Joint Labor-Management Benefits Committee (JLMBC) COMMITTEE REPORT 18-15 JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE MEMBERS: Management Date: March 22, 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 JLMBC receive and file projects and activities report regarding informational items, projects updates, staffing summary, and completed projects/meeting calendar for February 1 March 15, 2018. DISCUSSION A. Informational Items 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 February 2018. 1. 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. Since the last update provided to the JLMBC on February 8, 2018, Anthem confirmed that it had extended its contract with Huntington Memorial through February 15, 2018. On February 14, 2018, Anthem notified the City that it had secured a contract extension with Huntington Memorial through March 31, 2018. On March 9, 2018, Anthem notified the City that they have successfully negotiated a multi-year contract with Huntington Memorial effective April 1, 2018. The City has had 99 HMO and 41 PPO employees and dependents utilize Huntington Memorial Hospital in 2017; these members will be able to continue to access services at this location without interruption. 2. Prime Healthcare Services On February 26, 2018, Anthem notified the City that they will not be renewing a joint commercial hospital agreement with the following Prime Healthcare Services hospitals: Centinela Hospital Medical Center, Garden Grove Hospital & Medical Center Huntington Beach Hospital La Palma Intercommunity Hospital JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE www.keepinglawell.com
Paradise Valley Hospital Sherman Oaks Hospital West Anaheim Medical Center The termination of the agreement will take effect on March 25, 2018 and will only apply to non-emergency hospital services. Emergency services are covered at the in-network level of benefits. The termination will not affect any medical groups used by employees; however, medical groups may no longer refer members to these facilities for non-emergency services. Pre-termination letters were sent to applicable physicians on February 23, 2018 to notify them of this change. A copy of that letter is provided as Attachment B. A total of 53 individuals (employees and dependents) on the City s group health plan have used one of these hospital locations in the past 12 months, with a majority (78%) of the visits being for emergency room services. A termination notification letter will be sent to these individuals within five days of the termination date. A draft sample of this termination letter is provided as Attachment C. 3. Universal Health Systems On March 5, 2018, Anthem notified the City that they are in negotiations with Universal Health Systems (UHS) to renew their agreement, which currently terminates on March 30, 2018. The UHS agreement covers the following five hospital locations in Riverside and Los Angeles Counties: Corona Regional Medical Center (Riverside, CA) Palmdale Regional Medical Center (Los Angeles, CA) Southwest Healthcare System Murrieta (also known as Rancho Springs Medical Center) (Riverside, CA) Southwest Healthcare System Wildomar (also known as Inland Valley Medical Center) (Riverside, CA) Temecula Valley Hospital (Riverside, CA) The City has had 23 HMO and 7 PPO employees and dependents utilize one of these locations in the past 12 months. A pre-termination letter dated February 28, 2018 (provided as Attachment D) has been sent to all applicable physicians to notify them of alternate hospital admitting options should the termination take effect. Anthem will continue to provide staff and the JLMBC with immediate updates related to these negotiations. B. Projects Updates Affordable Care Act (ACA) Tax Reporting Update As reported during the JLMBC meeting of February 8, 2018, staff worked with Benelogic, LLC and the Civilian Benefits Program s Third-Party Administrator, Mercer to provide ACA tax reporting services for the 2017 calendar year. Final data to populate and generate the ACA related IRS tax forms for all eligible employees was provided to Benelogic on February 12. Staff completed its review of the tax forms and approved the forms for production and mail fulfillment on February 15. The ACA tax form mailing deadline was extended to March 2, 2018, and all tax forms were sent to City employees and postmarked no later than March 2, 2018 to meet the deadline. 2
Under the ACA, fully-insured health plans such as Kaiser and Anthem are required to provide IRS Form 1095-B to demonstrate whether an individual and their dependents had health insurance coverage during the calendar year. Both Kaiser and Anthem have completed mailing of Form 1095-B to eligible City employees. To provide informational resources to City employees on the different tax forms they will receive from both the City and health plan carrier, staff completed work on the following communications materials: Citywide Email On January 31, 2018, a Citywide email was distributed which reminded City employees that the City will issue and mail IRS Form 1095-C to their home address by March 2 and that the form is not required to file a tax return. Additionally, the email provided a brief overview of the different tax forms. Postcard On February 12, 2018, a printed version of the Citywide email was mailed to about 42,000 civilian and sworn employees who will receive IRS Form 1095-C. The purpose of the postcard is to provide a brief overview of the tax forms and assist in directing questions from recipients. Mailing of the postcard was completed on February 13, 2018. Frequently Asked Questions (FAQs) Staff worked with the City Attorney and finalized an ACA Health Care Reform FAQs to answer commonly asked questions regarding the ACA and IRS tax forms. On January 31, 2018, the FAQs were posted on the www.keepinglawell.com website along with links to 1) questions and answers regarding the ACA on the IRS website and 2) an electronic copy of the email/postcard communication. Benefits Service Center Phone Script Staff developed and approved a final phone script for the Benefits Service Center call center service representatives to use to answer questions from City employees related to the ACA IRS tax forms. The phone script, email/postcard, and FAQs were provided to the Benefits Service Center on January 30, 2018 ahead of the tax forms being mailed to ensure proper coaching and training is provided to call center representatives. Since mailing of the postcard and delivery of the ACA tax forms, the call center has received a minimal number of calls on this subject matter. Benefits Provider Information Exchange At its February 8, 2018 meeting, the JLMBC requested staff to research the feasibility of the LAwell Civilian Benefits Program s vision and dental service providers, EyeMed and Delta Dental to share patient information with health plan carriers, Kaiser and Anthem with the goal of improving the efficiency and effectiveness of patient care. Staff and benefits consultants, Keenan and Segal, met with EyeMed, Delta Dental, Kaiser, and Anthem to discuss available options and potential legal conditions governing the exchange of member data for fully insured plans. Further research and discussions are ongoing to identify the full capabilities, and any legal considerations, that are available. Staff will provide an update to the JLMBC at its April 2018 meeting. Employee Benefits Trust Fund Revisions and Refunds Update At its February 8, 2018 meeting, the JLMBC received an update on proposed changes to certain provisions of the Los Angeles Administrative Code regarding the Employee Benefits 3
Trust Fund (Trust Fund) that would provide authority for refunds of certain balances to be issued from the Trust Fund. The ordinance amending the Administrative Code is currently being routed for Council consideration and approval. Staff will update the JLMBC on the status of the ordinance change. Meanwhile, staff has scheduled a meeting with the Office of the City Controller to develop an implementation plan and timeline for producing and distributing refund checks to eligible individuals. Staff anticipates providing the JLMBC with an update for issuing the refunds at its May 2018 meeting. Ad Hoc Governance Subcommittee: JLMBC Bylaws Review At its February 8, 2018 meeting, the JLMBC established an Ad Hoc Governance Subcommittee to work with staff to review the Policies Governing the Joint Labor-Management Benefits Committee bylaws and recommend revisions and updates as necessary to ensure sound governance practices. Staff is presently drafting proposed revisions to the bylaws and once that document is completed will convene the Ad Hoc Subcommittee for review and discussion. Benefits Service Provide Procurement Update As previously reported, the Requests for Proposals (RFPs) for Tax-Advantaged Spending Accounts and Employee Assistance Program (EAP) services were approved by the JLMBC at its October 5, 2017 meeting. Both RFPs were subsequently released on the City s Business Assistance Virtual Network on December 13, 2017. A mandatory pre-proposal conference was held for both RFPs on January 8, 2018, and proposals were due on January 30, 2018. Two proposals were received for the Tax-Advantaged Spending Accounts RFP and six proposals were received for the EAP RFP. Staff anticipates completing its evaluation and presenting its findings on the Tax-Advantaged Spending Accounts RFP and the EAP RFP to the JLMBC at its April 5, 2018 and May 3, 2018 meetings, respectively. Communications Planning Meeting Employee Benefits Division staff attended a communications planning meeting hosted by benefits consultant, The Segal Company on February 22, 2018 to review the development and implementation results of the 2018 Open Enrollment communications campaign and to begin planning for the 2019 Open Enrollment communications campaign, which includes developing a long-term benefits communications plan to enhance and strengthen the LAwell Benefits Program s overall communications efforts. C. Staffing Summary Adriana Beltran-Herrera, formerly Benefits Specialist accepted a position with the Department of Planning effective February 20, 2018. The division is currently working to fill the vacant position. 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% 4
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 Vacant 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% 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% D. 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). Submitted by: Reviewed by: Approved by: Paul Makowski Jenny M. Yau Steven Montagna 5
COMPLETED PROJECTS & UPCOMING MEETINGS CALENDAR COMPLETED PROJECTS: FEBRUARY 1 MARCH 15, 2018 # STATUS PROJECT 1 Completed JLMBC Report: Anthem PPO Member Survey 2 Completed JLMBC Report: Employee Benefits Trust Fund 3 Completed JLMBC Report: Ad Hoc Governance Subcommittee JLMBC Bylaws Review 4 Completed JLMBC Report: LIVEwell Wellness Program Update 5 Completed JLMBC Minutes: Meeting of the January 4, 2018 Special Meeting 6 Completed JLMBC Appeals February 2018 8 total completed in EBD 7 Completed Catastrophic Illness Cases February 2018 0 cases processed 8 Completed New hire benefits presentations Public Works, Engineering, Library, and LAPD 9 Completed Reconciliation of 2017 flexible spending accounts contributions 10 Completed Dropped Dependent(s) and Cash-in-Lieu confirmation statements due to no documentation received mailed 11 Completed Reminder letter to submit Evidence of Insurability forms for life insurance elected during Open Enrollment mailed to affected employees 12 Completed Tax-Advantaged Spending Accounts and EAP Request for Proposals Mandatory Pre- Proposal Conferences (completed in January 2018) 13 Completed Tax-Advantaged Spending Accounts RFP Performance Exam 14 Completed Request for Proposal for ACA Eligibility and Tax Reporting Services released 15 Completed ACA Compliance Approximately 42,000 IRS Form 1095-C mailed 16 Completed ACA Communications Citywide email, postcard, FAQs, call center script 17 Completed ACA Request for Proposal Mandatory Pre-Proposal Conference 18 Completed 2018 Communications Planning Meeting 19 Completed Benefits Third-Party Administrator Transition Kick-Off Meeting JLMBC UPCOMING MEETINGS CALENDAR MEETING AGENDA ITEM PRESENTATION 5-Apr-18 JLMBC Report: Wellness Program Services RFP Evaluation JLMBC Report: Tax-Advantaged Spending Accounts RFP Evaluation JLMBC Report: TPA Transition Update JLMBC Report: Quarterly Staff Reimbursements JLMBC Report: Benefits Trust Fund Review JLMBC Report: Benefits Provider Information Exchange JLMBC Report: Wellness Program Update JLMBC Report: Monthly Projects & Activities Update 6 Anthem Blue Cross 3-May-18 2018 LAwell Benefits Plan Design Review and Renewals None JLMBC Report: EAP RFP Evaluation JLMBC Report: TPA Transition Update ATTACHMENT A
JLMBC Report: Employee Refunds Update JLMBC Report: Wellness Program Update JLMBC Report: Monthly Projects & Activities Update 17-May-18 2018 LAwell Benefits Plan Design Review and Renewals None JLMBC Report: TPA Transition Update JLMBC Report: Anthem PPO Member Survey Results JLMBC Report: Wellness Program Update JLMBC Report: Monthly Projects & Activities Update 7