Yeah.

Yeah, I can get two.

Good morning.

I'm calling the group healthcare committee meeting to order at 836 a.m.

Your, could you please do the roll call?

SPPA, Rachel Rulinantham.

Here.

IAFF, Chris Hartwick.

Darren Partica.

OE, non-supervisory, Leanne Rolloffs.

Here.

We have a quorum.

Thank you.

Next on the agenda is item 3.1.

Public comment.

Do we have anyone wishing to make a public comment?

I do not have any comment for it.

Thank you.

Next on the agenda is item 4.1, approval of the agenda for possible action.

Can I get a motion to approve the agenda?

Rachel Rulinantham as PPA, just based on the what we're voting on today.

I know it would be a waste of people's time.

For the record for everyone, we are trying to get a hold of the fire representative.

One is willing to call in.

So procedurally, would we approve the agenda as is?

But Brian, running to the record.

I think we would approve the agenda, and if it comes time to that action item, and the members still want to um delay it or kick it out for fire to be present, that would be the time to do so.

Okay.

Okay.

Is that acceptable?

Okay.

So Rachel Rudan Anthem, as PPA, I make a motion to approve the agenda.

Leanne Roloffs, OE3.

Um, I second.

All right, we have a motion and a second.

If you can do them on the tablets.

Any further discussion?

And please vote on your tablet.

I don't see the voting part.

Just no, that's not fine.

Sometimes I worry it's user error.

Um it let me click the button and I did that part, but then it just disappeared.

It just let me again.

It let me um second it again.

I like one out and back in.

Now it's up on the screen, so I think we're getting closer.

For the record, Darren Partika has joined from IAFF at 840 a.m.

And Derek, because you Darren, Derek, because you just logged in.

Um we are having some technical difficulties on our tablets.

Dare in and dare ick.

I'm getting my names confused.

Darren Partika.

Yes, it's just thank you.

Okay.

We're on item four point one and waiting for the tablets to catch up for approvals.

There we go.

We're good.

All right.

Motion passes.

Next is item five point one.

We actually have minutes for two different meetings to approve.

Item 5.1 is consideration and possible approval of the minutes for of the Sparks Group Healthcare Committee meeting for March 19th, 2026.

Can I get a motion to approve the minutes for March 19th, 2026?

Looks like Rachel was the mover and Leanne was the second.

Please vote on your tablets.

All right.

Motion passes.

Next item, consideration and possible approval of the minutes for the Sparks Group Health Care Committee workshop for May 21st, 2026.

Can I get a motion to approve the minutes of May 21st, 2026?

Um Ryan Northington for the record.

If I could have the members verbalize the motion, I would appreciate it.

You bet.

Lee Ann Roll Off's OE3.

I motion.

Rachel and Anthem SPPA, I second the motion.

If you could say the I move to approve.

Yeah.

Leanne Roloffs OE3, I move to approve the minute of the Sparks Group Health Care Committee workshop for May 24st, 2026.

Thank you.

Rachel and Anthem SPPA.

I second that motion.

Okay.

We have a motion by OE.

I guess I could do that.

And seconded by SPPA.

Any further discussion?

Seeing none, please vote on your tablets.

Motion passes.

Next item is 6.1.

Some announcements from the chair.

First of all, Shauna Halterman, HR director for the record.

I keep forgetting to do that.

I forgot that last night too.

Last group healthcare committee meeting, there was a uh a vote to remove the 26 speech therapy session cap and replace it with a 25 session limit with medical review for anything above 25 sessions.

That was taken to city council on June 22nd and approved.

The UMR plan document has been revised, so the new um speech therapy benefit is of effective July 1st, 2026.

A copy of that document's posted on the website.

Also at that meeting that was a question about whether a new state law would impact the decision on the therapy.

And I think Rachel, you had asked about that, and we said it was autism.

It's not autism, it's stuttering.

Just FYI.

But no, it didn't have any in relation to that the state law.

That was the only thing I have from the chair.

Oh.

Okay.

Thank you.

Okay.

Um procedurally, we're gonna back up a little bit to 5.1 and 5.2.

Okay.

Darren, because you are not present here in the chambers and don't have the tablet, we're gonna need uh a verbal vote.

We're gonna do a verbal vote for everything now going forward.

Um so item 5.1, consideration and possible approval of the minutes of the Sparks Group Healthcare Committee for March 19th, 2026.

Darren Partica, how do you vote?

We vote yes.

That was a yes.

Okay.

Yeah, we'd like to approve.

Thank you.

Um item 5.2, consideration and possible approval of the minutes for the group health care committee of May 21st, 2026.

How do you vote?

Darren Parkia.

Yes, we vote to approve.

Okay.

All right.

I am done with 6.1.

So the next is 6.2.

Any announcements from members?

No.

Do you have any announcements?

I do not, other than I apologize for the not being there.

It's all right.

Thanks for calling in.

All right.

Next is 6.3.

This is the report from uh the finance department on the group health care fund.

And Wayne, could you please come up?

Perfect.

Thanks, Julie.

I'll take over to the screen.

Good morning, members of the group health care committee.

For the record, uh, accounting manager Wayne Weber budget division.

The item before you today is the current financials for the fund as of June.

And now I must classify this as we're still starting our year-end audit, so there could be some adjustments to these numbers.

We'll we'll see as we go forward.

Currently, the fund uh during the last quarter, we actually saw a little increase in expenditures.

Um you can see that our um health care claims have uh reached 10 million dollars, which is a little bit higher than our budget.

Overall, we uh estimated about a 14.4% increase year over year.

This year we're currently at about 16.2 percent.

So we're starting to see some of the increases that Nate's spoke about in some prior meetings.

Um I wanted to get us through June so I could show you some information.

I know we've talked about the balances of the fund as we've gone forward, and I um I have a little history for you.

Well, first, is there any questions on the financial statements?

Okay, all right.

So this slide is a 15-year look at the fund's net assets.

The bars are the net asset amount in millions, and this is from 2012.

The red line is the months of coverage, so that's the if you take the full cost divide it by 12.

That's how much the net assets would cover.

As you can see, you can look back to 2014, 2015, 2016, and see where our balance was critically low.

And over the past 10 years, we've started to climb out of that hole, as we'll say, and give ourselves a little bit of cushion.

Um currently, we are at about eight point.

Let's see, I can sorry about that.

We are at 10 and a half million as of fiscal 26 currently, and our months of coverage is right above eight, right at eight months.

So now I want to take you to a new next slide, and this is gonna show rate increases over the last 15 years.

You can see how it's the same chart with the net assets, and then you can see where we've increased the rates in fiscal 15 and 16.

We had the largest increases of 25 percent, and that was because the net assets were basically zero.

So we needed those net assets, we needed that revenue to create this balance that we're getting.

And then over the past 15 years, we've averaged about 4.2 percent in increase.

We've had some zero years, which we had in 26, and we also had a zero increase in 22.

We had a zero increase in 2018, and 2017.

And in 2014, or 13 and 14, we actually had decreases of 8%.

So that's the correlation in that movement that we've increased rates.

And with that, I can answer in questions.

Rachel Rulinanthem, SPPA.

So when you're talking about rate increase, just to be clear, we're talking about premium premiums.

Yes, premiums.

I'm sorry, yes, the premiums.

Okay, so let me see if I got this right.

13 and 14.

We re Sparks reduced the premiums by eight percent each year.

Each year.

And then 15 and 16, they were both 25, so 25 and 25 back to back.

Wow.

Okay, thank you.

All right.

Any other questions for Wayne?

Rachel Rulene at the SPPA.

Um, so just based on this graph, are you?

I appreciate seeing it like this because it makes more sense.

Um are you trying to say like you project that there will be premium increases in the next year, or this is a good level that we're at, we're stable, or this is just history.

I I think there's there's always been a question of you know why we would increase rates.

And I think if you look at 14, 15, and 16, you can see the necessity for us to increase rates.

I mean, our net assets were practically zero.

We we had no cushion at all.

Now, and you have to remember too, net assets consumption of the plan, use of the plan, and then you know, members' revenue.

So it's it's a combination of things for 27.

We're not looking at an increase, it's zero.

So that's that's good for the employees, and we'll have to sort of maintain the same kind of spending to stay at this current level we're at.

No, I appreciate this graph, it makes a little bit more sense in my head.

Leanne Roloffs, OE3.

Um, do we have the numbers for because we're looking at like insurance costs coming out of this account, but also people's premium costs.

Do we have the numbers on how many premiums like retirees we cover it 100%?

That's coming out of this account as well.

Let me go back to the first slide, Lena.

Okay, so and this is at a high level, and and when you start to talk about retirees, it gets a little different because a lot of retirees have different plans.

Okay, so the city makes contributions for active employees, right?

In fiscal 26.

Oh, yeah, I'm sorry.

In fiscal 26, the city contributed 11 million three hundred sixty-eight thousand dollars.

Now, the employees, active employees, paid premiums of one million one hundred and six thousand dollars.

So that's our as employees contribution to the point.

Now, for the retirees, the retiree subsidies, once again, now I'm this is a bundle of a lot of different contracts, so I can't break it out.

So the city contribution for certain retirees totaled 325,000.

Now, if you come down, you're gonna see retiree paid premiums.

So this is some retirees have to pay the full amount, some retirees pay a portion depending on their contract once again.

So the the retiree paid premiums in 2026 were 900,000.

So I'm hoping that answers your question.

Yeah, I'm trying to figure out when contracts go into negotiation and stuff like that, and premiums are brought into those conversations.

Do we also because like we're not voting on those contracts going through per se for other contracts?

Who's looking at the health of the fund as if a contract's like, oh, we're gonna cover that at 100%, and the city says yes, but the committee doesn't have a say in those premiums.

Are you talking about during labor negotiations?

Um, it's ultimately the city manager who is going to determine if that's um something that the city is agreeable to, whatever the proposal is, uh, and then the council after that.

Ultimately, it's to vote.

Right.

Just thinking out loud.

If I go through even department head contracts, typically we're covering 100% of the premiums for them and their spouse and maybe a fraction of their dependents or them their spouse and their dependents, and that's still also coming out of this account.

However, when we get a rate increase, they don't also see that rate increase because we're covering 100% of their premiums.

So if we are going to look at a rate increase, I would like to openly, you know, ask department heads or members of council to look at that they too should be considered maybe having a MOU to their contract to also help employees with this account.

I'm not sure if we could see those numbers on if they contributed what the health of the account would look like as well.

I think that's really a deeper discussion to have at another time.

But I I see what you're saying, but there's also about 55 people who have 100% coverage because they started here before 2006.

And so there are people under different contracts, under different MOUs, different resolutions that do have different benefits.

Some of those benefits are higher because they gave something else up.

So each contract stands alone.

Yeah.

Yeah.

Just something to throw out there for consideration.

You bet.

Anything else?

All right.

No other questions for Wayne?

All right.

Thank you.

Next item is item 6.4.

There it is.

This is the um regular report on the healthcare cost analysis review dated May 2026, presented by LP and Nate will be presenting.

All right, good morning.

Uh Nate Kerr with LP Insurance for the record, here to go over the group health plan cost analysis report for the city of Sparks through the month of May 2026.

Turning to the first exhibit, the active employee claims.

Averaging 520 employees per month.

Those employees who carry dependents, also known as a dependent unit, is down about 1%, averaging 349.

Total number of dependents, uh, i.e.

belly buttons for the dependents is relatively flat, averaging 854, and total membership total all in heads is down about 1%, averaging 1,374.

Uh line 12 is the cost for employee claims uh through the first five months is up about 25%, averaging 749.

Line 20 for dependent cost is up about 37%, averaging $1,834.

When we combine the two for a total all-in active claim cost, line 28, the total composite cost is up about 34%, averaging 1,979 per employee per month.

Retirees uh single retiree enrollment is relatively flat at 141.

Those who carry dependents is flat at 70.

The total number of dependents again, relatively flat at 83, and the the total membership uh also flat at 223 individuals.

The retiree only cost per employee line 12 is about up about 5% over the prior period, averaging 1,354.

Line 20 cost for dependents is down about 4%, averaging 1,200.

And combined line 28 overall retiree paid claims for the first five months is up about 2%, averaging 1,949 per member per month, per subscriber per month.

This is simply adding in the two for an all-in claims cost.

Um calling your attention down to line 31, uh, all in 27% above the prior period, averaging 1,918 per employee per month.

Total plan cost, this is where we bring in all of the fixed costs, uh i.e.

the cost for administration, stop loss insurance, et cetera.

Combine that with the claims cost to give us an all-in total cost of the plan.

Line 31 down at the bottom, far right, uh so far through the first five months is up about 25%, averaging 2,088 per employee per month.

Uh I'll call your attention to line 23, just as a notable.

Uh that's a good good sign there.

Total fixed cost is basically flat, which is good.

So the cost cost increases we're seeing, or the higher performance is purely due to perform claims performance, not necessarily what we're having to pay all of our vendors and for insurance coverage, which is always good.

The IBNR or incurred but not reported, that's the outstanding liability of the plan through the month of May is at 1.285 million, roughly makes up 11% of total spent.

Any questions for Nate?

Darren No questions.

Okay.

Thank you.

And we're gonna move on to 6.5.

Um, item 6.5 is a report on the City of Sparks pharmacy plan performance for the first quarter of 2026 presented by Vital One.

Jennifer is on the phone, I believe.

Good morning for the record, Jennifer Salas with Vital One.

Today we're gonna be taking a look at how first quarter of 2026 performed against first quarter of 2025.

We're gonna take a look at the numbers at a glance and key findings, and then we'll move on to a clinical overview that will be provided by Derek and Derek is on the phone this morning.

If we could proceed on to the executive summary slide.

I'm sorry, 1.3 million for 15% decrease in trend.

Some of our key findings and observations.

The GLP one script count percent changed by 15.5% with a total of 82 claims in the first quarter of 2026.

There are currently 39 utilizers in this class, which is an increase from last year of um where it was at 33 utilizers.

This is a change of 18.2%.

Moving on to traditional and specialty.

Traditional trend is driven by diabetes and cardiovascular.

Traditional drugs account for 36.1% of overall plan cost and 91% of claims submitted.

Specialty trend is driven by hereditary ankeodema and chronic inflammatory disease.

Our specialty therapies account for 63.9% of overall spend and 1.9% of claims submitted.

Moving on to our next slide.

This is 16.7% lower than our benchmark.

The average plan cost per script came in at 326.33 cents.

This is 14% lower than our previous year's reporting, which is 136.61 cents greater than our benchmark.

And this is 14% greater than our benchmark.

Derek, we'll go into some greater details with regards to therapeutic classes and drugs.

Moving on, generic expense rate is holding steady and grade at 86%.

Our RX count per member per month trend came in at 3%.

And our member cost share is showing at 7.9%, which is 10% less than our benchmark.

Moving on to cost per member per month trend and taking a look at benchmarking, we get a visual.

The blue represents our benchmark and orange represents our City of Sparks, as noted earlier.

The trend is down by 11%.

It's 16.7% lower than our benchmark.

And taking a look at specialty versus traditional, here we see that specialty came in at 186.91 cents in 2025.

And at 151 dollars and 83 cents for 2026, showing that decrease of 18.8%.

For traditional in 2025, we had 82.67 cents compared to 2026 at the 85.86 cents coming in at 3.9% difference.

Traditional brand versus generic, our brands had a 2% increase between 2025 and 2026, and generic had a 9.6% change.

Do we have any questions before I move on?

Any questions?

No.

Okay.

Average plan cost per script did come in at 326.

This is a decrease of 14.4% and is 136.61 cents greater than our benchmark.

Taking a look at specialty versus traditional, specialty did decrease by 17%, and we had pretty much landed flat from a traditional standpoint.

Brad versus generic, our brands did show a 5.8 increase between the two periods, and our generics showed a 16.3% increase.

Between 2025 and 2026, we did have four additional claims that came in for specialty.

However, it was a 5.8%.

I'm sorry.

Yes, we had a decrease, a decrease of 5.8%.

I apologize for that.

And I'm going to turn it over to Derek now.

He's going to give his clinical overview and inspections.

All right.

Thank you, Jennifer.

For the record, Derek Bergquist.

Looking at the clinical savings scorecard, we did have a bit of movement here in the first quarter, but diabetes from the traditional side still remains the primary driver.

I think that kind of matches with what we had seen in Jennifer's reporting.

So you saw about a 3.9% increase in diabetes.

And actually, you saw the same that really matched the 3.9% traditional spend.

So definitely a positive here with uh with that relative consistency there.

Now, when I talk about the movement, I meant more here with a couple other classes.

You know, cardiovascular is now the number two after dropping to number three, uh, pain and spasm slides in at number three after we saw some decrease in the blood modifiers group, uh, which moved them out of the top three to number four.

Uh really when you think the top two through seven classes, both all kind of revolved around a 20 to 35,000 total each.

So not much separating those classes, which can kind of lead to that from fluctuation, but you know, a good variety of the positive there from uh, you know, from a health perspective, you know, you're not having uh you know too many uh outliers driving the cost because diabetes is gonna be your number one for everybody, typically.

Now, in regards to specialty, uh, relatively steady from a class perspective, but uh hereditary angiodema is still the primary cost at about 40% of that special spend.

So that is you know still significant, but that one high cost utilizer.

Uh chronic enzyme actually is now back at number two.

Uh, much like I expected after previously discussing the annual, we saw that cystic fibrosis now foot-flopped back to number three.

Um, really, we saw those colide co claims that I had kind of talked about in that cystic fibrosis class, which were essentially rebuild claims.

So those have kind of fallen off, which really attributes, you know, quite a bit to that specialty drop of 19% quarter over quarter.

Um, so that was really you know expected, which you know, we like to see what we're kind of expecting from our discussion at the annual.

So good to see that kind of come to fruition and data.

Um otherwise, specialty claims really haven't moved that much.

And in fact, you know, you look at the savings portion next to it.

You know, we actually did see some increase in the managed copay solutions as well.

That kind of went along with some of that increased chronic inflammatory utilization.

So those are really those common drugs.

You know, we always talked about humera forever.

Now we kind of saw some biosimilar utilization there.

Uh, but also just any of those drugs in that class, you're gonna have some additional manufacturer dollars available, just typically.

And so that's why we, even though we saw maybe total specialty spend decrease, we did see some additional savings um thanks to those kind of medications, you know, having some savings out there.

Uh opio utilization remains steady.

Um, however, we did have the care improvement program adding an additional layer of protection there with the pharmacist continually monitoring.

Uh so I'm actually excited to see that uh we did see the care improvement program results uh come back.

So you see the savings there at about 79,000.

Um, and that helps with you know um overall uh health and wellness, um, which kind of falls in line with what we're seeing for adherence rates, you know, 91 to 94% or so.

That's you know, I think I've talked about that before, but just you know, those are phenomenal adherence numbers.

Um, but just to give an example of okay, what am I talking about with this care improvement program?

You know, I always want to remind us what we're talking about.

That's where we're talking outreach to the providers.

And we started that in 2025.

Um, and so just an example, just to give you an example of what we're talking about.

Um, so there's an example where basically current diabetes guidelines, you know, we recommend any patient um over the age of 40 with diabetes, takes one of those statins of that lip birth uh lipid lowering agent.

Um, and you know, so because having diabetes essentially increases your risk of heart disease.

You know, you're talking heart attack, stroke.

Um, and so what we saw was we identified 9% of that of the population was not necessarily on appropriate statin care um of these members.

So after reaching out to the provider, 17% of identified members had statins actually added to their treatment plan and closed that gap.

Um so you know what this type of program doesn't necessarily stop there.

You know, once we do that, we're essentially gonna have ongoing medication monitoring.

And that even did show that those members who did start have remained adherent.

So it's nice because they're relatively low cost generics when you've added, but you're gonna see the medical cost, you know, down the line.

So I just wanted to mention that was you know something that we saw, some really good um, you know, savings, and you know, we're seeing it actually come to fruition, hopefully giving that better cost uh or not just cost, but you know, health and wellness uh savings to the members.

Um, and then just last but not least, and still some good savings with our better choices program, just as a reminder, you know, essentially where we're blocking kind of high cost medications with low clinical value.

So still benefiting, um, benefiting the plant.

Any questions before I move on to the kind of therapeutic classes slide?

Any questions?

Rachel and Anthem SPPA.

So for our utilization of the better choice program and then the care improvement program.

Is that a fixed cost that we pay to you guys, or does that fluctuate?

So your uh better choices program, that's free of charge.

Um that's one, you know, that just we try to make sure everybody has that.

Um I think I saw something today that kind of talked about, you know, a new medication came out where they basically had an old triumph in the line generic and threw in some gauze and they set it at like a couple thousand dollars.

Like those are kind of like we just want to make sure that those don't happen.

And so there's no cost of the plan on that.

But the care improvement program, that cost is uh it's a set per member per month.

Um, you know, and so it's uh it set it, I I think your contract about like I think 75 cents or a dollar per member per month.

If you do that, so that is it is a set cost, but it does fluctuate based on your eligibility, if that makes sense.

Yes, it does.

Thank you.

Any other questions?

No good question.

There's no more questions.

All right.

Um, so let's uh let's take a peek here at the uh summary of the therapeutic classes slide, kind of gives us just an idea of how we're you know, comparing to the book of business.

Um so looking on the left side, um, you know, we've seen this before, but you know, diabetes here, that's really where you can see, okay.

Yep, that is clearly still the driver of cost, but it is slightly um below the book of business.

So despite being the number one driver, that's that's still uh good to see.

Now there was some growth around a variety of disease states, nothing like too drastic necessarily.

I saw the hormonal agents went up a bit, but when I looked at it, it appeared to be more just an increase in utilization among among members.

Um on a positive side, you know, we saw you know, with some increases, there were decreases, you know, in other classes.

So, you know, for example, maybe we saw increase in that class, but then I did see like allergy asthma cold went down significantly.

And so ultimately, like I kind of mentioned earlier, relatively neutral on the traditional side of things.

Um, I think it was about 3.9%.

And we'll we'll see that when it when it kind of goes uh on the traditional breakout.

Uh specialty is really where on the right side, that's what contributed to that overall decrease in spend that we saw.

You know, there wasn't a ton of movement.

However, that movement that did occur was significant.

So, you know, chronic inflammatory.

Um, you know, that one um is still way below the book of business, but we did see some increase in in utilization.

Um, you know, I I think when I looked at that increase though, there were there were like two new utilizers on on one specific drug called GPICent.

So we did see that in the top five.

But really, when you compare it to the end of the year at 2025, not a ton of growth there.

So I think this was more so the latter half of 2025, where we had seen some increase in utilization.

Uh, but of course, that does get hopefully offset a little bit with that uh that MCS program, you know, going after those available manufacturer dollars.

So just wanted to highlight that.

Um, you know, that hereditary angiodema, that's really where you can see, you know, it's just anytime you have a really rare disease day like that, you know, you see it immediately.

You know, it's like most clients just don't have that.

Um, another one that I you know, of course highlighted earlier, but that's that cystic fibrosis.

You can see the big decrease.

Um, you know, it's still gonna compare, you know, really it's a lot more than your book of business because you still have the one utilizer on the on a drug.

Um so it was colleitico, but the member kind of switched um to a lift trick.

Um so with that being it's still a high cost med, you know, there's if you have cystic fibrosis, you're gonna be on these medications, you know, uh, you know, lifelong.

Um, and so you know, considering the disease is still pretty rare.

Um, and compared to the group's uh, you know, size, you're gonna still be higher than uh in the book of business.

But just nice to see that yes, okay, the the trend did drop significantly uh when we removed those uh collector claims that it kind of popped in at Q1 of 2025.

Uh there was one other orphan drug.

That's that attribute we'll see on the specialty breakout.

Um that one we had known about in 2025.

There was just a little bit of an increase.

Um, but that was because there were only two fills, because that member basically didn't start till February.

So when you're looking at it just quarter quarter quarter, it looks like a bigger increase percentage-wise.

But I think as we get into the year, a full year on the plan, um, it won't look as big of a growth.

It'll basically be maybe 13 prescriptions versus 12 instead of three versus two.

So you know, mentioning from a percentage perspective, sometimes it makes it look worse than it really is.

Uh, but let's take a peek uh, you know, at the at the breakout, we just have the next slide, it's gonna be um traditional drugs.

Um, you know, Jaro is still the primary driver that kind of mirrors that uh that diabetes being the main trend.

That is very typical, uh typical uh for my uh for my other groups.

Um and really across the board we hear about you know, just the just the the increase in in utilization of these drugs, but they also do we've talked about it before, they work really well.

And so that's why, you know, oftentimes they're switching from other therapies as well.

Um so they've definitely been dominating the diabetes spectrum, those GLP ones.

Um, OZEPIC is still there, but um, you know, the Mujaro is starting to dominate um even among that class, as it does have uh a little bit better efficacy than the OZMP.

Um now when you talk about the other drugs that kind of pop in here, anytime I'm seeing you know, other PMPM numbers in the three and under, I think that's a good sign.

You know, we're we're only you know, we're seeing those standard GLP ones still be there.

Um, but otherwise, um, you know, we're not seeing massive numbers in those spikes.

And you know, hopefully we can you know continue to see increased uh generic utilization, some of these other classes.

It really mirrors that diabetes trend.

So it's like when you have that big of a trend.

Anytime it's moving in that class, it's gonna kind of drive your class, but just some ups and downs in those other classes kind of remained relatively net neutral.

So that's a positive sign for the plan.

And then we take a peek at the specialty on the following slide.

And you know, obviously, the number one thing we see right away is about 18.8% decrease PMPM.

You know, obviously that's awesome.

I kind of alluded to it.

That's because of that colide co kind of falling off on the CF side.

You know, sinrise is gonna be your number one.

You know, that's that uh, you know, that's the high cost um credit for an edema class uh member um that we've been seeing for a long time.

Um chronic inflammatory, or sorry, since in February, that's the lift track pops in at number two, attribute of the orphan drug that I mentioned.

So those three in particular, those are just really, you know, it's like you get one utilizer on this drug, it's really high cost, and it's just it's gonna pop up right to the top.

So, you know, we've talked about this ad nauseum, but uh just as a reminder, you know, when you have these kind of rare disease, uh more rare diseases, it's gonna look like a you know nasty number on the on the page.

Now, do pixin on the other hand, that's where it pops in at number four.

This is the first time where we're seeing a chronic inflammatory disease pop in.

Um that has not been, you know, that's not typical.

Normally I see that one maybe number one.

Uh Sky Ridge is popping in there.

We didn't actually see the sky research.

That might explain maybe why chronic inflammatory isn't as high as uh some other groups.

Um, but fixent has been you know commonly growing, you know, it has added new indications.

So I'm not surprised by that.

Um, you know, in this space, and then you know, you have an oncology drug pop-up, um, not too atypical either.

But uh ultimately, you know, nice to see you know, some of that net neutral, you know, movement after the growth from last year.

Um so that's what's helped that uh 19% decrease really appear after we lost both uh that that other collectical.

So I'm always happier to see these kind of numbers than uh and then kind of a contingent increase.

But uh so just I just want to you know just highlight that that positive.

And so, you know, it might kind of become a little more neutral over the course of the year, uh, but uh definitely a positive from that perspective.

But any questions?

Um, I know that's that's always a a lot to kind of take in, but any questions?

Any questions for Derek or Jennifer?

There are no questions.

No questions.

Thank you.

Thanks, Tim.

All right.

Next item is 6.6.

Report on the City of Sparks Group Health Plan Performance provided by our third-party administrator UMR.

Russ, just give us a minute to pull up your presentation.

Yeah, good morning, everyone.

Uh this is Russ Garrett from UMR.

Uh my presentation.

Oh, go ahead.

Yeah, give us a second to bring it up.

Oh, okay.

You good?

Okay.

We're ready.

All right.

So this would be uh total kind of falls LP's report, claims paid through to through uh the end of May.

Uh total number of claims that we have processed, taking into account medical, RX and dental, 21,741, 12,536 was medical, 7700 in RX and 1486 uh dental.

So then we look at really what you pay on each of those.

And the total paid uh as Nate has alluded to 4.1 million dollars on the medical side, 400,000 dental, uh, and about 1.9 million in RX.

So total paid for the first five months, 6.47 million dollars.

Uh good news is that 99.4% of all your claims are going in networks.

Um, and you're getting a savings amount of about 66.4% on those in-network claims.

And then we drop straight down, kind of give you more of like a per member per month total.

Um, that drops uh to a $760 per member per month.

But when you look at that kind of our book of business norm, you can see that it is quite a bit higher.

Uh, and you guys typically have been higher than our norm um in that marketplace.

Then you slide over to the left a little bit, number of claims denied, 747, although that number seems high.

We've talked about this in the past.

Uh duplicate claims becomes the number one, us being in the secondary position, but not getting the primary EOB.

That's been an issue.

Um this is little things such as those make up the denied claims.

But then we also look at the claims that we've pended so far.

So we have eight claims pending uh over 30 days, 26 claims between 10 and 29 days, and 259 claims at 10 days or less, right along where we should be as far as our book of business and performance guarantees go.

Total number of ER uh visits so far is 193.

You've paid uh 691,000, which comes out to a per visit claim cost of $3,582 in comparison to our book of business of uh $2400.

Virgin care claims you've had 312 paid out 31, almost $32,000.

Average paid per visit is 102, real close to what we see in our you know, book of business actually lower, uh, where we see across the country, you know, 114 per uh e urgent care visit.

Before I go to the next page, is there any questions on those numbers?

Which kind of regurgitate what Nate said.

Any questions for us?

No questions.

On the next slide, uh, of course, we do you know show you guys uh our performance guarantees, which we've actually hit.

You see the targets, what we actually didn't make.

So we've we've uh hit all of our performance guarantees, and then the calls that we receive uh within the time frame, we received 1245 calls, 249 for members, 121 from dependents, and the majority being from a provider 848.

Sometimes we don't get to uh register the call as one of those three categories, so it falls into the all other category, uh, which is 27.

My portion is fairly quick unless there's any additional question.

That's all I have.

Any questions for us?

And the UMR rep is on site a week from today on the 16th, if anybody wants to meet with her.

All right, thank you, Russ.

All right, next item is 7.1.

I'll give it a second here to catch up.

There we go.

Consideration discussion and possible approval to recommend to city council adding additional health plan options for the City of Sparks insurance users, choosing from option A, B, or C as presented.

Nate from LP will present, um, but I may also add additional information is needed.

Uh Nate from LP for the record.

Do you want me to review the go over the presentation?

The shorter PowerPoint, yeah.

I think she's got it there.

Okay.

Um, I think most everyone was present last couple times we went over this, so I'll I'll try and kind of breeze through it.

Um, if if you want me to slow down and spend a little bit more time on any particular exhibit, let me know when we can do that.

But given that most of this is probably is review for most of you.

I'll uh try and keep it moving.

Uh agenda is pretty self-explanatory there.

First page again is just a high-level summary of uh to give a little bit more detail in around preventive care according to what's required under the Affordable Care Act.

I think the main takeaway from this slide that we just wanted to get across was regardless of what plan or how many plans is offered at the city.

Uh preventive coverage is the same across all plans from a benefit perspective.

Um what you're seeing here is the original presentation.

We had reduced it down to about seven slides for this presentation, and apparently that's not it.

I have it on the thumb drive if you want to use it.

Okay.

That's why I was gonna switch over.

It's version three, if you see that we condensed it down to just the basics for this since this has already been fully presented.

Uh Mariah Northington for the record while we wait for the updated PowerPoint.

Rachel, if you still have the same concern you raised earlier after the presentation would be the time to raise that again.

Not sure if that's changed since Mr.

Partica is present, but I will defer to you on that.

Yeah, because he's present, I have no issues.

Thank you.

Yeah.

There you go.

That looks right.

Um I can't see that from here.

Is this like seven pages?

I think that's it.

Yeah, because there's a header, and yeah.

That looks better.

Okay.

All right.

Thank you.

Back to it.

Uh this again, just a high level summary from a benefits perspective of the plans that uh have been recommended for potential additions to the benefit offering.

Uh with the idea being just as a reminder, we kind of trying to use the city of Reno as somewhat of a benchmark so that we could maybe bring Sparks more in line with the world around us.

So with those three plans in mind, those three plan options in mind, we put together some cost exhibits uh in different combinations based on different contribution approaches.

So the first offering is offering A.

Uh this is this option is assuming that we you utilize basically the same cost as what the city is paying all in today, and just set it uh at a fixed cost for each tier level.

We arbitrarily, not necessarily whole arbitrarily, but arbitrarily set those numbers based on the total dollar cost broken out by each individual tier, which is where we came up with the 1100, 1800, 1700, 2400 numbers.

Uh but bottom line is it under that type of a structure, which again is a fixed dollar contribution model.

You guys are used to a percentage-based City of Sparks has been on a very traditional percentage-based contribution structure where you pay 100% of employee and a percent of dependence, depending upon what has been agreed to.

So this would be a uh change or a shift away from that traditional structure from a percentage-based to a fixed dollar or defined contribution, as we sometimes call it.

So you can see how the numbers play out.

Uh, obviously, is you go farther to the right in these plan designs, the cost, the overall cost or the total cost column goes down, uh, which makes uh the employer contribution at that set dollar amount obviously more um favorable to the employee as you get down the the cost spectrum.

And then we just took that and broke it out just for uh visual for folks of what that looks like on a uh purely an employee cost.

What's it gonna cost me, the employee?

And a point of clarification, just as a reminder, the only difference between current plan and new current plan is the contribution structure would change.

The benefits are identical, the current plan and the new current plan.

Offering B is the next contribution structure of consideration.

This basically says we're going to maintain the current plan at the current cost structure just as it is today.

So we're not changing anything.

That and we're gonna make that the quote unquote base plan or the starting point, if you will, for everyone.

In addition to that, we're then going to add those two other two options.

Uh, but we're gonna pay the exact same.

I say we, the city would pay the same exact amount for each of those plans based on the base plan.

Uh with the idea here being that if you like what you have today or you're okay with the cost that you're paying today, you have an option to stay as is.

No changes.

However, this does introduce choice into the equation for these other two plans in not only benefit structure based on how what type of needs you may have as an individual, but also from a cost perspective.

I think we talk about retirees quite a bit, have to pay uh a heavy, quite a heavy amount of the contributions.

This will at least provide some options where there are lower cost uh options available.

Then again, the breakout down at the bottom, just on an employee uh cost.

What will it cost an employee?

Questions.

Any questions so far?

No questions.

Okay.

The last one, offering C.

Same concept as the prior slide, offering B, same concept here, only the quote unquote base plan.

We are moving from the current plan to option one.

So option one will be the starting point, if you will, for what the city would pay for.

And that those numbers under ER cost, which stands for employer cost or city cost, are based on the same contribution structure that you have today.

100% for employee, 75% for dependent.

So that's that's how those numbers were created.

And we then, as of the base plan, utilize those numbers and carry them uh both both to the right, which is for uh a buy down option or a lower cost option, and or we allow force folks to buy up, pay the difference between this new option one plan and the uh current plan, which would be then the buyup plan.

So same concept where we're picking one plan as a starting point and then offering options around it.

This one is we have one lower cost option and one higher cost option.

This again is just the rate exhibit for the retirees with Medicare.

Obviously, retirees with Medicare receive a slight subsidy because they have Medicare.

They're paying for Medicare, they have to pay for Medicare uh B.

And so the city provides a credit for that premium amount, understanding that for those types of individuals, Medicare's primary and Sparks is secondary, so it only makes sense that the rates would be slightly less claim scenarios.

Uh I won't go super into depth knowledge.

We've already reviewed these, but again, in this was an attempt to at least give folks a better feel for uh how things could might play out for each of the three plan offerings.

And the four scenarios here we uh attempted to demonstrate on a hypothetical is from relatively mild or um very low cost, that's scenario one being preventive care, all the way up to a much higher cost, higher severity type uh claim situation, that being an inpatient hospitalization.

And then obviously each of the bullet points under each of those scenarios let you know which plan uh and and what that would look like from an employee out of pocket.

What would this cost me an employee?

Any questions?

Any questions for Nate?

No.

Any questions for me?

That Nate didn't answer.

Shauna, Darren Partika IFF, just a quick question since I can't see the slide.

Um, I'm not.

I'm just on a cell phone out in the mountain.

Um I just want to confirm that option B with the one we discussed the previous meeting, it was like our current plan, the PPO 400, and then the high deductible 2600.

Correct.

Yeah.

So the current plan would be.

I'm sorry, could you repeat that?

And all the um numbers from the last kind of presentation stay the same on that option, is my understanding?

These are the exact same slides.

Nothing is changed.

Okay, perfect.

Yeah.

Cool.

I'm familiar with those slides.

I just want to make sure I didn't miss anything from the last meeting to this one as well before we move on.

We just condensed the presentation and remove some of the slides, but otherwise they're the same.

Perfect.

Thank you.

Yeah, if I understood the presentation, just want to make sure I was on the same page.

Thanks, uh, Nate and Shauna.

Thank you.

All right.

So at this time, you probably have to switch it back.

There you go.

I am seeking a motion to approve and recommend to city council the adoption of either plan offering A, B, or C.

Um, and my understanding is if there isn't a motion, then it just dies, correct?

Right.

Yeah.

Is there a motion for any of these plan offerings?

Leanne roll offs OE3.

I move to approve and recommend to City Council the addition of plan offering B as a health plan option for the City of Sparks insurance users.

All right.

We have a motion.

Do we have a second?

Darren F by second that motion.

All right.

I have a motion and a second.

Any further discussion?

Seeing none, um, we're gonna vote verbally.

Um, so we need everybody to vote.

Yay or nay.

Yes.

Yes.

Nay.

Nay.

Okay.

So we have two yes and one.

Um I'm waiting for your to um put these on the system.

Is it up there?

Yeah.

Leon roll offs OE3.

Are we able to ask Rachel what your group wanted or the justification during this time?

So Rachel Erlinantham, SPPA, we did a vote um, and the majority of the members had said no change.

Um tried to get some clarification on what their concerns were.

Some of the concerns were um with Shauna had um I'd emailed Sean about was how this would impact medical on retirement.

Some concerns were brought up because there's a lot of talk about consolidation with Washoe County.

Um, and then what's considered the cherry picking clause, so picking the best whatever from the different agencies and were the best health care in the valley.

That was another concern that was brought up.

Um I think there was something else, but that's the only ones that stand out.

But it was pretty we had the majority, I think it was about 51% voted for no change.

And then it was like I can look up the have a break here.

51% voted no change, 36% voted option B, 11% voted option A, two percent voted um option C.

Thank you.

I appreciate that.

Um just to note plan offering B, which now that we do have uh two votes, does pass.

Um the next step would go to City Council.

We plan to take it on July 27th for their approval, but all employees would be able to remain on the current plan with no change.

So if that was a concern, it's okay.

I've emailed you before about that too.

And so yeah.

If if that 51% doesn't want to change, they don't have to.

That's fine.

Uh, but there will be choice for those who do have um other situations where their health care could could be different.

Um so it also in regards to that.

Um, I've spoken to both our LP reps and our UMR reps.

We'll have some in-depth detailed sessions, uh, some one-on-ones in October, November, before and during open enrollment to help people decide which choice would work for them.

And they do have the option to change every year.

So okay.

Excuse me, Sean.

This is Ross from UMR.

It was a little bit hard to understand.

Was that motion for option B or C?

B as a boy.

Okay, thank you.

Like Bravo.

Yep.

Yes.

So option B, which retains the current plan and adds the option one and option two to it uh with the same 7525 structure.

All right.

Um so that motion passed uh a two to one.

Moving on to the next item.

Request for future agenda items.

Are there any requests for future agenda items?

Hearing none, move on to item number nine.

Announcements from staff and committee members.

Um, my only announcement is I mentioned the UMR rep is on site next week.

And um that we will take this to council on the 27th, and if it's approved, it will be uh plan offering B.

It will be uh effective in January, and we'll have uh those changes during open enrollment.

Any um comments from committee members.

Leanne roll offs OE3.

Um I just wanted to thank everybody for putting together the presentations, answering our questions, and then also still holding the sessions in October, November.

I also just want to ask members who are more worried about what option they're picking to actually utilize those resources.

I think the most frustrating thing is getting a ton of emails about questions, and then people don't actually attend the sessions that are being brought forth.

So I highly urge everybody to go to them.

And if there isn't one that works with your schedule, email us and let us know so that we can maybe find another date that works for people as well.

Um but overall, thank you very much for all your guys's work into this too.

Yeah, you're welcome.

We do want to uh educate people as much as possible.

I know for a lot, it's it's a lot of new information, and we want to make sure that we we get that out as much as possible.

I held 11 of those sessions with different departments, different locations via teams to try to explain the differences, and we'll have a lot more.

Yep.

And I agree with Leanne and a lot of my members reached out and said how receptive you were within the day, and then if you didn't know from our meetings from those sessions, if you didn't know, you got back to us very quickly.

So we're all very appreciative.

Good.

Yep.

Glad we uh we got got it done.

Uh Darren, do you have any comments?

Uh yeah, I'll meet it's cutting out, yeah.

Could you hear what he said?

Yeah, me either.

The phone kind of cut in and out.

Can you hear me now?

Sort of the record.

Yeah.

Yeah.

So vote now.

Are you guys able to hear it all?

Yeah, now we can hear you.

Okay, perfect.

Uh, no questions on my end.

Thank you guys for all the information getting into the vote.

And I appreciate you guys for accommodating me uh on my phone up in the mountain today.

Thanks for joining us.

We appreciate it.

Of course.

Okay, any comments from the public.

Do we have any public comments here?

We do not.

Okay.

We don't have any public comments.

That leads us to an adjournment.

There being no more further business, the meeting is adjourned at 9 48.