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09/16/2021
Staff: Committee Members: Chris Huot Councilmember, Ken Weir - Chair Assistant City Manager Councilmember, Patty Gray Councilmember, Bruce Freeman SPECIAL MEETING NOTICE PERSONNEL COMMITTEE of the City Council - City of Bakersfield Thursday, September 16, 2021, 12:00 p.m. City Hall North – Conference Room A 1600 Truxtun Avenue, First Floor Bakersfield, California 93301 A G E N D A 1. ROLL CALL 2. PUBLIC STATEMENTS 3. ADOPT MAY 18, 2021 AGENDA SUMMARY REPORT 4. NEW BUSINESS A. 2022 Health Care Plan Renewals – Huot/Tenter 5. COMMITTEE COMMENTS 6. ADJOURNMENT SPECIAL NOTICE Public Participation and Accessibility September 16, 2021 Personnel Committee On March 18, 2020, Governor Gavin Newsom issued Executive Order N-29-20, which includes a waiver of Brown Act provisions requiring physical presence of the Committee members or the public in light of the COVID-19 pandemic. Personnel Committee Special Meeting September 16, 2021, Agenda Page 2 Based on guidance from the California Governor’s Office and Department of Public Health, as well as the County Health Officer, in order to minimize the potential spread of the COVID-19 virus, the City of Bakersfield hereby provides notice that as a result of the declared federal, state, and local health emergencies, and in light of the Governor’s order, the following adjustments have been made: 1. Consistent with the Executive Order, Committee members may elect to attend the meeting telephonically and to participate in the meeting to the same extent as if they were physically present. 2. The public may participate in the meeting and address the Committee as follows: • If you wish to comment on a specific agenda item, submit your comment via email to the City Clerk at City_Clerk@bakersfieldcity.us no later than 5:00 p.m. Monday, the day before the Committee meeting. Please clearly indicate which agenda item number your comment pertains to. • If you wish to make a general public comment not related to a specific agenda item, submit your comment via email to the City Clerk at City_Clerk@bakersfieldcity.us no later than 5:00 p.m. Monday, the day before the Committee meeting. • If you wish to make a comment on a specific agenda item as it is being heard, please email your written comment to the City Clerk at City_Clerk@bakersfieldcity.us. All comments received during the meeting may not be read but will be provided to the Committee and included as part of the permanent public record of the meeting. ________________________________________________________________ S:\Council Committees\2021\Personnel\05_May\May 18 ASR.docx Page 1 CH:mc Committee Members Staff: Chris Huot Councilmember, Ken Weir, Chair Assistant City Manager Councilmember, Bruce Freeman Councilmember, Patty Gray SPECIAL MEETING OF THE PERSONNEL COMMITTEE Tuesday, May 18, 2021 12:00 p.m. City Hall North – Conference Room A 1600 Truxtun Avenue Bakersfield, CA 93301 AGENDA SUMMARY REPORT Meeting called to order at 12:05 p.m. 1. ROLL CALL Committee members Present: Councilmember, Ken Weir, Chair Councilmember, Patty Gray Councilmember, Bruce Freeman, participated telephonically City staff: Christian Clegg, City Manager Chris Huot, Assistant City Manager Joe Conroy, Public Information Officer Brianna Carrier, Administrative Analyst Nathan Gutierrez, Management Assistant Michelle Cruz, Management Assistant Josh Rudnick, Deputy City Attorney Christi Tenter, Human Resources Director Mari Blowers, Benefits Supervisor Kim Gearheart, Benefits Technician Retired employee & BCARE: Margaret Ursin Others present: Members of the Public 2. ADOPTION OF AUGUST 18, 2020 AGENDA SUMMARY REPORT A motion to receive and file the Personnel Committee’s August 18, 2020 Agenda Summary Report was approved. /s/ Chris Huot DRAFT ________________________________________________________________ S:\Council Committees\2021\Personnel\05_May\May 18 ASR.docx Page 2 CH:mc 3. PUBLIC STATEMENTS There were no public statements. 4. NEW BUSINESS A. CalPERS Cost Projection and Other Post Employment Benefit Status Update – Huot/McKeegan Assistant City Manager Huot introduced Finance Director McKeegan who provided an overview of the City’s CalPERS cost projections including the current pension plans, actuarial reports, long range financial model, and other post-employment benefits by way of a PowerPoint presentation in response to inquiries made by several Council Members during their March 17, 2021 City Council meeting. Key points of his report are: CalPERS nation’s largest public pension fund with 2 million participants o 31% State members, 31% Public agency members, 38% School members As of June 30, 2020, CalPERS is 70.6% funded (assuming a 7% discount rate) Local Pension Reform – Measure D approved by voters in November 2010 o Affected Public Safety Employees hired after January 1, 2011 o Reduced maximum benefits formula & o Eliminated employer paid member contributions (EPMC) State Public Employee Pension Reform Act (PEPRA) o Affected employees hired after January 1, 2013 o Reduced maximum benefits formula and pensionable compensation o 50% of normal cost covered by employee o Eliminated EPMC o Final compensation based on highest 36 consecutive months Three pension plans with different tiers and formulas o Miscellaneous Unit 3% at age 60 for employees hired before 08/20/2008 2.7% at age 55 for employees hired after 08/20/2008 but before 1/1/2013 2% at age 62 for PEPRA employees hired after 1/1/2013 o Fire Unit 3% at age 50 for employees hired before 1/1/2011 2% at age 50 for Measure D employees hired after 1/1/2011 but before 1/1/2013 2.7 at age 57 for PEPRA employees hired after 1/1/2013 o Police Unit 3% at age 50 for employees hired before 1/1/2011 2% at age 50 for Measure D employees hired after 1/1/2011 but before 1/1/2013 2.7% at age 57 for PEPRA employees hired after 1/1/2013 2021 Actuarial Reports total accrued liability total $1.44 billion as of 06/30/2019 o $465.8 million unfunded liability Hypothetical Termination Liability to Exit CalPERS o Based on Treasury Yield discount rate of 2-3% Long Range Fiscal Model improves projections of costs out to FY 2040 o Includes multiple scenarios (i.e. discount rates & investment returns) o Includes calculations for vacancies & reduction of EMPC DRAFT ________________________________________________________________ S:\Council Committees\2021\Personnel\05_May\May 18 ASR.docx Page 3 CH:mc Additional Funding Options o Section 115 Trust (Pension Rate Stabilization Fund) Other Paid Employer Benefits o Retiree Medical Liability – 42% subsidy of PPO premium Program closed to employees hired after 2006 757 retirees receiving benefit; 513 active employees eligible upon retirement City Manager Clegg added that the new Long Range Fiscal Model will assist the city in projecting future costs associated with additional positions to the City’s compliment. Committee Chair Weir asked staff to provide further information regarding the OPED liability increases between 2014 and 2016. Committee member Gray made a motion to receive and file the report. The motion was unanimously approved. 5. COMMITTEE COMMENTS There were no comments. 6. ADJOURNMENT The meeting was adjourned at 1:20 pm DRAFT Documents Presented At The Personnel Committee September 16, 2021 Meeting © 2021 by The Segal Group, Inc. Personnel Committee City of Bakersfield September 16, 2021 Calendar Year 2022 Renewal 2 Executive Summary 2022 Plan Renewal Overview 2022 Renewal Rate Summary Appendix │Agenda 3 Due to mixed experience from the Blue Shield and Kaiser plans, renewals increased slightly for 2022. •After negotiations, the following carriers agreed to reduce overall premiums: o Blue Shield reduced its overall annual premium by $441,000. o Unum reduced its overall annual premium by $7,500. The City’s 2022 overall budget cost for active employee benefits increased by $134,500 or 0.8% overall, based on current enrollment and an 80% City contribution level. The 2022 overall cost for retiree benefits decreased slightly by $2,400 or 0.03% overall based on current enrollment. The City’s renewal experience fluctuates from year to year Executive Summary 4 │2022 Plan Renewal Overview 5 Carrier Rate Action by Plan Comments Blue Shield •HMO/Trio HMO: 6.50% Increase •PPO (Actives): 2.20%Increase•PPO (Retirees): No Change •Medicare HMO: 8.31% Increase •HMO and PPO rate increases due to high trend factors and COVID utilization adjustments•After negotiations, concession resulted in projected annual premium savings of ($441,000) Kaiser •HMO (Active):5.00% Decrease •Deductible HMO Mid (Active): 5.00% Decrease•Deductible HMO Low (Active): 5.00% Decrease •HMO (Non-Medicare Retiree): No Change •Deductible HMO Low (Non-Medicare Retiree): No Change •Senior Advantage (Medicare Retiree): 4.29% Decrease •Active rate decreases due to lower utilization in all major service categories•Non-Medicare Retiree plans currently have no enrollment UCCI •DPPO: No Change •DHMO: No Change •Rates are guaranteed through December 31, 2022 •As a result of Segal negotiations, UCCI provided a rate cap of 3% for the 2023 plan year MESVision •PPO:No Change•HMO: No Change •Rates are guaranteed through December 31, 2024 Voya •Basic Life: No Change •Basic AD&D: No Change •Supplemental Life: No Change •Supplemental AD&D: No Change •Proposed rates are guaranteed through December 31, 2023 Optum •EAP: No Change •Proposed rates through December 31, 2022 P&A Group •Section 125 Flexible Benefits: 25.00% Decrease •As a result of an RFP, P&A lowered its rate due to competitive pressure Unum •Long-Term Disability: No change •Rates are guaranteed through December 31, 2022 •After negotiations, concession resulted in projected annual premium savings of $7,500 2022 Plan Renewal Overview 6 2022 Annual Premiums City Contribution at 80% The projections of annual premium in this report are estimates of future costs and are based on information available to The Segal Company at the time the projections were made. The Segal Company has not audited the information provided. Projections are not a guarantee of future results. Actual experience may differ due to, but not limited to, such variables as changes in the regulatory environment, local market pressure, health trend rates and claims volatility. The accuracy and reliability of health projections decrease as the projection period increases. Active Plan Enrollment Current City Contribution at 80%2022 City Contribution at 80%Annual Change Percentage Change Blue Shield Full HMO 164 $2,068,200 $2,202,600 $134,400 6.5% Narrow HMO 84 $903,700 $962,500 $58,800 6.5% PPO 616 $8,455,400 $8,641,500 $186,100 2.2% Subtotal 864 $11,427,300 $11,806,600 $379,300 3.3% Kaiser HMO 481 $4,611,000 $4,380,400 -$230,600 -5.0% HDHP Mid 7 $45,500 $43,200 -$2,300 -5.1% HDHP Low 47 $236,900 $225,000 -$11,900 -5.0% Subtotal 535 $4,893,400 $4,648,600 -$244,800 -5.0% United Concordia (1) HMO 367 $150,700 $150,700 $0 0.0% PPO 1,070 $1,032,900 $1,032,900 $0 0.0% Subtotal 1,437 $1,183,600 $1,183,600 $0 0.0% MES Vision (2) HMO 780 $33,100 $33,100 $0 0.0% PPO 610 $40,700 $40,700 $0 0.0% Subtotal 1,390 $73,800 $73,800 $0 0.0% Total Medical, Dental, Vision (3)$17,578,100 $17,712,600 $134,500 0.8% (1) United Concordia agreed to a not-to-exceed rate increase of 3% for the HMO and PPO plans for the 2023 plan year. (2) MES Vision rates are guaranteed through December 31, 2024. (3) Voya Life and AD&D, Optum EAP, Unum LTD and P&A Group are not included above. 7 2022 Annual Premiums Retirees Retiree Plan Enrollment Current Annual Premium 2022Annual Premium Annual Change Percentage Change Blue Shield PPO 419 $7,091,000 $7,091,000 $0 0.0% Medicare Advantage 40 $157,400 $170,500 $13,100 8.3% Subtotal 459 $7,248,400 $7,261,500 $13,100 0.2% Kaiser HMO 0 $0 $0 $0 N/A HDHP Low 0 $0 $0 $0 N/A Senior Advantage 138 $361,300 $345,800 -$15,500 -4.3% Subtotal 138 $361,300 $345,800 -$15,500 -4.3% United Concordia (1) HMO 223 $61,100 $61,100 $0 0.0% MES Vision (2), (3) HMO 0 $0 $0 $0 N/A Total Premiums $7,670,800 $7,668,400 -$2,400 0.0% (1) United Concordia agreed to a not-to-exceed rate increase of 3% for the HMO and PPO plans for the 2023 plan year. (2)Vision plan is bundled with the Non-Medicare Kaiser plan, which has no enrollment. (3)MES Vision rates are guaranteed through December 31, 2024. 8 │2022 Renewal Rate Summary 9 2022 Monthly Medical Rate Summary Blue Shield of California Blue Shield -Access+ HMO (Full Network) Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 49 $587.89 $626.10 6.50%$500.88 $125.22 $30.57 $7.64 Two-Party 22 $1,181.54 $1,258.34 6.50%$1,006.67 $251.67 $61.44 $15.36 Family 93 $1,727.30 $1,839.57 6.50%$1,471.66 $367.91 $89.82 $22.45 COBRA/Cal-COBRA Single 1 $587.89 $626.10 6.50% No City ContributionTwo-Party 0 $1,181.54 $1,258.34 6.50% Family 0 $1,727.30 $1,839.57 6.50% Blue Shield -Trio ACO HMO (Narrow Network) Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 15 $479.37 $510.53 6.50%$408.42 $102.11 $24.93 $6.23 Two-Party 23 $963.44 $1,026.06 6.50%$820.85 $205.21 $50.10 $12.52 Family 46 $1,408.48 $1,500.03 6.50%$1,200.02 $300.01 $73.24 $18.31 COBRA/Cal-COBRA Single 0 $479.37 $510.53 6.50% No City ContributionTwo-Party 1 $963.44 $1,026.06 6.50% Family 1 $1,408.48 $1,500.03 6.50% 10 2022 Monthly Medical Rate Summary Blue Shield of California Blue Shield -PPO Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 167 $627.83 $641.64 2.20%$513.31 $128.33 $11.05 $2.76 Two-Party 115 $1,257.81 $1,285.48 2.20%$1,028.38 $257.10 $22.14 $5.53 Family 334 $1,890.06 $1,931.64 2.20%$1,545.31 $386.33 $33.26 $8.32 COBRA/Cal-COBRA Single 2 $627.83 $641.64 2.20% No City ContributionTwo-Party 0 $1,257.81 $1,285.48 2.20% Family 0 $1,890.06 $1,931.64 2.20% Retiree Single 284 $1,051.48 $1,051.48 0.00% VariesTwo-Party 127 $2,102.83 $2,102.83 0.00% Family 8 $3,154.27 $3,154.27 0.00% Blue Shield -Medicare Advantage Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Over 65 Retiree VariesSingle40$327.87 $355.11 8.31% 11 2022 Monthly Medical Rate Summary Kaiser Kaiser Permanente -HMO Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 147 $458.21 $435.30 -5.00%$348.24 $87.06 ($18.33)($4.58) Two-Party 53 $916.42 $870.60 -5.00%$696.48 $174.12 ($36.66)($9.16) Family 281 $1,296.73 $1,231.89 -5.00%$985.51 $246.38 ($51.87)($12.97) COBRA Single 1 $458.21 $435.30 -5.00% No City ContributionTwo-Party 0 $916.42 $870.60 -5.00% Family 0 $1,296.73 $1,231.89 -5.00% Under 65 Retiree Single 0 $1,647.01 $1,647.01 0.00% VariesTwo-Party 0 $3,294.03 $3,294.03 0.00% Family 0 $4,661.05 $4,661.05 0.00% Kaiser Permanente -Deductible HMO Middle Plan ($20 Copay) Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 4 $406.43 $386.11 -5.00%$308.89 $77.22 ($16.26)($4.06) Two-Party 1 $812.86 $772.22 -5.00%$617.78 $154.44 ($32.51)($8.13) Family 2 $1,150.19 $1,092.69 -5.00%$874.15 $218.54 ($46.00)($11.50) COBRA Single 0 $406.43 $386.11 -5.00% No City ContributionTwo-Party 0 $812.86 $772.22 -5.00% Family 0 $1,150.19 $1,092.69 -5.00% 12 2022 Monthly Medical Rate Summary Kaiser Kaiser Permanente -Deductible HMO ($30 Copay) Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 27 $310.57 $295.04 -5.00%$236.03 $59.01 ($12.42)($3.11) Two-Party 5 $621.13 $590.08 -5.00%$472.06 $118.02 ($24.84)($6.21) Family 15 $878.93 $834.99 -5.00%$667.99 $167.00 ($35.15)($8.79) COBRA Single 0 $310.57 $295.04 -5.00% No City ContributionTwo-Party 0 $621.13 $590.08 -5.00% Family 0 $878.93 $834.99 -5.00% Under 65 Retiree Single 0 $1,421.65 $1,421.65 0.00% VariesTwo-Party 0 $2,843.29 $2,843.29 0.00% Family 0 $4,023.25 $4,023.25 0.00% Kaiser Permanente -Senior Advantage Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Over 65 Retiree VariesSingle138$218.20 $208.84 -4.29% 13 2022 Monthly Dental Rate Summary United Concordia (UCCI) United Concordia (UCCI) -Dental HMO Enrollment 2021 Rates 2022 Rates (1)Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 123 $20.75 $20.75 0.00%$16.60 $4.15 $0.00 $0.00 Two-Party 68 $38.05 $38.05 0.00%$30.44 $7.61 $0.00 $0.00 Family 176 $60.00 $60.00 0.00%$48.00 $12.00 $0.00 $0.00 COBRA Single 1 $20.75 $20.75 0.00% No City ContributionTwo-Party 1 $38.05 $38.05 0.00% Family 6 $60.00 $60.00 0.00% Retiree Single 113 $15.85 $15.85 0.00% No City ContributionTwo-Party 102 $28.85 $28.85 0.00% Family 8 $44.60 $44.60 0.00% United Concordia (UCCI) -Dental PPO Enrollment 2021 Rates 2022 Rates (1)Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 276 $39.63 $39.63 0.00%$31.70 $7.93 $0.00 $0.00 Two-Party 206 $81.49 $81.49 0.00%$65.19 $16.30 $0.00 $0.00 Family 588 $135.84 $135.84 0.00%$108.67 $27.17 $0.00 $0.00 COBRA Single 7 $39.63 $39.63 0.00% No City ContributionTwo-Party 9 $81.49 $81.49 0.00% Family 0 $135.84 $135.84 0.00% (1) United Concordia agreed to a not-to-exceed rate increase of 3% for the HMO and PPO plans for the 2023 plan year. 14 2022 Monthly Vision Rate Summary MES Vision Note: Rates are guaranteed through December 31, 2024. Medical Eye Services (MES) -Vision HMO Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 248 $2.30 $2.30 0.00%$1.84 $0.46 $0.00 $0.00 Two-Party 152 $4.14 $4.14 0.00%$3.31 $0.83 $0.00 $0.00 Family 380 $5.93 $5.93 0.00%$4.74 $1.19 $0.00 $0.00 COBRA Single 2 $2.30 $2.30 0.00% No City ContributionTwo-Party 2 $4.14 $4.14 0.00% Family 3 $5.93 $5.93 0.00% Retiree Single 0 $2.30 $2.30 0.00% VariesTwo-Party 0 $4.14 $4.14 0.00% Family 0 $5.93 $5.93 0.00% Medical Eye Services (MES) -Vision PPO Enrollment 2021 Rates 2022 Rates Percentage Change 2022 City Contribution 2022 Employee Contribution 2022 City Contribution Change 2022 Employee Contribution Change Active Single 169 $3.40 $3.40 0.00%$2.72 $0.68 $0.00 $0.00 Two-Party 114 $6.80 $6.80 0.00%$5.44 $1.36 $0.00 $0.00 Family 327 $8.84 $8.84 0.00%$7.07 $1.77 $0.00 $0.00 COBRA Single 3 $3.40 $3.40 0.00% No City ContributionTwo-Party 6 $6.80 $6.80 0.00% Family 1 $8.84 $8.84 0.00% 15 2022 Monthly Life and AD&D Rate Summary Voya Voya -Life and AD&D Insurance (Rate per $1,000) 2021 Rates 2022 Rates Percent Change City Costs Basic Life $0.130 $0.130 0.00% Basic AD&D $0.020 $0.020 0.00% Voluntary Employee Costs Supplemental Life (Employee and Spouse) <30 $0.070 $0.070 0.00% 30-34 $0.100 $0.100 0.00% 35-39 $0.120 $0.120 0.00% 40-44 $0.180 $0.180 0.00% 45-49 $0.270 $0.270 0.00% 50-54 $0.440 $0.440 0.00% 55-59 $0.760 $0.760 0.00% 60-64 $1.170 $1.170 0.00% 65-69 $2.260 $2.260 0.00% 70-74 $3.660 $3.660 0.00% 75+$3.660 $3.660 0.00% Supplemental Dependent Life $0.200 $0.200 0.00% Supplemental AD&D Subscriber Only $0.050 $0.050 0.00% Family $0.080 $0.080 0.00% 16 2022 EAP, Flexible Benefits, and LTD Summary Optum, P&A Group, and Unum Optum -EAP 2021 Rates 2022 Rate Percentage Change Active $1.74 $1.74 0.00% P&A Group -Section 125 Flexible Benefits 2021 Rates 2022 Rate Percentage Change FSA and/or DCAP $4.00 $3.00 -25.00% Unum -Long Term Disability (Rate per $100) 2021 Rate 2022 Rate Percentage Change Long Term Disability $0.60 $0.60 0.00% 17 │Appendix 18 Executive Summary -Historical Medical Rates Active Plan Rate Action 1 Kaiser DHMO Mid plan was implemented in the 2020 calendar year. 9.6% -5.0% 4.0% -5.0%-5.0% -0.3% -5.0%-5.0%-5.0% 1.6% -5.0% 2.8% -5.0%-5.0% -2.1% 7.4% -2.7% 14.3% -5.1% 2.2%3.2% 1.1% -0.2%0.0% 3.5% 6.5% 2.2% 6.8% -0.2%0.0% 3.5% 6.5% 3.3% -10.0% -5.0% 0.0% 5.0% 10.0% 15.0% 20.0% 2018 2019 2020 2021 2022 Average Kaiser HMO Kaiser DHMO Mid ¹Kaiser DHMO Low Blue Shield PPO Blue Shield Full HMO Blue Shield Narrow HMO 19 Executive Summary -Historical Medical Rates Non-Medicare Advantage Retiree Rate Action 15.0%15.0% 0.0%0.0%0.0% 6.0% 15.0%15.0% 0.0%0.0%0.0% 6.0% 2.4%2.1% 0.9% -5.0% 0.0%0.1% -10.0% -5.0% 0.0% 5.0% 10.0% 15.0% 20.0% 2018 2019 2020 2021 2022 Average Kaiser HMO Kaiser DHMO Low Blue Shield PPO 20 Executive Summary -Historical Medical Rates Medicare Retiree Rate Action 7.2% 2.3%2.3% -9.2% -4.3% -0.3% 11.5% -21.2% 9.3% 4.4% 8.3% 2.4% -25.0% -20.0% -15.0% -10.0% -5.0% 0.0% 5.0% 10.0% 15.0% 2018 2019 2020 2021 2022 Average Kaiser Senior Advantage Blue Shield Medicare Advantage 21 Principle Causes of Rate Change Blue Shield of California, Kaiser, and UCCI Carrier Rate Change Factors Blue Shield of California (HMO Plans) •Medical claims increased by 146.4% •Pharmacy claims decreased by 3.8% •Capitations increased by 5.0% •Claims experience accounts for 50% of rate development •2 members reached the pooling point of $200,000 Blue Shield of California (Active PPO Plan) •Medical claims increased by 8.7% •Pharmacy claims increased by 24.3% •3 member reached the pooling point of $200,000 Blue Shield of California (Retiree PPO Plan) •Medical claims increased by 1.7% •Pharmacy claims decreased by 16.5% •1 member reached the pooling point of $200,000 Kaiser (Active Plans)•Paid Claims decreased by 17.2% •Pooling Charge increased by 9.0% •No members reached pooling point of $235,000 UCCI DPPO •Rate pass proposed due to historical claim uncertainty because of COVID impacted months and the competitive pressure in the dental insurance market