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Home My WebLink About11/27/2007• B A K E R S F I E L D Staff: John W. Stinson Assistant City Manager City Council members: Harold Hanson, Chair David Couch Ken Weir SPECIAL MEETING NOTICE PERSONNEL COMMITTEE of the City Council -City of Bakersfield Tuesday, November 27, 2007 3:00 p.m. City Manager's Conference Room, Suite 201 Second Floor, City Hall, 1501 Truxtun Avenue, Bakersfield, CA AGENDA 1. ROLL CALL 2. ADOPT OCTOBER 31, 2007 AGENDA SUMMARY REPORT 3. PUBLIC STATEMENTS 4. DEFERRED BUSINESS A. Discussion regarding Medical Insurance Renewals -Lozano, Stinson 5. COMMITTEE COMMENTS 6. ADJOURNMENT ~.~ Dft,RFT B A K E R S F I E L D ~ Harold Hanson, Chair Staff: John W. Stinson David Couch Assistant City Manager Ken Weir AGENDA SUMMARY REPORT SPECIAL MEETING of the PERSONNEL COMMITTEE Wednesday, October 31, 2007 1:00 p.m. City Manager's Conference Room 1501 Truxtun Avenue Bakersfield, California 93301 1. ROLL CALL Called to Order at 1:03:29 PM Committee members present: Councilmember Harold Hanson, Chair Councilmember David Couch Councilmember Ken Weir Staff present: John W. Stinson, Assistant City Manager Rhonda Smiley, Assistant to the City Manager Rick Kirkwood, Management Assistant -City Manager's Office Steven Teglia, Administrative Analyst -City Manager's Office Virginia Gennaro, City Attorney Javier Lozano, Human Resources Manager Ginger Rubin, Benefits Clerk Pamela McCarthy, City Clerk Nelson Smith, Finance Director Sandra Jiminez, Assistant Finance Director Ron Fraze, Fire Chief John Patterson, Maintenance Craftworker -Bakersfield Fire Department Bill Macauley, Firefighter -Bakersfield Fire Department Scott Monroe, Engineer -Bakersfield Fire Department Derek Tisinger, Engineer -Bakersfield Fire Department Bryan Perry, Captain -Bakersfield Fire Department Brian West, Detective -Bakersfield Police Department Brad Underwood, Operations Manager- Public Works Department Sam Russell, Communications Technician -Public Works Department Retired employees: Margaret Ursin and Gene Bogart Others: Jim Summers and Vivian Nuedeck, Buck Consultants Chuck Waide, SEIU Local 521 Miscellaneous members of the media 2. ADOPT SEPTEMBER 4, 2007 AGENDA SUMMARY REPORT I~RAF Adopted as submitted 3. PUBLIC STATEMENTS Bryan Perry with the Bakersfield .Fire Department asked for assistance with insurance issues surrounding a family member's illness. This matter was referred to staff for follow-up. 4. DEFERRED BUSINESS A. Discussion regarding Educational Incentive Program -Lozano, Stinson Committee Chair Hanson requested that this item be brought back for further discussion. Information was distributed. Staff requested guidance from the Committee. City Attorney Gennaro pointed out a concern on page 2, 4th bullet, regarding the employee signing a pledge note. It may cause tax consequences for the employee if they were to sign the pledge note and then have it forgiven. It would then become taxable income and no longer a benefit. In response to a question by Committee Chair Hanson, Assistant City Manager Stinson reported that, as an example, in 2003, 113 employees participated, 2 of whom left the City's employment. It varies from year to year, but it is a small number. Human Resources Manager Lozano reported that training costs outweigh retention and recruitment costs. Committee member Weir indicated that the Committee and staff have taken all the steps to limit exposure and still provide a valuable benefit. He does not want the employee to incur the tax consequence. Committee member Couch stated that having the employee sign a pledge note would provide an incentive for that employee to stay employed with the City. The Committee voted two to one to move forward with the program as proposed by staff, with the deletion of the 4th and 5th bullets, which contain the reference to the pledge note. 5. NEW BUSINESS A. Discussion regarding Medical Insurance Renewals -Lozano, Stinson Chuck Waide with SEIU Local 521 stated that the process, which has worked well in the past, has been for all bargaining units to meet throughout the year as an Insurance Committee to receive preliminary information on medical insurance from consultants and provide subsequent recommendations to the Council. During the past year, the only time a meeting was held was to meet the new Human Resource Manager. No data was received regarding insurance. There is a contractual requirement to meet and confer in good faith to reach an agreement prior to October 31St, and that has not occurred. He requested that the Personnel Committee make an immediate recommendation to the City Council that they terminate the contract with Buck S:\Council Committees\2007\07 Personnel\October 31\October 31 ASR.doc Page 2 DRAFT Consultants and find a new group to assist with the insurance. He further stated that this is a charge for unfair labor practice. Retiree Margaret Ursin agreed with Mr. Waide's statements regarding the process. She has received numerous calls from retirees asking about the new rates and when open enrollment will take place. There is concern that there will not be enough time to consider the options and make the appropriate decisions about health care. Firefighter Scott Monroe also agreed with Mr. Waide's statements regarding the process. He has been on the Committee since 1991 and has never seen it run this way before. He also is concerned about the time in which employees will have to make educated decisions about health care. Human Resources Manager Lozano stated that he is now responsible for the process and that Buck Consultants has performed well. This is an opportunity for both the Personnel and Insurance Committees to share the preliminary findings as provided by Buck Consultants. Assistant City Manager Stinson said that staff is not asking for a decision at this time and that Insurance Committee meetings are being scheduled. City Attorney Gennaro stated for the record that what Mr. Lozano indicated was not an unfair labor practice. Jim Summers and Vivian Nuedeck with Buck Consultants gave a presentation regarding the 2008 insurance renewal results which are based on current plan trends as provided by all medical insurance carriers. Hard copies of the presentation were distributed. Plan design change scenarios were detailed and recommendations made for the City to consider. The information also included the GASB 45 liability and cost related to post-retirement benefits. Blue Cross: The recommended rate increase for active employees enrolled in the PPO Plan is 20.2%. The large increase is due to a high utilization of emergency rooms. Retired employees in this plan would have no increase in rates. A 0.9% increase is recommended for the HMO plan in which active employees are enrolled. Retired employees enrolled in this plan would see a 19.4% increase. This large increase is due to the typical large claims as filed by seniors, such as those related to heart condition, respiratory ailments, and conditions directly related to obesity. The year 2008 is year 3 of a 5-year plan to unblend rates between active and retired employees. The Retiree Senior Secure Plan is the Medicare supplement associated with Blue Cross called Medicare Plus Choice. There is no increase recommended for the Vision or Dental plans. Kaiser: The recommended rate increase is 11.9% for active employees and 56.7% for retired employees. The large increase for retirees is due to 2008 being the first year in a three-year plan to unblend rates between active and retired employees. Additionally, Kaiser stated that they are now automated and can more accurately track claims. DRAFT S:\Council Committees\2007\07 Personnel\October 31\October 31 ASR.doc Page 3 The recommended increase for the Senior Advantage Plan is 44.6%. The 2007 premium was a mistake by Kaiser by decreasing the rates by 15.7% instead of increasing it by 22.0%. The 2008 rate does not attempt to recover those funds. Other benefit plans: • There is no increase recommended for Dedicated Dental. • Pacific Dental HMO rates are based on a two-year rate guarantee. Rate increases are recommended at 6.0% for active employees and 4.0% for retired employees. • There is no increase recommended for Medical Eye Services, and that is a two-year guaranteed rate. • Life and disability plans are not up for renewal until 2010. Overall, active employees have a proposed increase of 11.7%, and retired employees 11.6%. The annual cost in 2008 and 2007 are based on the same work population numbers, not a growth in the census. Premiums for active employees are paid 80.0% by the City and 20.0% by the employee. Retired employee rates are based on a formula according to years of service. Last year, the consultants and staff the health plans and the decision was made to stay with Blue Cross. Some plan change scenarios were discussed, which included raising deductibles and increasing co-payments. They are included in the materials presented by the Health Care Consultants. Mr. Monroe inquired about which cities were surveyed. Both he and John Patterson of the Fire Department cited a City resolution that defines which cities can be surveyed. According to Mr. Summers and Ms. Nuedeck of Buck Consultants, no cities were surveyed. The analysis was the result of data provided by all insurance carriers nationwide. Comparing cities will not give an accurate picture as trends fluctuate from city to city due to differing populations, utilization, and provider reimbursements, among other variables. GAS B 45: As of July 1, 2007, the post-retirement medical liability must now be measured by employers who are subsidizing retiree premiums. Buck Consultants summarized the results of the July 2007 actuarial report and provided regarding a possible rate cap on City subsidy of retiree medical premiums. Human Resources Manager Lozano is expecting to call a meeting of the Insurance Committee on November 14, 2007. According to Benefits Technician Ginger Rubin, the City Council must approve the contracts before open enrollment can be held. Should the process extend into 2008, the rates will still increase although the benefits will not change. Assistant City Manager Stinson stated that there were concerns in the past that decisions were being made before the Personnel Committee saw the information. Staff attempted this year to provide the information to ail parties at the same time. Committee member Couch directed that staff be timelier next year. City Attorney Gennaro suggested tabling this issue until the next Personnel Committee meeting. S:\Council Committees\2007\07 Personnel\October 31\October 31 ASR.doc ~~ Page 4 Mr. Monroe stated for the record that since 1991, the Insurance Committee has always received information from the consultants earlier than November. There has not been a problem with the process until this year. 5. COMMITTEE COMMENTS None 6. ADJOURNMENT The meeting was adjourned at 2:50:49 PM cc: Honorable Mayor and City Council DRAFT S:\Council Committees\2007\07 Personnel\October 31\October 31 ASR.doc Page 5 City of Bakersfield -- Medical Rates Without Kaiser Proposed Renewal Increase Enrollment 2008 % Blue Cross Active Monthly Rates Prudent Buyer PPO EE 155 $ 426.2] EE+1 189. $ 853.84. Family 393 $ 1,282.99 Monthly Total 737 $ 731,653 Annual Total $ 8,779,839 20.2% pepm $ 992.75 Retiree Monthly Rates EE l12 $ 867.81 EE+1 52 ' $ >1,735:56 Family 1 $ 2,603.33: Monthly Total 165 $ 190,047 Annual Total $ 2,280,566 0.0% pepm $ 1,151.80 Blue Cross Active Monthly Rates CaliforniaCare HMO EE 213 $ 350.70 EE+1 163 $ 704.84 Family , 358 _ $ 1,030.40 .._ ,: :: Monthly Total 734 $ 558,471 Annual Total $ 6,701,650 0.9% pepm $ 760.86 Retiree Monthly Rates _ 1 < 65 79 $ 632.53 2 < 65 35 ' $ " 1,311.72 Family < 65 6 ;; $ 1,848.98 1 > 65 51 $ 385.21. 2 > 65 28 $ 774.48 Family > 65 2 $ 1,350.23 EE < 65/SP > 65 5 $ 1,021.80 EE > 65/SP < 65 2 $ 1,064.40 Monthly Total 208 $ 158,243 Annual Total $ 1,898,920 19.4% pepm $ 760.79 Blue Cross Senior Secure Monthly Rates Senior Secure EE 78 f $ '~' '- 280 99~ ~! ~ Monthly Total 78 _ $ 21,917 Annual Total $ 263,007 8.0% pepm $ 280.99 pepm 2008 Active pepm 877.04 Actives $ 15,481,489 1.0% Retiree pepm 820.86 Retirees $ 4,442,493 7.0% Total pepm . 863.86 Total $ 19,923,982 2.3% Active pepm increase 1.0% check $ 19,923,982 2.3% Retiree pepm increase 7.0% $ 446,235 Total pepm increase 2.3% if all go HMO dollar cost $ 2,782.63 annual additional cost per each former Kaiser going PPO City of Bakersfield -- Medical Rates Final Proposed Renewal Increase Renewal Increase Enrollment 2007 2008 % $ Blue Cross Active Monthly Rates Monthly Rates Prudent Buyer PPO EE 155 $ 354.64 $ 426.21 EE+1 189 $ 710.47 ' $ 853.84 Family 393 $ 1,067.43 $ 1,282.99 Monthly Total 737 $ 608,748 $ 731,653 Annual Total $ 7,304,980 $ 8,779,839 20.2% $ 1,474,859 pepm $ 825.98 $ 992.75 Retiree Monthly Rates Monthly Rates EE 132 $ 867.81 ~ $ 867:81 EE+l 5? $ 1,735.56 $ 1,735.56 Family . 1 , $ 2,603.33 ; $ 2,603.33 _. . Monthly Total 165 $ 190,047 $ 190,047 Annual Total $ 2,280,566 $ 2,280,566 0.0% $ pepm $ 1,151.80 $ 1,151.80 Blue Cross Active Monthly Rates Monthly Rates _ . . CaliforniaCare HMO EE 118. _. _ $ 347.51 $ 350.70 :. EE+1 96 $ 698.43 ' $ 704.84 Family 228 $ 1,021.04 $ 1,030.40 Monthly Total 442 $ 340,853 $ 343,978 Annual Total $ 4,090,232 $ 4,127,739 0.9% $ 37,507 pepm $ 771.16 $ 778.23 Retiree Monthly Rates Monthly Rates 1 < 65 27 ,_. $ 529.77 $ 632.53 3 <65 9 $ 1,098.61 ' $ 1,311.72 ' Family < 65 2 $ 1,548:60 $ 1,848.98 1 > 65 51 $ 3~?:63 $ 385.21 2 > 65 28 $ -648.66 $, 774.48 Family>65 2 .$ 1,130.88. $ 1,350.23' EE < 65/SP > 65 5 $ 855.80 $ 1,021.80 EE > 65/SP < 65 2 $ 891.47 $ 1,064.40 Monthly Total 126 $ 70,229 $ 83,851 Annual Total $ 842,745 $ 1,006,214 19.4% $ 163,468 pepm $ 557.37 $ 665.49 Blue Cross Senior Secure thly Rates Mo Monthly Rates Seuior Secure EE 35 n ~$ X60.18 ; ~$ _ _, X80 99:? Monthly Total 35 $ 9,106 $ 9,835 Annual Total $ 109,276 $ 118,016 8.Oo1o $ 8,740 pepm $ 260.18 $ 280.99 Kaiser HMO Active _ _ Monthly Rates _ _ _, Monthly Rates . _ .. - EE 95 $ 301:43 . $ 337.43 EE+1 67 $ 603.86: $ 674.86 Family _ 130 $ - _ 853.05 $ _ _ 954X43 Monthly Total 292 $ 179,924 $ 201,412 Annual Total $ 2,159,087 $ 2,416,941 11.9% $ 257,854.26 pepm $ 616.18 $ 689.77 Early Retiree Monthly Rates Monthly Rates EE 52 $ 301.43 ; ' $ 472:40 ' EE+1 26 $' 602.86 l $ s 944.80 Family 4 $ 853.05 . -,~ $ 1,336y89-. .. Monthly Total 82 $ 34,761 $ 54,477 Annual Total $ 417,131 $ 653,726 56.7' $ 236,595 pepm $ 423.91 $ 664.36 Senior Advantage ._~ __ _ . Medicaze Retiree 43" $ 126.94 , $ 183.54 2 Medicare 0 $ 253.88_ ! $ 367.08 1 Medicare/1 < 65 0 $ , 428.37 2 Medicaze/Dep < 65 0 $ 504.07 1 Medicaze/2 Dep <65 0 $ 678.56 ~ Monthly Total 43 $ 5,458 $ 7,892 Annual Total $ 65,501 $ 94,707 44.6% $ 29,206 pepm $ 126.94 $ 183.54 2008 Active pepm 868.15 Actives $ 13,554,299 $ 15,324,519 13.1% $ 1,770,220 Retiree pepm 767.41 Retirees $ 3,715,219 $ 4,153,228 11.8% $ 438,009 Total pepm 844.51 Total $ 17,369,518 $ 19,477,747 12.8% $ 2,208,230 check $ 17,269,518 $ 19,477,747 12.8% $ 2,208,230 Additional Trend Information Buck Health Trend Survey Second Half 2007 PPO HMO National Result 10.7% 11.1 California Specific Result 10.7% 10.1 Data: Blue Shield of CA and United Healthcare - CA Kaiser Family Foundation Employer Health Benefits Survey 2007 (not Kaiser Permanente) Average Premium Year Increase PPO HMO West Government 2001 10.9% 11.6% 10.4% 10.4% 9.6% 2002 12.9% 12.7% 13.5% 13.1 % 13.2% 2003 13.9% 13.7% 15.2% 16.3% 12.8% 2004 11.2% 10.9% 12.0% 12.1 % 10.9% 2005 9.2% 9.4% 9.4% 7.9% 8.7% 2006 7.7% 7.3% 8.6% 7.2% 7.6% 2007 6.1 % 5.3% 8.3% 5.6% 6.6% How Deductible Leveraging Impacts Rate Increases This Year's Claim $275 less deductible -250 $25 at 90% coinsurance $22.50 Insurer's claim cost this year With 10% medical inflation annually Next Year's Claim $302.50 less deductible -250 $52.50 at 90% coinsurance $47.25 Insurer's claim cost next year increase 110% in year over year insurer's claim cost If the first year claim had been $400, the leveraged increase would be 26.7%. If the deductible amount is not increased with trend each year, the cost of insurance is leveraged resulting in greater than trend premium increases, even when claims only increase at expected trend. This happens with copays as well, to a lesser degree. Buck Consultants, LLC November 21, 2007 t~ er u 7 G A ~ ~ _ ~„ a ~ ~ rn `~ ~ ~ C' ~ r ~ CV GV _ S ,. .- C 7 ciJ a -,„„ .~. ~ ~ V ~ ~ C ~ ~ ~r -. te o ~ L r~ e+~ u r-~ c~~i eq~4 cn r - ys t ~ .- r-- r r- r ~ "" cp Y L _ ,. ~ ..~ ~. w ,.. w. 1 \' ~ ~ ~} ~} tom' Q} ~ ~- 1th4C9 <5 ~ c ~ Fi f t ~y w•a ~ { 9to~ ~ rV e~~ , e( p ~ N3 ? C... ' '. ~O . ~ , r~{ t3 Efl ~_~ ~1 .~ :9 ~ ; M f j ~~ t~ 7 ~J - ~~ OOC NN ~ _ ~ . ~_~ fJ C~7C~J4 0~3 _ ~ ~ ~ ~ ~ ~ ~ DR Ti ~J - Z ~ iV ~ .~ C ~ 1 ~ Qt ~ 4 .. ~ L QT Q1 ~ .~ L N c d a " - a ' ti L ' ~ `-~ c. ~ c :~y ~ ~ ~ ~ ~ _ ~ ~ a .c`s ~ ~ t ~ c t '3 ttl '~ ~ ~ ~ C ~ _ -_ tiY ~. Ot " ~ 4 .~ _ t `.. C ~ °O ~. ~ ~ r _ - {~ t ~ r J 'J ~ ~ cas i { 6 t x ~~ r~~~~ ~. ~.. «~ i 7 s a t ~ a O ~ t '.., ] l~ ' _ .^ ~ 'J ev '~ ~ ~ of of !~ f r' 1 ~ y fif ~.. i (~ T ',.. ~i L W ~ ~ a~ C C C ~ ~ ~ 1 E ~ - ~ r ~- T. i~ ~ z~ ~~'' . c . ~ ~ ~- ~, ~- r C} ~ ~ ~ ~ ~~ ~ ~. =~ ~~.. `. ,.- i ._.I ui c m c~ m Documents related to the Special Meeting of the Personnel Committee November 27, 2007 CITY OF BAKERSFIELD Dental Benefits (Dental benefits not available to retirees) DEDICATED DENTAL PACIFIC UNION SYSTEMS DENTAL Annual Maximum Unlimited Unlimited Deductible None None Prophylaxis As needed, no charge No charge X-rays Full Mouth No charge Limit once in 2 years Amalgam No charge No charge Root Canal Therapy -One Canal No charge No charge Root Canal Therapy -four Canals No charge No charge Osseous Surgery per Quadrant No charge No charge Simple single extraction No charge No charge Gingivectomy per Quadrant No charge No charge Complete Upper Denture $55 copay $55 copay Limit once in 5 years Complete Lower Denture $55 copay $55 copay Limit once in 5 years Crown -Porcelain to Metal $45 copay $45 copay Limit once in 5 years General Anesthesia Not a benefit 50°x6 of UCR Orthodontia Must be referred by participating dentist Records $200 copay $200 copay Phase t -Child or Adult $525 copay $600 copay Phase II -Child or Adult $1,125 copay $1,200 copay Retainers $100 copay $100 copay These charts are informational only, please consult your benefit booklets/brochures for specific details. GR: P:Unwranq Z007NNS COMPARE CHART12007 GR.Canprbon Ch~rt~k 1N13/2008 CITY OF BAKERSFIELD Dental Benefice (Dental benefits not available to retirees) BLUE. CROSS PRUDENT BUYER Maximums Annual Maximum $2,500 Child Ortho Lifetime Maximum $1,500 Dentures One set every four years Deductible Individual $50 Two Party $100 Family $150 Preventative Services Visits and consultations 100% Diagnostic procedures including dental x-rays Deductible does not apply Prophylaxis, including scaling, polishing and to teeth cleaning and x-rays fluoride treatments twice a year Space maintainers Restorative Services Fillings Oral and dental surgery Crowns not attached to a bridge Endodontics, including pulpal therapy ~ root gp°~ canal fillings Periodontics, including procedures for treating gums and bones supporting the teeth Antibiotic injections Anesthesia Prosthodontic Services Preparation and installation of partial or full dentures gp°~ Crowns attached to a bridge Orthodontic Services Orthodontic appliances that move teeth or expand the arch 50% Photographs and tracings One case per lifetime Limited to dependent children to age 23 These charts are informational only, please consult your benefit booklets/brochures for specific details. GR: P:\Inwnna Z007YNS COMPARE CHART\2007 GR.Comp~riwn Chrtxk 10/13/Z006 CITY OF BAKERSFIELD Vision Benefits MEDICAL EYE SERVICES (MES) www.mesvision.com CALIFORNIA CARE and KAISER PERMANENTE Group #16269 BLUE CROSS. FEE FOR SERVICE Not available to Retirees Group #16270 (MES CLAIM FORM REQUIRED) (MES CLAIM FORM REQUIRED) (Not available to Retirees) Participating Non-Participating Participating Non-Participating Providers Providers Providers Providers Deductible None None None None Contact your medical Exam Paid in full group Paid in full $40 Maximum benefit One each 12 months Lenses Up to 61 mm eyesize Single Paid in full $30 Maximum benefit Paid in full $30 Maximum benefit Bifocal Paid in full $50 Maximum benefit Paid in full $50 Maximum benefit Trifocal Paid in full $65 Maximum benefit Paid in full $65 Maximum benefit Lenticular or Aphakic Paid in full $125 Maximum benefit Paid in full $125 Maximum benefit Contact lenses Medically Necessary Paid in full $250 Maximum benefit Paid in full $250 Maximum benefit Cosmetic or Convenience up to $100 $100 Maximum benefit up to $100 $100 Maximum benefit Frames (Standard) $60 Maximum bane $40 Maximum benefit $60 Maximum benefit $40 Maximum benefit Limitations Frames /Lenses Frames /Lenses Every 2 years Every 2 years Elm Comprehensive - 24 months Follow up- 12 month interval These charts are informational only, please consult your benefit booklets/brochures for specific details. GR: P:Ynwranee 2007UNS COMPARE CHART~200~ GR.Comp~rtwn ChMadc 10H3/2006 CITY OF BAKERSFIELD Mental Health Benefits PacifiCare Behavioral Health Mental Health/Substance Abuse Benefits for Employees ~ Retirees www.PBHLCOM Note: You must contact Pac~Care at 800.999-9585 for pre-approval of treatment In cases of emergency, you must contact PacltiCa-e wlthln 72 hours California Care & Fee For Service & Kaiser Permanente See PaciflCsro brochuro for further details MENTAL HEALTH BENEFIT Inpatient Deductible None Inpatient Per Admission Fee Same as Medical Plan Inpatient, Partial and Day Treatment 30 Days per calendar year • covered at 100% after an applicable admission fee " Days to be determine based on the following ratios: Impatient Treatment -1 Day Residential Treatment - 70 % of 1 Day Day Treatment - 60 % of 1 Day Outpatient Mental Health 3o visits $10 co-payment per visit CHEMICAL DEPENDENCY All levels of Chemical Dependency Care Includes Detox $15,000 Annual Maximum, $0 copay and covered at 100°~ $25,000 Lifetime Maximum SERIOUS MENTAL ILLNESS BENEFIT Inpatient Deductible None Inpatient Per Admission Fee Same as Medical Plan Inpatient, Partial and Day Treatment Unlimited days covered at 100%after applicable admission fee Annual Maximum Benefit for Inpatient Treatment None Outpatient Mental Health Treatment Unlimited Visits $10 co-payment per visit Lifetime Dollar Maximum for Parity Dfagnoeb: Applied to Meical Plan Itfetime dollar maximum benefit Pre Authorization is required for all Inpatient and Outpatient and Serious Mental Illness benefits. Serious Mental illness Diagnosis include: Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Major Depressive Disorder, Panic Disorder, Obsessive-Compulsive Disorder, Pervasive Developmental Disorders (Autism), Anorexia, Bulimia Nervosa, Severe Emotional Disturbances of Children (SED) These charts are informational only, please consult your benefits booklet/brochure for specific details. GR: P:11nw~ 2007~NS COMPARE CHART120W GR.Compariwn Ch~txb 1°N312008 COVERAGE FOR RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMIES A recently enacted federal law requires group health plans and insurers that provide coverage for mastectomies to also cover reconstructive surgery after a mastectomy, effective January 1, 1999. While our plan generally covers the services now mandated by the new law, we are required by the law to provide the following notice: Under Federal law, group health plans and health insurance insurers that provide medical and surgical benefits with respect to a mastectomy must, in the case of a covered individual who is receiving benefits in connection with a mastectomy, provide coverage for: * reconstruction of the breast on which the mastectomy has been performed; * surgery and reconstruction of the other breast to produce a symmetrical appearance; and * prostheses and physical complications in all stages of the mastectomy, including lymphedemas; in a manner determined in consultation with the attending physician and the patient. Such coverage may be subject to annual deductibles and coinsurance provisions as may be deemed appropriate and as are consistent with those established for other benefits under the plan or coverage. CITY OF BAKERSFIELD imealcal r senerlts ror vl itm to ees ana Ketirees ue roes California Care Kaiser Permanents Fee For Service In Network (PPO) ~% b Out of Network 60% Thera Speech -- Only covered if due No charge Inpatient: No charge In Network 90% to surgery, injury or disease (short term/60 day max Outpatient: $20 Copay Out of Network 60% per injury or illness) Physical Same as above Same as above ChirO ractlC In Network 90% Not covered Not covered Out of Network 60% $50 max benefit/visit; $750tyear max Durable iNedical E ui ment No charge No charge In Network 90% $2,000 max per year Out of Network 60% Other Acupuncture Not covered Not covered In Network 90% Out of Network 60% up to $500 Unreplaced Blood and Blood Products No charge No charge 90% Health Education Classes Offered by Medical Group Offered by Medical Group Not covered at little or no charge Hospice No charge No charge 80% Organ and Tissue Transplant No charge No charge Center of Expertise Exam, contact primary care Exam, contact primary care 100% "cye Care physician physician Eyewear Eyewear Eye Exam and Eyewear Covered by Medical Eye Covered by Medical Eye Covered by Medical Eye Service www.mesvision or Service www.mesvision or Service www.mesvision or corrtact your Benefits office corrtact your Benefits office contact your Benefits office for forms & information for forms 8 information for forms & information ~r@-Existin Conditions Yes. No payment will be None None made for treatment of a pre- existing condition during a 6 month period following your effective date, except pregnancy. May be waived with proof of creditable prior coverage. These charts are informational only, please consult your benefits booklet or brochure for specific details. ,w,srlooe ~ CITY OF BAKERSFIELD Medical Benefits for Citv Emfalovees and Retirees ue roes California Care Kaiser Permanents Fee For Service In Network (PPO) 90% 8 Out of Network 60% Dia nostic X-Ra $ Laborato In Network 90% )iagnostic X-Ray and No charge No charge Out of Network 60% ~boratory Servfces Prescri tion Dru s Formulary Brand or Generic $10/$20 copay )rugs (approved by the $10/$20 copay $10/$20 copay for generic/brand Food and Drug Administration for generiGbrand 30 day supply and prescribed by a physician) 30 day supply up to 100 day supply Limitations contact Maintenance Medication: After 2nd 30 day refill Member Services After 2nd 30 day refill Mail Order Refills Mail Order Refills Mandatory Mandatory Mail Order Program $10/$20 copay n/a $10/$20 copay 90 day supply 90 day supply Emer enc Care/Services $100 Copay 5100 Copay 5100 Copay (waived if admitted) (waived if admitted) (waived if admitted) Ambulance In Network 90% around Ambulance Services No charge $50 per trip Out of Network 60°~ (when medically necessary) Famil Plannin Sterilization $50 copay: Vasectomy $20 Copay In Network 90% $150 copay: Tubal Ligation Out of Network 60% nfertility Testing/Treatment 50% copay 50% copay Not covered contraceptive Devices/Ffitting No charge No charge Not covered Home Health Services in Network 90% Nedfcally necessary services No charge No charge Out of Network 6086 ~btafned through a licensed Ulimited visits (Limit; 100 visits/year) come Heaflth Agency; custodial care not covered) Skilled Nursin Services provided fin a licensed No charge No charge In Network 90% ~kilfled nuafng facility when (up to 1.00 days/year) (up to 100 days/year) Out of Network 60% nedically necessary; (Limit: 365 daystyear) :ustodial care not coverod These charts are informational only, please consult your benefits booklet or brochure for specific details. ~a~ae°°a ~ CITY OF BAKERSFIELD nnealcal ~ enerlts ror GI tm to ees ana rcetlrees ue rose California Care Kaiser Permanents Fee For Service In Network (PPO) ilf0% 8 Out of Network 60% Lifetime Maximum None None 000 $5 000 , ,. Deductible Individual None None $250.00 Two Party None None $500.00 Family None None $750.00 Carryover Provision None None Yes (last 3 months of calendar veer) Sto Loss Limit $1,500 Copay max single $1,500 Copay max single In Network $1,000 $ 3,000 Copay max family $ 3,000 Copay max family Out of Network $3,000 Hos ital INPATIENT $250 Copay $250 Copay 6260 Copay Room and board and all medically necessary services, In Network 90% including general nursing care (sll care must be referred by (all care mt~t be referred by Primary Out of Network 60% services, operating and special Primary Csre Provider 3 authorized Care Provider 8 authorized by the room fees, dlagnOBtIC X-fay by the Medical Group) Medical Group) and laboratory services OUTPATIENT ;20 Copay $20 Copay Physicians, Surgeons & Assistants In Network 90% Anesthesiology, Surgical room fee, (all care must be referred by Radiation and Chemotherapy Primary Care Provider & authorized Out Of Network 60% treatment, renal dialysis by the Medical Group) *Non-certification penalty: 25% penalty plus $250 deducctible if precertifii;ation is not obtained prior to admission Ph sician Care Ofi9ce/Home Visits $20 Copay $20 Copay In Network 90% Hospital physician No charge No charge Out of Network 60% Outpatient surgical center There is an ambuloatory surgical center deductible of $500 ff you use anon- participationg provider Allergy Testing/Treatment No charge No charge In Network 90% Immunization-influenza No charge (if approved by No charge Out of Network 60% Medical Group) Well Child Care $20 Copay (no charge for $20 Copay in Network 90% (including immunizations) immunizations) Out of Network 80% Wellness (annual physical exam, $20 Copay $20 Copay (Up to age 19) $50.00 Copay, no deductible papsmear, mammogram, prostate exam) ( subscriber and spouse only) These charts are informational only, please consult your benefits booklet or brochure for specific details. ,onarzoos Or n m m a H o' ~_ ~ O ~ 7 ~ D~ 7 ~ i ~ °0 3 ±v T - w ~,~ moo ~a~ O~ ~_. O~ ~c a OWE tic x m eao ~' f ° i'n 1 < ' ~ n < ~ w• ; O ~ ~ fA ~• a fl- ° °_ °~ o ~ ~ p m O of n O N C O C'1 ~~ D~ ~ ~ O O fA ~D ~ fl. -~ O c D ~ r ~ 0 0 N O O v n M W d N a 0 -a o' W v 0 0 N N N O O v cs 0 .. ~, ~ A w ~ m w> a X 0~1 X X W X X O W K y = ?' 0"t i ~ ~_ N ~ c a ~ a ~a "~_ `'~~~ on ~~ ~ ~ W ~ '~ 7C ~ N t~11 ~D d a SPECIAL MEETING OF THE PERSONNEL COMMITTEE Tuesday, November 27, 2007 ATTENDANCE LIST Name S Organization Contact: Phone/ E-mail 3 _ tJ ~, n'IGu~a ~ 0 7 /'3R > ~- ~v ~v ~ S i ~3 P~ 3 S :S ~ u-u~oo~ C~ ~u,c~ w~e.~ 3 ~ ~~~ ~i /b/ BPD 3~2 ~ c~~v -~ a ~"~ c s Ge l u 5 u ~~ ~, an ~ °l ~-- ~ ~Z C~ ~aS-9s a ~ ~ I~ /1~.~5~ ~ 3 Z~ - 7 `~~ ~ ~~ ~~ Q.r ~ tl z~ ~.~ ~'~. 3~' ~ ~1 LvLK ~t bLNCI ~ ~ 7~ r ~~ ~- O , Z -37 ~l .S a„~c,n 2 `~. G .~~Y7