Los Angeles Unified School District Health & Welfare Benefits Program Update Presentation to the Committee of the Whole September 25, 2008 David R. Holmquist Chief Operating Officer Gregory Kildare Chief Risk Officer
Purpose of Today s Presentation Provide an update on the state of the District s Health and Welfare Benefits Program Address health benefits currently faced by the District More plan participants because burgeoning number of retirees will increase expenditures dramatically Declining student enrollment = decrease in revenue Healthcare unit costs continue to increase above basic consumer prices 2
District Benefits Summary Benefit Paid By Benefit Provided To District Employee Active Retiree Dependent Health Care Health (Medical, Dental, Vision) Health Care Flexible Spending Account Dependent Care Flexible Spending Account Employee Assistance Program Continuation of Health Coverage COBRA Life Insurance Basic Life Insurance Optional Life Insurance Accidental Death & Dismemberment (AD&D) Retirement State Teachers Retirement System (STRS) Public Employees Retirement System (PERS) Public Agency Retirement Services (PARS) 403(b) 457(b) How is LAUSD s plan different from the norm? (survey data from Segal) No premium contributions for employees, retirees, spouses, or dependents Dual employee enrollment Enrollment waiting period less than 30 days Level of benefits Lifetime retiree benefits Minimum number of units required for dependent college students Allows addition of dependents post retirement 3
Overview of Current District Health & Welfare Benefits Plan Plan design by the Health Benefits Committee/Coordinated Bargaining Process Eligibility rules Benefited active employee benefits are the same, whether employee is full-time or at least half-time, except T.A. s Retiree benefits are the same, whether full-time or part-time 1 No variation in retiree benefits based on years of service No employee/retiree premium contribution for medical, dental and vision Low copayments and deductibles Lifetime medical, Rx, dental and vision for employee and spouse (and eligible dependents) District pays 100% of premium Retirees pay deductibles and make copayments Retiree plan richer than active employee plan because of PPO access 1 Retiree must meet service requirements. 4
Medical Benefit Examples (More Than Half of LA County Unified School District have Active Employee Premium Contributions) School District Pre-Medicare Retirees* Post-Medicare Retirees Active Employee Contribution Long Beach Unified Full coverage to age 67 for certificated None post 67; self pay basis available No Glendale Unified Full coverage to age 65 None post 65; self pay basis available for some No San Diego Unified ER contribution up to $200/month prior to age 67 None post 67 No Montebello Unified Full coverage to age 67 None; self pay basis available Yes for some plans Santa Monica-Malibu Unified Full coverage at HMO rate to age 65 ER contribution of $97/month post 65 Yes for some plans *Employee must meet pre-medicare eligibility criteria. 5
$1,200 $1,000 $800 $600 How do LAUSD s H&W Costs Compare with Other School Districts Costs? Health & Welfare Benefit Costs (Actives and Retirees) per Average Daily Attendance (ADA) Los Angeles Unified School District (LAUSD) Statewide Average Unified School Districts Statewide Average All Districts $818 $648 $632 $846 $685 $679 $940 $730 $729 $1,010 $790 $785 $400 $200 $- 2003-04 2004-05 2005-06 2006-07 Source: California Department of Education: Ed Data: http://www.ed-data.k12.ca.us. Note: Figures reflect expenditures for postemployment benefits other than pensions (OPEB) for (a) retirees and other former employees, whether for current-year benefit costs financed on a pay-as-you-go basis or for amortization of that portion of the past unfunded liability relating to retirees and other former employees, and (b) for amortization of the past unfunded liability relating to active employees, if such costs are not direct-charged. Does not include expenditures for normal costs for active employees. Prior to 2007, expenditures for both former and active employees were included. LAUSD figures are based on pay-as-you go and would be much higher if based on value of benefits to be provided. 6
The Retiree Health Issue Substantial benefit No funding for prior years earned benefits An increasing retiree population with decreasing student enrollment No incentives to choose lower priced plans 7
$350 $300 Expenditure Per Student for Retiree Health Benefits Other Post Employment Benefits (OPEB) Expenditure per Average Daily Attendance (ADA) Los Angeles Unified School District (LAUSD) Statewide Average Unified School Districts Statewide Average All Districts $282 $292 $250 $245 $254 $200 $150 $100 $77 $68 $90 $80 $104 $93 $114 $102 $50 $- 2003-04 2004-05 2005-06 2006-07 Source: California Department of Education: Ed Data: http://www.ed-data.k12.ca.us. Note: Figures reflect expenditures for postemployment benefits other than pensions (OPEB) for (a) retirees and other former employees, whether for current-year benefit costs financed on a pay-as-you-go basis or for amortization of that portion of the past unfunded liability relating to retirees and other former employees, and (b) for amortization of the past unfunded liability relating to active employees, if such costs are not direct-charged. Does not include expenditures for normal costs for active employees. Prior to 2007, expenditures for both former and active employees were included. LAUSD figures are based on pay-as-you go and would be much higher if based on value of benefits to be provided. 8
OPEB Benefit Values & Retiree Counts Number of Retirees 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Source: Segal Company. Data as of 5.29.08. May 28, 2008. An employee that retirees at 55 with 25 years of service receives a benefit worth almost $250,000. 38 108 360 1,543 4,405 5,827 6,085 5,871 4,909 2,875 1,180 444 Under 45 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95 & Over Age Retiree Count Average Benefit Value Benefit Value (PV) $450,000 $400,000 $350,000 $300,000 $250,000 $200,000 $150,000 $100,000 $50,000 $0 9
No Funding for Earned Benefits Yields Higher Costs Nominal Value of Total Benefits Earned to Date = $30.0 billion Discounted Value of Benefit (Unfunded Liability): 1 $10.6 billion Discounted Value of Benefit increased by more than $600 million since June 2005 Decisions to not fund the prior earned benefit have already cost the District almost $20.0 billion over the next 40+ years because of unearned interest Source: Segal Company, 2008. Note: Figures may vary slightly due to rounding. 1 For employee services to date. 10
Projection of Retiree and Active Population 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Calendar Year Active Retiree: Median Projection Retiree: Aggressive Projection Source: Active projections from Budget August 2008. Retiree projections from Segal Company August 2008. 11
Health & Welfare Enrollment Counts Type of Enrollee 2007-08 Enrollment CY 2020 Enrollment Active Employees 74,958 67,840* Retirees 32,947 76,498 Active Dependents 114,407 103,543 Retiree Dependents 22,203 51,552 Total 244,515 299,433 Source: 2007-08 LAUSD Business Tools for Schools (BTS). CY 2020 Segal Company. Note: Figures exclude AB 528, COBRA and charter school enrollees. * Active employee count from Budget. 12
3,000 2,500 642,153 Cash Flow for H&W Benefits 621,491 602,404 585,381 571,709 558,499 Active and Retiree Cost No GASB Funding 546,316 537,371 531,212 527,846 $2,254 $2,515 $2,815 527,444 529,859 700,000 600,000 2,000 $1,821 $2,024 526,708 500,000 $ in Millions 1,500 1,000 500 $1,644 $1,489 $1,353 $1,232 $1,123 929 $1,029 801 $944 $894 691 596 514 443 269 285 330 382 625 659 699 741 789 839 893 953 1,020 1,095 1,077 1,177 1,248 1,267 1,448 1,367 400,000 300,000 200,000 100,000 Student Population 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Calendar Years Active Cost Retiree Cost Student enrollment 0 Source: Segal Company August 2008; Student population Budget. 13
Most Choose More Expensive Plans Percentage of Persons in Each Plan and Average Yearly Cost of Plan Per Participant (Based on 2008 Enrollment) Retirees Under 65 Retirees 65 & Over PacifiCare 4.5% $8,125 Not Enrolled 2.2% PacifiCare 2.1% $4,300 Not Enrolled 6.7% Kaiser 40.3% $11,580 Blue Cross 53% $13,735 * Kaiser 34.3% $3,690 Blue Cross 57% $7,365 * Source: Segal Company as of August 11, 2008 based on calendar year 2008 costs. Figures exclude AB 528, COBRA and charter school costs. *Based on composite rate for HMO, HMO Plus, and Blue Cross Preferred. 14
Retiree Health Benefits Public Sector Expenditure Comparison Public-Sector Entity San Diego City Unified School District Burbank Unified School District Type 2003-04 Retiree Health Benefits Expenditure 2003-04 Total Expenditure School $2.4M $1.58B 0.15% School $500K $160M 0.33% Orange County $14.2M $2.67B 0.53% Long Beach City $6.8M $1.27B 0.53% San Diego City $13.0M $2.07B 0.63% Los Angeles County $169.3M $15.65B 1.08% Retiree Health Benefits as a % of Total Expenditure LA County Metro Transit Authority Santa Ana Unified School District Special $17.0M $1.26B 1.36% School $5.7M $380M 1.52% LAUSD School $164.7M $8.22B 2.00% Source: The Center for Government Analysis, 2006 (most recent study); data obtained from Comprehensive Annual Reports from several public agencies including cities, counties and school districts. Note: Figures are rounded. 15
Retiree Health Benefit Coverage: Public Employer Type of Payment Percentage of Public Sector Employers Offering Each Type of Payment No Payment, 19% Full Payment for Life, 1% Partial Payment, 6% Full Payment to Age 65, then Partial Payment, 7% Full Payment to Age 65, then no Payment, 39% Partial Payment to Age 65, then no Payment, 28% 86% of employers surveyed do not pay for retiree health insurance after age 65. 19% of employers surveyed do not pay anything for retiree health insurance. Source: California State Teachers Retirement System (CalSTRS) 2006 Health Benefits Survey of Employers; survey consists of school districts, community college districts, and county offices regarding health insurance coverage and health benefits costs as of January 1, 2007. 16
What are other Employers Doing to Minimize Costs? 58% Percentage of Large Private-Sector Employers that Made Changes to Retiree Health Benefits in Mentioned Areas (for Retirees over Age 65) 25% 24% 16% 10% 10% 9% 7% 6% 4% 3% 2% Increased Retiree Contributions to Premiums Increased Retiree Contributions to Premiums Increased Rx Drug Copayments or Coinsurance Increased Sharing Requirements Replace Fixed Replaced Fixed Dollar Copayments for Rx Drugs with Coinsurance in 1 or more Tiers Dollar Copayments for Rx Drugs with Required Mail Order for Refills of Maintenance Rx Drugs Terminated all Terminated all Subsidized Benefits for Future Retirees Subsidized Benefits for Future Retirees Added or Improved Coverage Place a New Cap on Firm Contributions Placed a New Cap on Firm Contributions Adopted a Defined Contribution Approach Offered an Increased Increased Retiree Cost- Out-of-Pocket Sharing Limits Requirements Offered an Account- Based Retiree Health Plan (HSAs or HRAs) Retiree Cost- Account- Based Retiree Health Plan (HSAs or Raised Age and/or Service Requirement for Eligibility Source:Kaiser/Hewitt 2006 Survey on Retiree Health Benefits, December 2006 survey of 302 large private-sector firms (with 1,000 or more employees) that currently offer health benefits to retirees. HSA: Health Savings Account. HRA: Health Reimbursement Account. 17
Savings from Elimination of Post-67 Benefit for Active Employees (Long Beach Unified Plan) Reduces the outstanding liability from $10.6 billion to $6.25 billion Reduces cash payments in 2020 by more than $665 million Reduces the normal cost of the plan by more than $270 million annually Source: Segal Company, 2008. Note: Figures may vary slightly due to rounding. 18
3,000 Cash Flow - Termination of Benefits at Age 67 Active and Retiree Cost No GASB Funding $2,815 $2,515 2,500 $ in Millions 2,000 1,500 1,000 500 $1,123 $1,029 $944 $894 269 285 326 370 416 $2,024 $1,821 $1,748 $1,644 $1,626 $1,489 $1,353 $1,232 653 606 556 509 462 625 659 699 741 789 839 893 953 1,020 1,095 $2,254 $1,881 704 1,177 $2,025 758 1,267 $2,186 819 1,367 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Calendar Years Active Cost Retiree Cost - Alt Plan Terminated at 67 Baseline Source: Segal Company August 2008; Student population Budget. 19
Active Plans No incentives for enrollees to choose lower priced plans Higher cost plans provide higher subsidies to highest paid employees Health benefits are major tool for recruiting and retaining high quality employees 20
Role of Benefits in Recruitment & Retention: Employees Top 5 Drivers in Each Category RECRUITMENT Rank 2003 2005 2007 1 Competitive health care benefits Competitive base pay Competitive base pay 2 Competitive base pay Competitive health care benefits Competitive health care benefits 3 Work/life balance Work/life balance Vacation/paid time off 4 Competitive retirement benefits Career advancement opportunities Convenient work location 5 Career advancement opportunities Salary increases linked to individual performance RETENTION (Survey of Employees Nationwide) Flexible schedule Rank 2003 2005 2007 1 Career advancement opportunities Organization retains people w/ needed skills 2 Organization retains people w/ needed skills Opportunities to learn & develop new skills 3 Overall work environment Organization s reputation as a great place to work 4 Development of employees skills Fair compensation compared to others doing similar work 5 Resources to get the job done Manager understands what motivates employees Career advancement opportunities Satisfaction w/ the organization s business decisions Good relationship w/ supervisor Organization s reputation as a great place to work Work/life balance Source: Towers Perrin Global Workforce Study United States (2003, 2005, 2007-2008). Findings do not necessarily reflect similar conditions at LAUSD. 21
Public Sector Survey of Work Rewards What do Employees Consider Important? Percentage of survey participants responding very important or extremely important. Career 60% 77% Work Content 77% 76% Benefits 64% 65% Pay 50% 56% Age <40 Age 40+ 0% 20% 40% 60% 80% 100% Source: Public Sector Rewards of Work Study, Segal Survey, 2008. Findings do not necessarily reflect similar conditions at LAUSD. 22
$800 $700 $600 LAUSD s H&W Expenditures vs. Other School Districts Costs Active Employees Health & Welfare Benefit Costs (Actives) per Average Daily Attendance (ADA) Los Angeles Unified School District (LAUSD) Statewide Average Unified School Districts Statewide Average All Districts $573 $571 $564 $592 $595 $599 $658 $626 $636 $718 $676 $683 $500 $400 $300 $200 $100 $- 2003-04 2004-05 2005-06 2006-07 Source: California Department of Education: Ed Data: http://www.ed-data.k12.ca.us. 23
Most Choose More Expensive Plans Percentage of Persons in Each Plan and Average Yearly Cost of Plan Per Participant (Based on 2008 Enrollment) Actives PacifiCare 10.8% Opt-outs 2.2% $6,875 Not Enrolled 4.1% Kaiser 42% $7,335 Blue Cross 40.9% $8,415 * Source: Segal Company as of August 11, 2008 based on calendar year 2008 costs. Figures exclude AB 528, COBRA and charter school costs. *Based on composite rate for HMO, HMO Plus, and Blue Cross Preferred. 24
Medical Plan Participation by Salary 60% Percentage of LAUSD Employees Enrolled in Each Medical Plan, by Salary Band 61% of total participants 50% 40% 30% 20% Higher annual salary bands chose Blue Cross 10% 0% 0-30 40-60 70-90 100+ Source: LAUSD Business Tools for Schools (BTS) as of June 1, 2008. Salary Band (in $000) Kaiser Blue Cross PacifiCare 25
Typical Cost Containment Strategies Strategies Employer Contributions Based on Mid-Priced Plan ROM Savings Per Category $103M Closed Formulary on all Drug Plans $7M Increase Rx co-pay $16M Allow families to only enroll in one plan $5M Increase office visit co-pays $15M Cap Reimbursement for Medicare eligible retirees at HMO costs only* $51M CY 2009 Plan Cost without Cost Savings 1 $938M Total Savings $197M CY 2009 Plan Cost with Cost Savings 2 $741M Source: Segal Company. $938M based on static 2008 population. 1 Does not include offsets for Medicare D. Excludes costs associated with AB 528, COBRA, and Charter Schools, but includes District Administrative costs. 2 Does not include savings from administration efficiencies. *3 tier plan for Blue Cross of $5/$10/$15. Note: The above table represents a sample of cost savings options available to the District for demonstrative purposes; additional options and combinations may exist. * Retirees could still elect another plan and pay difference in cost. 26
3,000 Cash Flow for H&W Benefits with Plan Design Changes Active and Retiree Cost No GASB Funding $2,815 2,500 $2,515 $2,254 $2,228 2,000 $1,821 $2,024 $1,783 $1,991 $ in Millions 1,500 1,000 500 $894 269 625 $1,644 $1,601 $1,489 $1,441 $1,353 $1,302 $1,232 $1,179 $1,123 $1,071 $1,029 988 $944 $975 $888 852 735 $814 634 $748 547 226 261 302 351 407 472 522 553 586 624 664 707 755 807 866 931 1,003 1,146 1,082 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Calendar Years Active Cost Retiree Cost - Alt Plan Terminated at 67 Baseline Source: Segal Company August 2008; Student population Budget. 27
3,000 Cash Flow - Termination of Benefits at Age 67 with Plan Design Changes Active and Retiree Cost No GASB Funding $2,815 2,500 $2,254 $2,515 $2,024 $ in Millions 2,000 1,500 1,000 500 $894 269 625 $1,232 $1,123 $1,029 $944 $955 $880 $812 $748 226 259 294 331 $1,353 $1,031 $1,197 $1,821 $1,644 $1,605 $1,489 $1,385 $1,490 $1,111 $1,288 519 481 442 367 404 602 559 522 553 586 624 664 707 755 807 866 931 1,003 $1,732 650 1,082 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Calendar Years Active Cost Retiree Cost - Alt Plan Terminated at 67 Baseline Source: Segal Company August 2008; Student population Budget. 28
Next Steps Bargaining Table (Began July 2008) 2009 Open Enrollment (Nov 2008)* Control Future Cost Implement an Effective Communications Program New Plan Year (Jan 2009) Parties must declare impasse if agreement is not reached (Oct 2008) 2008-09 Support Legislative Solutions On-going *Based on tentative timeframe. 29
Questions? 30