Title
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 Retiree and COBRA 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; and
2) Delegate authority to the Human Resources Department 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.
Body
DISCUSSION / BACKGROUND
Health Plans
On August 27, 2024 (Legistar file 24-1397), the Board of Supervisors adopted the 2025 health plan rate cards for active employees, outside agencies whose benefits are administered through the County, and Operating Engineers, Local 3 (OE3)’s Health Trust plans for their members in our Trades and Crafts (TC) and Corrections (CR) bargaining units.
Medicare Retirees who are 65 or older are eligible to purchase Medicare Advantage supplement health plans through UnitedHealthcare (UHC) and Kaiser Permanente Senior Advantage (KPSA). The rates for the KPSA and UHC plans were not yet available to be presented to the Board on August 27, 2024 with Legistar file 24-1397. As the KPSA and UHC rates have since been received, Human Resources is returning to the Board for the adoption of the 2025 Retiree rate card.
For the 2025 plan year, the following retiree Medicare Advantage supplement plans are scheduled to renew as follows:
KPSA 7.0% Increase
UnitedHealthcare 27.9% increase*
*Industry-wide, Medicare Advantage supplement plans are generally seeing large rate increases, mostly as a result of the change in the Medicare prescription benefit due to the Inflation Reduction Act (IRA); Medicare’s lower-than-expected Medicare Advantage and Part D (prescription drug coverage) payment rates to insurers (which make the primary Medicare plans more affordable) resulted in significant 2025 Medicare Advantage supplement plan rate increases.
As a summary from the August 27, 2024, Board item, for the 2025 plan year, health and retiree-relevant ancillary benefit programs 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
Delta Dental 1.3% increase
VSP Vision 10.0% decrease
On April 9, 2024 (Legistar file 24-0502), the Board of Supervisors newly approved the County’s participation in the “ConcernPlus” Employee Assistance Program (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 will continue to access our traditional EAP.
The EAPs have monthly Per Enrolled Participating Member (PEPM) rates, in addition to Critical Incident Stress Debrief (CISD) hours that can be purchased at $450/hour on a fee-for-service (FFS) basis as needed. The County now has the option to renew the ConcernPlus program through the term ending December 31, 2025; 2025 EAP renewal PEPM rates are as follows:
EAP Concern PRISM $3.56 PEPM (No change)*
EAP ConcernPlus PRISM $11.96 PEPM (26.3% increase)
*The County’s traditional EAP provider, Concern EAP, has a three-year rate guarantee period ending June 30, 2026.
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 2025 COBRA health plan rate card.
ALTERNATIVES
The Board could choose not 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.
If ConcernPlus is not renewed, the program offering will end with a final date of coverage December 31, 2024; effective January 1, 2025, benefit eligible “first responder” employees will transition back to the County’s traditional EAP through Concern EAP.
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
08/27/2024 Legistar file 24-1397: Board adopted 2025 health plan rate cards for active employees and outside agencies, and authorized Human Resources to execute administrative health and benefit program plan renewals for the 2025 health benefits plan year.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
The total percentage change from the 2024 rates is 6.9%. The overall increase in annual premium from last year is approximately $2,579,377 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