Joint Labor Management Benefits Committee

Transcription

1 Joint Labor-Management Benefits Committee COMMITTEE REPORT Date: March 3, 2016 To: From: Subject: Joint Labor Management Benefits Committee Staff Health-Dental Survey Analysis & Communications JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE MEMBERS: Management Wendy G. Macy, Chairperson June Gibson Tony Royster Matthew Rudnick Miguel Santana Employee Organizations Cheryl Parisi, Vice-Chairperson Paul Bechely Chris Hannan David Sanders Gregory West RECOMMENDATION: That the Joint Labor-Management Benefits Committee (JLMBC) (a) receive and file update and attachments regarding the Flex Benefits Health and Dental Benefits Survey results; (b) review the timetable for review and analysis of the 1,654 comments offered by employees; and (c) approve proposed member communication plan regarding the survey results and update of the heath/dental procurement processes. DISCUSSION: At its meeting on November 12, 2015, the JLMBC adopted a Flex Benefits member survey. The purpose of the survey was to solicit member feedback which could be used to help inform development of the JLMBC s procurements for health and dental providers. At its meeting on January 21, 2016, staff presented the survey results to the JLMBC. Staff indicated that the survey window was open to Flex members November 30- December 21 and generated approximately 2,266 responses, representing 9.4% of the eligible population. Staff further indicated that Mercer was not able to finalize its formal survey report in time for that meeting, but was able to supply the raw data results, which staff summarized and presented within its report. A. Mercer Survey Report The Mercer Survey report is provided as Attachment A. The inclusion of paper surveys accounted for an increase in the total number of responses to 2,279. In staff s review of the Mercer data, staff found that Mercer s findings were very consistent with the findings reached by staff in the analysis it presented to the JLMBC at the January 21, 2016 meeting. The report includes an executive summary which arrives at many of the same conclusions previously provided by staff. However, one addition from Mercer was the use of red and green shaded cells in the overall results section to identify which plan received (according to Mercer) statistically significant favorable or less favorable ratings by question. JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE

2 B. Survey Comments The survey generated 1,654 open-ended comments by employees broken down by the following self-reported themes: Dental Medical Vision Overall healthcare costs Other Prescription drugs Open enrollment No topic selected Access to information Staff has requested the assistance of the Flex Program s new consultants at Keenan and Segal to work with staff in reviewing and conducting an analysis of these comments. Given that our new consultants will be assisting with evaluating vendor proposals, staff found it more appropriate to request the assistance of our current consultants rather than pursuing Mercer s assistance. Given the volume of comments and the resources required to review and analyze all of them, staff is proceeding to conduct the analysis in stages. The review will occur in the following stages: Category # of Comments Report to JLMBC Status Reviewer Vision 262 Mar-16 Complete Keenan Medical 441 Apr-16 Pending Segal Dental 454 Apr-16 Pending Segal Overall healthcare costs 164 Apr-16 Pending Keenan Prescription drugs 88 Apr-16 Pending Keenan Open enrollment 56 Apr-16 Pending Keenan Access to information 32 Apr-16 Pending Keenan No topic selected 53 Apr-16 Pending Keenan Other 104 Apr-16 Pending Keenan C. Member Communications At its January 21, 2016 review of the survey results, the JLMBC requested that staff develop a proposal for communicating the results back to the membership. Staff proposes developing a special communication sent via direct mail to employees with the purpose of providing the results of the survey as well as delivering details regarding the objectives and status of the health, dental and vision procurements. This 2

3 communication aligns with staff s and the JLMBC s objective to conduct a transparent procurement process that values employee feedback and seeks to keep employees well-informed of potential changes and improvements to the Flex Benefits Program. Staff will present its proposed communication to the JLMBC at its April 7, 2016 meeting. Submitted by: Maria Koo Approved by: Steven Montagna 3

4 H E A L T H W E A L T H C A R E E R C I T Y O F L O S A N G E L E S H E A L T H & D E N T A L B E N E F I T S S U R V E Y S U M M A R Y O F K E Y F I N D I N G S January 2016

5 T A B L E O F C O N T E N T S P R O J E C T S C O P E E X E C U T I V E S U M M A R Y O V E R A L L R E S U L T S D E M O G R A P H I C R E S U L T S V E R B A T I M C O M M E N T S A P P E N D I X MERCER

6 P R O J E C T S C O P E Survey objective: The purpose of the survey was to obtain feedback about how City of Los Angeles Flex Program members use and value their health and dental benefits Target audience: Civilian Flex Program members of the City of Los Angeles were invited to participate in the survey, of which 2,279 responded. This sample provides a statistically representative snapshot of employee opinion regarding the City s current health and dental benefits Demographic questions: All respondents were asked a series of demographic questions to drive results, segmented by employee group. Segmentations included tenure, gender, age, and health/dental plan, among others Administration dates: November 30 th December 21 st Administration method: Electronic and paper-based MERCER

7 E X E C U T I V E S U M M ARY MERCER MERCER

8 E X E C U T I V E S U M M A R Y ( 1 O F 2) O V E R A L L R E S U L T S Overall, employees favorably evaluate the health and dental benefits provided by the City of Los Angeles: At least 8 in 10 respondents believe that their health benefits meet their needs, while 3 out of 4 report that both the health and dental benefits provide good value relative to what they pay With respect to health plans, employees on the Blue Shield PPO are less favorable, while those on the Kaiser HMO plan provide the highest overall ratings Respondents are generally favorable on various aspects of dental coverage, regardless of the plan they are on. The exception to this is the Delta Preventive Only plan, where respondents are slightly less favorable All respondents are significantly less positive, in an absolute sense, regarding the plans annual deductibles. It should be noted, however, that a very high percentage of respondents (>50%) were neutral on deductibles, indicating they do not have a strong opinion In general, however, most employees register a fairly high degree of satisfaction (>60%) with plan choice, access to doctors, and quality of care While satisfaction with wait times to see a specialist are somewhat lower, overall satisfaction with the quality of care from one s primary care physician is high Satisfaction among those on either the Blue Shield Narrow Network or PPO plans is significantly below other plans on various plan aspects such as off-hours care, customer service, access to health information and health record portability With respect to health record portability, a very large percentage of respondents (35% for all respondents) were neutral, suggesting that they are unsure about the portability of their health history MERCER

9 E X E C U T I V E S U M M A R Y ( 2 O F 2) O V E R A L L R E S U L T S While wellness programs receive lower favorable endorsements, a very high percentage of respondents provided a neutral response (>40% for all plans except the Kaiser HMO). This suggests that many respondents are either unaware of these programs or do not feel they are applicable to their individual circumstances Overall satisfaction with various aspects of dental coverage such as plan variety, access to dentists, quality of care (etc.) is fairly high, with the exception of the Delta Preventive Only plan Employees register lower satisfaction with respect to the cost for major services, annual deductibles and the annual maximum benefit Satisfaction with one s dental provider, both in terms of rapport with their provider and overall quality of care, is very high Regarding benefits information, a majority of respondents (66%) prefer to access information through myflexla.com. Other preferred forms of communication are documents sent to the home (47%) and s from the City of Los Angeles (43%) In terms of demographic findings: Younger (40 and under), and less tenured employees (4 years or less) are somewhat less positive overall Clerical employees are the most positive; technical / professional report mildly lower satisfaction There is very little variability by other variables, such as department Finally, approximately 18% of respondents report having switched their health and dental plans within the past year. The reasons for switching are varied, ranging from dissatisfaction to wanting access to a broader network of providers MERCER

10 OVERAL L R E S U LT S MERCER MERCER

11 O V E R A L L R E S U L T S B Y H E A L T H P L A N V A L U E O F B E N E F I T S Item 1. Flex Program health benefits meet my needs (including those of my family/dependents, if applicable). 2. Flex Program dental benefits meet my needs (including those of my family/dependents, if applicable). 3. The health and dental benefits offered play a significant role in my decision to work for the City The Open enrollment process is easy I can easily find answers to questions I have about my health and dental benefits. 6. I believe our health and dental benefits provide good value relative to the overall cost that I pay. 7. My health and dental benefits do a good job of supporting my overall health and well-being. % Favorable Results for Primary (City of LA Overall (2279)) In general, respondents provide high marks regarding their overall health and dental benefits At least 8 in 10 respondents believe that their health benefits meet their needs, while 3 out of 4 report that both the health and dental benefits provide good value relative to what they pay Employees on the Blue Shield PPO provide somewhat lower overall ratings, while those on the Kaiser HMO plan are the most favorable Shaded cells indicate statistically significant differences from the City of LA overall scores. MERCER

12 O V E R A L L R E S U L T S B Y D E N T A L P L A N V A L U E O F B E N E F I T S Item 2. Flex Program dental benefits meet my needs (including those of my family/dependents, if applicable). 3. The health and dental benefits offered play a significant role in my decision to work for the City. 5. I can easily find answers to questions I have about my health and dental benefits. 6. I believe our health and dental benefits provide good value relative to the overall cost that I pay. 7. My health and dental benefits do a good job of supporting my overall health and well-being. % Favorable Results for Primary (City of LA Overall (2279)) Respondents are generally favorable on various aspects of dental coverage, regardless of the plan they are on Those on the Delta Preventive Only plan are slightly less favorable overall MERCER

13 O V E R A L L R E S U L T S B Y H E A L T H P L A N H E A L T H B E N E F I T S Item % Favorable Results for Primary (City of LA Overall (2279)) Employees on the Kaiser HMO plan are significantly more positive about health benefits than those on other plans 8. I am satisfied with the range of health plans to choose from (Kaiser HMO, Blue Shield Narrow, Blue Shield Full Network, Shield Spectrum PPO). 9. My medical provider network gives me a good range of primary care doctors to choose from. 10. I believe the following health plan benefit levels are reasonable: Copay (for routine office visits, ER, etc.) 11. I believe the following health plan benefit levels are reasonable: Prescription copay (brand or generic) 12. I believe the following health plan benefit levels are reasonable: Annual out-of-pocket maximum 13. I believe the following health plan benefit levels are reasonable: Annual deductible (Blue Shield PPO only) 14. In general, the primary care physician I see (or that my family / dependents see) takes the time to answer my questions. 15. Overall, I have good rapport (a good relationship) with my primary care physician. 16. Overall, the level of care I (or my family / dependents) receive is good n/a n/a 32 n/a I trust my health plan to provide me quality care when I need it Satisfaction: Overall choice of an in-network primary care physician 19. Satisfaction: Stability in the primary care physician that I and/or my dependents see (versus seeing a different person each time) 20. Satisfaction: Wait time to get an appointment with my primary care physician Respondents on the Blue Shield PPO are the least favorable regarding copays and annual out-of-pocket maximums All respondents are significantly less positive regarding the plans annual deductibles. It should be noted, however, that a very high percentage of respondents (>50%) were neutral on deductibles* In general, however, most employees register a fairly high degree of satisfaction with plan choice, access to doctors, and quality of care 21. Satisfaction: Ease of getting a referral to a specialist MERCER 2016 *All plans except the Blue Shield PPO whose neutral response was only 21% 9

14 O V E R A L L R E S U L T S B Y H E A L T H P L A N H E A L T H B E N E F I T S ( C O N T. ) Item 22. Satisfaction: Wait time to get an appointment with specialists Satisfaction: The overall quality of care I and/or my dependents receive from my primary care physician 24. Satisfaction: The customer service I receive at the physician/provider s office from office representatives Satisfaction: Prescription drug costs Satisfaction: Choices for where I can fill my prescriptions Satisfaction: Ease of filling and refilling prescriptions Satisfaction: Ability to access my benefits information online Satisfaction: Ease of accessing care outside of normal working hours (e.g., emergency or urgent care) 30. Satisfaction: Ability to find providers reasonably close to my home 31. Satisfaction: Customer service assistance from the health plan to answer questions or resolve problems 32. Satisfaction: Quality of educational resources provided by my health plan 33. Satisfaction: How well my health plan communicates my share of the cost of services 34. Satisfaction: Ability to access my health records / information online 35. Satisfaction: Portability of my health records / information (i.e., from one service provider to another) % Favorable Results for Primary (City of LA Overall (2279)) While satisfaction with wait times to see a specialist are somewhat lower, overall satisfaction with the quality of care from one s primary care physician is high Satisfaction among those on either the Blue Shield Narrow Network or PPO plans is significantly below other plans on various plan aspects such as offhours care, customer service, access to health information and health record portability With respect to health record portability, a very large percentage of respondents (35% for all respondents) were neutral, suggesting that they are unsure about the portability of their information MERCER

15 O V E R A L L R E S U L T S B Y H E A L T H P L A N H E A L T H B E N E F I T S ( C O N T. ) Item 36. Satisfaction: My health plan s Wellness programs (e.g., nutrition, exercise, stress management, smoking cessation) Satisfaction: My healthcare provider s web site Satisfaction: Information provided by my health plan regarding my vision benefits 39. Satisfaction: The level of vision benefits provided by my health plan % Favorable Results for Primary (City of LA Overall (2279)) While wellness programs receive lower favorable endorsements, it should be noted that the neutral response on this question was over 40% for all plans except the Kaiser HMO (22% neutral) This suggests that a very high percentage of employees either do not place high value on wellness programs and/or do not feel they are applicable to their personal situations Similarly, well over 40% of respondents on all plans except the Kaiser HMO (12%) were neutral on their provider s web site, suggesting that these sites are not generally accessed by employees Other findings (see Appendix) reveal that myflexla.com is the preferred source for benefits information MERCER

16 O V E R A L L R E S U L T S B Y D E N T A L P L A N D E N T A L B E N E F I T S Item 40. I am satisfied with the range of dental plans to choose from (Delta Dental HMO, Delta Dental PPO, Delta Preventive). 41. My dental provider network gives me a good range of dentists to choose from. 42. I believe the following dental plan benefit levels are reasonable: Preventive care (e.g., cleanings, x-rays) 43. I believe the following dental plan benefit levels are reasonable: Basic services (e.g., fillings, extraction, root canal) 44. I believe the following dental plan benefit levels are reasonable: Major services (e.g., crown, dentures, implants) 45. I believe the following dental plan benefit levels are reasonable: Annual deductible (Delta Dental PPO only) 46. I believe the following dental plan benefit levels are reasonable: Copay (for routine office visits, procedures, etc.) 47. I believe the following dental plan benefit levels are reasonable: Annual maximum benefit (Delta Dental PPO only) 48. In general, the dentist I see (or that my family / dependents see) takes the time to answer my questions. 49. Overall, I have good rapport (a good relationship) with my dentist. 50. Overall, I have good rapport (a good relationship) with my dental hygienist. 51. Overall, the level of care I (or my family/dependents) receive is good. % Favorable Results for Primary (City of LA Overall (2279)) n/a 55 n/a n/a 44 n/a Overall satisfaction with various aspects of dental coverage such as plan variety, access to dentists, quality of care (etc.) is fairly high, with the exception of the Delta Preventive Only plan Employees register lower satisfaction with respect to the cost for major services, annual deductibles and the annual maximum benefit Satisfaction with one s dental provider, both in terms of rapport with their provider and overall quality of care, is very high 52. I trust my dental plan to provide me quality care when I need it Satisfaction: Overall choice of an in-network dentist Satisfaction: Stability in the dental provider that I (or my dependents) see (versus seeing a different person each time) MERCER

17 O V E R A L L R E S U L T S B Y D E N T A L P L A N D E N T A L B E N E F I T S ( C O N T. ) Item 55. Satisfaction: Wait time to get an appointment with my dentist Satisfaction: The ease of getting a referral to a specialist Satisfaction: Wait time to get an appointment with a specialist Satisfaction: The overall quality of care I (or my family / dependents) receive from my dental provider 59. Satisfaction: The customer service I receive at the physician/provider s office from office representatives 60. Satisfaction: Ability to access my dental benefits information online 61. Satisfaction: Ability to find dental providers reasonably close to my home 62. Satisfaction: Customer service assistance from the dental plan to answer questions or resolve problems 63. Satisfaction: Quality of educational resources provided by my dental plan 64. Satisfaction: How well my dental plan explains my share of the cost of services 65. Satisfaction: Portability of my dental records / information (i.e., from one provider to another) % Favorable Results for Primary (City of LA Overall (2279)) The majority of items on this slide with lower favorable scores are driven by significantly higher neutral scores: Specialist referral / wait time Accessing on-line information Quality of educational resources Explanation of overall plan costs Portability of dental records Satisfaction with provider s web site 66. Satisfaction: My dental care provider s web site MERCER

18 D E M OGRAP H I C R E S U LT S MERCER MERCER

19 O V E R A L L R E S U L T S B Y H E A L T H P L A N C O V E R A G E V A L U E O F B E N E F I T S Item % Favorable Results for Primary (City of LA Overall (2279)) Scores are reasonably uniform by coverage level although employees who only insure themselves are slightly less favorable 1. Flex Program health benefits meet my needs (including those of my family/dependents, if applicable). 2. Flex Program dental benefits meet my needs (including those of my family/dependents, if applicable). 3. The health and dental benefits offered play a significant role in my decision to work for the City The Open enrollment process is easy I can easily find answers to questions I have about my health and dental benefits. 6. I believe our health and dental benefits provide good value relative to the overall cost that I pay. 7. My health and dental benefits do a good job of supporting my overall health and well-being MERCER

20 O V E R A L L R E S U L T S B Y H E A L T H P L A N C O V E R A G E H E A L T H B E N E F I T S Item % Favorable Results for Primary (City of LA Overall (2279)) Again, those employees who only opt for self coverage are less favorable on a number of plan aspects 8. I am satisfied with the range of health plans to choose from (Kaiser HMO, Blue Shield Narrow, Blue Shield Full Network, Shield Spectrum PPO). 9. My medical provider network gives me a good range of primary care doctors to choose from. 10. I believe the following health plan benefit levels are reasonable: Copay (for routine office visits, ER, etc.) 11. I believe the following health plan benefit levels are reasonable: Prescription copay (brand or generic) 12. I believe the following health plan benefit levels are reasonable: Annual out-of-pocket maximum 13. I believe the following health plan benefit levels are reasonable: Annual deductible (Blue Shield PPO only) 14. In general, the primary care physician I see (or that my family / dependents see) takes the time to answer my questions. 15. Overall, I have good rapport (a good relationship) with my primary care physician. 16. Overall, the level of care I (or my family / dependents) receive is good I trust my health plan to provide me quality care when I need it Satisfaction: Overall choice of an in-network primary care physician 19. Satisfaction: Stability in the primary care physician that I and/or my dependents see (versus seeing a different person each time) 20. Satisfaction: Wait time to get an appointment with my primary care physician Satisfaction: Ease of getting a referral to a specialist MERCER

21 O V E R A L L R E S U L T S B Y H E A L T H P L A N C O V E R A G E H E A L T H B E N E F I T S Item % Favorable Results for Primary (City of LA Overall (2279)) 22. Satisfaction: Wait time to get an appointment with specialists Satisfaction: The overall quality of care I and/or my dependents receive from my primary care physician 24. Satisfaction: The customer service I receive at the physician/provider s office from office representatives Satisfaction: Prescription drug costs Satisfaction: Choices for where I can fill my prescriptions Satisfaction: Ease of filling and refilling prescriptions Satisfaction: Ability to access my benefits information online Satisfaction: Ease of accessing care outside of normal working hours (e.g., emergency or urgent care) 30. Satisfaction: Ability to find providers reasonably close to my home 31. Satisfaction: Customer service assistance from the health plan to answer questions or resolve problems 32. Satisfaction: Quality of educational resources provided by my health plan 33. Satisfaction: How well my health plan communicates my share of the cost of services 34. Satisfaction: Ability to access my health records / information online 35. Satisfaction: Portability of my health records / information (i.e., from one service provider to another) MERCER

22 O V E R A L L R E S U L T S B Y D E N T A L P L A N C O V E R A G E D E N T A L B E N E F I T S Item 40. I am satisfied with the range of dental plans to choose from (Delta Dental HMO, Delta Dental PPO, Delta Preventive). 41. My dental provider network gives me a good range of dentists to choose from. 42. I believe the following dental plan benefit levels are reasonable: Preventive care (e.g., cleanings, x-rays) 43. I believe the following dental plan benefit levels are reasonable: Basic services (e.g., fillings, extraction, root canal) 44. I believe the following dental plan benefit levels are reasonable: Major services (e.g., crown, dentures, implants) 45. I believe the following dental plan benefit levels are reasonable: Annual deductible (Delta Dental PPO only) 46. I believe the following dental plan benefit levels are reasonable: Copay (for routine office visits, procedures, etc.) 47. I believe the following dental plan benefit levels are reasonable: Annual maximum benefit (Delta Dental PPO only) 48. In general, the dentist I see (or that my family / dependents see) takes the time to answer my questions. 49. Overall, I have good rapport (a good relationship) with my dentist. 50. Overall, I have good rapport (a good relationship) with my dental hygienist. 51. Overall, the level of care I (or my family/dependents) receive is good. % Favorable Results for Primary (City of LA Overall (2279)) There is very little variability in response levels by dental plan coverage As with the overall findings, respondents are generally less favorable regarding the cost of major services, annual deductibles and annual maximum benefits 52. I trust my dental plan to provide me quality care when I need it Satisfaction: Overall choice of an in-network dentist Satisfaction: Stability in the dental provider that I (or my dependents) MERCER see 2016 (versus seeing a different person each time) 18

23 O V E R A L L R E S U L T S B Y D E N T A L P L A N C O V E R A G E D E N T A L B E N E F I T S ( C O N T. ) Item % Favorable Results for Primary (City of LA Overall (2279)) 55. Satisfaction: Wait time to get an appointment with my dentist Satisfaction: The ease of getting a referral to a specialist Satisfaction: Wait time to get an appointment with a specialist Again, overall favorable scores on dental plan aspects are reasonably high High neutrals on plan elements such as online access, educational resources and portability suggest a high degree of uncertainty and/or lack of awareness about these characteristics 58. Satisfaction: The overall quality of care I (or my family / dependents) receive from my dental provider 59. Satisfaction: The customer service I receive at the physician/provider s office from office representatives 60. Satisfaction: Ability to access my dental benefits information online 61. Satisfaction: Ability to find dental providers reasonably close to my home 62. Satisfaction: Customer service assistance from the dental plan to answer questions or resolve problems 63. Satisfaction: Quality of educational resources provided by my dental plan 64. Satisfaction: How well my dental plan explains my share of the cost of services 65. Satisfaction: Portability of my dental records / information (i.e., from one provider to another) Satisfaction: My dental care provider s web site MERCER

24 V E R B AT I M C OMMENTS MERCER MERCER

25 V E R B A T I M C O M M E N T S Employees were given the opportunity to offer open-ended comments at the end of the survey. Respondents were asked to self-code their comment by theme One thousand six hundred and fifty-four (1,654) were provided in total. A breakdown by theme is shown below Representative comments from the top 3 topics are shown on the subsequent slides TOPIC # OF COMMENTS % OF COMMENTS Dental % Medical % Vision % Overall healthcare costs % Other 104 6% Prescription drugs 88 5% Open enrollment 56 3% No topic selected 53 3% Access to information 32 2% Total 1, % MERCER

26 S A M P L E C O M M E N T S D E N T A L Very dissatisfied with dental coverage for wife and I. I would be willing to pay more for more coverage in the variety of dental work. Not able to with the dental plan. The medical care provides a fair amount of coverage at all levels without breaking the bank. For instance, currently I have run out of covered dental coverage for the year. So, I am waiting for the 1 st of January to continue with my dental work. Some of the billing for dental work typically run $ per visit. Can not afford to go on a regular basis. Wife has a bunch of dental specialty work done, and it is very expensive, but only 50% or less is covered. The co payment for root canals, fillings, and crowns should be $20 maximum. Teeth are a key component for health. The better the teeth, the healthier the heart. I pay for the best dental plan the city has to offer and in a recent visit I had to pay out of pocket more than my dental insurance paid. I do not think that it is fair for me to pay the majority of any dentist bill especially when I am paying every paycheck to have what the city believes to be the best dental insurance they have to offer. The costs of Dental care are almost unaffordable for me. And I would say in some instances so costly that I am forced to avoid the dental care I need to have done. Delta Dental says that they will pay 80% of reasonable and customary fees. I have not been able to find a dentist in the South Bay that charges the little fee they says is R&C for procedures that I and my family have had. And among my family and me - we've tried 5 different dentists in the past couple of years. I am typically paying 50%+ of the bill. Maybe the R&C fee is for dentists in Mexico or maybe rural Alabama. I am dissatisfied with how long it takes to get reimbursed for services provided by my dentist. I see an out of network dentist, so I pay out of pocket and then am later partially reimbursed by paper check. It would be great if I could be reimbursed quicker and by direct deposit. MERCER

27 S A M P L E C O M M E N T S M E D I C A L My heart doctor that i have used for 15 years has been taken of the list. When you dropped UCLA from the HMO plan, I lost my primary care doctor and have not found another decent doctor. I feel the service is terrible, and the don't have a clue about my history or anything. Cost for Blue Cross or Blue Shield PPO is not competitive against my husband's employer/s medical coverage. He has Anthem Blue Cross (CalPers). Our choice of Blue Shield was a miserable mistake. All of my doctors, whom I have been seeing for many years have all signed on to be part of the UCLA medical system and Blue Shield does not have a contract with them for HMO services only on a PPO in the full spectrum at the highest cost. I find this unacceptable for those of us who live on the west side of the City of Los Angeles. Most of the competent doctors on the west side are now part of the UCLA system. Add more choices of health plans with affordable and wider coverage and more choices of Primary Care Physicians. Don't eliminate any of the choices we have for medical. I like the PPO plan. It was unfortunate that Anthem PPO was eliminated, but fortunately all of my doctors were available through Blue Shield PPO. Although BOTH medical plans' sites were hacked - so much for medical privacy. If you are sick, by the time you can actually see the doctor, it is so long you will either be already better, or in the hospital. For preventive care it is much easier to see doctor than if you are actually sick. I am very satisfied with my health plan. MERCER

28 S A M P L E C O M M E N T S V I S I O N I have a hard time finding a vision specialist that is covered with my plan. I know it's pretty standard for vision services to only provide some contact lens coverage once every 2 years. It would be better if contact lens are covered annually because contact lens wearers need a new vision test and new supply on an annual basis. Kaiser's Vision products are overpriced. I think the vision benefits on all medical plans are weak if not out of date. They really don't cover the more advanced options for glasses and contacts available nowadays. I think more information needs to be provided that clearly explains the vision plan, including exam and corrective lens coverage. Its very difficult to find details about what is covered, as it is not included in the packet mailed and the name is different than the actual medical insurance. The vision plan under the Blue Shield PPO is not very good. The benefits offered are minimal and they do not cover specialized glasses (progressive lenses, etc.). I received better benefits through VSP when I was in MOU 3. I would encourage the City to consider replacing the vision plan with one from VSP. My vision is covered by Kaiser. My benefit is approx $200. The problem is that the frames Kaiser carries cost a lot more. So my benefit covers the lens, but Kaiser or their sales people try to get you to buy their very expensive frames or a specific type of lenses (the glass). Twice already I have brought in my own frame in order to get my prescribed lenses. MERCER

29 AP P E N D I X MERCER MERCER

30 Percentage P E R C E N T A G E O F E M P L O Y E E S T H A T H A V E S W I T C H E D H E A L T H P L A N S I N T H E P A S T Y E A R 90% 80% 70% 82% In the past year, 82% of respondents chose not to switch their health plans. 60% 50% 40% 30% 20% 10% 0% I have not switched health plans 3% Unhappy with quality of care 1% Unhappy with member service support 3% 3% 4% Wanted a less expensive plan Wanted more coverage for the services I value Response Wanted a larger network / more choice of providers 1% Concerns about portability / out-ofstate coverage for dependents 4% Other MERCER

31 Percentage P E R C E N T A G E O F E M P L O Y E E S T H A T H A V E S W I T C H E D D E N T A L P L A N S I N T H E P A S T Y E A R 90% 80% 82% In the past year, 82% of respondents chose not to switch their dental plans. 70% 60% 50% 40% 30% 20% 10% 3% 1% 3% 5% 3% 3% 0% I have not switched dental plans Unhappy with quality of care Unhappy with member service support Wanted a less expensive plan Wanted more coverage for the services I value Wanted a larger network / more choice of providers Other Response MERCER

32 Frequency Percentage P R E F E R R E D S O U R C E F O R B E N E F I T S I N F O R M A T I O N % Close to 7 in 10 respondents prefer myflexla.com as their source for benefits information 70% 60% % % 47% % % % % % 10% 0 myflexla.com s from the City of Los Angeles Documents sent to my residence (e.g., enrollment packet) Response Provider website (e.g., Kaiser, Blue Shield, Delta Dental) Provider 800 number 0% MERCER

33 MERCER