Title
Human Resources Department recommending the Board take the following actions regarding Health Plan Programs and Ancillary Employee Benefit Programs for the 2023 Plan Year:
1) Approve the updated 2023 COBRA health plan rate card based on the change of cost associated with the new Employee Assistance Program (EAP) Provider, Concern EAP, effective July 1, 2023; and
2) Grant Human Resources the authority to correct any minor clerical errors or adjustments, if necessary, to the approved health plan rate cards for the 2023 health benefits plan year, as needed.
FUNDING: COBRA participants pay the full EAP cost should they elect coverage.
Body
DISCUSSION / BACKGROUND
Health Plans
On February 15, 2011, with Legistar 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.
On August 16, 2022, the Board approved the adopted the 2023 Health Plan Programs and Ancillary Employee Benefit Programs plan year renewal and 2023 rate cards. At the time, PRISM and the County had anticipated a full year EAP renewal at an existing rate guarantee (no change in annual rate), through the current provider, Managed Health Network (MHN). However, in January, MHN notified PRISM that their parent company, Centene, had purchased another EAP provider, and that MHN would exit the EAP marketplace effective June 30, 2023. PRISM subsequently conducted a comprehensive Request for Proposal (RFP), evaluating vendors based on their experience working with public entities overall, EAP capabilities, provider network, digital platform attributes, and service model. Ultimately, PRISM approved the replacement of MHN by Concern, with Concern EAP coverage and rates effective July 1, 2023.
Concern is a top tier provider of employee mental health services and comprehensive crisis support. Employees will have access to counseling, coaching, work-life services, guided mindfulness, and a full-service digital platform. Concern can offer both an access center with licensed counselors to answer intake calls and a self-service digital platform for members to match with counselors. Counseling sessions can occur in-person through a concierge provider selection service or through virtual counseling using multiple modalities. The number of EAP sessions currently available through MHN (5 counseling sessions per incident) will be matched by Concern for the initial three-year period, through June 30, 2026. The change from MHN EAP to Concern EAP will initially result in reduced Per Enrolled Participating Member rates during the initial three-year term/rate guarantee period:
MHN PEPM: $5.17
Concern PEPM: $3.56
The EAP is an employer-provided benefit for benefit-eligible County employees. When an employee terminates coverage (i.e. due to change in employment status or benefit eligibility), they and any covered dependents have the ability to enroll in a continuation of coverage (COBRA) at their own cost, including the EAP. As the COBRA rate card is the only rate card that reflects the EAP cost, it is recommended that the Board approves the updated 2023 COBRA health plan rate card based on the change of cost associated with the new EAP provider, Concern EAP, effective July 1, 2023.
ALTERNATIVES
Because the Board previously approved our 2023 Health Plan Programs and Ancillary Employee Benefit Programs plan year renewal, and as our EAP is provided through PRISM Health as part of that program with the cost set by PRISM Health and the EAP vendor, there are no alternatives to this action.
PRIOR BOARD ACTION
The Board adopted the 2023 Health Plan Programs and Ancillary Employee Benefit Programs plan year renewal and 2023 rate cards on August 16, 2022 (Legistar 22-1240).
The Board authorized the County to pay BCC for any Third Party Administrator services received under the Master Agreement between PRISM and BCC, on July 21, 2020 (Legistar 20-0949).
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
The EAP has a three-year rate guarantee based on the current level of service. Though COBRA participants pay the full EAP cost should they elect coverage, the EAP is otherwise an employer-paid benefit for active, eligible employees; the decrease in EAP PEPM rates should result in cost savings to the County each year of the three-year rate guarantee, based on current enrollment.
CLERK OF THE BOARD FOLLOW UP ACTIONS
None
STRATEGIC PLAN COMPONENT
Good Governance
CONTACT
Joseph Carruesco, Director of Human Resources