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HomeMy WebLinkAbout1999-04-22 (2)MINUTES ADJOURNED JOINT MEETING OF THE PALM DESERT CITY COUNCIL AND PALM DESERT REDEVELOPMENT AGENCY THURSDAY, APRIL 22,1999 2:30 P.M. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I. CALL TO ORDER Mayor/Chairman Spiegel convened the meeting at 2:36 p.m. H. ROLL CALL Present: Excused Absence: Councilmember/Member Jean M. Benson Mayor Pro-Tempore/Vice Chairman Buford A. Crites Councilman/Member Jim Ferguson Councilman/Member Richard S. Kelly Mayor/Chairman Robert A. Spiegel Also Present: Ramon A. Diaz, City Manager arrived at 3:26 p.m. David J. Erwin, City Attorney arrived at 3:40 p.m. Sheila R. Gilligan, Director of Community Affairs/City Clerk John M. Wohlmuth, ACM/Director of Administrative Services Carlos L. Ortega, RDA Executive Director Phil Drell, Director of Community Development J. Luis Espinoza, Finance Operations Manager Gloria Darling, Human Resources Manager Ken Weller, Risk Manager Rachelle D. Klassen, Deputy City Clerk III. ORAL COMMUNICATIONS None IV. NEW BUSINESS A. CONSIDERATION OF SECTION 125 (CAFETERIA) PLAN AND CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM HEALTH BENEFIT CONTRACT. Mr. Wohlmuth presented information regarding California Public Employees' Retirement System Health Benefits and the City's proposed Cafeteria Plan, a copy of which is attached and made MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * a part of these Minutes as Exhibit "A." Ultimately, he stated that the plan would require the adoption of up to three City Council resolutions, should the program be accepted, one for City Council, one for management, and one for the Palm Desert Employees Organization (PDEO). He said a Health Fair had been planned for May 20, where all the vendors under contract with Ca1PERS would be present to provide more information; however, in order to conduct the Fair, Ca1PERS would like a City Council resolution from any one of the bargaining units in order to continue with the process. Mr. Wohlmuth explained some of the reasons for investigating a Cafeteria Plan included the fact that current Principal Mutual rates were $913 per month per family, after being under contract with Principal for the last approximately 14 years; a similar program under Ca1PERS was $710 per month per family. He noted that the City's current contract was outdated in the health industry— $5 co -pays, $500 maximum out-of-pocket for the family, and premiums had been raised about 11 % per year over the last four years. He said in comparison, Ca1PERS health care premiums had increased approximately 2% per year over the last five years. He stated that Ca1PERS' PERSCare was the comparable option to Principal Mutual's contract, and PERS offered many other choices. Mr. Wohlmuth went on to say that over a year ago, an actuarial was done on retiree health, and the actuary reported the City paid 25% over its claim history (the amount of claims made by employees on their health insurance). Additionally, he said the City's rates were raised 22% last year; therefore, the City paid substantially over its claim history. Mr. Wohlmuth said the Cafeteria Plan offered options of health, dental, and vision, in addition to some other options. He said staff proposed a three-tier health contract, consistent with the Ca1PERS arrangement; whereas, the City was currently offering a two-tier health contract with single and family. In order to come up with the formula, the City took the same pool of dollars currently being spent, $1.2 million per year for the three benefits (health, dental, and vision), or $101,684 per month, and divided it per Ca1PERS' formula of a single, a two-party, and a family contract: 1) Single at $402.83 per month; 2) Two-party at $805.08 per month; 3) Family at $1,087.05. Further, he said there was a new proposal for dental being considered, Delta Dental, with very comparable, if not better, coverage than the current Phoenix Mutual plan, and he provided costs of the three benefits for the three-tier program, calculated at the highest possible coverage available (Figures would be adjusted should a participant choose less expensive health coverage.) Dental Visipn Health / Available Remaining Cafeteria Balance* Single $ 34.44 $ 25.44 $273.00 / $ 69.95 Two -Party 64.94 25.44 546.00 / 168.70 Family 109.65 25.44 710.00 / 241.96 2 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22, 1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *To be used any way allowed under the Internal Revenue Service (IRS) Code, per the optional programs noted below. Mr. Wohhnuth said mandatory employee coverage would include health, dental, and vision, and optional spending choices would include deferred compensation in the two approved plans PEBSCO or ICMA (with a maximum 25% of an employee's salary, or $8,000 per year), child care (maximum $5,000 per year, or $433 per month), medical reimbursement, a pre-tax pool, as much as the employee desired from his discretionary balance in the Cafeteria Program, placed into an account that the employee could use any way he wanted during the plan year for legitimate medical expenses (co -payment, pharmaceuticals, dental, etc., with the exception of cosmetic surgery). In closing, Mr. Wohlmuth said the Cafeteria Plan would affect retiree health in three ways: 1) Would reduce the City's unfunded liability from $30 million to the City's monthly amount; 2) would allow for retiree spousal continuance; and 3) would reduce employee cost. Additionally, he said since the City paid such a high premium for Principal Mutual, it was time to examine a different option, and Ca1PERS offered such options for employees without spending additional money to obtain those necessary benefits, in addition to some extra benefits. He said if Principal Mutual continued to increase the City's premiums at the present rate, in the long run, the Cafeteria Plan would offer the City substantial savings on its health insurance expenditures. Upon question by Mayor/Chairman Spiegel whether any other providers were solicited for bids, Mr. Wohlmuth responded there were other plans solicited; however, they were nothing like Principal Mutual. Therefore, with Ca1PERS' bidding over one million employees, staff felt it had the bargaining power to offer choices and the best possible contract desired by employees. Further, he answered that the City was in the third year of a five-year memorandum of understanding (MOU), and employees had the option to reject the proposed Cafeteria Program. However, he said management employees saw the benefit to be derived from the discretionary income available in the subject plan, as opposed to the entire amount being spent with Principal. Mayor/Chairman Spiegel asked whether the current MOU specified Principal Mutual as the provided insurance. Mr. Wohlmuth said it did not; he said employees could keep what they had, if they chose. Councilman/Member Kelly asked what percentage was required, and Mr. Wohlmuth responded 51 % of the bargaining unit was required. In response to Mayor/Chairman Spiegel's question, Mr. Wohlmuth stated it was possible the PDEO Board wouldn't take the proposal to its general membership. He said if no vote was taken, or the Cafeteria Program was rejected, the City's pool would stay the same, except that Principal would probably raise rates for the next two years, similar to the increase it imposed in years' past, for the City's 80 employees in the PDEO bargaining unit of the 120 total employees. 3 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22, 1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * MS. DONNA BEAUMONT, Ca1PERS . Health Benefit Services Division representative, addressed the Council with regard to the proposed program, as outlined in Exhibit "A," and answered specific questions about how the program would affect participants. She noted that PERS had been administering health benefits for over 37 years, with over 1,200 public agencies and over 100 school districts participating in the system currently. Further, she said PERS had the largest health risk pool in California, second largest in the nation (first being the federal government) with over one million covered lives. She said those numbers provided PERS significant negotiating power with its contracted health plans-- ten different HMO's and two self - funded PPO's (PERSCare and PERSChoice) administered by Blue Cross under the Prudent Buyer Plan. MS. BEAUMONT stated PERS negotiations began each year in January for the following year's premiums, which were locked in by June 1 in order to notify participating employers of premiums to be charged the following January 1. She went on to say that agencies could participate in the PERS Health Program either as a whole or by recognized employee group, which she said was the way the City had indicated it would choose to participate should it enter the program. She said that as long as PERS received an adopted resolution by the tenth of any month, the agency could name the first of the following month as its effective date. Agencies were able to name the first of any month as their initial effective date; however, she recommended at least a month and a half lead time in order to process all the necessary administrative work and provide participants with identification cards before the effective date. MS. BEAUMONT said one of the more attractive features of the PERS Program for employers was the cost of participation, with an administration cost of only 0.5% of total premiums. She stated the maximum amount that could be charged was 2%, as written in Public Employees' Retirement Law under the Public Employees' Hospital and Medical Care Act, which governed the Ca1PERS Health Program. She reported that the two methods of contributions agencies could adopt were the equal and the unequal method, and she believed Palm Desert would come in under the equal method, where retirees received an equal contribution as that set for active employees. Ms. Beaumont noted that by offering a Cafeteria Plan, made available for more than one benefit, agencies benefitted because money placed in the Cafeteria Plan was not designated specifically as a health contribution. She said PERS' minimum requirement was $16, as written into the law in 1962 (the Kaiser rate at that time). Under the equal method of contribution, the $16 amount would be named as the minimum contribution for both active and retired employees, permitting the City to manage its retiree cost while allowing retirees' participation in group coverage negotiated by PERS. She reiterated that PERS took an aggressive position in negotiating benefits and premiums for its membership. MS. BEAUMONT stated that agencies and their employees under the program would be able to pick and choose amongst all of the eligible plans, noting HMO's were regulated by the Department of Corporations and operated within certain geographically restricted areas as determined by zip code (shown on Exhibit "A"). She went on to say agencies received one bill, 4 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * and PERS paid the various health plans. She then outlined eligibility requirements for the participating employees and retirees, stating that PERS' open enrollent period was September 1 to October 15 each year for a January 1 effective date. Upon question by Councilman/Member Kelly when a Council decision was expected,. Mr. Wohlmuth answered the Council could vote as a bargaining unit, and he hoped to present it at the May 13, 1999, meeting. He also anticipated management employees' decision being on the May 13 agenda. He said if the Council bargaining unit resolution was passed May 13, it would allow Councilmembers to participate in the Health Fair planned for May 20, where various health organizations would be present to answer questions and offer enrollment at that time. With City Council/Agency Board concurrence, staff was directed to move forward and provide the subject information and obtain votes from the three bargaining units of City Council, Exempt Groups A & B (management) of City employees, and the Palm Desert Employees Organization. B. REVIEW OF DISPOSITION AND DEVELOPMENT AGREEMENT WITH CALIFORNIA STATE UNIVERSITY - SAN BERNARDINO. With City Council/Agency Board concurrence, review and discussion of the subject agreement was deferred until a study session for such purpose could be scheduled by the City Council. No action was taken. V. ADJOURNMENT With City Council/Agency Board concurrence, Mayor/Chairman Spiegel adjourned the meeting at 3:50 p.m. ATTEST: fSHEILA RILLIGANaCITY CLERK/AGEN(CCRETARY CITY OF PALM DESERT, CALIFORNIA/ PALM DESERT REDEVELOPMENT AGENCY OBERT A. SPIEGEL, M OR/ IRMAN 5 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * EXHIBIT 'A' Cafeteria Benefits That Are Qualified For Tax Favored Treatment Include: - Group team life insurance for death benefits up to the $50,000 gross income exclusion; as well as group term life insurance that provides death benefit coverage in excess of $50,000 and results in additional imputed income. - Accident and health insurance coverage including all types of medical, vision, prescription, and dental plans, long term disability, short tam disability, and accidental death and dismemberment. - Coverage under a group legal services plan. - Dependent care assistance plans that provide tax favorable treatment for monies spent on the care of certain dependents, provided that such care is necessary and allows the employee to maintain his or ha job. - Medical expense reimbursement for items not covered by an insurance policy or carrier. - Participation in a qualified cash -or deferred arrangement subject to Internal Revenue Code Section 401 fir). 6 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * immimummi Employaaa �7 Empfoy..+ M* Ernpbyaa ONI� E110°p5 + ? EmpbyM + Fam0y Totals DRAFT 7 13 20 49 24 35 01 124 Y�Mre � aao11 Mu111 MYW t'Y YID 1 7 2,52tl.07 2 28 10,070.13 2 tl 52 21,741.05 Of 3551/50 41510 16503 202.07 273.00 52511 511.05 525.10 540.00 f. ii otl 455.11 151.87 i1tIo0 145.10 5507 05.20 200.10 170.00 15570 377.06 arta 241.55 1 24 0.501.25 402.55 150.03 245.52 273.00 121.55 72.52 00.05 2 70 25.177.12 105.00 311.02 45.411 540.00 258.00 130.85 100.70 2.8 150 03.145.25 1.048.54 403.20 443.44 110.00 3305/ 210.41 201.55 253 101,4414.30 Page 1 i i• 53,471.334iv i Ross 55.31 12.031NoMi 81.443.751mdh Can.da UN/ 71'aNalnsllh 52,077.55 will Principel MAW MINUTES ADJOURNED JOINT Mi i i iiiG PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY * * * * * * * * * * * * * * * * * APRIL 22, 1999 * * * * * * * * * * * * * * BENEFIT COMPARISON FOR CITY OF PALM DESERT Proposed Cafeteria Plan FY 1999/2000 10% 40% $5 $10+ 20% $15 dwgae• .4096 $5 $10+ 20% $15 no charge** 40% $5 $10+ 20% $15 10% 4096 $5 $10+ 20% $15 10% 10% 90/10 80/20 $100 - Facility $100 ded. $100 ded. $15 Co - Pay/ Physician 10% 40% $5 $10+ 20% $15 20% 10% 4096$5 $10+ 20% $15 $500 mix per calendar year 10% 40% As any illness $15 $5 generic or $10 brand $3 $3 $8 34-dav amply 34-dav simply $5 90-day $5 90-day N/A N/A N/A Not Covered Not Covered lifetime Lifetime Lifetime max. max. max. $15,000• . $15,000• $15,000• 10% 1096 90/10 80/20 $100 dad. $100 dad. IAI 113) 10% 10% $12,000life- 30 visite/ time max. Calendar year Detoxification only 15 days/ calendar year 110 IBi Detox. Only Ind. as any other illness. Max benefit payable: 30 days per colander year. Iljetime max. $50.000 100% facifty $15 co -pay phyoleian $50,000 Lifetime Maximum 8 MINUTES ADJOURNED JOINT MIu I uiG PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY * * * * * * * * * * * * * * * * * APRIL 22,1999 * * * * * * * * * * * * * * 9 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 2211999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CITY OF PALM DESERT Dental Marks** Rah Exhibit ED PROPOSED 119, EE'a CURRENT Phoenb l.Kellte NMI Pool DE TAI21 I P radMea. PPO DENTAL Ordsaadtrl Simile 21 S 31.59 $ 34.44 S 31.85 Two-PEAv 31 S 94.79 $ 64.94 $ 67.25 Fem*v 52 S 94.79 S 109.65 S 101.33 Monthly Tots' 104 S 8.531 S 8.438 S 8.023 Annual Total S 142.372 $ 101.258 S 96.273 PRE -PAID DENTAL - *Inds 3 $ 31.59 $ 14.64 S 14.63 Two-Par1v 4 S 94.79 $ 24.14 $ 27.23 Family 6 $ 94.79 S 35.71 S 42.01 Montle/ Total 13 $ 1.043 1 355 S 405 Annual Total S 12.517 S 4.257 S 4.858 Overall Monthly Total S 9.574 $ 8.793 $ 8.428 Overall Annual Total S 114.184 S 108.518 S 101.132 S Difference S f9.3591 $ 113.7521 % Difference .8% 42% Ddet2l Include. Adult a Chad Craw on DPO Pion. Paoaka . Ind.n.dly lead.. Adm. & Chid Who. 'Cirri* Coy ady s0as PPO. PP011nafad spa ralanalod at SOWS% far canprt.en peprns pa eb.MlmM.. Actud.nramanMd wl wry and Mad overall toll Clam* City an2r11rraleplan. RaqueMdSlierPatio Inrn.dr*.apa. atq.request Data quota eeraee 10016 £mply.►mnrbAan. Rafts amid vary ono..mplp. canMaunon schedule Is developed. Bath as ira mull.1SX madman. M:PNnDeaefl1199414W0ent L9e Rttes.bt 5 HCM Benefits, Inc. 10 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ANNUAL DEDUCTIBLE SINGLE .. FAMILY... CALENDAR YEAR MAXIMUM ORTHODONTIC BENEFITS PREVENTIVE CARE ORAL EXAMS. CLEANINGS X-RAYS BASIC TREATMENT FlwNcs ROOT CANAL EXTRACTIONS - SINGLE TOOTH MAJOR PROCEDURES CROWNS -RESIN DENTURES ORTHODONTIA BENEFIT LIFETIME MAXIMUM S25 S75 $2,000 Adult & Child 100% 100% 80% 80% 80% 80% 80% 50% CITY OF PALM DESERT DENTAL BENEFITS COMPARISON CURRENT PROPOSED DELTA PROPOSED PHOENIX HCM ►OOL PACIFICARE INDEMNITY PMI DPO/NON-DPO PREPAID VANGUARD PLAN 735 398 PPO VW DPO: $15 None NON-DPO: $25 None $25 DPO: $45 None NON-DPO: $75 None $75 None $2,000 None 61,500 Adult & Child Adult & Child Adult & Child None 100% 100% 100% $40 Co -pay 100% $45 Co -pay $110 Co -pay 100% 100% 100% 100% 100% 100% 80% 100% 80% B0% $35 Co -pay 80% BO% 100% 80% 80% $90 Co -pay 50% 80% S70 Co -pay 50% ChNd Co -pay $1800 Adult Co -pay $1800 50% Co -pay $1895 50% Start UP $350 $1,000 N/A $1,000 N/A $1,000 *Note: DPO Baufb are the yams tor DPO and NorWPO providers. Member wll haw Nos out of pocket coot by utilizing DPO denlbb. This & merely a summary of benefits for wmp.Ason pmpases only. \WCMB4I SYSCLIENTSIPALMDESNa9SN10ents! Bens.doo 6 HCM Rnnafitn, Ina 11 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APB 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CITY OF PALM DESERT Life & AD3b Marketing Rate Exhibit Current Proposed Proposed Proposed Proposed Volume Principal 11CM Poor Standard Fortis RSL. Basic Lice $ 5.775,050 $ 0.34 $ 0.22 $ 0.23 $ 0.22 $ 0.22 Basic ADM) $ 5.775.050 $ 0.025 S 0.03 $ 0.04 $ 0.03 $ 0.02 Combined Rate $ 0.385 $ 0,250 $ 0.270 $ 0.250 9 0.240 Monthly Total $ 2.108 $ 1,444 $ 1.559 $ 1,444 $ 1,386 Annual Total $ 25,295 $ • 17.325 $ 18.711 $ 17228 8 16.832 $ Difference $ (7.970) $ (8,584( $ (7.9701 $ (8.8831 % Difference -32% -28% -32% -34% IRate Guarantee None 3 Years 3 Year 2 Years 2 Years j • Canada Ufa far Basic Uhl/ TnnsAmedce tar flask noon. Volum, estimated *cm census dated 3rs1I98. MAranDe i.r61999 491ent llb Rates.* $ HCM Benefits, Inc. 12 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY * * * * * * * * * * * * * * * * * BENEFIT PROVISIONS BENEFIT AMOUNT AGE REoucrwNTo Lira MRovwgoN. WAIVER OF PREMIUM ACCELERATED DEATH BENEFIT CONVERSION PORTABILITY ADBD PROVISIONS SEAT BELT BENEFIT AIR BAG BENEFIT COMA BENEFIT EXPOSURE & DISAPPEARANCE CURRENT PRINCIPAL 1x Annual Salary to Maximum of $200,000 Not Clear in Contract No 50% wl Life Expectancy of 12 Months Yes No No No No No WICIMMIWa1CLIENTaPALM0ESNYMN1lh ADO Bom.doe APRIL 22,1999 * * * * * * * * * * * * * * CITY OF PALM DESERT BASIC LIFE & AD&D COMPARISON PROPOSED HCM POOL (CANADA LIFE /TRANSAMERICA ) 1x Annual Salary to Maximum of $200,000 65% ® Age 65 45% C Age 70 35% • Age 75 Yes 50% to Maximum of $60,000 Yes No Yes. 100% to maximum of$50,000 No Yes. 1 % for 100 Months Yes PROPOSED STANDARD 1 x Annual Salary, up to maxknum of $200.000 65% 0 Aga 65 50%Ca Age 70 35% s Am 75 9 Yes 75% Yes No Yes. $10,000 No No No PROPOSED FORTIS 1 x Annual Salary, up to maximum of $200,000 66%0Age 65 86% © Age 70 Yes 80% Yes No Yes. 20% No No No HCM Benefits, Inc. PROPOSED RELIANCE STANDARD 1 x Annual Salary, up to maximum of $200.000 35%®Age 65 45%®Age 70 Yes 50% w/ Life Expectancy of 12 Months Yea No Yes ' Yes Yes No 13 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * BENEFR PROVISIONS AD&D Loss iloso CURRENT PRINCIPAL CITY OF PALM DESERT BASIC LIFE & AD&D COMPARISON PROPOSED HCM POOL (CANADA LIFE I /TRANSAMERICA PROPOSED STANDARD PROPOSED FORTIS PROPOSED RELIANCE STANDARD LIFE 100% 100% 100% 100% 100% ONE HAND 50% 50% 50% 50% , 5O% ONE FOOT 50% 50% 50% 50% 50% Slow Ra ONE EYE 50% 50% 50% 50% 50% TYVO OR MORE OF 100% 100% 100% 100% 100% ABooE MEMBERS Loss OF SPEECH Not Covered 50% Not Covered Not Covered 50% Loss OF HEARING IN Not Covered 50% Not Covered Not Covered 50% OWN EARS low- HEARIN° IN Not Covered 25% Not Covered Not Covered Not Covered 0. .AR THUMSItINDEX FoaER oN ONE . Not Covered 25% Not Covered Not Covered 25% HAND I QUADRimmoiA Not Covered 100% Not Covered Not Covered Not Covered PARAPLEOU Not Covered 75% Not Covered Not Covered Not Covered HBUPLEOIA Not Covered 50% Not Covered Not Covered Not Covered IWC.f11341VM CU@R6pALMDE511/1111WMADM NM.dos mix mon 0, sumiwy0/pl um for pompom D1dhosesmay 10 HCM Benefits, Inc. 14 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CAMS Hea1thPro& as.. Available Health Plans For 1999: RIVERSIDE & SAN BERNARDINO Counties: Aetna U.S. Healthcare Blue Shield Access + HMO PacifiCare Maxicare Kaiser Foundation Health Plan CIGNA Health Net PERSCare PERS Choice Zip Code 92260 Aetna U.S. Healthcare Blue Shield Access + HMO PacifiCare Maxicare Kaiser Foundation Health Plan Health Net PERSCare PERS Choice CalPERS Website: www.calpers.ca.gov 15 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 *•* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CaiPERS Health Program Information 1999 16 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY * * * * * * * * * * * * * * * * * * * CaIPERS Health Program Information APRIL 22,1999 * * * * * * * * * * * * "What's New for 19991 CaIPERS Health Program Features 1999 Basic Plan Premiums 1999 Supplement & Managed Medicare P 1999 PERSCare & PERS Choice Benefit remiums Summaries 2 3 4 5 (Basic Plans) 6 Ca1PERS 1999 HMO Basic Health Plan Benefit Summary 7 Non-Ca!PERS Agencies Welcomel 17 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Whot's New for 1999! New Administrator for PERSCare & PERS Choice Effective January 1, 1999, Blue Cross of California will be the new administrator for our self -funded preferred provider organization (PPO) plans, PERSCare &PERS Choice. Blue Cross was chosen clue to its exceptional customer service features and its lower administrative fees. Blue Cross operations fit very well with our requirements for top- notch customer service and advanced technological claims processing. New Rates For contract year 1999, the Basic HMO plan premiums represent an average of 7.3 percent increase. Considering the high costs of prescription drugs and inflation, CaIPERS believes this increase is reasonable, at the same time delivering a stable and secure product! For contract year 1999, PERSCare will experience a rate increase of ONLY 0.7 percent, while PERS Choice will experience a rate increase of ONLY 2.5 percent. This marginal increase was due to Blue Cross' low administrative fee and discounts. New Practices CAPERS will be introducing New Practices to simplify our business rules. "It's Simple to do Business with Ca1PERr" • 2 • 18 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22, 1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CaIPERS Health Prod .m Features • Stability, Flexibility & Choice • Participation by Individual Employee Groups • No Utilization or Actuarial Review for New Agencies • No Exclusions for Pre-existing Conditions During Initial & Open Enrollments • No Waiting Period • Program T Rates & Benefits are the Same for All Contracting Agencies • Individual Choice Between PPO, HMO or Association Plans • Preferred Provider Organization (PPO) Plans: • Ca1PERS self -funded plans • Administered by Blue Cross of California • Self referral • Non -formulary prescriptions • Nationwide & worldwide coverage • Health Maintenance Organization (HMO) Plans: • Standardized benefits • Out -of -State coverage available on some plans • Association Plans: • California Professional Firefighters' Association (CPFA) • Peace Officers' Research Association of California (PORAC) • Dependent Coverage for Children: • Covers up to age 23 (unmarried) • Natural, step, or adopted child • Do not need to be a student nor reside with enrollee • Economically -dependent child coverage available • Lifetime Health Coverage for Disabled Children • Lifetime Health Coverage for Eligible Retirees • Toll -Free Customer Service (800) 237-3345 • 3 • 19 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 1999 Basic Monthly Pr, Jums Health Plan 1 Party 2 Party Family Premium Premium Premium PPOs PERSCare PER; Choice 273.00 164.00 546.00 710.00 328.00 426.00 HMOs Aetna U.S. Healthcare 167.73 335.46 436.11 Blur Shield Access+ 170.11 340.22 442.28 CIGNA 163.37 326.75 424.77 Health Net 164.41 328.82 427.48 HP of the Redwoods 165.97 331.94 431.52 Kaiser 164.83 329.67 428.57 Lifeguard 176.13 352.25 457.94 Maxicare of California 159.71 319.42 415.24 Omni 176.10 352.20 457.86 PacifiCare 164.64 329.28 428.05 ASSOCIATIONS CPFA 247.00 ' 461.00 579.00 PORAC 199.00 389.00 518.00 • 4 • 20 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22, 1999 * * *•* * * * * * * * * * * * * * * * * * * * * * * * * * * * 1999 Supplemental t Managed Mohan Monthly P1 Hums Health Plan PPOs PERSCare PERS Choice 1 Party 2 Pcrly Family Premium Premium Premium 198.00 396.00 594.00 189.00 378.00 567.00 HMOs .Aetna U.S. Healthcare' 79.84 159:68 ' 239.52 Blue Shield Access+ 150.88 301.76 452.64 CIGNA' 59.00 118.00 177.00 Health Net' 87.00 174.00 261.00 HP of the Redwoods 140.10 280.20 420.30 Kaiser' 46.71 93.42 140.13 Lifeguard 149.83 299.66 449.49 Maxicare of California . 142.99 285.98 428.97 Omni' 150.43 300.86 451.29 PacifiCare' 72.09 144.18 216.27 ASSOCIATIONS CPFA 149.00 261.00 399.00 PORAC 'Managed Medicare Plans 165.00 330.00 495.00 • 5 • 21 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY * * * * * * * * * * * * * * * * * * Comparison of PERSC.. 4 and PERS Choice Plans Basic Plan 1999 Contract Year Premiums 1 Party 2 Party Family Calendar Naar Deductible Member Family Maximum Amuse'Capapnent' Member Family Ld etime Maximum Bandit Per Member Services Hospital Physician Services (Office/hospital visit) Imnnmizationneell-Baby Care Periodic Health Exams Diagnostic X-ray and lab Ambulance Emergency Care Services Chiropractic Services Acupuncture Services Mental Health Inpatient Outpatient Home Health Care Hearing aid Benefit Prescription Drugs Retail Pharmacy -Program Mail Service Program 24 Hour Nurseline PERSCore Your Cost $273 S546 5710 8250 5500 $2,000 $4,000 nine PERSCare PPO Non-PPO APRIL 22, 1999 * * * * * * * * * * * * * PERS Choice Your Cost 5164 S328 $426 $250 5500 S3,000 • $6,000 S2,000,000 PERS Choice PPO Non-PPO 10%" 40%•` 20% 40% 10% 40% S10 copay" 40% no charge•• 40% nocharge' • 40%M no charge' • 40% no charge' • 40% 1096 40% 20% 40% 20% 20% 20% 20% 10rtr 10r!tr 20% 20% 10% 40% 20% 40% 1096 409b 20% 40% • EPA 4096 10% 40% 1O% 40% 1O% 40% $1,000 Max- every 36 months 85 generic/SIO brand name S5 generic or brand name YES 20% 40% 20% 40% 2096' 40% 20% 40% $1,000 Max. every 36 months S5 generic/S10 brand name $5 generic or brand name YES ' Iesperteat the maximum entuol repayment apples only if services are received hem o Preferred Provider, or R you ire and receive covered services outside of a Preferred Proriib area. R covered services we received from nenPreferred Providers, whether mfened by o Pretend Provider or net (there is no impled contract), there is no maximum repayment resporr aide " The plea waives the ded.ctile regiment far these senates! This is only o summery of benefits offered by PERSCare end PERS Choice. Please see the Evidence of Coverope booklets for the exact terns of covenpe. • • 22 MINUTES ADJOURNED JOINT MEETING PALM DESERT CITY COUNCIL PALM DESERT REDEVELOPMENT AGENCY APRIL 22,1999 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CaIPERS HMO Bass 'eahh Plan Benefit Sunaaary 1999 Contract Year Services CaIPERS Hh1Os Hospital Inpatient Outpatient Physician Care Office Visib Allergy Test/Treat Hearing Exam/Test Immunizations/Inoculations $5 Gynecological Exam S5 Periodic Health Exam $'5 Meld Baby Care $5 Inpatient Hospital Visits No Charge Surgery/Anesthesia No Charge Eye Refraction S10 )4e limit varies by plan Diagnostic x-ray and Iab No Charge Outpatient Durable Medical Equipment ( Xu Charge Includes Orthotics anti Prosthetics Prescription Drugs 1 S5/30 day S5/90 day mail Infertility Testing & Treatment ! 50% of charges Ambulance I No Charge Emergency Care I Varies by plan Mental Health inpatient No charge up to 30 days per calendar year Outpatient I 520 per visit/20 visits per calendar year Substance Abuse Inpatient No Charge Outpatient S5 per visit/20 visits per calendar year Home Health No Charge Shilled Nursing Care I No Charge up to 100 days per calendar year Speech/Physical/Occupational Therapy Limited to short-term therapy for a period No charge for inpatient visits at a hospital not exceeding 60 consecutive calendar days or spilled nursing facility. $5/visit for per condition following the date of the first outpatient and home visits. therapy session. Applies to each therapy. Long-term rehabilitation is not covered. Hospice I No Charge Chiropractic Varies by plate S5 per visit /20 visits per calendar year Blond N Blood Products I No Charge Tearing Aid Benefit 51,000 Max. every 36 months No Charge No Charge $5 S5 SS bapereakt Ibis is only u summary of benefits offend. Please see the Evidence of (orange booklets for the soot tens of comp. e.7e 23