City of Stockton
2022-2023 Annual Health
Benefits Report
March 2022
ATTACHMENT A
I. Executive Summary
II. Medical Plan Renewal
III. Ancillary Renewals
IV. Next Steps
Exhibits:
Employee and Employer Health
Contributions
2 Agenda
ATTACHMENT A
Executive Summary
ATTACHMENT A
2022-2023 Renewal Overview
4 Coverage Carrier Result
Medical Kaiser HMO: Rate Increase +1.0% (+0.6% with admin fees) HDHP: Rate Increase: +1.0% (+0.6% with admin fees)
POS: Rate Decrease -0.5% (-0.7% with admin fees)
PPO: Rate Increase +1.0% (+0.9% with admin fees)
Medical Sutter Health
Plus
HMO: Rate Increase +6.9% (+6.1% with admin fees)
HDHP: Rate Increase +7.0% (+6.1% with admin fees)
Dental PPO Delta Dental
(Self Funded)
Direct Renewal
Change to Funding Rates: -6.55% decrease
Recommended Option:
Self-Funded quote through PRISM – consolidate all members onto Fire plan (enhanced plan design): -5.7% decrease (rates are slightly higher due to the enhanced plan design)
Dental HMO DeltaCare Currently in a rate guarantee through 6/30/2023
ATTACHMENT A
2022-2023 Renewal Overview
5 Coverage Carrier Result
Vision VSP
(Self Funded)
Current ASO fee in a rate guarantee through 6/30/2025
Recommended change to Funding Rates:
-3.9% decrease
Life/AD&D MetLife The MetLife Life and AD&D policy is in a Rate Guarantee through 6/30/2023 Recommended Option:
Move to Lincoln (PRISM) for a decrease of -27.3% which equates to a savings of $41,877 annually
Long Term
Disability
Reliance
Standard
The Reliance Standard Long Term Disability policy is in a Rate Guarantee through 6/30/2023
Recommended Option:
Move to Lincoln (PRISM) for a decrease of -33.3% which equates to a savings of $145,720 annually
EAP Halcyon Currently in a rate guarantee through 6/30/2023 FSA/HSA/HRA P&A Currently in a rate guarantee through 6/30/2023 COBRA APA Benefits Currently in a rate guarantee through 6/30/2025
ATTACHMENT A
2022-2023 Financial Overview (With Recommended Changes) 6 Line of Coverage Current Renewal % ∆
Sutter Health Plus HMO $6,363,134 $6,750,198 6.1%
Sutter Health Plus HDHP $1,574,454 $1,670,642 6.1%
Kaiser HMO $8,564,691 $8,617,294 0.6%
Kaiser POS $51,195 $50,856 -0.7%
Kaiser PPO $28,971 $29,236 0.9%
Kaiser HDHP $3,403,546 $3,422,705 0.6%
Delta Dental DHMO $82,686 $82,686 0.0%
PRISM
Delta Dental DPPO - Self-Funded $1,815,925 $1,712,407 -5.7% VSP Vision - Self-Funded $273,696 $263,027 -3.9%
Lincoln (PRISM)
MetLife Basic Life and AD&D $153,549 $111,672 -27.3%
Lincoln (PRISM)
Reliance Standard LTD $437,161 $291,440 -33.3%
Halcyon EAP $29,529 $29,529 0.0%
APA COBRA $12,835 $12,835 0.0%
P&A FSA $8,446 $8,446 0.0%
P&A Commuter $390 $390 0.0%
P&A HSA $10,830 $10,830 0.0%
P&A HRA $9,288 $9,288 0.0%
TOTAL ANNUAL PREMIUM $22,820,325 $23,073,480
ANNUAL DOLLAR CHANGE $253,155
ANNUAL PERCENTAGE CHANGE 1.1%
ATTACHMENT A
Medical Plan Renewal
ATTACHMENT A
Medical Financial Summary
8 Kaiser Current Renewal % ∆
Kaiser HMO $8,564,691 $8,617,294 0.6%
Kaiser POS $51,195 $50,856 -0.7%
Kaiser PPO $28,971 $29,236 0.9%
Kaiser HDHP $3,403,546 $3,422,705 0.6%
KAISER ANNUAL PREMIUM $12,048,402 $12,120,090
Sutter Health Plus Current Renewal % ∆
SHP HMO $6,363,134 $6,750,198 6.1%
SHP HDHP $1,574,454 $1,670,642 6.1%
SHP ANNUAL PREMIUM $7,937,588 $8,420,840
TOTAL MEDICAL ANNUAL PREMIUM $19,985,989
ANNUAL PERCENTAGE CHANGE 2.8%
$20,540,930
ATTACHMENT A
Kaiser Executive
Summary
Effective July 1, 2022, Kaiser proposes a renewal rate adjustment of:
A
ctives HMO: Rate Increase +1.0% (+0.6% with admin fees) HDHP: Rate Increase: +1.0% (+0.6% with admin fees)
POS: Rate Decrease -0.5% (-0.7% with admin fees)
PPO: Rate Increase +1.0% (+0.9% with admin fees)
For Kaiser’s 2022-
2023 Renewal
Annual trend decreased from 10.19% to 5.63%
(h
igher trend was used for the last renewal to
account for lower claims due to lower utilization in
2020)
Pooling point increased from $310,000 to
$32
5,000
Rates are based on the
following Underwriting
factors:
100% Credibility (City’s utilization)
Health Care Reform
Impacts:
Federal Health Insurer Fee is no longer included
PCORI fee remained at $0.23 PMPM
Administrative Fees
Included:
2022 Plan Year Internal HR Admin Fees: $42.87 (
EE
O
nly), $77.19 (EE+1), and $102.91 (EE+Family).
COBRA (self-pay) fees of $0.70 PEPM
Wellness Kaiser has not approved any wellness dollars, however they recommend a meeting with their
Workforce Health Consultant to review no-cost
resources. Including resilience resources
9 ATTACHMENT A
Kaiser HMO Renewal
10 This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
Medical Plan Benefits Kaiser HMO
Current / Renewal
Calendar Year Deductible
Individual / Family None
Annual Out-of-Pocket Maximum
Individual / Family $1,500 / $3,000
Embedded / Aggregate Embedded
Physician Office Visit $20 / Visit
Specialist Copay $20 / Visit
Preventative Care No Charge
Lab and X-Ray
CT, MRI, PET scans $50 / Procedure
Other lab and x-ray tests $10 / Encounter
Hospitalization
Inpatient $250 / Admit
Outpatient $100 / Procedure
Emergency Room $100 / Visit
(Copay waived if admitted)
Urgent Care Services $20 / Visit
Durable Medical Equipment 20%
Chiro
practic/Acupuncture Care $15 / Visit
(max 30 Visits combined)
PRESCRIPTION DRUGS Generic / Brand-name / Specialty
Rx Copay Out-of-Pocket Maximum Included with Medical
Separate Brand Name Rx Deductible None
Retail - 30 day supply $10 / $30 / 20% up to $150 max
Mail Order - up to 100 day supply $20 / $60 / Not Covered MONTHLY RATES EEs Current Renewal
EE Only 199 $711.58 $716.27
EE + 1 108 $1,280.96 $1,288.73
EE + Family 254 $1,707.78 $1,718.06
561
MONTHLY PREMIUM $713,724 $718,108
ANNUAL PREMIUM $8,564,691 $8,617,294
ANNUAL DOLLAR CHANGE $52,603
ANNUAL PERCENT CHANGE 0.6%
Enrollment as of March 2022
*Current Rates include the following:
• City's administrative fees of $42.87 for Employee
only, $77.17 for Employee plus one, and $102.88
for Employee plus family.
• Eligibility/COBRA (self-pay) fees of $2.82 for
Employee only, $5.08 for Employee plus one, and
$6.77 for Employee plus family.
**Renewal Rates include the following:
• City's administrative fees of $42.88 for Employee
only, $77.19 for Employee plus one, and $102.91
for Employee plus family
• COBRA (self-pay) fees of $0.70 PEPM
ATTACHMENT A
Kaiser HDHP Renewal
11 This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
Medical Plan Benefits Kaiser HDHP
Current / Renewal
In-Network
Calendar Year Deductible
Individual / Family $1,400 / $2,800
Embedded / Aggregate Aggregate
Annual Out-of-Pocket Maximum
Individual / Family $2,800 / $2,800
Embedded / Aggregate Embedded
Physician Office Visit No Charge (after ded)
Specialist Copay No Charge (after ded)
On-line Visit
Preventative Care No Charge
Lab and X-Ray
CT, MRI, PET scans No Charge (after ded)
Other lab and x-ray tests No Charge (after ded)
Hospitalization
Inpatient No Charge (after ded)
Outpatient No Charge (after ded)
Emergency Room No Charge (after ded)
Urgent Care Services No Charge (after ded)
Durable Medical Equipment No Charge (after ded)
Chiropractic Care $15
(
30 Visits / calendar year)
Acupuncture Care Not Covered
PRESCRIPTION DRUGS Generic / Brand-name / Specialty
Rx Copay Out-of-Pocket Maximum Combined with Medical
Rx Deductible N/A
Retail - 30 day supply $10 / $20 / $20
Mail Order - 100 day supply $20 / $40 / Not Covered
MONTHLY RATES EEs Current Renewal
EE Only 59 $629.17 $633.05
EE + 1 27 $1,132.51 $1,138.94
EE + Family 143 $1,510.00 $1,518.35
229
MONTHLY PREMIUM $283,629 $285,225
ANNUAL PREMIUM $3,403,546 $3,422,705
ANNUAL DOLLAR CHANGE $19,159
ANNUAL PERCENT CHANGE 0.6%
Enrollment as of March 2022
*Current Rates include the following:
• City's administrative fees of $42.87 for Employee
only, $77.17 for Employee plus one, and $102.88
for Employee plus family.
• Eligibility/COBRA (self-pay) fees of $2.82 for
Employee only, $5.08 for Employee plus one, and
$6.77 for Employee plus family.
**Renewal Rates include the following:
• City's administrative fees of $42.88 for Employee
only, $77.19 for Employee plus one, and $102.91
for Employee plus family
• COBRA (self-pay) fees of $0.70 PEPM
ATTACHMENT A
Kaiser POS Renewal
12 This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
Medical Plan Benefits Kaiser POS
Current / Renewal
HMO Tier Participating
Provider Tier
Non-
Participating
Provider Tier
Calendar Year Deductible
Individual / Family None $500 / $1,000 $1,000 / $2,000
Embedded / Aggregate Embedded
Annual Out-of-Pocket Maximum
Individual / Family $1,500 / $3,000 $2,500 / $5,000 $5, 000 / $10,000 E
mbedded / Aggregate Embedded
Physician Office Visit $20 $30 (ded waived) 40%
Specialist Copay $20 $30 (ded waived) 40%
On-line Visit $20 $30 (ded waived) 40%
Preventative Care No charge No charge
(ded waived)
No charge
(ded waived)
Lab and X-Ray
CT, MRI, PET scans No Charge $30 (ded waived) 40%
Other lab and x-ray tests No Charge $30 (ded waived) 40% Hospitalization
Inpatient $250 Copa y $250 Copay + 20% $500 Copay + 40% Outpatient $100 Copay /
Procedure 20% per procedure 40% per
procedure
Emergency Room $100 Copay
(waived if admitted)
Urgent Care Services $20 20% 40%
Durable Medical Equipment 20% 30% 50%
Chiropractic/Acupuncture Care $15 $15 Not Covered
(30 visits / calendar year)
PRESCRIPTION DRUGS Generic Preferred / Generic Non-Preferred / Brand Preferred / Brand Non-Preferred / Specialty
Rx Copay Out-of-Pocket Maximum Combined with Medical
Retail - 30 day supply $10 /$10 / $30 / $30
/ 20% to $200 max
$20 / $50 / $40 / $50
/ 30% to $250 max Not Covered
Mail Order - 100 day supply $20 / $60 Not Covered Not Covered MONTHLY RATES EEs Current Renewal
EE Only 1 $1,523.62 $1,513.76
EE + 1 1 $2,742.63 $2,724.21
EE + Family 0 $3,656.68 $3,632.04
2 MONTHLY PREMIUM $4,266 $4,238
ANNUAL PREMIUM $51,195 $50,856
ANNUAL DOLLAR CHANGE -$339
ANNUAL PERCENT CHANGE -0.7%
Enrollment as of March 2022
*Current Rates include the following:
• City's administrative fees of $42.87 for Employee
only, $77.17 for Employee plus one, and $102.88
for Employee plus family.
• Eligibility/COBRA (self-pay) fees of $2.82 for
Employee only, $5.08 for Employee plus one, and
$6.77 for Employee plus family.
**Renewal Rates include the following:
• City's administrative fees of $42.88 for Employee
only, $77.19 for Employee plus one, and $102.91
for Employee plus family
• COBRA (self-pay) fees of $0.70 PEPM
ATTACHMENT A
Kaiser PPO Renewal
13 This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any
discrepancies, the official plan documents will govern.
Medical Plan Benefits Kaiser PPO
Current / Renewal
In-Network Out-of-Network
Calendar Year Deductible
Individual / Family $500 / $1,000 $1,500 / $3,000
Embedded / Aggregate Embedded
Annual Out-of-Pocket Maximum
Individual / Family $3,500 / $7,000 $7,000 / $14,000
Embedded / Aggregate Embedded Embedded
Physician Office Visit $20 (ded waived) 40%
Specialist Copay $20 (ded waived) 40%
On-line Visit $20 (ded waived) 40%
Preventative Care No Charge 40% (ded waived)
Lab and X-Ray
CT, MRI, PET scans 20% 40%
Other lab and x-ray tests 20% 40%
Hospitalization
Inpatient $250 Copay / Admit + 20% $500 Copay / Admit + 40% Outpatient $100 Copay + 20% $150 Copay + 40%
Emergency Room $150 Copay / Visit + 20%
(Copay waived if admitted)
Urgent Care Services $35 (ded waived) 40%
Durable Medical Equipment 30% 50%
Chiropractic/Acupuncture Care $15 30%
(30 visits / calendar year)
PRESCRIPTION DRUGS Generic / Brand / Specialty
Rx Copay Out-of-Pocket Maximum Combined with Medical
Separate Brand Name Rx Deductible None
Retail - 30 day supply $15 / $40 / 30% to $250 max Not Covered Mail Order - 100 day supply $30 / $80 / Not Covered Not Covered MONTHLY RATES EEs Current Renewal
EE Only 1 $2,414.22 $2,436.35
EE + 1 0 $4,345.82 $4,384.88
EE + Family 0 $5,794.10 $5,846.27
1 MONTHLY PREMIUM $2,414 $2,436
ANNUAL PREMIUM $28,971 $29,236
ANNUAL DOLLAR CHANGE $266
ANNUAL PERCENT CHANGE 0.9%
Enrollment as of March 2022
*Current Rates include the following:
• City's administrative fees of $42.87 for Employee
only, $77.17 for Employee plus one, and $102.88
for Employee plus family.
• Eligibility/COBRA (self-pay) fees of $2.82 for
Employee only, $5.08 for Employee plus one, and
$6.77 for Employee plus family.
**Renewal Rates include the following:
• City's administrative fees of $42.88 for Employee
only, $77.19 for Employee plus one, and $102.91
for Employee plus family
• COBRA (self-pay) fees of $0.70 PEPM
ATTACHMENT A
SHP Executive
Summary
Effective July 1, 2022, SHP proposes a renewal rate adjustment of:
A
ctives HMO: Rate Increase +6.9% (+6.1% with admin fees) HDHP: Rate Increase +7.0% (+6.1% with admin fees)
Factors for SHPs
renewal include:
Annual trend increased from 5.3% to 6.8%
Increase in membership at the July 2021 renewal
which was based on the higher cost population
from the PPO plan
Mandatory changes None
Administrative Fees
Included:
2022 Plan Year Internal HR Admin Fees: : $42.88
(EE Only), $77.19 (EE+1), and $102.91 (EE+Family).
COBRA (self-pay) fees of $0.70 PEPM
Wellness Credit SHP provided a $3,000 wellness credit effective 7/1/2022-6/30/2023.
It can be used towards the cost of programs,
materials, healthy snacks, exercise equipment
,
in
centive programs for challenges
To use the wellness program credit, submit the
request for reimbursement and supporting
documentation (e.g., receipts, invoices, etc.) to the
SHP Account Manager Jill Kelley at
[email protected]
14 ATTACHMENT A
SHP HMO Renewal
15 This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
Medical Plan Benefits Sutter Health Plus HMO
Current / Renewal
Calendar Year Deductible
Individual / Family None
Annual Out-of-Pocket Maximum
Individual / Family $1,500 / $3,000
Embedded / Aggregate Embedded
Physician Office Visit $20 / Visit
Specialist Copay $20 / Visit
Preventative Care No Charge
Lab and X-Ray
CT, MRI, PET scans No Charge
Other lab and x-ray tests Lab: $20 /Visit; X-Ray: No Charge Hospitalization
Inpatient $250 / Admit
Outpatient $100 / Visit
Emergency Room $100 / Visit
(Copay waived if admitted)
Urgent Care Services $20 / Visit
Durable Medical Equipment 20%
Infertility 50%
Chiropractic / Acupuncture Care $20 / Visit
Unlimited Visits
PRESCRIPTION DRUGS Generic / Brand / Non-Formulary / Specialty Rx Copay Out-of-Pocket Maximum Included with Medical
Separate Brand Name Rx Deductible None
Retail - 30 day supply $10 / $30 / $60 / 20% up to $250 max Mail Order - up to 100 day supply $20 / $60 / $120 / Not Covered MONTHLY RATES EEs Current Renewal
EE Only 129 $721.99 $766.28
EE + 1 84 $1,300.45 $1,379.59
EE + Family 189 $1,734.85 $1,840.11
402
MONTHLY PREMIUM $530,261 $562,516
ANNUAL PREMIUM $6,363,134 $6,750,198
ANNUAL DOLLAR CHANGE $387,064
ANNUAL PERCENT CHANGE 6.1%
Enrollment as of March 2022
*Current Rates include the following:
• City's administrative fees of $42.87 for Employee
only, $77.17 for Employee plus one, and $102.88
for Employee plus family.
• Eligibility/COBRA (self-pay) fees of $2.82 for
Employee only, $5.08 for Employee plus one, and
$6.77 for Employee plus family.
**Renewal Rates include the following:
• City's administrative fees of $42.88 for Employee
only, $77.19 for Employee plus one, and $102.91
for Employee plus family
• COBRA (self-pay) fees of $0.70 PEPM
ATTACHMENT A
SHP HDHP Renewal
16 This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
Medical Plan Benefits Sutter Health Plus HDHP
Current / Renewal
In-Network
Calendar Year Deductible
Individual / Family $1,400 / $2,800
Embedded / Aggregate Embedded
Annual Out-of-Pocket Maximum
Individual / Family $2,800 / $2,800
Embedded / Aggregate Embedded
Physician Office Visit No Charge
Specialist Copay No Charge
Preventative Care No Charge
Lab and X-Ray
CT, MRI, PET scans No Charge
Other lab and x-ray tests No Charge
Hospitalization
Inpatient No Charge
Outpatient No Charge
Emergency Room No Charge
Urgent Care Services No Charge
Durable Medical Equipment No Charge
Chiropractic Care Not Covered
Acupuncture Care Provided for treatment of nausea or chronic pain only
PRESCRIPTION DRUGS Generic / Brand / Non-Formulary / Specialty Rx Cop
ay Out-of-Pocket Maximum Combined with Medical
Rx Deductible Medical Deductible Applies
Retail - 30 day supply $10 / $20 / $35 / No Charge
Mail Order - 100 day supply $20 / $40 / $70 / No Charge MONTHLY RATES EEs Current Renewal
EE Only 33 $639.39 $678.78
EE + 1 17 $1,150.95 $1,221.29
EE + Family 59 $1,534.55 $1,628.11
109
MONTHLY PREMIUM $131,204 $139,220
ANNUAL PREMIUM $1,574,454 $1,670,642
ANNUAL DOLLAR CHANGE $96,188
ANNUAL PERCENT CHANGE 6.1%
Enrollment as of March 2022
*Current Rates include the following:
• City's administrative fees of $42.87 for Employee
only, $77.17 for Employee plus one, and $102.88
for Employee plus family.
• Eligibility/COBRA (self-pay) fees of $2.82 for
Employee only, $5.08 for Employee plus one, and
$6.77 for Employee plus family.
**Renewal Rates include the following:
• City's administrative fees of $42.88 for Employee
only, $77.19 for Employee plus one, and $102.91
for Employee plus family
• COBRA (self-pay) fees of $0.70 PEPM
ATTACHMENT A
Ancillary Renewal
ATTACHMENT A
2022 – 2023 Renewal Results
18 Coverage Decision/Outcome
DeltaCare DHMO Currently in a rate guarantee through 6/30/2023 Delta Dental PPO (Self-
Funded)
Direct Renewal
Change to Funding Rates: -6.55% decrease from current Alliant performed a Marketing and procured a quote through SISC to consolidate all members onto the Fire plan (enhanced plan design)
Recommended Option:
Self-Funded quote through PRISM –5.7% decrease from current (rates are slightly higher than direct due to the enhanced plan design)
VSP Vision Current ASO fee in a rate guarantee through 6/30/2025 Recommended change to Funding Rates:
-3.9% decrease
MetLife Life/AD&D The MetLife Life and AD&D policy is in a Rate Guarantee through 6/30/2023 Alliant performed a Marketing and procured significant savings with an enhanced plan design by moving the coverages to Lincoln through SISC
Recommended Option:
Move to Lincoln (PRISM) for -27.3% which equates to -$41,877 in annual savings Includes enhanced plan design and special open enrollment up to guarantee issue amounts Reliance Standard Long Term
Disability
The Reliance Standard Long Term Disability policy is in a Rate Guarantee through 6/30/2023 Alliant performed a Marketing and procured significant savings by moving the coverages to Lincoln through SISC Recommended Option:
Move to Lincoln (PRISM) for -33.3% which equates to -$145,720 in annual savings Halcyon EAP Currently in a rate guarantee through 6/30/2023 P&A FSA/HSA/HRA Currently in a rate guarantee through 6/30/2023 APA COBRA Currently in a rate guarantee through 6/30/2025
ATTACHMENT A
PRISM Overview
19 PRISM
Established in 1979, PRISM (Public Risk Innovation, Solutions, and Management) is a risk sharing pool dedicated to controlling losses and providing effective risk management solutions. PRISM is a member directed pool serving California public agencies.
Membership in Property & Casualty and Employee Benefit coverages has expanded to include 95% of counties, 60% of cities, as well as numerous school districts, special districts, housing authorities, fire districts, and other Joint Powers Authorities.
Employee Benefit Coverages Offered
Medical (PRISMHealth – Anthem/Blue Shield/Kaiser)
Dental (Delta Dental)
Vision (VSP/MES)
EAP (MHN/Anthem)
Life & Disability (Voya/Lincoln)
PRISM Membership Highlights
Medical – 45 member groups – 40,000 covered
Dental – 176 member groups – 91,500 covered
Vision – 116 member groups –42,000 covered
EAP – 103 member groups – 47,000 covered
Life & DI – 127 member groups – 80,800 covered
ATTACHMENT A
Dental
ATTACHMENT A
21 PRISM Dental
Program
Features
Largest dental network in California (Delta Dental)
Low administrative fee (*continues to decrease as the pool grows*) Full servicebenefits administration
Highlights
176 member groups; 91,500 public agency employees covered The plan design through the PRISM Pool is exactly the sameas Delta Dental direct, however we have proposed an option for all members to consolidate on the Fire plan, which is a slightly enhanced plan design
All information would stay the same for members (no new ID cards, etc.) Advantages of PRISM vs. Direct
Administrative Fees
The City will benefit from lower administrative fees through PRISM Currently the Delta Dental direct administrative fee is $8.26 PEPM The PRISM Delta Dental administrative fee is 6.7% of claims, which equates to $6.27 PEPM Lower Funding Rates
The underwriting recommendation calls for a -5.7% decrease in funding rates for the consolidated (enhanced) plan option whereas the direct renewal is a -6.55% decrease in f
unding rates.
Overallthis is a savings of approximately ~$103K annually from current
ATTACHMENT A
Dental Renewal and Marketing
Self-Funded Program - Consolidated Plans
22 This document is intended as
a quick reference, not a
comprehensive description.
Limitations and exclusions
can be found in the official
plan documents. In case of
any discrepancies, the official
plan documents will govern.
Enrollment as of January 2022
from Delta Dental
*Current and Renewal Rates
include the composite internal
administration fee of $4.96
PEPM
**Proposed PRISM Rates
include the composite internal
administration fee of $4.98
PEPM in all rates (self-funded
and fully insured)
Dental Plan Benefits Delta Dental DPPO (Direct) Delta Dental DPPO (Direct) Delta Dental DPPO (PRISM) All Others Firefighters and Fire Management ALL - Consolidated Self-Funded Current / Renewal Self-Funded Current / Renewal Self-Funded Proposed Calendar Year Maximum PPO Non-PPO PPO Non-PPO PPO Non-PPO Per Member $1,500 $1,500 $1,500
(D & P counts towards maximum) (D & P does not count towards maximum) (D & P does not count towards maximum) Calendar Year Deductible
Individual / Family None None None
Diagnostic and Preventive
Oral Exam
X-Rays
Teeth Cleaning
Fluoride Treatment
Basic Services
Sealants
Anesthesia
Periodontics (Gum disease)
Endodontics (Root Canal)
Simple & Surgical Extractions
Major Services
Single Crowns
Inlays, Onlays, Veneers
Dental Implants
Bridges & Dentures
Repair & Maintenance of Bridgework & Dentures
Orthodontics Adult & Child Adult & Child Adult & Child
Benefit Percentage 50% 50% 50%
Lifetime Maximum $2,000 $2,000 $2,000
Out-of-Network Reimbursement Contracted Fees Contracted Fees Contracted Fees
RATE GUARANTEE
2 Years
(7/1/21 - 6/30/23)
2 Years
(7/1/21 - 6/30/23)
1 Year
(7/1/22 - 6/30/23)
MONTHLY RATES EE'S Current 3% Margin Renewal EE'S Current 3% Margin Renewal EE'S PRISM Self-Funded Consolidated Plan Employee Only 345 $58.53 $54.70 30 $58.53 $54.70 375 $55.20 Employee + 1 211 $117.07 $109.40 18 $117.07 $109.40 229 $110.40 Employee + Family 570 $152.18 $142.21 104 $152.18 $142.21 674 $143.50 1126 152 1278
TOTAL MONTHLY PREMIUM $131,637 $123,015 $19,690 $18,400 $142,701 TOTAL ANNUAL PREMIUM $1,579,647 $1,476,175 $236,279 $220,800.48 $1,712,407 ANNUAL DOLLAR CHANGE -$103,471 -$15,478 -$103,518
ANNUAL PERCENT CHANGE -6.6% -6.6% -5.7%
80% 80% 80%
100% 100% 100%
50% 50% 50%
80% 80% 80%
ATTACHMENT A
Vision
ATTACHMENT A
Vision Plan Renewal
24 The VSP plan is currently self-insured directly through VSP Alliant recommends a vision reserve fund of approximately $12,000 to cover 3 weeks of claims Effective 7/1/2022, Alliant’s VSP underwriting analysis indicates a rate decrease of -3.9% The underwriting analysis includes the following:
• Claims through December 2022
• 2.1% Trend (Note – Gallagher’s underwriting project included 4.5% trend) • 3% margin
• The most recent 12 months as weighted 100% due to the prior 12 months being lower than usual due to COVID-19
• In a typical year we would weight the claims 70% for current 12 months and 30% for the prior 12 months o 2022-2023 Administrative Fees:
• VSP ASO: $1.25 PEPM
• Internal HR Admin Fees: $ 0.70 PEPM
ATTACHMENT A
Vision Renewal
25This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in theofficial plan documents. In case of any discrepancies, the official plan documents will govern.
Enrollment as of December 2021
*Current Rates include the composite
internal administration fee of $0.72
P
EPM in all rates (self-funded
**Proposed Renewal Rates include
the composite internal administration
fee of $0.70 PEPM
Vision Plan Benefits VSP Choice Plan
Self-Funded - Current / Renewal
In-Network Out-of-Network
Copay
Plan pays
up to:
Exam $10 $37
Lenses
Single $20 $34
Bifocal $20 $51
Trifocal $20 $68
Contact Lenses* $120 Allowance
(Copay Waived) $100
Frames $120 Allowance
+ 20% Discount $40
Frequency of Services
Eye Examination 12 months
Lenses 12 months
Frames 12 months
Contact Lenses* 12 months
* In lieu of frames
Administration Rate Guarantee 5 Years
(7/1/2020-6/30/2025)
Admin Fee $1.25 PEPM
BCC and Program Management Fees (PEPM) N/A
MONTHLY RATES EE'S Current Renewal
Employee Only 444 $7.91 $7.60
Employee + 1 Dependent 265 $15.84 $15.22
Employee + Family 734 $20.57 $19.77
1443
TOTAL MONTHLY PREMIUM $22,808 $21,919
TOTAL ANNUAL PREMIUM $273,696 $263,027
ANNUAL $ DIFFERENCE ($10,670)
ANNUAL % DIFFERENCE -3.9%
ATTACHMENT A
Life and Disability
ATTACHMENT A
Features
Coverage offered through Lincoln
Customized plan design, with enhancements from current Various value adds available included at no cost, such as:
• Additional EAP Resources
• Health Advocacy Services
• Financial Wellness Resources
• And More
Highlights
127 member groups; 80,800 public agency employees covered Advantages of PRISM vs. Direct
Significant premium savings
-31.8% which equates to -$187K in annual savings for employer paid coverages
No change to rates for Voluntary Life insurance
Enhanced Plan Design
Enhanced guarantee issue amounts for Voluntary Life with no change t
o rates
Special open enrollment with no medical underwriting up to the g
uaranteed issue amounts in the upcoming open enrollment PRISM Life &
Disability Program
27 ATTACHMENT A
Life/AD&D/LTD Recommended Option
28 Line of Coverage Current Lincoln (PRISM)
Proposed % ∆
MetLife Lincoln
Basic Life / AD&D $153,549 $111,672 -27.3%
Reliance Standard Lincoln
Long Term Disability $437,161 $291,440 -33.3%
TOTAL ANNUAL PREMIUM $590,710 $403,112
ANNUAL DOLLAR CHANGE ($187,597)
ANNUAL PERCENTAGE CHANGE -31.8%
ATTACHMENT A
Basic Life and AD&D Recommended Option
29 Basic Life and AD&D MetLife Lincoln (PRISM)
Plan Benefits Current Proposed
Class 1
All Full-Time members classified as Mayor, City Manager, Unrepresented Department Heads, City Attorney Executives, Represented Mid-Management Members, Unrepresented Mid-
Management Members, City Attorney Professionals, Police Management and Operations and Maintenance Unit
Members, Represented Supervisors, Unrepresented
Supervisors, Unrepresented Confidential Members, City
Attorney Support Personnel, Water Supervisory Unit
Members.
All Full-Time members classified as Mayor, City Manager, Unrepresented Department Heads, City Attorney Executives, Represented Mid-Management Members, Unrepresented Mid-
Management Members, City Attorney Professionals, Police Management and Operations and Maintenance Unit
Members, Represented Supervisors, Unrepresented
Supervisors, Unrepresented Confidential Members, City
Attorney Support Personnel, Water Supervisory Unit
Members.
Class 2
All Full-Time members classified as Fire Management, Sworn Fire Members, Sworn Police Members, Administrative and
Clerical Unit Members, Professional and Technical Unit
Members and Trades and Maintenance Unit Members.
All Full-Time members classified as Fire Management, Sworn Fire Members, Sworn Police Members, Administrative and
Clerical Unit Members, Professional and Technical Unit
Members and Trades and Maintenance Unit Members.
Life Benefits: Class 1
Life Benefits: Class 2 $50,000 $50,000
AD&D Benefits: Class 1 Equal to Life Benefit Equal to Life Benefit AD&D Benefits: Class 2 Not Covered Not Covered
Guaranteed Issue Amount
Age Reduction Age Reduction
70 35% 70 35%
75 50% 75 50%
Retirement 100% Retirement 100%
Accelerated Death Benefit Included Included
Waiver of Premium Included Included
Seat Belt Provision (AD&D)
Air Bag Provision (AD&D)
RATE GUARANTEE
2 Years
(7/1/2021 - 6/30/2023)
1 Year
(7/1/2022 - 6/30/2023)
MONTHLY RATES Current Proposed
Insurance Volume $77,550,000 $77,550,000
Basic Life Rate per $1,000 $0.142 $0.100
Basic AD&D Rate per $1,000 $0.023 $0.020
Combined Rate $0.165 $0.120
MONTHLY PREMIUM $12,796 $9,306
ANNUAL PREMIUM $153,549 $111,672
ANNUAL $ DIFFERENCE -$41,877
ANNUAL % DIFFERENCE -27.3%
$50,000
Benefit Reduction Formula
Included
Included
$50,000
$50,000
$50,000
Included
Included
This document is intended as a quick
reference, not a comprehensive
description. Limitations and
exclusions can be found in the official
plan documents. In case of any
discrepancies, the official plan
documents will govern.
Volume as of 2021 Renewal
ATTACHMENT A
Voluntary Life and AD&D Recommended Option
30 Voluntary Life MetLife Lincoln (PRISM)
Plan Benefits Current Proposed
Eligibility
Employee Life Benefit
Maximum Lesser of 5 times BAE or $500,000 Lesser of 5 times BAE or $500,000 Minimum $10,000 $10,000
Increments of: $10,000 $10,000
Guaranteed Issue Amount $200,000 $300,000
Spouse Life Benefit
Maximum Lesser of 50% of EE amount or $100,000 Lesser of 50% of EE amount or $100,000 Minimum $5,000 $5,000
Increments of: $5,000 $5,000
Guaranteed Issue Amount $25,000 $30,000
Spouse Rate Basis Based on spouse's age as of their last birthday Based on spouse's age as of their last birthday Dependent Child(ren) Life Benefit
Maximum
Under 15 days old: $500
15 d
ays and older: $10,000
Under 15 days old: $500
6 m
onths and older: $10,000
Minimum $1,000 $1,000
Increments of: $1,000 $1,000
Guaranteed Issue Amount $10,000 $10,000
Waiv
er of Premium Included Included
AD&D Benefit Equal to Life Benefit Equal to Life Benefit Portability Included Included
RATE GUARANTEE
2 Years
(7/1/2021 - 6/30/2023)
1 Year
(7/1/2022 -
6/30/2023)
MONTHLY RATES Current Proposed
Monthly Rates per $1,000 Employee Rates Spouse Rates Empl oyee Rates Spouse Rates Under age 30 $0.060 $0.080 $0.060 $0.080
Ag
e 30-39 $0.090 $0.120 $0.090 $0.120
Age 40-49 $0.150 $0.250 $0.150 $0.250
Age 50-59 $0.430 $0.740 $0.430 $0.740
Age 60-69 $1.270 $2.350 $1.270 $2.350
Age 70+ $2.060 $4.350 $2.060 $4.350
Dependent Child(ren) Rates per $1,000 $0.232 $0.232
E
mployee AD&D $0.028 $0.028
Spouse AD&D $0.021 $0.021
Child AD&D $0.055 $0.055
All full-time employees All full-time employees
This document is intended as a quick
reference, not a comprehensive
description. Limitations and
exclusions can be found in the official
plan documents. In case of any
discrepancies, the official plan
documents will govern.
ATTACHMENT A
Long Term Disability Recommended Option
31 This document is intended as a quick
reference, not a comprehensive
description. Limitations and
exclusions can be found in the official
plan documents. In case of any
discrepancies, the official plan
documents will govern.
Volume as of November 2021
Long Term Disability Reliance LTD Lincoln (PRISM) LTD
Plan Benefits Current Proposed
Eligibility:
Class 1:
Assistant City Manager, Chief Financial Officer, Chief of Police, City Attorney, City Manager, Deputy Chief of
Police II, Deputy City Manager II, Director of Municpal Utilities and Director of Public Works
Assistant City Manager, Chief Financial Officer, Chief of Police, City Attorney, City Manager, Deputy Chief of
Police II, Deputy City Manager II, Director of Municpal Utilities and Director of Public Works
Class 2:
Employee, except employee not listed in any other class per plan highlights: Each Active, Full time employee
worki
ng 40 or more hours per week, except any person
working on a temporary or seasonal basis.
All Other Full-Time Employees
Elimination Period 90 Days 90 Days, or to the end of accumulated sick leave, whichever is greater
Monthly Benefit Percentage 66.67% 66.67%
Maximum Monthly Benefit
Class 1:
Class 2:
$14,000
$10,
000
$14,000
$10,
000
Own Occupation Definition 24 Months 24 Months
Disability Earnings Test Covered Monthly Earnings Covered Monthly Earnings Definition of Disability Own Occupation Own Occupation
Mental Health/Substance Abuse
Limit 24 Months 24 Months
Maximum Benefit Duration SSNRA or RBD Later of age 65 or SSNRA Pre-Existing Condition 3/12 3/12
RATE GUARANTEE
2 Years
7/1/2021 - 6/30/2023
1 Year
7/1/2022 - 6/30/2023
MONTHLY RATES Current Bundle Option
Covered Payroll Volume $5,782,547 $5,782, 547
Rate per $100 of Covered Payroll $0.630 $0.420
MONTHLY PREMIUM $36,430 $24,287
ANNUAL PREMIUM $437,161 $291,440
ANNUAL $ DIFFERENCE $0 -$145,720
ANNUAL % DIFFERENCE 0.0% -33.3%
ATTACHMENT A
EAP
ATTACHMENT A
Employee Assistance Program through Halcyon:
The City implemented the program on Oct. 1 2020
with a 5 year guarantee
Rate guaranteed through September 30, 2025
Employee
Assistance Program
Summary
33 ATTACHMENT A
Employee Assistance Plan
34 Employee Count as of March 2022
1Additional beyond 3 sessions available at
$100/visit (self-fund), up to 10 sessions. The City
will receive an invoice from Halcyon for each visit
beyond initial 3.
This document is intended as a quick
reference, not a comprehensive
description. Limitations and exclusions
can be found in the official plan
documents. In case of any discrepancies,
the official plan documents will govern.
EAP Halcyon EAP
Plan Benefits Current
Sessions
All Other 3 Sessions every 6 months1
First Responder N/A
Digital Capabilities
Digital Platforms Web Portal, eConnect mobile app, and
textcoach text therapy
Telephonic Included
Video Included
Text Included
Employee Services
Legal Included
Financial Included
Dependent Care Included
Employer Services
Management Consultations Unlimited
CISD Seminar(s) Unlimited
Onsite Orientations 10 Hours
Add-On
Coaching N/A
RATE GUARANTEE - All Others
5 Years
(10/1/2020 - 9/30/2025)
RATE GUARANTEE - First Responder N/A
MONTHLY RATES EE's Current
Per Employee Per Month BLENDED 1519 $1.62
Per Employee Per Month All Others 923 N/A
Per Employee Per Month First Responder 596 N/A
MONTHLY PREMIUM $2,461
ANNUAL PREMIUM $29,529
ATTACHMENT A
FSA and COBRA
ATTACHMENT A
FSA / HRA / HSA Administration (P&A)
• The City received a rate pass on 7/1/2022 for 12 months COBRA Administration (APA)
The City renewed on 7/1/2020 with a 5 year rate guarantee (through 6/30/2025)
Flexible Spending
Account and
COBRA Summary
36 ATTACHMENT A
FSA and COBRA Overview
37 Line of Coverage Current Renewal % ∆
APA APA
COBRA $12,835 $12,835 0.0%
P & A P & A
FSA $8,446 $8,446 0.0%
P & A P & A
HSA $10,830 $10,830 0.0%
P & A P & A
HRA $9,288 $9,288 0.0%
P & A P & A
TSA $390 $390 0.0%
TOTAL ANNUAL PREMIUM* $41,789 $41,789
ATTACHMENT A
COBRA Administration
38 COBRA APA COBRA
Plan Benefits Current
Core Services
Eligibility updates to Carrier or TPA Included
Optional Services
Open Enrollment Packets Included
Current Participant Count
COBRA eligible employees 1528
RATE GUARANTEE
5 Years
(7/1/2020 - 6/30/25)
FEES Current
Annual Fee N/A
Monthly Administration Fee (PEPM) $0.70
FIRST YEAR FEES $12,835
ANNUAL FEES $12,835
ANNUAL $ DIFFERENCE $0
ANNUAL % DIFFERENCE 0.0%
This document is intended as a quick reference, not a comprehensive description.
Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
ATTACHMENT A
FSA Administration
39 FSA P&A FSA
Plan
Benefits Current / Renewal
General Information
Debit Card Included
Direct Deposit Included
Online Account Access Included
Plan Document Creation and Modification
Plan Document and Summary Plan
Description (SPD) Included
Current Participant Count
Unique FSA Participants
(HCFSA Only, DCFSA Only or HCFSA and DCFSA) 207
RATE GUARANTEE
1 Year
(7/1/2021 - 6/30/2022)
1 Year
(7/1/2022 - 6/30/2023)
FEES Current / Renewal
Annual Fee N/A
Monthly Administration Fee (PPPM)1 $3.40
FIRST YEAR FEE $8,446
ANNUAL
FEES $8,446
ANNUAL $ DIFFERENCE $0
ANNUAL % DIFFERENCE 0.0%
Enrollment as of November 2021 from P&A
1Employees participating in both the Health Care FSA (HCFSA) anf Dependent Care FSA (DCFSA) will be counted as one participant
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan docu
ments will govern.
ATTACHMENT A
HSA Administration
40 HSA P&A HSA
Plan Benefits Current / Renewal
Core Services
Debit Cards Included
Current Participant Count
Participants 361
RATE GUARANTEE
1 Year
(7/1/2021 - 6/30/2022)
1 Year
(7/1/2022 - 6/30/2023)
FEES Current / Renewal
Annual Fee N/A
Monthly Administration Fee (PPPM) $2.50
FIRST YEAR FEES $10,830
ANNUAL FEES $10,830
ANNUAL $ DIFFERENCE $0
ANNUAL % DIFFERENCE 0.0%
Enrollment as of November 2021 from P&A
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
ATTACHMENT A
HRA Administration
41 HRA P&A HRA
Plan Benefits Current / Renewal
Core Services
Debit Cards Included
Current Participant Count
Participants 172
RATE GUARANTEE
1 Year
(7/1/2021 - 6/30/2022)
1 Year
(7/1/2022 - 6/30/2023)
FEES Current / Renewal
Annual Fee N/A
Monthly Administration Fee (PPPM) $4.50
FIRST YEAR FEES $9,288
ANNUAL FEES $9,288
ANNUAL $ DIFFERENCE $0
ANNUAL % DIFFERENCE 0.0%
Enrollment as of November 2021 from P&A
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
ATTACHMENT A
Commuter Administration
42 Commuter Plan P&A Commuter
Plan Benefits Current / Renewal
General Information
Debit Card Included
Current Participant Count
Commuter Participants 10
RATE GUARANTEE
1 Year
(7/1/2021 - 6/30/2022)
1 Year
(7/1/2022 - 6/30/2023)
FEES Current / Renewal
Annual Fee N/A
Monthly Administration Fee (PPPM) $3.25
FIRST YEAR FEES $390
ANNUAL FEES $390
ANNUAL $ DIFFERENCE $0
ANNUAL
% DIFFERENCE 0.0%
Enrollment as of November 2021 from P&A
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.
ATTACHMENT A
Next Steps
ATTACHMENT A
Next Steps
To move into the Dental program through PRISM, the following document is required to be signed prior to 7/1/2022:
PRISM Dental Memorandum of Understanding (MOU)
Sign (2) copies and retain one copy for your files (original is sent to PRISM). This document also spells out the City’s rights and obligations as an employer participating in the PRISM Dental program.
44 ATTACHMENT A
Disclosures
45 Alliant embraces a policy of transparency with respect to its compensation from insurance transactions. Details on our compensation policy, including the types of income that Alliant may earn on a placement, are available on our website at www.alliant.com. For a copy of our policy or forany inquiries regarding compensation issues pertaining to your account you may also contact us at: Alliant Insurance Services, Inc., Attention: General Counsel, 701 B Street, 6th Floor, San Diego, CA 92101.
Analyzing insurers' over-all performance and financial strength is a task that requires specialized skills and in-depth technical understanding of all aspects of insurance company finances and operations.Insurance brokerages such as Alliant typically rely upon rating agencies for this type of market analysis. A.M. Best has been an industry leader in this area for many decades, utilizing a combination of quantitative and qualitative analysis of the information available in formulating their ratings.
Alliant’s standard protocol is to only place coverage with carriers with no less than an “A-”- rating from A.M. Best. However, where Alliant determines that it is prudent to consider coverage with a lower rated carrier, the financial rating of the carrier is to be disclosed to the client. Should Alliant becomes aware of a carrier’s rating dropping below “A-“ mid-policy period we will review and advise you of the situation and consider if an alternative carrier can be reasonably provided prior to renewal.
A.M. Best has an extensive database of nearly 6,000 Life/Health, Property Casualty and International companies. You can visitthem at www.ambest.com. Ratings
for Carriers included in this presentation are:
Carrier A.M. Best
Kaiser NR
Sutter Health NR
Delta Dental A
VSP A-
MetLife A+
Reliance A++
Lincoln A+
Plans are rates presented are generally effective July 1, 2022 through June 30, 2023 Rates quoted assume current employer contribution levels and participation levels unless otherwise stated. Final rates will be based on final enrollment underwriting.
Updated claims experience or other information may be required to finalize rates. If group demographics, enrollment levels oremployer contributions change, rates may change or the quote may be withdrawn.
In general, employees must be actively act work on the effective date of the plan. When implementing new coverage, employees who are not actively at work will not be covered under the plan until they return to active state. It may be possible to waive the actively at work provision.
This proposal should not be interpreted as inclusive of all plan provisions and limitations. For further details, refer to the insurance carrier proposals and carrier plan documents. Benefit coverage and eligibility provisions for fully insured health plans may vary from state to state, based on state mandates. Illustrated enrollment is based on the information provided (employee census, current premium statement and or carrier renewal).
Coverage is not in effect until it is approved by the insurance carrier’s underwriter.
ATTACHMENT A
© 2022 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
ATTACHMENT A