OPENPUBLICA · PUBLIC MEETING RECORD
Record of Proceedings

Jon Fland City Council Informal Meeting - June 2, 2025: Insurance Renewal and RFP Update

City CouncilMonday, June 2, 2025
BodyJoplin, Missouri
SessionCity Council
DateMonday, June 2, 2025
StatusFILED
Video Record

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Transcript — Verbatim
0:00

Good evening, everyone.

0:02

Welcome to the informal meeting of the Jon Fland City Council.

0:05

It is 5 15 p.m.

0:07

on June 2nd, 2025.

0:10

Our first item on the agenda is the semi-annual insurance update by Siegel.

0:15

Good evening, Mrs.

0:16

Haas.

0:17

Good evening, Mayor.

0:18

Council.

0:20

Every five years, the city goes to bid for all lines of our health related insurance through our consultant Siegel.

0:28

So health insurance, dental insurance, vision, life, disability.

0:33

And this is our year to do that for coverage starting January 1st of 26th.

0:39

So tonight, Kim Wixon, and Brian Hunter Hunter is back here.

0:43

We'll cover the normal budget to actual report and then the recommendations and next steps from the from the bid process.

0:55

Oh there they are.

0:57

I'd like to see the slide in the back.

1:00

We'll get it going here in a minute.

1:02

We're from the country.

1:04

It takes us a minute to get things going.

1:07

Thank you.

1:12

Well, good evening and welcome.

1:14

We're glad that you're here.

1:15

Look forward to your report.

1:17

Yeah, well, thank you for having me.

1:18

And I think we have I'm I'm I'm very pleased with the report we're going to give you today.

1:25

Um, actually, all of the reports, but we're gonna start off with the preliminary budget to actual report, which we give every year at this time, and we go over the 2024 uh calendar year, and then what we've seen for the first quarter in 2025 to kind of give a preview of maybe what to expect when we give the final um budget report, usually in the October time frame.

1:49

I'm going to go over this a little bit more quickly because I want to make sure we have enough time because we have all the RFPs to go through, and I want to make sure we have time for questions as well.

1:58

But we do have pretty good news on slide three.

2:06

This actually includes our um the 2024 financial statement on a cash basis.

2:12

So this is mean when bills are presented, um, that's when they're included in this report.

2:19

Um, and you can see from our contributions, they've remained pretty consistent throughout the year.

2:26

We've seen some uptick.

2:27

We did have some growth in the number of employees, so did expect that to increase a little bit.

2:32

Um in December, you can see it's a little bit lower, and that's just because the last contribution payroll contribution for the last payroll, you'll see that reflected in the January report.

2:47

So that's why it's a little bit lower.

2:49

It's just where it's like uh where it had been accounted for.

2:53

Um, on our medical claims, they were also pretty consistent.

2:56

You can see we had a fairly major dip in May, um, but then we had a subsequent um increase in June.

3:05

Sometimes when claims, if we had a big claim that uh was readjudicated, we may see a credit in one month and then see the readjudication of that claim in the previous month.

3:16

But overall, it's been fairly consistent.

3:19

Uh on our stop loss reimbursements.

3:22

We did have reimbursements in the first part of this year, and what that um generally is for are for actual claims that were paid in the previous year, but late in the year in November or December.

3:38

So then when we actually get those credits coming through, they usually come through in the following in the following year.

3:45

Uh but you can see we also had some credits coming through in October, November, and December, and those were for claims that were paid in the 2024 um calendar year.

3:57

Prescription drugs um are pretty consistent as well.

4:00

Sometimes you'll see some fluctuations.

4:03

We are billed prescription drug claims on a bi-weekly basis.

4:07

So a couple months a year, sometimes you see a little bit of an increase because it's that third um biweekly payment in that particular month, but we've seen those um pretty consistent, but those have been gradually um increasing over time.

4:21

On the prescription drug rebates, these are actually um, we've actually seen some increases as we're moving into the year, and as we go into the RFP in terms of our projections, we are actually um our guarantees are increasing quite a bit.

4:38

So we should see an increase in those in those prescription drug rebates over time, and that actually offsets the cost of your prescription drug claims, are those uh prescription drug rebates.

4:51

Um, and you will also see when we look into 2025.

4:56

There is um rebates are paid a little bit in arrears.

5:01

So we do have we generally should get four big rebate checks every year, but you'll see that it's kind of like with the contributions in December, we'll actually see that re those rebates come through in January, which would have been our fourth payment.

5:23

Those remained fairly consistent throughout the year.

5:27

The only changes we'll have is if we have changes in single and family coverage, as you will have throughout the year because there's different pricing depending upon whether you're you know single coverage or you have family coverage.

5:42

You could see overall for the year, our um total um expenses were actually less than our revenue by about by 176,468 dollars.

5:54

So that is like the good news to report that we basically came very close to budget on what we had budgeted um last um October 2023, and we were able to build our reserves from 2.9 million to 3.1 million.

6:13

So very good news for 2024.

6:19

And if you turn to the next okay, go to the next slide.

6:30

This is the oops, am I I went too far ahead?

Discussion Breakdown — Share of Meeting
Insurance Management█████████████████████████████████████████████46%
Budget Equity Analysis█████████████████████████████30%
Health Department Update███████████████████████24%
Summary of Proceedings

Jon Fland City Council Informal Meeting - June 2, 2025

The Jon Fland City Council held an informal meeting on June 2, 2025, from 5:15 PM to approximately 5:57 PM. The sole agenda item was the semi-annual insurance update presented by Siegel, the city's consultant. The presentation covered the 2024 budget-to-actual financial report, first-quarter 2025 data, and the results of a comprehensive request for proposals (RFP) process for all lines of insurance (dental, vision, life, disability, medical, and prescription drugs). Key recommendations were made for vendor selections and benefit changes, with savings projected for the city and employees.

Discussion Items

  • 2024 Financial Performance: Siegel reported that 2024 total expenses were $176,468 less than revenue, allowing the city to increase its insurance reserves from $2.9 million to $3.1 million. Medical and prescription drug claims were consistent, with a slight dip in May 2024 and a subsequent increase in June. Prescription drug rebates came in 16.6% higher than budgeted. On a per-employee-per-month basis, actual costs were only 1.6% below budget.
  • First Quarter 2025 Performance: For Q1 2025, contributions and income totaled approximately $2.2 million, expenses were $1.6 million, resulting in an operating surplus of $588,000. This surplus is typical early in the year due to deductibles and co-insurance. Preliminary data showed medical claims running 12.1% below projections, partly due to rebates hitting earlier than in 2024.
  • Large Claims Analysis: In 2022, a single claimant incurred nearly $700,000 in claims. In 2024, the number of large claimants (over $50,000) increased to 23 (from 14 in 2023), but the average claim amount dropped from $152,000 to $88,000. Prescription drug large claims grew significantly (from 5 in 2023 to 13 in 2024), reflecting high-cost specialty drugs.
  • RFP for Ancillary Lines (Dental, Vision, Life, Disability): The city received multiple bids for each line. After evaluation and a best-and-final-offer round, the consultant recommended:
    • Dental: Move from Delta Dental to MetLife. The proposed plan increases the annual maximum from $750 to $1,000, increases the orthodontia lifetime maximum from $750 to $1,000, and excludes preventive/diagnostic services from the annual maximum. This enhanced benefit costs about $33,000 less than the current plan. MetLife offered an additional 2% discount on dental premiums.
    • Vision: Award to current provider IMED (highest score) with no benefit changes.
    • Basic and Supplemental Life & AD&D: Award to current provider MetLife.
    • Long-Term Disability: Award to current provider MetLife. MetLife provided three-year rate guarantees on life and disability lines.
  • RFP for Medical and Prescription Drugs: Proposals were received from Anthem, Aetna, and UMR (United Healthcare's TPA). Cigna declined to bid citing cost competitiveness. UMR scored highest overall due to strong network discounts (70.1%), a five-year administrative fee guarantee, and superior prescription drug rebate guarantees. Under UMR's proposed terms, total costs (including EAP and HSA admin fees) would be approximately 10.4% lower than current contract terms when trended to 2026. Anthem's proposal was about 2% better than current terms. Aetna's costs were higher. The recommendation is to award the medical and prescription drug contract to UMR.
  • Additional Considerations:
    • HSA-Qualified Plan: The consultant recommended further research and employee surveying before considering a high-deductible health plan compatible with a Health Savings Account.
    • Weight-Loss GLP-1 Drugs: Coverage was not recommended at this time due to high costs (over $1,000/month), lack of long-term data, and ongoing uncertainty regarding President Trump's executive order on drug pricing, which could dramatically reduce costs (e.g., Wegovy priced at $1,348 in the U.S. vs. $328 in Germany). The consultant advised continued evaluation.
  • Council Member Comments: Council Member Jackson praised the negotiation results and asked about adding voluntary benefits (e.g., critical illness, accident plans) through MetLife to potentially generate additional savings or credits. The consultant agreed to explore that option.

Key Outcomes

  • Pending Decisions: No formal votes were taken at this informal meeting. The council is expected to act on the consultant's recommendations at a future formal session.
  • Recommended Vendor Awards:
    • Dental: MetLife (with enhanced benefits and $33,000 in savings)
    • Vision: IMED
    • Basic & Supplemental Life & AD&D: MetLife
    • Long-Term Disability: MetLife
    • Medical & Prescription Drugs: UMR (United Healthcare)
  • Next Steps:
    • Continue research on HSA-qualified plan (survey employees).
    • Continue evaluation of GLP-1 drugs; monitor drug pricing developments.
    • Stop-loss insurance renewal to be addressed in October 2025 with nine months of claims data.
    • Consultant to explore voluntary benefits and potential system technology credits with MetLife.

Meeting Transcript

Good evening, everyone. Welcome to the informal meeting of the Jon Fland City Council. It is 5 15 p.m. on June 2nd, 2025. Our first item on the agenda is the semi-annual insurance update by Siegel. Good evening, Mrs. Haas. Good evening, Mayor. Council. Every five years, the city goes to bid for all lines of our health related insurance through our consultant Siegel. So health insurance, dental insurance, vision, life, disability. And this is our year to do that for coverage starting January 1st of 26th. So tonight, Kim Wixon, and Brian Hunter Hunter is back here. We'll cover the normal budget to actual report and then the recommendations and next steps from the from the bid process. Oh there they are. I'd like to see the slide in the back. We'll get it going here in a minute. We're from the country. It takes us a minute to get things going. Thank you. Well, good evening and welcome. We're glad that you're here. Look forward to your report. Yeah, well, thank you for having me. And I think we have I'm I'm I'm very pleased with the report we're going to give you today. Um, actually, all of the reports, but we're gonna start off with the preliminary budget to actual report, which we give every year at this time, and we go over the 2024 uh calendar year, and then what we've seen for the first quarter in 2025 to kind of give a preview of maybe what to expect when we give the final um budget report, usually in the October time frame. I'm going to go over this a little bit more quickly because I want to make sure we have enough time because we have all the RFPs to go through, and I want to make sure we have time for questions as well. But we do have pretty good news on slide three. This actually includes our um the 2024 financial statement on a cash basis. So this is mean when bills are presented, um, that's when they're included in this report. Um, and you can see from our contributions, they've remained pretty consistent throughout the year. We've seen some uptick. We did have some growth in the number of employees, so did expect that to increase a little bit. Um in December, you can see it's a little bit lower, and that's just because the last contribution payroll contribution for the last payroll, you'll see that reflected in the January report. So that's why it's a little bit lower. It's just where it's like uh where it had been accounted for. Um, on our medical claims, they were also pretty consistent. You can see we had a fairly major dip in May, um, but then we had a subsequent um increase in June. Sometimes when claims, if we had a big claim that uh was readjudicated, we may see a credit in one month and then see the readjudication of that claim in the previous month. But overall, it's been fairly consistent. Uh on our stop loss reimbursements. We did have reimbursements in the first part of this year, and what that um generally is for are for actual claims that were paid in the previous year, but late in the year in November or December. So then when we actually get those credits coming through, they usually come through in the following in the following year. Uh but you can see we also had some credits coming through in October, November, and December, and those were for claims that were paid in the 2024 um calendar year. Prescription drugs um are pretty consistent as well. Sometimes you'll see some fluctuations. We are billed prescription drug claims on a bi-weekly basis. So a couple months a year, sometimes you see a little bit of an increase because it's that third um biweekly payment in that particular month, but we've seen those um pretty consistent, but those have been gradually um increasing over time. On the prescription drug rebates, these are actually um, we've actually seen some increases as we're moving into the year, and as we go into the RFP in terms of our projections, we are actually um our guarantees are increasing quite a bit. So we should see an increase in those in those prescription drug rebates over time, and that actually offsets the cost of your prescription drug claims, are those uh prescription drug rebates.

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