUM PER SHARE PER
EMPLOYEE EMPLOYEE
KAISER — NON MEDICARE (Cont.)
2-Party 270 $1 ,164.29 $931.43 $3,017,833.00
Family 1,082 $1 ,164.29 $931.43 $12,093,687.00
TOTAL 2,2.06 $19,203,463.00
HEALTH NET HMO/EPO — NON MEDICARE
Single [1 employee 482 $598.09 $478.47 $2,761 ,728.00
full pay]
2-Party 157 $1,467.14 $1,173.71 $2,211 ,269.00
Family 627 $1 ,467.14 $1 ,173.71 $8,830,984.00
TOTAL 1 ,266 $13,803,991 .00
HEALTH NET PPO — NON MEDICARE
Single 34 $832.24 $487.20 $ 198,777.00
2-Party 3 $1 ,977.04 $1,157.37 $ 41 ,665.00
Family 12 $1,977.04 $1 ,157.37 $ 166,661 .00
TOTAL 49 $ 407,103.00
TOTAL YEARLY COUNTY COST ACTIVE EMPLOYEE $69,557,818.00
HEALTH INSURANCE PREMIUMS
2
F.
RETIRED EMPLOYEES
JANUARY 1, 2008 CENSUS
FAMILY UNIT NUMBER TOTAL COUNTY YEARLY COUNTY
MONTHLY MONTHLY COST
PREMIUM PER SHARE PER
RETIREE RETIREE
CCHP A - NON MEDICARE
Single 207 $516.49 $506.09 $1 ,257,127.00
2-Party 213 $1 ,230.38 $1,205.77 $3,081,948.00
Family 71 $1 ,230.38 $1 ,205.77 $1 ,027,316.00
TOTAL 491 $5,366,391 .00
CCHP -- B — NON MEDICARE
Single 12 $569.72 $512.75 $ 73,836.00
2-Party 9 $1 ,353.74 $1,218.37 $ 131,583.00
Family 3 $1 ,353.74 $1,218.37 $ 43,861 .00
TOTAL 24 $ 249,280.00
KAISER — NON MEDICARE
Single 222 $499.70 $399.76 $1 ,064,960.00
2-Party 165 $1 ,164.24 $931.43 $1 ,844,231 .00
Family 55 $1 ,164.24 $931 .43 $ 614,743.00
TOTAL 442 $3,523,934.00
s See note 2.
3
FAMILY UNIT NUMBER TOTAL COUNTY YEARLY COUNTY
MONTHLY MONTHLY COST
PREMIUM PER SHARE PER
RETIREE RETIREE
HEALTH NET HMO/EPO — NON MEDICARE
Single 156 $598.09 $478.47 $ 895,695.00
2-Party 86 $1 ,467.14 $1 ,173.71 $1 ,211 ,268.00
Family 29 $1 ,467.14 $1 ,173.71 $ 408,451 .00
TOTAL 271 $2,515,414.00
HEALTH NET PPO — NON MEDICARE
Single 38 $832.24 $487.20 $ 222,163.00
2-Party 8 $1 ,977.04 $1 ,157.37 $ 111 ,107.00
Family 3 $1 ,977.04 $1 ,157.37 $ 41 ,665.00
TOTAL 49 $ 374,935.00
CCHP — A — COB - MEDICARE
Single 113 $420.02 $420.01 $ 569,533.00
2-Party 100 $1 ,133.98 $1 ,133.97 $1 ,360,764.00
Family 34 $1 ,037.58 $1 ,037.57 $ 423,328.00
TOTAL 247 $2,353,625.00
CCHP — B — COB - MEDICARE
Single
11 $473.32 $473.31 $ 62,476.00
2-Party 6 $1 ,257.34 $1 ,228.01 $ 88,416.00
4
FAMILY UNIT NUMBER TOTAL COUNTY YEARLY COUNTY
MONTHLY MONTHLY COST
PREMIUM PER SHARE PER
RETIREE RETIREE
Family 2 $1 ,160.94 $1,160.93 $ 27,862.00
TOTAL 19 $ 178,754.00
KAISER SENIOR ADVANTAGE — MEDICARE
Single 465 $226.97 $226,96 $1 ,266,436.00
2-Party — 1 Med 111 $891 .56 $809.65 $1 ,078,453.00
Family - 2 Med 246 $618.83 $618.82 $1 ,826,756.00
Family — Comb 2 $1 ,010.69 $1 ,010.68 $ 24,256.00
Family Comb 24 $943.74 $943.73 $ 271 ,794.00
TOTAL 848 $4,467,695.00
KAISER COST — MEDICARE
Single 235 $551 .88 $537.90 $1 ,516,878.00
2-Party - 1 Med 15 $1 ,216.47 $1,069.58 $ 192,524.00
2-Party - 2 Med 73 $1 ,268.65 $1 ,207.72 $1 ,057,962.00
KAISER COMBINATION - MEDICARE
2-Party - 1 Med 1 $1 ,539.02 $1 ,424.02 $ 17,088.00
Family - 2 Med 1 $892.56 $809.65 $ 9,715.00
TOTAL 325 $2,794,167.00
5
FAMILY UNIT NUMBER TOTAL COUNTY YEARLY COUNTY
MONTHLY MONTHLY
PREMIUM PER SHARE PER
RETIREE RETIREE
HEALTH NET HMO/EPO COB - MEDICARE
single 166 $404.42 $404.41 $ 805,584.00
2-Party rt - 1 Med 41 $1,002.51 $898.41 $ 442,017.00
Family 2 Med g2 $808.86 $808.85 $ 892,970.00
- "'
TOTAL 299
$2,140,571,00
HEALTH NET SENIORITY PLUS
Single 10�--'.
$296.40 $296.39 $ 362,781.00
Family 2 Med 4��' $592.80 $592.79 $ 334,333.00
-
2P
arty — 1 Med 1 ,15 $894.49 $811 .99 $ 146,158.00
Health Net Combination 1 $700.82 $700.81 $ 8,409.00
(Sr. Plus and HMO)
Health Net Combination 2 $938.88 $768-93 $ 18,454.00
(Sr. Plus and PPO)
Health Net Combination 2 $1 ,128.64 $783.58 $ 18,085.00
(Sr. Plus and PPO)
$ 888,220.00
TOTAL 16)9
HEALTH NET PPO COB
Single PPO COB 162 $642.48 $472.54 $918,617.00
2 Party
COB — 2 Med 58 $1 ,2.84.97 $944.99 $657,713.00
2 Pay
rt COB — 1 Med 29 $1,474.72 $959.13 $333,777.00
6
TOTAL HEALTH 249 $1 ,910,107.00
NET PPO
TOTAL YEARLY COUNTY COST OF PREMIUMS $69,557,818.00 (72%)
FOR ACTIVE EMPLOYEES
TOTAL YEARLY COUNTY COST OF PREMIUMS $26,763,093.00 (28%)
FOR RETIRED EMPLOYEES
TOTAL YEARLY COUNTY COST OF PREMIUMS $96,320,911.00
FOR ACTIVE AND RETIRED EMPLOYEES
SURVIVING SPOUSES
JANUARY 1, 2008 CENSUS
FAMILY UNIT NUMBER
CCHP - A - NON MEDICARE 2
CCHP - A COB - MEDICARE 8
CCHP .- B - COB - MEDICARE 2
KAISER - NON MEDICARE 23
KAISER SENIOR ADVANTAGE - MEDICARE 119
KAISER COST COB - MEDICARE 15
HEALTH NET HMO - NON MEDICARE
Single 4
2-Party/Family 1
HEALTH NET HMO - COB - MEDICARE 20
HEALTH NET PPO - NON MEDICARE 1
HEALTH NET PPO - COB - MEDICARE 21
HEALTH NET SENIORITY PLUS - MEDICARE 15
TOTAL 231
r
E
7
TOTAL NUMBER OF EMPLOYEES, RETIREES, AND SURVIVING SPOUSES IN
COUNTY HEALTH INSURANCE PLANS AND PEMHCA PLANS
JANUARY 1, 2008
Active Employees in County-sponsored plans 6,523
Active Employees in PEMHCA plans 1 ,109
Retired Employees in County-sponsored plans 3,430
Retired Employees in PEMHCA plans 774
Surviving Spouses in County-sr;Ionsored plans 231
Surviving Spouses in PEMHCA plans 74
TOTAL 12,141
Prepared May 15, 2008, by L. Douglas Pipes, Senior Deputy District Attorney(Ret.), Contra Costa County.
8
CHART 1-6
2008 YEARLY COUNTY PREMIUM COSTS
UNDER PEMHCA HEALTH INSURANCE PLANS
COMPARED TO COUNTY HEALTH INSURANCE PLANS'
ACTIVE EMPLOYEES
JANUARY 1, 2008 CENSUS
FAMILY NUMBER 87% COUNTY 80% COUNTY COUNTY PLANS
UNIT SUBSIDY OF SUBSIDY OF EXISTING COST
PERS COST PERS COSTO
CCHP — A NON MEDICARE
Single 765 $3,759,026.00 $3,457,096.00 $4,645,906.00
2-Party 389 $3,822,951.00 $3,515,330.00 $5,628,534.00
Family 1 ,556 $19,879,144.00 $18,279,701 .00 $22,514,137.00
CCHP — B NON MEDICARE
Single 108 $530,686.00 $488,060.00 $664,524.00
2-Party 37 $363,622.00 $334,363.00 $540,956.00
Family 147 $1 ,878,042.00 $1 ,726,938.00 $2,149,204.00
' The numbers in this chart of active employees by health plan and family unit were provided by Contra Costa County in
response to a request under the California Public Records Act in a document entitled "January 1, 2008 Enrollment
Census, County Medical Plans." These numbers assume that County health plan participants would switch to
comparable PERS health insurance plans: County Kaiser participants to PERS Kaiser; County CCHP participants to
PERS Kaiser; County Health Net HMO participants to PERS Blue Shield; and County Health Net participants to PERS
Choice.
2 See Chart 1-5.
3 The County share of premium costs which would result from switching to CalPERS Health plans (PEMCHA) with an 87%
County subsidy of the premiums is calculated by multiplying the number of health plan participants by the monthly County
87% share of the Kaiser Non Medicare premium costs and then annualizing that total. Where 87% of the Kaiser Non
Medicare premium cost exceeds the actual total premium cost, the County subsidy is reduced to the total premium cost,
less one penny ($.01), as provided in existing County rules.
4 The County share of premium costs which would result from switching to CalPERS Health plans with an 80% County
subsidy of the premiums is calculated by multiplying the number of health plan participants by the monthly County 80%
share of the Kaiser Non Medicare premium costs and then annualizing that total. Where 80% of the Kaiser Non
Medicare premium cost exceeds the actual total premium cost, the County subsidy is reduced to the total premium cost,
less one penny($.01), as provided in existing County rules.
1
FAMILY NUMBER 87% COUNTY 80% COUNTY COUNTY PLANS
UNIT ::SUBSIDY OF SUBSIDY OF EXISTING COST
F'ERS COST PERS COST
TOTAL CCHP $30,233,471.00 $27,802,063.00 $36,143,261 .00
KAISER — NON MEDICARE
Single 854 $4,196,351.00 $3,859,294.00 $4,091 ,943.00
2-Party 270 $2,653,462.00 $2,439,946.00 $3,017,833.00
Family 1 ,082 $13,823,415.00 $12,711 ,206.00 $12,093,687.00
TOTAL KAISER $20,673,228.00 $19,010,446.00 $19,203,463.00
BLUE SHIELD — HEALTH NET HMO - NON MEDICARE
Single 482 $2,368,432.00 $2,178,196.00 $2,761,728.00
2-Party 157 $1,542,939.00 $1 ,418,783.00 $2,211 ,269.00
Family 627 $8;010,426.00 $7,365,920.00 $8,830,994.00
TOTAL BLUE SHIELD $11 ,921 ,797.00 $10,962,899.00 $13,803,991 .00
PERS CHOICE — HEALTH NET PPO - NON MEDICARE
Single 34 $167,067.00 $153,64.00 $198,777.00
2-Party 3 $29,482.00 $27,110.00 $41 ,665.00
Family 12 $153,309.00 $140,974.00 $166,661.00
TOTAL PERS CHOICE $349,858.00 $321,732.00 $407,103.00
2
-71
TOTAL COUNTY COST OF PREMIUMS FOR ACTIVE EMPLOYEES:
COUNTY PLANS $69,557,818.00
PERS WITH 87% COUNTY SUBSIDY $63,178y354.00
PERS WITH 80% COUNTY SUBSIDY $58,097,140.00
COUNTY COST OF PREMIUMS (OTHER THAN CCHP) FOR ACTIVE
EMPLOYEES
COUNTY PLANS $33,414,557.00
PERS WITH 87% COUNTY SUBSIDY $32,944,883.00
PERS WITH 80% COUNTY SUBSIDY $30,295,077.00
YEARLY COST SAVINGS TO CONTRA COSTA COUNTY
TRANSFERING ALL ACTIVE EMPLOYEES TO PERS $6,379,464.00
WITH 87% COUNTY SUBSIDY
OF KAISER RATES
TRANSFERRING ALL ACTIVE EMPLOYEES TO PERS $11,460,678.00
WITH 80% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING ACTIVE EMPLOYEES EXCEPT CCHP $ 469,674.00
WITH 87% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING ACTIVE EMPLOYEES EXCEPT CCHP $3,119,480.00
WITH 80% COUNTY SUBSIDY OF KAISER RATES
3
CHART 1 -7
2008 YEARLY COUNTY PREMIUM COSTS
UNDER PEMHCA HEALTH INSURANCE PLANS
�
COMPARED TO COUNTY HEALTH INSURANCE PLANS
RETIRED NON-MEDICARE EMPLOYEES
JANUARY 11 2008 CENSUS
FAMILY NUMBER 87/a
0 COUNTY 2 80% COUNTY' COUNTY PLANS
UNIT SUBSIDY OF SUBSIDY OF EXISTING COST'
PERS COST PERS COST
CCHP — A NON MEDICARE vis. PERS KAISER NON MEDICARE
Single
207 $1 ,017,148.00 $935,449.00 $1 ,257,127.00
2-Party 213 $2,093,287.00 $1 ,924,846.00 $3,081 ,948.00
Family
71 $907,081 .00 $834,099.00 $1 ,027,316.00
CCHP — B — NON MEDICARE vs. PERS KAISER NON MEDICARE
Single
12 $58,965.00 $54,228.00 $ 73,836.00
2-Party 9 $88,448.00 $81 ,331 .00 $ 131 ,583.00
Family
3 $38,327.00 $35,243.00 $ 43,861.00
by
ntra
The numbers in this chart of retired Non Medicare
Pubbc Recohds Act nand
a document ntitled Janfamily unit were duary 12008
costa county in response to a request under the California
Enrollment Census, County Medical Plans."' These numbersatoume at county PERS Kaiser, County CCHP participants`toc o
comparable PERS health insurance plans: County K participants
PERS Kaiser; County Health Net HMO participants to PERS Blue Shield; and County Health Net participants to PERS
Choice.
2 The County share of premium costs which would result from switchingnumber of alPE plan palth an s(by the mon hly Co 8 County
County subsidy of the premiums is calculated by multiplying
87% share of the Kaiser Non Medicare premium costs md cost, the County annualithat zing
sl reduced ed to the totah premium cost,
Kaiser Non
Medicare premium cost exceeds the actual total prem
less one penny ($.01), as provided in existing County rules.
a The County share of premium costs which would re{huetfrom switching to number of health planPparticipants hbyl the monthly County 80
ans with an 80% County
subsidy of the premiums is calculated by multiplying
share of the Kaiser Non Medicare premium otals cost the Countynd then annualizing total. Where subsidy 8subsid s reduced to the total premium cost,
' Medicare premium cost exceeds the actual t premium
less one penny($.01), as provided in existing County rules.
4 See Chart 1-5.
c
FAMILY NUMBER 87% COUNTY 80% COUNTY COUNTY PLANS
UNIT SUBSIDY OF SUBSIDY OF EXISTING COST
PERS COST PERS COST
TOTAL CCHP $4,203,256.00 $3,865,196.00 $5,615,671.00
KAISER — COUNTY NON MEDICARE vs. PERS KAISER NON MEDICARE
Single 222 $1 ,090,854.00 $1 ,003,235.00 $1 ,064,960.00
2-Party 165 $1 ,621 ,560.00 $1 ,491,078.00 $1 ,844,231.00
Family 55 $702,669.00 $646,133.00 $ 614,743.00
TOTAL KAISER $3,415,083.00 $3,140,446.00 $3,523,934.00
HEALTH NET HMO NON MEDICARE vs. BLUE SHIELD HMO NON MEDICARE
Single 156 $766,546.00 $704,976.00 $ 895,695.00
2-Party 86 $845,177.00 $777,168.00 $1 ,211 ,268.00
Family 29 $370,498.00 $340,688.0.0 $ 408,451 .00
TOTAL BLUE SHIELD $1 ,982,221 .00 $1 ,822,832.00 $2,515,414.00
HEALTH NET PPO NON MEDICARE vs. PERS CHOICE PPO NON MEDICARE
Single 38 $186,722.00 $171,725.00 $ 222,163.00
2-Party 8 $78,621 .00 $72,294.00 $ 111 ,107.00
Family 3 $38,327.00 $35,243.00 $41 ,665.00
TOTAL PERS CHOICE $303,670.00 $279,262.00 $ 374,935.00
2
TOTAL COUNTY COST OF: PREMIUMS FOR RETIRED NON MEDICARE
EMPLOYEES:
COUNTY PLANS $12,029,954.00
PERS WITH 87% COUNTY SUBSIDY $9,904,230.00
PERS WITH 80% COUNTY SUBSIDY $9,107,736.00
COUNTY COST OF PREMIUMS (OTHER THAN CCHP) FOR RETIRED
NON MEDICARE EMPLOYEES:
COUNTY PLANS $6,414,283.00
PERS WITH 87% COUNTY SUBSIDY $5,700,974.00
PERS WITH 80% COUNTY SUBSIDY $5,242,540.00
YEARLY SAVINGS TO CONTRA COSTA COUNTY:
TRANSFERRING ALL RETIRED NON MEDICARE EMPLOYEES $2,125,724.00
TO PERS WITH 87% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING ALL RETIRED NON MEDICARE EMPLOYEES $2,922,218.00
TO PERS WITH 80% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING RETIRED NON MEDICARE EMPLOYEES $ 713,309.00
EXCEPT CCHP WITH 87% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING RETIRED NON MEDICARE EMPLOYEES $1,171,743.00
EXCEPT CCHP WITH 80% COUNTY SUBSIDY OF KAISER RATES
3
CHART 1-8
2008 YEARLY COUNTY PREMIUM COSTS
UNDER PEMHCA HEALTH INSURANCE PLANS NSA
COMPARED TO COUNTY HEALTH INSURANCE PL
RETIRED MEDICARE EMPLOYEES
JANUARY 1, 2008 CENSUS
FAMILY
NUMBER 87% COUNTY2 80% COUNTY' COUNTY PLANS4
UNIT SUBSIDY OF SUBSIDY OF EXISTING COS
PERS COST PERS COST
CCHP — A MEDICARE vs. PERS KAISER MEDICARE
Single
113 $370,662.00 $370,662.00 $569,533.00
2-Party - 2 Med 34 $223,057.00 $223,057.00 $4231328.00
2-Party — 1 Med 100 $892,824.00 $892,824.00 $1 ,360,764.00
CCHP -- B MEDICARE vs. PERS KAISER MEDICARE
Single 11 $36,082.00 $36,082.00 $62,476.00
2-Party - 2 Med 2 $13,12100 $13,121 .00 $271862.00
2-Party — 1 Med 6 $53,569.00 $53,569.00 $88,416.00
TOTAL. CCHP/PERS KAISER $1 ,589,315.00 $1 ,589,315.00 $2,532,379.00
' The numbers in this chart of retired Medicare
employees
oPubli cRecords Act in a docuy health plan and lment entitled ly unitrJanuary 1, 2008 Costa
County in response to a request under the California
assume tht county eah plan particints would swith t
Enrollment Census, County Medical Plans_"�Qhe{e numbers
u b participants toaPERS KahserltCounty CCHP participants toc o
comparable PERS health insurance plans. Y
PERS Kaiser, County Health Net HMO participants to PERS Blue Shield; and County Health Net participants to PER
Choice. with an 87%
z The County share of premium costs which would result from calculated d by multiplying he number of health plan participantslby he monthly County
County subsidy of the premiums is ca Y of the Kaiser Non
87% share of the Kaiser Non Medicare prertotal remiuma osiu t,nthe county subsidy zing that t sl reduced to th. Where e total p premium cost,
Medicare premium cost exceeds the actualp
less one penny ($.01), as provided in existing County rules.
a The County share of premium costs which would result thenumber of health planparticipants by
ching to PHealth
plans
the monthly County 80%
subsidy of the premiums is calculated by multiplying
share of the Kaiser Non Medicare premium totalpremium and then an
Medicare premium cost exceeds the actual
the Couualizing nty tsubsidy is h reducedere 8 �to the total preof the Kaiser No m um cost,
less one penny ($.01), as provided in existing County rules.
4 See Chart 1-5.
FAMILY NUMBER: 87% COUNTY 80% COUNTY COUNTY PLANS
UNIT SUBSIDY OF SUBSIDY OF EXISTING COST
PERS COST PERS COST
COUNTY KAISER SENIOR ADVANTAGE vs. PERS KAISER SENIOR
ADVANTAGE
Single 465 $1,525,293.00 $1 ,525,293.00 $1 ,266,436.00
2-Party - 2 Med 246 $1,613,887.00 $1 ,613,887.00 $1 ,826,756.00
2-Party — 1 Med 111 $991,034.00 $991,034.00 $1 ,078,453.00
Family — 3 Med 2 $19,681.00 $19,681 .00 $ 24,256.00
Family — 2 Med 24 $157,452.00 $157,452.00 $ 271 ,794.00
COUNTY KAISER COST MEDICARE vs. PERS KAISER SENIOR ADVANTAGE
Single 235 $770,847.00 $770,847.00 $1,516,878.00
2-Party — 2 Med 73 $478,917.00 $478,917.00 $1 ,057,962.00
2-Party — 1 Med 15 $133,923.00 $133,923.00 $ 192,524.00
KAISER COMBINATION MEDICARE vs. PERS KAISER SENIOR ADVANTAGE
2-Party — 2 Med 1 $ 6,560.00 $ 6,560.00 $ 9,715.00
2-Party — 1 Med 1 $ 8,928.00 $ 8,928.00 $ 17,088.00
TOTAL KAISER 1 ,173 $5,706,522.00 $5,706,522.00 $7,261 ,862.00
2
FAMILY NUMBER 87% COUNTY 80% COUNTY COUNTY PLANS
UNIT SU SUBS DY OF SUBSIDY OF EXISTING COST
PERS COST PERS COST
HEALTH NET HMO/EPO COB MEDICARE vs. BLUE SHIELD MEDICARE
Single 166 $680,128.00 $680,128.00 $805,584.00
2-Party — 2 Med 92 $753,888.00 $753,888.00 $892,970.00
2-Party — 1 Med 41 $402,933.00 $370,510.00 $442,017.00
TOTAL HEALTH 299 $1 ,836,949.00 $1 ,804,526.00 $2,140,571.00
NET/BLUE SHIELD
HEALTH NET SENIORITY PLUS vs. BLUE SHIELD MEDICARE
Single 102 $417,910.00 $417,910.00 $ 362,781 .00
Family - 2 Med 47 $385,138.00 $385,138.00 $ 334,333.00
2-Party — 1 Med 15 $147,414.00 $147,414.00 $ 146,158.00
Health Net Comb 1 $8,194.00 $8,194.00 $ 8,409.00
Sr. Plus and HMO
Health Net Comb 2 $16,757.00 $16,757.00 $ 18,454.00
Sr. Plus and PPO
Health Net Comb 2 $19,655.00 $19,655.00 $ 18,085.00
Sr. Plus and PPO
TOTAL SENIORITY 169 $995,068.00 $995,068.00 $ 888,220.00
PLUS/BLUE SHIELD
COMBINATIONS
HEALTH NET PPO/FLEX NET/NATIONAL PPO COB vs. PERS CHOICE
MEDICARE
Single PPO COB 162 $678,650.00 $678,650.00 $918,617.00
2. Party — 2 Med 58 $485,954.00 $485,954.00 $657,713.00
3
FAMILY NUMBER 87% COUNTY 80% COUNTY COUNTY PLANS
UNIT SUBSIDY OF SUBSIDY OF EXISTING COST
PERS COST PERS COST
HEALTH NET PPO/FLEX NET/NATIONAL PPO COB vs. PERS CHOICE
MEDICARE (cont.)
2 Party — 1 Med 29 $285,001.00 $262,068.00 $333,777.00
TOTAL HEALTH 249 $1,449,605.00 $1 ,426,672.00 $1,910,107:00
NET PPO
TOTAL COUNTY COST OF: PREMIUMS FOR RETIRED MEDICARE
EMPLOYEES:
COUNTY PLANS $14,733,139.00
PERS WITH 87% SUBSIDY $11,577,459.00
PERS WITH 80% SUBSIDY $11,522,103.00
COUNTY COST OF PREMIUMS (OTHER THAN CCHP) FOR RETIRED
MEDICARE EMPLOYEES:
COUNTY PLANS $12,200,760.00
PERS WITH 87% SUBSIDY $ 9,988,144.00
PERS WITH 80% SUBSID)' $ 9,932,788.00
4
YEARLY COST SAVINGS TO CONTRA COSTA COUNTY
TRANSFERING ALL MEDICARE RETIREES TO PERS $3,155,680.00
WITH 87% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING ALL MEDICARE RETIREES TO PERS $3,211,036.00
WITH 80% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING MEDICARE RETIREES EXCEPT CCHP $2,212,616.00
WITH 87% COUNTY SUBSIDY OF KAISER RATES
TRANSFERRING MEDICARE RETIREES EXCEPT CCHP $21267,772.00
WITH 80% COUNTY SUBSIDY OF KAISER RATES
5
CHART 1 -9
YEARLY COUNTY PREMIUM SAVINGS'
TRANSFERRING ALL ACTIVE EMPLOYEES AND RETIREES:
87% COUNTY SUI3SIDY OF PREMIUMS $11 ,660,868.00
80% COUNTY SUI3SIDY OF PREMIUMS $17,593,932.00
TRANSFERRING ACTIVE EMPLOYEES AND RETIREES
EXCEPT FOR CCHP:
87% COUNTY SUIBISIDY OF PREMIUMS $ 393953599.00
80% COUNTY SUBSIDY OF PREMIUMS $ 635591195.00
COUNTY PREMIUM SAVINGS OVER 30 YEARS2
TRANSFERRING ALL ACTIVE EMPLOYEES AND RETIREES:
87% COUNTY SUBSIDY OF PREMIUMS $349,826,040.00
80% COUNTY SUBSIDY OF PREMIUMS $527,817,960.00
TRANSFERRING ACTIVE EMPLOYEES AND RETIREES
EXCEPT FOR CCHP:
87% COUNTY SUBSIDY OF PREMIUMS $101 ,867,970.00
80% COUNTY SUBSIDY OF PREMIUMS $196,775,850.00
' These yearly savings calculations are! for the 2007-2007 fiscal year. Because inflation and a growing
retiree population would increase the savings in future years, the 30 year savings projections in this chart
must be subjected to a "real dollars" analysis that would result in 30 year savings figures that would be
higher than simply multiplying the first year's savings by 30 years, as I have done in this chart. Since the
unfunded OPEB liability was determined using "real dollars" in future years, the County's savings from
transferring to PERS Health must be calculated using the same methodology.
2 30 years has been selected to mirror the time period used by Buck Consultants to calculate the
unfunded OPEB liability for Contra Costa County.
CHART 2-1
EMPLOYEE/RETIREE SHARES OF MONTHLY
PREMIUMS - COUNTY PLANS vs. PERS PLANS
COUNTY PLANS PERS PLANS PERS PLANS
87% COUNTY 80% COUNTY
SUBSIDY subsidy
KAISER KAISER KAISER
Non Medicare Non Medicare Non Medicare
Single $99.94 $61 .19 $94.08
2 Party $232.86 $122.37 $188.27
Family $232.86 $159.09 $244.75
HEALTH NET HMO BLUE SHIELD HMO BLUE SHIELD HMO
Non Medicare Non Medicare Non Medicare
Single $119.62 $68.74 $101 .63
2 Party $293.43 $137.47 $203.37
Fa
mi $293.43 $178.72 $264.38
HEALTH NET PPO PERS CHOICE PERS CHOICE
on Medicare Non Medicare Non Medicare
Single $345.04 $73.00 $105.89
2 Party $819.67 $145.99 $211 .89
Family $819.67 $189.80 $275.46
1
COUNTY PLANS PERS PLANS PERS PLANS
87% COUNTY 80% COUNTY
SUBSIDY subsidy
KAISER S/A KAISER CALIF. KAISER CALIF.
Medicare Medicare Medicare
Single $.01 $.01 $.01
2 Party $.01 $.01 $.01
2 Med
2 Party $81 .91 $.01 $.01
1 Med
Family $.01 $.01 $.01
2 Med
KAISER COST KAISER CALIF. KAISER CALIF.
Medicare Medicare Medicare
Single $13.98 $.01 $.01
2 Party $60.73 $.01 $.Q1
2 Med
2 Party $146.89 $.01 $.01
1 Med
Family $107.88 $.01 $.01
3 Med
2
COUNTY PLANS PERS PLANS PERS PLANS
87% COUNTY 80% COUNTY
SUBSIDY subsidy
HEALTH NET HMO BLUE SHIELD BLUE SHIELD
Medicare Medicare Medicare
Single $.01 $.01 $.01
2 Party $.01 $.01 $.01
2 Med
2 Party $82.50 $55.40 $121 .30
1 Med
HEALTH NET PPO PERS CHOICE PERS CHOICE
Medicare Medicare Medicare
Single $169.94 $.01 $.01
2 Party $339.98 $.01 $.01
2 Med
2 Party $515.59 $12.62 $78.52
1 Med
3
CHART 3-1
NON STATE AGENCIES
WHICH CONTRACT WITH
PERS HEALTH FOR
HEALTH INSURANCE FOR
THEIR EMPLOYEES AND
RETIREES '
' Source: "Comprehensive Annual Flinancial Report, Year Ended June 30, 2007," California Public
Employees' Retirement System, pages 179— 188.
COUNTIES (29) San Pablo . San Francisco Bay
Area Rapid Transit
• Amador District
• Butte _DISTRICTS AND . San Ramon Valley
• Colusa OTHER PUBLIC Fire Protection
• Contra Costa AGENCIES (694) [21 District
• Glenn in Contra Costa • West Contra Costa
• Humboldt County] Healthcare District
• Inyo . West Contra Costa
• Lake Integrated Waste
Lassen Central Contra Costa Transit Authority Management District
•
• Madera • Contra Costa County
• Mariposa
Modoc Law Library SCHOOL
Contra Costa County
• Mono Schools Insurance DISTRICTS (115)
• Monterey Group [9 in Contra Costa
• Napa . Contra Costa Fire County]
• Nevada Protection District
• Placer . Contra Costa • Acalanes Union High
• F'lumas Mosquito Vector School District
• Riverside Control District • County School
• San Benito . Contra Costa Special Service — Contra
• San Luis Obispo Ed Local Plan Area Costa County
• Santa Cruz . Contra Costa Schools
• Shasta Transportation • John Sweet Unified
• Siskiyou Authority School District
• Solano . Crockett-Valona • Knightsen School
• Trinity Sanitary District District
• Tuolumne • Dublin San Ramon • Liberty Union High
• Yolo Services District School District
• Yuba • East Bay Regional • Martinez United
Park District School District
• East Diablo Fire • Mt. Diablo Unified
CITIES (302) [10 in District School District
Contra Costa • Kensington • Pittsburg Unified
Community Services School District
County] District • West Contra Costa
• Kensington Fire Unified School
• Antioch Protection District District
• Brentwood Moraga-Orinda Fire
Clayton Protection District
• Concord . Mt. View Sanitary
• Hercules District of Contra
• Martinez Costa County
• Orinda . Mt. Diablo Health
• Pinole Care District
• Richmond
ADMINISTRATIVE COST SAVINGS
TO CONTRA COSTA COUNTY
FROM TRANSFERRING
EMPLOYEES AND RETIREES TO
PERS HEALTH INSURANCE PLANS'
EXISTING YEARLY COUNTY COSTS
FOR ADMINISTERING COUNTY HEALTH PLANS
Health Plan Administra,tion (Org 1334) $1,480,416.00 per year
The current (2007-20043) County budget for administering the
County's health insurance plans (Org 1334 — Health Plan
Administration) is $1 ,460,384.00. These administrative costs
have averaged $1 ,480,416.00 over the past 4 years.
The administrative costs reflected in Org 1334 do not include the
salaries and benefits of the staff who administer the county's
health plans. Those salary costs are reflected in Org 1305
("Employee Benefits — &-lilarys [sic])T
It appears that Org 1334 includes administrative costs for
employees and retirees who are covered by CCHP. The amount
of these costs is not known at this time.
Outside Consultants $ 129,947.00 per year
From February 10, 2000;, through February 27, 2008, the County
paid outside consultants (Buck Consulting and Mellon Consulting)
a total of $1 ,039,581 .00 to assist the County in administering its
sponsored health insurance plans — an average of almost
1 This analysis has been performed and written by L. Douglas Pipes, Senior Deputy District Attorney
(Ret.), Contra Costa County, in his private capacity and not as a County employee, May 30, 2008.
1
$130,000.00 per year. Buck Consulting and Mellon Consulting
are subsidiaries of Mellon Financial Corporation.
TOTAL County Administrative Costs $1,610,363.00 per year
COUNTY ADMINISTRATIVE COSTS UNDER PERS
CaIPERS Yearly Administrative Fee - $282,300.00
Transfer of All County Employees and Retirees
CaIPERS charges a contracting agency a percentage of the total
premium costs for its employees and retirees as its total fee for
administering the PERS health insurance plans for those
employees and retirees. This administrative fee covers
negotiating rates and plan designs with health insurance
providers and administering each employee's and retiree's
participation in a PERS health insurance plan. This fee is set
each June or July by the State Department of Finance and
applies to the fiscal year July 1 st through June 30th. The fee for
fiscal year 2007 — 2008 is .0029 per cent.
Based on the County's January 1 , 2008, census data, if the
County were to have transferred its entire active employee and
retiree workforce to PERS Health, and these employees and
retirees selected PERS health insurance plans that are
comparable to their existing County plans, the total yearly
premiums paid to PERS for these transferred employees and
retirees in fiscal year 2007-2008 would have been approximately
$97,310,394.00.2
2 This total projected premium cost is calculated for the County's active employees and retirees who are
not already in PERS Health and does not include the PERS administrative fee for the 1,109 active County
safety employees, 774 County safety retirees, and 74 surviving spouses of County safety employees or
retirees who were already covered by PERS PEMHCA plans as of January 1, 2008.
2
Based on these statistics, the yearly fee that CaIPERS would
have charged the County for administering the PEMHCA health
insurance plans for 1-he County's newly-transferred employees
and retirees in fiscal year 2007-2008 would have been
approximately $282,300.00.
CaIPERS Yearly Administrative Fee - $120,086.00
Transfer of County Employees and Retirees
Other than CCHP
The yearly administrative fee from CaIPERS would be reduced if
the County were to keep the CCHP Plans as alternative plans for
County employees and retirees. The County would continue to
administer the CCHP plans as it does now and would collect and
disburse the monthly premiums for the CCHP plans.
If none of the existing gCCHP participants transferred to PEMCHA
plans under PERS, and the remaining employees and retirees
selected PERS health insurance plans that are comparable to
their existing County plans, the total premiums paid to PERS for
the transferred employees and retirees in fiscal year 2007-2008
would have been approximately $411409,243.00.
In this event the yearly fee that CaIPERS would have charged the
County for administering the PEMHCA health insurance plans for
the County's employees and retirees in fiscal year 2007-2008
would have been approximately $120,086.00. And the Court
would continue to incur expenditures for administering the CCHP
plans.
3 An unlikely scenario, as County employee/retiree participants of CCHP include some people, such as
the author of this analysis, who are members of CCHP for reasons that are unrelated to the low
participant share of the premiums and who would transfer to PEMCHA plans if given the choice.
3
COUNTY YEARLY ADMINISTRATIVE COST SAVINGS
FROM TRANSFERRING TO PERS HEALTH
Transferring All Employees & Retirees $1 ,3283063.00
Transferring All Employees & Retirees $1 ,490,277.004
Except CCHP Participants
Depending upon. the County's decision whether to transfer all
employees and retirees to CalPERS Health, or to transfer all
employees and retirees other than CCHP participants, the County
could save as much as $1 ,328,063.00 per year in its existing
costs for administering the County's health insurance plans.5
The yearly savings from reduced administrative costs would be
added to the County's reduced premium costs in determining the
total cost savings from transferring County employees and
retirees to PERS Health.
°The savings of this plan option would be less than this figure, as the County would incur administrative
costs for administering the CCHP plans. This figure represents the difference between the County's
current administrative costs and the fees that CalPERS would charge the County for administering the
PEMHCA plans for the employees and retirees who transferred to PEMHCA plans.
5 These cost savings figures do not include potential cost savings resulting from reduced salary and
benefits costs for County staff in Employee Benefits (Org 1305)whose positions would no longer be
necessary. Nor do these cost savings figures include potential cost savings from reduced salary and
benefits costs for staff in the Health Services Department whose positions would no longer be necessary
due to reduced demand for medical services resulting from the elimination of the CCHP alternative plans
or from a reduced participation in those plans- These salary and benefits cost savings can be
determined only by the County's fiscal and budget staff.
4
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