Insurance Benefits City Information

Thanks to Janet Frieman for attending city meetings regarding insurance benefits and for providing these notes to share:

City of Kenosha Health Ins Mtg 7/12/18

Subject:  Pharmacy and

   Potential changes in 2019

The City is recognizing the rising costs of using UHC which is currently the highest in the area.  It is also notoriously difficult to get any transparent data reports from UHC in order to manage costs.  One of the changes that UHC wants to mandate is an annual physical through a physician instead of using the HRA in order to not be charged the 5%.

Johnson Insurance is the city broker and is working on an August timeline and will be

negotiating with Humana, UHC, Aurora Anthem, Blue Cross-Blue Shield, Froedtert and get proposals. Aurora is actively looking for a relationship with the City.

Hopefully a report will be available by mid-September.

Pharmacy facts:

$2.3 million dollars spent on drugs annually

Currently there is about an 80% use of generics

OptimRX negotiates drug costs

Active negotiations are ongoing to separate from OptimRX through our PBM (pharmacy benefit manager).  The City also has difficulty getting transparent reports from OptimRX to manage costs.

The City and Johnson Ins are exploring Navitus out of Appleton which is a growing company that strives for transparency.

This would reflect a 20 to 30 percent possible savings which would reduce costs to city’s overall plan (a couple of hundred thousand dollar savings).

One way to save money is the use of rebates.

City will negotiate with them directly in August

One “drawback” is they don’t have an app like UHC, but customer service is a high priority.

There would be a separate card from Navitus for use at pharmacy.

The subject of dental was brought up:  In 2019 it will still probably continue to be Dental Associates but maybe get a quote from Delta Dental will be explored.  There have been many complaints from staff who do not like to go the Dental Associates.

One suggestion from a participant:  100 % coverage if using Dental Associates,

or if an employee wants to use their own private dentist, they would pay a premium.

Steve will ask Johnson to explore this to keep the budget at $600,000.

FYI: The City has explored the option of part-time employees being able to purchase insurance through the city at a reduced cost.  But hiring more full-time may be a better benefit for the City in the long run.

Again, all these conversations at these meetings are purely speculative.  Steve wants to exercise due diligence in making sure all suggestions and negotiations are transparent.

Next meeting:  to be scheduled

Re: List of preventatives and statistics for the clinic