Medical Insurance and Drug Plan - A Review of the Discussion



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AIRPORT AUTHORITY BOARD OF TRUSTEES FINANCE AND BUSINESS DEVELOPMENT COMMITTEE Minutes from the Meeting of November 3, 2008 ****REVISED**** In Attendance: Mary Simmons, Madame Chair, Finance & Business Development Committee* Randi Thompson, Trustee* Joe Mayer, Trustee* Tom Gribbin, Chairman of the Board Brooks Mancini, Trustee Krys T. Bart, President/CEO Marily Mora, Deputy Executive Director Rick Gorman, CFO Marty Mueller, Manager of Technology & Information Systems Joyce Humphrey, Purchasing & Materials Management Manager Leah Williams, Accounting Manager Tony Osendorf, Manager of Finance Julie Sternberg, Benefits Coordinator Alex Kovacs, Financial Analyst Felix Oroz, Advanced Insurance Solutions Patrick North, Acting Landside Manager Fritzi Witsoe, Acting Sr. Internal Auditor *Denotes Finance Committee member Note: The official minutes of the Finance Committee meetings are maintained on magnetic tape used to record the proceedings. The following is provided as a reference to the subject matter and conclusions reached from the discussion. Topics Discussed: I. Review of meeting minutes from August and September The minutes from the prior meeting of the Finance and Business Development Committee, October 6, 2008, were approved by the Committee. II. Items to be presented to the Finance and Business Development Committee for review and recommendation to the Board: #08(11)-77 A. AWARD OF PROFESSIONAL SERVICES AGREEMENT FOR ONE YEAR OF EXTENDED WARRANTY AND MAINTENANCE SERVICES FOR THE RENO-TAHOE AIRPORT AUTHORITY PARKNIG REVENUE CONTROL AND GROUND TRANSPORTATION MANAGEMENT SYSTEMS WITH SCHEIDT & BACHMANN USA IN THE AMOUNT OF $231,750 Staff proposed an extension of the warranties and maintenance services for the Parking Revenue Control System (PARCS) and Ground Transportation Management Systems (GTMS) that are responsible for the controlled collection of landside revenues that are due to expire on June 30, 2008 and February 1, 2009, respectively. The extended warranty provides for dedicated onsite support from the system provider with a guaranteed response time of four (4) hours for both materials and labor. The coverage is a 24 hours per day, seven days per week. 1

The Landside Operations Department budgeted $280,000 in professional services to renew both the PARCS and GTMS support agreements during FY2008-09. Both support agreements would be renewed at a cost of $231,750; a cost savings of $48,250, due to the application of a pro-rated discount for the remaining original manufacturer s warranty on the GTMS. Staff reported that the item was exempt from competitive bidding as outlined under NRS 332.115. The Committee unanimously recommended this item for approval at the upcoming Board meeting, contingent upon revisions to the Board Memorandum to include the NRS Competitive Bid clause. #08(11)-78 B. APPROVAL OF EMPLOYEE INSURANCE CONTRACTS WITH SAINT MARY S FOR MEDICAL FOR $2,395,709 AND THE STANDARD FOR LIFE/LONG TERM DISABILITY COVERAGE FOR $200,260 FOR 18 MONTHS (JANUARY 2009 JUNE 2010); AND SELF-INSURING PRESCRIPTION, DENTAL AND VISION COVERAGE Staff presented historical information regarding the formation of the Airport Authority Insurance Committee, a joint labor/management committee that was negotiated into collective bargaining agreements with the Airport Authority Employees Association (AAEA) and the Airport Authority Police Officers Protective Association (AAPOPA) about eighteen years ago. The sole purpose of the Insurance Committee (IC) is to make recommendations to the President/CEO on the Authority s employee insurance benefit programs. Staff stated that the Medical and Life/Long Term Disability program contracts are due to expire at the end of the 2008 calendar year. The IC utilized the Authority s broker of record, Advanced Insurance Solutions (AIS), to place the Authority s insurance programs out to bid for calendar year 2009. The highlights of the discussion are as follows: Medical Staff reviewed the medical plan renewal rates from St. Mary s that represented a premium increase of 28.4%. St. Mary s indicated that the increase was attributed to the Authority s high loss ratio of 137% for the first six months of 2008 and an only somewhat better twelve month loss ratio of 95%. Insurance carriers prefer to see the loss ratio at 82% - 85% in order to cover administrative costs. St. Mary s agreed to provide an eighteen month renewal quote and additionally lowered their initial premium increase to an overall increase of 14.65% for the period of January June 2009, with a guaranteed overall increase of only 4.55% for the next twelve month period of July 2009-June 2010. Hometown Health Plan (HHP) refused to provide a quote to the Authority unless the Authority could guarantee them that the RTAA would switch coverage to HHP. 2

The IC discussed the feasibility of self-insuring the medical program. Given the uncertainty of the economy, the committee elected to not consider the option of self-insuring the medical plan at this time. Vision (Self-Insured Program) Costs are expected to be 14% over what was projected. This is most likely attributed to poor projection analysis based on limited information from the fully insured plan and the cyclical nature of glasses replacement every two years. Allowing for a 5% increase for trend in claims costs for the first six months in 2009 and then an additional 2.5% increase for the following twelve months through June 2010, the Authority s projected costs for the eighteen months is $63,089. Dental (Self-Insured Program) Costs are expected to be slightly over what was projected. Allowing for a 9% increase for trend in claims costs for the first six months in 2009 and then an additional 4.5% increase for the following twelve months through June 2010, the Authority s projected costs for the eighteen months is $359,268. Prescriptions (Self-Insured Program) Generic utilization is at 62.9% with total plan costs increasing only 8.5% over last year. Specialty drug utilization increased 64.3%, costing the plan $450-$2800 per prescription per month. Allowing for an 8% increase for trend in claims costs for the first six months in 2009 and then an additional 4% increase for the following twelve months through June 2010, the Authority anticipates the costs for the eighteen months to be $469,706. The IC recommended to the CEO that the Authority institute Dispense As Written (DAW) penalties for members that choose a brand name drug in lieu of a generic that is available. This penalty will not be charged if it is medically necessary for a member to take the brand name drug instead of the generic drug. Life & Long Term Disability The IC made the recommendation to the Executive Director to stay with The Standard for Life and Long Term Disability coverage. The Standard offered to maintain the current rates through December 2010. 3

In summary, Staff made the recommendation to maintain employee group medical coverage through St. Mary s; group Life/LTD coverage through The Standard; self-insure the Authority s prescription coverage utilizing Catalyst RX as the Pharmacy Benefit Manager to manage claims processing; selfinsure the Authority s dental coverage utilizing the Diversified Dental network and CDS Group Health to manage claims processing; and begin to self-insure group vision coverage utilizing Vision Service Plan to manage claims. Staff estimated FY2008-09 costs to be $2,187,787. Compared to the FY2008-09 budget amount of $2,420,600, there will be a budgetary cost savings of approximately $232,813. The FY2009-2010 budget will include an amount for the remaining twelve months of the eighteen month period. Trustee Mayer stated that he serves on the Board for the Northern Nevada Medical Center which has some ties with St. Mary s but none of the ties will affect his judgment or monetarily affect his ability to make a decision in this case. Chair Gribbin and the Committee members commended staff on their work. The Committee unanimously recommended this item for Board approval at the upcoming Board meeting. III. Items presented to the Finance and Business Development Committee for approval: IV. Items presented to the Finance and Business Development Committee for discussion: V. Items presented to the Finance and Business Development Committee for information: A. Review of Operating Results through September 2008 Staff reported that the airport is 2.6% under budget in operating revenues and 13.2% under budget in operating expenses. Total landed weights for the three-month period ending September 31, 2008 are 2.7% under budget or 24,488,000 pounds. Landing fees were budgeted for signatory airlines at $2.30 per 1,000 lbs. Based on actual activity through September, the landing fee rate should be $2.02 per 1,000 lbs. The budgeted cost per enplaned passenger is $5.53, and based on actual activity through September 2008, the cost per enplaned passenger is $5.24. Airline rents are under budget by 12.1% based on activity through September 2008. The budgeted average rental rate is $63.31 psfpa, and based on the actual requirement, the average rental rate should be 55.67 psfpa. Non-airline revenues are 5.1% under budget. B. Review of Budget Transfers (if any) 4

C. Review of Contracts and Professional Service Agreements for the Month of October 2008 Staff reviewed the Administrative Award of Contracts pursuant to Resolution #462. Staff confirmed that Intermountain Slurry Seal was a new contract that was acquired through a competitive bid process. Staff went out for two additional quotes whereby one bidder declined to quote and the second bidder stated that he did not have experience in doing the type of work requested. The Committee had no additional questions. D. Review of Legal Expenses through October 2008 Staff reported payments made toward legal costs that were expended through the month of October 2008. The Authority has expended 26% of the legal budget for Fiscal Year 2008-09 with 33% of the budget year expired. E. Review of Board Budget to date October 2008 Staff reported that October represents 33% of the budget year; actual costs are at 13% of the total budget. VI. Public Comment There were no comments. VII. Adjournment The meeting adjourned at 1:42PM MS:PN/faw 5