Joint Labor-Management Benefits Committee COMMITTEE REPORT 18-10

Transcription

1 c Joint Labor-Management Benefits Committee COMMITTEE REPORT JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE MEMBERS: Management Date: February 8, 2018 To: From: Subject: Joint Labor-Management Benefits Committee Staff Projects & Activities Report Wendy G. Macy, Chairperson June Gibson Rich Llewellyn Tony Royster Matthew Rudnick Employee Organizations Cheryl Parisi, Vice-Chairperson Paul Bechely Chris Hannan David Sanders William Violante RECOMMENDATION That the Joint Labor-Management Benefits Committee receive and file projects and activities report regarding informational items, projects update, completed projects/meeting calendar, and staffing summary for January DISCUSSION A. Informational Items Ongoing Open Enrollment Recordkeeping and Administration Activities Staff is working on the administrative and recordkeeping activities required for ensuring that employee benefits elections were implemented accurately. These activities include reviewing and auditing benefits elections and payroll activity for accuracy and resolving any administrative errors. Anthem Blue Cross (Anthem) Network Agreement Updates Staff provides monthly updates in the monthly projects & activities report regarding Anthem provider negotiations that may potentially impact City members. Below is the monthly Anthem network update for January Huntington Memorial Hospital As reported to the JLMBC at its September 7, 2017 meeting, Anthem informed the City that they are in negotiations with Huntington Memorial Hospital, a key provider for City employees and dependents. At the JLMBC meeting on November 30, 2017, staff informed the JLMBC that Anthem had extended its exiting hospital contract with Huntington Memorial Hospital to November 1. Since the last update provided to the JLMBC on January 4, 2018, Anthem has confirmed that it has extended this contract to February 15, As of February 8, 2018, Anthem indicates that it remains in active negotiations with Huntington Memorial Hospital and that it expects to reach an agreement or secure another contract extension prior to the termination date. The City has had 99 HMO and 41 PPO employees and dependents utilize Huntington Memorial Hospital in Anthem will continue to provide staff and the JLMBC with immediate updates related to these negotiations. JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE

2 2. Employee Health System Medical Group/EHS and Multicultural Primary Care Medical Group, collectively ( EHS ) Anthem informed the City on February 1, 2018 that they have terminated EHS from their network effective January 31, This action was taken as a result of a recent regulatory directive issued by the California Department of Managed Health Care (DMHC) to all health plans that contracted with EHS, citing concerns with the medical group s referral processes. This change impacts 24 City employees and 32 covered dependents. Members currently assigned to EHS have been transitioned to alternate medical groups, and when possible, will keep their current primary care physician affiliation. Anthem mailed notification letters to affected employees on January 26, 2018 (Attachment B). The letter advises impacted members of the transition, provides options for selecting a new provider, and describes the process for members to request continuity of care assistance. B. Projects Update Affordable Care Act Tax (ACA) Reporting and Annual Reporting Update Staff continues to work with its vendor, Benelogic, LLC (Contract No. C ), and its benefits Third-Party Administrator, Mercer to provide ACA tax reporting services for the 2017 calendar year. The City, Mercer, and Benelogic exchanged multiple test files over the past two months to ensure there are no issues with uploading the final data into the Benelogic system to generate the tax forms. Final data for all eligible employees will be sent to Benelogic no later than February 12. The ACA tax form mailing deadline was extended to March 2, 2018, and all the tax forms will be mailed no later than March 2. Concurrently, staff is working to finalize several communications materials including a phone script for the Benefits Service Center to answer member calls, Citywide communication, postcard, and FAQs related to the ACA tax forms. C. Completed Projects/Meeting Calendar Staff maintains a log of completed projects, as well as a calendar of upcoming Board meetings and proposed topics (Attachment A). D. Staffing Summary Following is a summary of staff positions supporting the LAwell Civilian Benefits Program: Personnel Position Authority Staff Member Function Est. % Allocated to LAwell Program Chief Personnel Analyst Steven Montagna Division Chief 60% Senior Personnel Analyst II Jenny Yau Section Manager 100% Senior Personnel Analyst I Daisy Tam TPA/Payroll/Kaiser 100% Senior Personnel Analyst I Paul Makowski Communications/Audits/Budget 100% Senior Personnel Analyst I Leo Reyes Wellness Program Coordinator 100% Personnel Analyst Russell Escueta Administration/COBRA/Anthem 100% Personnel Analyst Helen Georgeson Participant Services/JLMBC 100% Personnel Analyst Theodore Vasquez Wellness Program Assistant 100% Benefits Specialist Adriana Beltran-Herrera Supervisor-Member Services Section 100% Senior Administrative Clerk Mayra Martinez Member Services Rep: A-F 100% Senior Administrative Clerk Tameekah Ford Member Services Rep: G-I / K-M 100% 2

3 Senior Administrative Clerk Vincent Pacheco Member Services Rep: N-V 100% Administrative Clerk Maria Lopez Member Services Rep: J, W, Z, Sworn 100% City Attorney Assistant City Attorney Curtis Kidder Board Counsel 25% Submitted by: Reviewed by: Approved by: Paul Makowski Jenny M. Yau Steven Montagna 3

4 COMPLETED PROJECTS & UPCOMING MEETINGS CALENDAR COMPLETED PROJECTS: JANUARY 2018 # STATUS PROJECT 1 Completed JLMBC Report: Civilian Benefits Program Third-Party Administrator Request for Proposal 2 Completed JLMBC Report: Open Enrollment Implementation for Plan Year Completed JLMBC Report: Employee Benefits Trust Fund Staffing Reimbursements First Quarter of Fiscal Year Completed JLMBC Report: LIVEwell Wellness Program Monthly Update and Consultant Review 5 Completed JLMBC Report: Anthem PPO Engagement Strategies 5 Completed JLMBC Appeals January total completed in EBD 6 Completed Catastrophic Illness Cases January case processed 7 Completed Request for Proposal for Benefits Third-Party Administrator Services Response Evaluation and Vendor Selection 8 Completed ACA Compliance Communication requesting affected employees update their name and/or SSN information 9 Completed WageWorks Tax-Advantaged Spending Accounts Contract Extension Executed 10 Completed State of CA Surviving Spouse Health Reimbursement Claims for FY JLMBC UPCOMING MEETINGS CALENDAR MEETING AGENDA ITEM PRESENTATION 1-Mar-18 JLMBC Report: Wellness Services RFP Kaiser Permanente JLMBC Report: TPA Transition Update JLMBC Report: Employee Refunds Update JLMBC Report: 2018 Open Enrollment Debrief JLMBC Report: Benefits Trust Fund Review JLMBC Report: Wellness Program Update JLMBC Report: Monthly Projects/Activities ATTACHMENT A 5-Apr-18 JLMBC Report: EAP and Tax-Advantaged Spending Accounts RFP Evaluation JLMBC Report: Quarterly Staff Reimbursements JLMBC Report: TPA Transition Update JLMBC Report: Wellness Program Update JLMBC Report: Monthly Projects/Activities Anthem Blue Cross 3-May LAwell Benefits Plan Design Review and Renewals None JLMBC Report: TPA Transition Update JLMBC Report: Wellness Program Update JLMBC Report: Monthly Projects & Activities Update 4

5 ATTACHMENT B P.O. Box Van Nuys, CA January 26, 2018 «FNAME» «LNAME» «ADDRESS1» «CITY», «ST» «ZIP» Dear Anthem Blue Cross Member: Our records indicate that you are currently assigned to Employee Health System Medical Group/EHS that includes Multicultural Primary Care Medical Group, collectively ( EHS ). This letter is to inform you that EHS s CaliforniaCare agreement with Anthem Blue Cross will terminate end of day January 31, As a result, EHS will no longer be part of the Anthem Blue Cross commercial HMO Network beginning February 1, Please note: Multicultural Primary Care Medical Group (MPCMG) was merged into EHS mid July There is nothing you need to do. We understand the importance of maintaining the patient/doctor relationship. Every effort will be made to keep you assigned with your current primary care physician if he or she practices with another Anthem Blue Cross participating medical group. A new Anthem Blue Cross identification (ID) card will be mailed to you no later than five days before the February 1, 2018 effective date. We encourage you to contact your new medical group once you receive your new ID card and familiarize yourself with the medical group. For example, the specialists and hospitals used by the new medical group may be different from those offered by EHS. You will also be able to use the Find a Doctor Internet feature available on anthem.com/ca to see the physicians available to you. What if I want to select a different doctor or medical group? Once you receive your new ID card, if you wish to choose another Anthem Blue Cross primary care physician within your area, you can use the Find a Doctor feature available at anthem.com/ca, or contact us using the toll-free number on your current ID card. What if I am currently receiving care from EHS? We realize that if you are in a course of treatment it s important to not interrupt that care. Please contact us using the toll-free number on your current ID card if you: Are pregnant Currently receiving ongoing medical care Have a newborn child up to 36 months old who is receiving care Have a current authorization for health care services Otherwise concerned that this change will disrupt your care You can request completion of care or ask for further explanation of your rights to continued care. An Anthem Blue Cross Customer Service representative can assist you. Eligibility for continuity of care depends on factors outlined in your Evidence of Coverage and the Anthem Blue Cross Continuity of Care Policy. You can access and print Continuity of Care Policy online by visiting our website, Begin by clicking on MENU button. Under the Support Column, select FAQS to arrive at the State FAQs. Next select the box entitled Benefits & Claims to arrive at a listing of questions. Click on the plus (+) sign next to the question, How do I request transition/continuity of care? to obtain the response along with a link to the Continuity of Care, Transition of Care Policy. Click on the link to access the policy. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

6 P.O. Box Van Nuys, CA Who do I contact if I have more questions or concerns? Anthem Blue Cross is required by law to provide you with the following information: January 26, 2018 If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact Anthem Blue Cross customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects HMO consumers, by telephone at its toll-free number, HMO-2219, or at a TDD number for the deaf or hard of hearing at , or online at: Are my health care benefits changing? No, your enrollment in your Anthem Blue Cross plan remains the same and is not otherwise affected in any way. As always, if you receive a bill for covered services other than co-payments, co-insurance, or deductibles, please call Anthem Blue Cross Customer Service at the telephone number on your ID card so that it can be reviewed by our staff. If you are enrolled in a point-of-service (POS) plan and continue to access EHS after the termination date, you may have significantly higher out-of-pocket costs. Your Evidence of Coverage outlines your coverage for seeking care from a provider who is not part of our network. Also, Customer Service can provide this information. Your health care needs are very important to us, and we are committed to providing you with exceptional service. Please be assured that your health care coverage will not be interrupted and that this change will not result in a change to your covered benefits. Si usted necesita asistencia en español, por favor llame al Departamento de Servicio al Cliente de Anthem Blue Cross al número de teléfono gratis en su tarjeta de identificación. Sincerely, Anthem Blue Cross Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.