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HomeMy Public PortalAboutResolution 2020-62, Recommendation From Staff For Health Benefit Plan Full Time EmployeesRESOLUTION 2020-62 A RESOLUTION TO APPROVE A RECOMMENDATION FROM STAFF FOR AN EMPLOYEE HEALTH BENEFIT PLAN FOR FULL-TIME CITY EMPLOYEES WHEREAS, upon his appointment as City Administrator for the City of Riverdale, Kent Royster has contacted various providers of health insurance and similar programs to determine a cost-effective solution for providing the promised healthcare benefit in addition to salary that was part of the negotiated compensation package for both he and Deputy Clerk Katie Enloe, and; WHEREAS, the research conducted by Administrator Royster indicated the cost of a modest, employer -provided health insurance plan for two, full-time employees could cost the City of Riverdale between $9,821.80 and $ 15,609.32 (Exhibit "A"), and; WHEREAS, the City promised to provide coverage of up to $450/month/employee, and; WHEREAS, on July 23, 2020, staff met with a representative of Nelson Brothers Insurance and reviewed a proposed Qualified Small Employer Health Reimbursement Arrangement (QSE HRA) as an option to a traditional employer -provided, health insurance plan (Exhibit "B"), and; WHEREAS, the cost of the proposed QSE HRA is currently capped at $1 1,200-just $400 more than the negotiated amount which represents the annual service/maintenance fee charged by the brokerage for care, and; WHEREAS, the proposed healthcare program is significantly under (less than half) the amount for employee benefits certified in the FY21 budget, and; WHEREAS, the proposed QSE HRA is preferred by both full-time employees. NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF RIVERDALE, IOWA, That the City Council of Riverdale, Iowa authorizes the Mayor to sign the proposal and related administrative documentation required to establish the preferred QSE HRA for the full-time employees of the City. Passed and approved this 28th day of July 2020. APPROVED ATTEST Michael Baw+n, Mayor Katie Enloe, Deputy Clerk K City of Riverdale 10-1-20 riswt «. -- CARRIER EL MA WEILMARK WELIMA RK UNITED HEALTHCARE UNITED HEALTHCARE HERITAGE A.M. BEST RATING A A A A A WEBSITE www.welimark.com www.wellmark.com www.weiimark-com www.uhc.com www.uhc.com PLAN HIGHLIGHTS EnhancedBlue 2000 CompleteBiue 4000 My8IueHDHP Silver BSC7 -651A 6509 - 308A NETWORK Weimark PPO Weilmark PPO & POS Welintark PPO & POS Choice Plus PPO Heritage Select Pius METALLIC PER Go Id Silver Silver NSA Gold Silver MEDICAL to Network Out of Network In Network Out of Network In Network Out of Network In Network Out of Network In Network Out of Network NETWORK% 80% 50% 70% 50% 100% 100% 80% 50% 80% 50% DEDUCTIBLE Single/Family S2,000/54,000 $4,000/$8,000 $4,000/$8,000 $8,000/$16,000 54,500/59,000 $9,000/$11,000 $2,soo/$s,000 $5,000/$IQ000 56,000/$I3,000 512,000/524,000 OUT OF POCKET MAX Single/Family 35,000010,000 90,000/52.5,000 58,150/96.300 516,300/524,600 56,750/$13,500 $13,500/527,000 55,000/$10,000 $9,000/518,000 $8,150/$16,300 $14,000/$28,000 DR,OfFICECO-PAY $2S $75 $40 $120 Covered 100% After DED Covered 100% After DEO $20Adults $0 Kids 18 & Under Ded+50% $25Adults $0 Kids 18 & Under Ded +50% SPECIALIST CO -PAY $50 $150 $90 $270 $60 Copay After Deductible $180 Copay Ater Deductible $30 Premium 560 non Premium Ded + 50% $40 Premium $70 non Premium Ded + 50% VIRTUAL OFFICE VISITS $25 N/A $40 N/A Covered01D %After N/A $10 N/A $10 N/A BASIC LAB SERVICES Ded + 20% Ded + 50% Ded + 30% Ded* 50% Covered 100% After DED Covered 100%After DED Oed + 20% Ded + 50% Ded + 20% Ded • 50% INPATIENT HOSPITAL Oed + 20% Oed + 50% Ded + 30% Ded + 50X Covered 100% After RED Covered 100% After DEO Ded • 20% Ded + 50% Ded + 20% Ded + SO% GUT PATIENT SURGERY Dad + 20% Ded + SO% Ded + 30% Ded +SO% Covered 300%After DED Covered 100%After DED Ded + 20% Ded + 50% Ded + 20% Ded + 50% EMERGENCY CARE $400 $500 $250 Copay After Deductible $250 5800 + Ded + 20% MATERNITY Dad +20% Ded +SO% Ded +30% Ded +50% Covered 100%After DED Covered lUO%After DED Ded +20% Ded +50% Ded +20% Ded +50% PREVENTIVE CARE Covered 100% DEO Waived Ded +SO% Covered 100% DED Waived Ded +SO% Covered 100% DED Waived Covered 100% After DED Covered 100% DED Waived Ded +50% Covered 100% DED Waived Ded +50% DRUG CARO $15/$50/$125/$150/$500 $30/560/$125/$150/$500 520/S60f$325/$150J$500 Copays Apply After Deductible $15/540/$85/$250 520/545/$85/5250 RX DEDUCTIBLE Single/Family N/A N/A Medical Deducible Applies N/A N/A LIFETIME MAXIMUMS Unlimited Unlimited Unlimited Unlimited Unlimited RATES PPO POS PPO POS PPO POS Age banded Age Rated Kent Roy ster(47) 5698.63 5618.12 5563.65 5496.22 5518,01 5456.71 5160.21 $444.47 Katie Into (33) 5535.48 5473.77 5432.02 5380.34 5397.04 5350.06 5429.39 5340.68 Total Monthly Premium $1,234.11 $1,091.89 $995.67 $876.56 $911.U5 $806.77 $989.60 $785.15 An noel Se tyke Fe $400.00 5400.00 $400.00 5404)00 5400.00 Annual Premium 515,209,32 1 513,502.68 512,348.04 [ 510,918.72 511,380,60 510,081.24 $12,275.20 $9,421.80 NOTES Option 1 PPO Network includes Mayo Clinic but the HMO does not. Both include University of lows. ,r of network benefits only apply to the r#0 and POS plan. In network benefits only on HMO plan. HMO pricing is $1,064.95 Option 2 PPO Network includes Mayo Clinic but the HMO does not. Both include University of Iowa. Out of network benefits only apply to the PPO and POS plan. In network benefits Only on HMO plan. HMO pricing is $859.46 Option 3 PPO Network includes Mayo Clinic but the HMO does not. both include University of Iowa. Out of network benefits only apply to the PPO and P05 plan. In network benefits omy on HMO plan. HMO Pricing is $790.57 Option 4 Network includes Mayo Clinic and the University of Iowa. Option 5 Network includes the University of Iowa but --:,-; include Mayo Ciinic 'Welimark paysa limited agent commission on groups with 18.2 enrolled employees. $SPEPM for 1-2 enrolled 'UHC pays a limited agent commission on groups with under five enrolled employees. $SPEPM for 1-3 enrolled and $10 PEM for 4-5 enrolled I agree to purchase the circled plan and to the one time service fee of $ Signature: Date: QSE X4j s rt' " e Employer Reimbursement Plan The BASE' Qualified Small Employer Health Reimbursement Arrangement (QSE HRA) helps employers offer their employees a more attractive benefits package. Employers can help their employees pay for medical coverage for themselves and their families, tax-free. The employees can use the money for insurance premiums, co -pays, deductibles, eye care, dental care, or any other qualified healthcare expense. The amount provided is tax-free to the employees and 100% tax deductible to the employer. With a QSE HRA, employees have the ability to secure their own medical insurance either on or off the Marketplace. This allows the employee to have an active role in finding the right medical coverage for their situation. Who is a Qualified Small Employer HRA for? Employer need to meet two qualifications to offer this arrangement to their employees: • Employer must have less than S0 Full -Time Equivalents (FTEs) employees • Employer must not offera Croup Health Plan to its employees How does it work? Benefit to Employer • Employer derides on the benefit amount to offer and the amount is funded • Employee Satisfaction. Attract and retain talented solely (100%) by the employer. The employer can set different benefit limits for employees with an increased benefit package. self -only versus family coverage, up to the annual maximum established by the • Tax Benefit. All reimbursements are 100°0 deductible as a IRS. business expense. • Determine eligibility and other administrative details and provide all required • Controlled Funding limits. Employer determines benefit notification to employees with the help of BASE'', which will indude meeting amount and only pays when an expense is substantiated. specific timeframe requirements. No prefunding is required. • Employees must secure medical insurance that meets the minimum essential • Peace of Mind. All legal and administrative concerns are coverage definition and provide proof of coverage in order for reimbursement taken care of by BASE'. to be tax-free. • Employees must submit any documented healthcare expense under Code Benefit to Employee Section 213(d), induding individual health insurance premiums to BASE'. • Cost Savings. Employees now have additional money to • BASE" will work with employers to handle reimbursements and assist in the help wit the rising cost of healthcare. reporting requirements. • No Taxes. All reimbursements are considered non-taxable What are the benefits? income. • Convenience. Easy way to get reimbursed for healthcare expenses. QSE in Action Employer has chosen to sponsor QSE HRA for 10 employees & to reimburse each employee an annual max of $5,250.00*. EXAMPLE FOR 1 EMPLOYEE Including Qualified Subsidy Without QSE HRA Silver Plan on the Exchange Monthly Cost $55o..00 Annual Cost $5,600.00 Premium Tax Credit $150.00 $1,800.60 Cost to Employe_ $400.00 S4,800.00 EXAMPLE FOR 1 EMPLOYEE With Employer Sponsored QSE HRA Shyer Plan on EV:,5ar,ge Monthly Cost S550.00 $6,go.00 QSE HRt S-t3?.30 Cost to Employee 5112.30 Annual Cost 1 $1,350.00 $5,250.00 ' Annual maximum is subject to change, please contact BASE' for current maximum established by the IRS. Base 1.888.386.9680 www.BASEonline.com M.REV 2,11''2020 Request for Proposal as of July 16, 2020 Prepared for: City of Riverdale Prepared by: Michella Drummond 1-888-227-3105, ext. 228 MDrummond@BASEonline.com 1.888.386.9680 I www.BASEonline.com BASE' Administers Unique Employee Benefit Solutions Founded in 1999, BASE' has become one of the most trusted employee benefits companies in the country. BASE' is committed to providing the highest degree of service. The staff is always ready to go a step further and assist, not only in developing a strong benefit strategy, but also carrying out the administration to help simplify the complex. This means taking out the guesswork and designing benefit plans, implementing cost -saving measures, and staying compliant. BASE' is ready to raise your expectations. Benefits You Can Trust. Service You Can Count On.TM BASE' continually strives to provide quality service, as well as timely reactions to the ever changing legal landscape of health care and insurance markets. Today, BASE' helps employers nationwide to manage their tax -advantaged benefit plans and compliance services. BASE' administers products that provide health related cost containment, as well as tax savings and compliance services. Our commitment does not stop at the point of sale. The BASE' benefits team understands how important it is to listen and understand the needs of an employer, HR department, insurance buying team and other trusted advisors. The initial analysis provided by BASE' is key to developing a winning benefit strategy that is in compliance with the ACA, IRS, DOL, ERISA and insurance rules and regulations. BASE' takes it a step further by offering full ongoing support, which includes continued education on benefit and tax saving solutions, while providing excellent service. BASE' offers a wide range of tax -advantaged benefit plans and compliance services, which include: • Health Reimbursement Arrangements (Section 105, QSE, Integrated) • 125 Cafeteria Plan (FSA, Limited Purpose FSA, DCAP, POP) • ERISA Wrap BASE' has continued to expand to encompass employer needs. As the marketplace has continued to evolve, BASE* has been dedicated to its clients and understands the growing need for creative cost containment and compliance benefit strategies. BASE' Visions & Values Moving into the future, BASE' continues to provide more options for employers to help control the rising cost of health benefits, and mitigate the risk of continually changing rules and regulations. More options will allow for the customization needed to satisfy the benefit administration needs for employers of varying sizes, help them succeed in business, and provide a sound vehicle for creative money saving benefit strategies and compliance solutions. 1.888.386.9680 I www,BASEonline.com Page 2of8 BASE'S has been in business for close to 20 years, crafting benefit administration solutions for employers of varying sizes, as well as assisting those who consider themselves trusted advisors. Our Midwestern values, commitment, customer service and compliance hold the key to our success. MIDWESTERN VALUES Based out of central Iowa just minutes from Des Moines, noted as a hub for the insurance and financial industry, BASE° has access to a rich variety of resources. The standards we abide by are what set us apart from other administrators, which is proven in the work ethic and integrity of our staff. COMMITMENT BASE° is committed to each and every client. Whether employers are looking to enrich their current benefit plans, offset benefit cutbacks, or implement compliance and cost saving measures, the highly trained staff works diligently to ensure that each plan is customized to meet the specific needs of each client. CUSTOMER SERVICE BASE® believes customer service is the biggest key to success. BASE ° makes customer service a priority and available to assist clients throughout the duration of their plan. Along with the one-on-one contact with each client, BASE' ensures that plan information is always up-to-date and in compliance with government regulations. COMPLIANCE Compliance is vital to our outstanding reputation. BASE"° has an important responsibility to be vigilant and committed to the compliance surrounding our products, especially when they involve the IRS, DOL and ERISA. Below is just a sampling of what our clients and Business Partners are saying: Our BASE' representative is prompt and very thorough in getting answers to me., as well as any of my staff The BASE' staff is excellent on every level! Anne M. BASE' Client Since 2014 :" The people at BASE' seem to have an understanding of what business owners are going through and their concerns.l never hesitate to put a client on the phone with BASE', because I see them as an extension of expertise and value. Not only does the BASE' staff say they are there for you if you have any trouble, they mean it. Knowing that they will be there every step of the wcry, it makes working with BASE' effortless. Susan S. BASE' Business Partner Since 2003 1.888.386.9680 j www.BASEonline.com Page 3©f6 BASE® Product Information Expanding Benefit Options Self -Funding With a Safety Net Employers can help their employees pay for medical coverage for themselves and their families, tax-free. The employees can use the money for insurance premiums, co -pays, deductibles, eye care, dental care, or any other qualified health care expense. The amount provided is tax-free to the employees and 100% tax deductible to the employer. With a QSE HRA, employees have the ability to secure their own medical insurance either on or off the Marketplace. This allows the employee to have an active role in finding the right medical coverage for their situation. Employers can rest assured that they have a compliant benefit option when group health insurance is no longer an option. With this type of tax -preferred benefit in place, employees will know in advance how much will be available for reimbursement of qualified medical expenses. • Funded solely (100%) by the employer • Tax-free reimbursements for health insurance premiums and out-of-pocket medical costs • Flexible benefit solution BASE' QSE HRA Delivers Web Portal for Employer & Employee Summary Plan Description Plan Document Adoption Agreement Administrative Guidelines & Forms Claims Substantiation HIPAA Privacy Non -Discrimination Testing Ongoing Compliance & Product Updates Service & Support 1.888.386.9680 [ www.BASEonline.com Page 4 of 6 SASE" Administration Fees For SASE' QSE HRA Annual Administration Fee Fee based on the number of employees participating, and is set for full 12-month cycle regardless of number of employees changing mid -year. * Plan enrollment and implementation. O Plan funding services. O Compliance services. O Employee enrollment and education. © Participant services. O Employee assistance, enrollment support. O Direct deposit set-up. O Annual non-discrimination testing and IRS Form 5500 preparation. • Plan re -enrollment and support. O Plan design changes and enhancement. Page 5 of 6 BASE® Administered Plans (HRAs & 125 Plans) Proposed fees are guaranteed for 90 days after Request for Proposal date noted for administered plans. The setup fee should be remitted at the same time as the application. Please allow a minimum of 30 days to implement the plan. The BASE® Implementation and Service Team will assist you with all questions regarding your plan. Should you have any changes after your initial plan start date, you will want to be sure to contact BASE® immediately to provide any updates, including life changing events. employee termination, etc. Page 6 of 6