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Human Resources Department recommending the Board take the following actions regarding Health Plan Programs and Ancillary Employee Benefit Programs for the 2025 Plan Year:
1) Approve the proposed 2025 health plan rate cards (Attachment A) based on the cost sharing of health premiums in the current Memoranda of Understanding with all bargaining units, the Salary and Benefits Resolution for unrepresented employees and in accordance with the Patient Protection and Affordable Care Act;
2) Authorize the Director of Human Resources, or Assistant Director of Human Resources, to execute administrative health and benefit program plan renewals for services that otherwise fall under existing executed master agreements; and
3) Grant Human Resources the authority to correct any minor clerical errors or adjustments, if necessary, to the approved health plan rate cards for the 2025 health benefits plan year, as needed.
FUNDING: Countywide cost, shared between the County Departments (General Fund and Non-General Fund) and employees.
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DISCUSSION / BACKGROUND
Health Plans
On February 15, 2011 (Legistar file 11-0121), the Board of Supervisors entered into a Memorandum of Understanding (MOU) with CSAC-EIA (EIA) to join the CSAC-EIA Health program (EIA Health). In 2020, EIA changed its name to PRISM. PRISM is a Joint Powers Authority (JPA) comprised of California counties, cities, and public agencies organized to jointly develop and fund insurance and related programs with the most favorable terms and costs. As a member of this organization, the County has successfully controlled costs of the health plans offered through PRISM Health.
The Board authorized the County to pay Benefit Coordinators Corporation (BCC) for any Third Party Administrator services received under the Master Agreement between PRISM and BCC, on July 21, 2020 (Legistar file 20-0949).
For the 2025 plan year, health plans are scheduled to renew as follows:
Blue Shield PPO 200 Standard 6.2% increase
Blue Shield PPO 1650* ABHP Low 6.2% increase
Blue Shield PPO 2000 ABHP High (ACA Compliant Plan) 6.2% increase
Kaiser HMO Standard 6.2% increase
Kaiser 1650* ABHP 6.2% increase
*Account Based Health Plan (ABHP) minimum deductibles increased to stay in compliance with IRS regulations. Minimum deductibles increased per IRS from $1,600 to $1,650.
For 2025, the IRS has not yet announced the ACA affordability limit. The ACA affordability limit is the maximum amount that an employee can be required to pay for their share of the premium for employee-only coverage in an employer-sponsored health plan. Because the Blue Shield PPO 2000 ABHP High plan is the County’s ACA Compliant Plan, the employee/employer share of premium rates for that plan cannot be established until after the IRS announces the ACA affordability limit. Therefore, staff will return to the Board to adopt the ACA Complaint Plan rate card once the affordability factor is announced.
Retirees who are 65 or older are eligible to purchase health plans through UnitedHealthcare (UHC) and Kaiser Permanente Senior Advantage (KPSA). The UHC and KPSA rates have not been received; therefore, since these rates are included on the same retiree rate card, Human Resources will return to the Board at a later date for approval.
Flexible Spending Account (FSA) and Health Savings Account (HSA) Contribution Limits
Health Care Reimbursement Account (HCRA) $3,050*
Dependent Care Reimbursement Account (DCRA) $5,000*
Health Savings Account (HSA) $4,300 individual/$8,550 family
*Contribution limits adjust to stay in compliance with IRS regulations. Current contribution limits are $3,050 for HCRA and $5,000 for DCRA; limits may be subject to change for 2025 should it be required by the IRS.
Ancillary Benefit Programs
Delta Dental 1.3% increase
VSP Vision 10.0% decrease
Lincoln Financial Basis Life Rate guarantee
Lincoln Financial Long Term Disability Rate guarantee
EAP Concern PRISM No change*
EAP ConcernPlus PRISM Pending*
The annual funding contribution for dental and vision are used to maintain sufficient funds in the self-insured plans, and funds are used to pay submitted claims. The annual funding contribution serves as the basis for determining monthly “premium” rates.
*The County’s Employee Assistance Program (EAP) provider, Concern EAP, has a three-year rate guarantee period ending 6/30/2026. On April 9, 2024 (Legistar file 24-0502), the Board of Supervisors newly approved the County’s participation in the “ConcernPlus” EAP for first responders through the County’s current EAP provider, Concern EAP, for the remainder of the 2024 plan year ending December 31, 2024. ConcernPlus gives first responders generally the same benefits otherwise provided through our EAP to eligible employees, including emotional health and substance abuse, parenting and childcare needs, financial coaching, legal consultation, and eldercare resources, while providing law enforcement first responders with specific culturally competent short-term counselors. The designation of eligible “first responders” is determined on a department-by-department basis by their respective appointing authorities. Benefit-eligible employees not designated as first responders access our existing EAP. ConcernPlus renewal option and rates have not yet been received; therefore, Human Resources will return to the Board at a later date for approval to continue with the ConcernPlus EAP program.
OE3 Health Trust Rate Card
The Operating Engineers, Local 3 (OE3) labor organization offers two health plans (Anthem Blue Cross “Plan A” and Kaiser “Plan B”) to their members in our Trades and Crafts (TC) and Corrections (CR) bargaining units through its OE3 Health Trust, in addition to what is offered by the County. The County contributes to those plans equal to what is contributed to the comparable County-sponsored health plans.
The OE3 Health Trust has provided the County with their plan rates; the County then applied the County contribution per the applicable Memoranda of Understanding (MOUs) to create the published rate cards for employees.
While the County does not have any responsibility for the OE3 Health Trust health plan or programs, the County does have a responsibility to the Employer and Employee contribution for the applicable OE3 Health Trust plans based on the MOUs with the OE3 represented bargaining units.
The Human Resources Department is requesting the Board review and approve the attached 2025 OE3 Health Trust health rate card for the two plans available to our employees.
Next Steps
Upon Board approval, the next steps will consist of the following:
1. Human Resources will post and distribute renewal plans and corresponding rates to employees, COBRA participants, and affiliated agencies prior to open enrollment in October 2024, with an effective date of pay period 25 for active employees and December 1, 2024 for all other participants;
2. Human Resources will return to the Board with the 2025 ACA compliant plan, Retiree KPSA/UHC benefits plans, and ConcernPlus EAP rates;
3. Human Resources will secure health insurance carrier and other ancillary benefit program contract renewals; and
4. The Director of Human Resources, or Assistant Director of Human Resources, will sign health and other ancillary benefit contracts for services that otherwise fall under existing executed master agreements.
ALTERNATIVES
The Board could choose to override the recommendation to renew the 2025 Employee Benefits Insurance Program Renewal as recommended; however, if the Board chooses to not approve the recommendations as listed herein, the County would not meet the deadlines required by the vendors for the plan year.
Regarding the 2025 OE3 rate card, because the County both offers the two OE3 Trust health plans and makes County Contributions pursuant to the terms of the negotiated MOUs with OE3 represented bargaining units, there is no recommended alternative.
PRIOR BOARD ACTION
02/15/2011 Legistar file 11-0121: County joined CSAC-EIA Health program (now PRISM Health)
07/21/2020 Legistar file 20-0949: BCC approved as County’s third party benefits administrator under PRISM Health
04/09/2024 Legistar file 24-0502: Board authorized ConcernPlus EAP program through term ending December 31,2024
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
The total percentage change from the 2024 rates (excluding UHC and KPSA rates, which are not yet available) is 5.4%. The overall increase in annual premium from last year (excluding the UHC and KSA plans) is approximately $2,020,906 for all listed benefit programs. Costs are shared between employees and salary and benefits budgets for each County department. It is anticipated that most departments can cover the six months of increased costs with Salaries and Benefits savings from vacancies. Departments will assess these costs with the mid-year budget report and request a budget transfer to address any increases that cannot be covered with savings.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
Workforce Excellence
Priority: Focus on Employee Development & Well- Being
Action Item: Continue to implement wellness initiatives and activities for El Dorado County employees
CONTACT
Joseph Carruesco, Director of Human Resources