Agenda Item

AGENDA STAFF REPORT

 

ASR Control 19-000919

 

MEETING DATE:

09/10/19

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

County Executive Office (Approved)

Department contact person(s):

Renee Catanzariti (714) 834-2564

 

 

Lauren Pierson (714) 834-5376

 

 

Subject: Approve Corrected Versions of the 2020 Self-Funded PPO Health Plan Documents

 

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Resolution to Form

Consent Calendar

 

 

3 Votes Board Majority

 

 

 

Budgeted: N/A

Current Year Cost: N/A

Annual Cost: N/A

 

 

 

Staffing Impact:

No

# of Positions:

Sole Source: N/A

Current Fiscal Year Revenue: N/A

Funding Source: N/A

County Audit in last 3 years: N/A

 

 

Prior Board Action: 06/04/2019 #41, 06/04/2019 #40, 08/22/2017 #51, 08/22/2017 #52

 

RECOMMENDED ACTION(S):

 

 

1.

Authorize the Chief Human Resource Officer or designee to approve the corrected versions of the third amended and restated Sharewell Choice and Sharewell Retiree Health plan documents effective January 1, 2020.

 

2.

Authorize the Chief Human Resource Officer or designee to approve the corrected versions of the fourth amended and restated Wellwise Choice and Wellwise Retiree Health plan documents effective January 1, 2020.

 

 

 

 

SUMMARY:

 

Approval of the corrected 2020 plan year Sharewell and Wellwise plan documents will amend the durable medical equipment coverage to match the current 2019 benefit.

 

 

 

BACKGROUND INFORMATION:

 

The County offers self-funded Preferred Provider Organization (PPO) health plans for County employees and retirees. The 2020 plan documents approved by the Board of Supervisors (Board) on June 4, 2019, did not include the correct co-insurance amount for the out-of-network durable medical equipment (DME) coverage. The 2020 plan documents have been corrected to reflect the 30 percent co-insurance for out-of-network DME which is consistent with the last version of the plan documents approved by the Board in 2017 and is consistent with the out-of-network co-insurance amounts for most other benefit categories.

The plan documents are on file with Clerk of the Board.

 

CONTRACT AND PRIOR BOARD ACTIONS:

 

On June 4, 2019, the Board approved the fourth amended and restated Wellwise Choice Health Plan and Wellwise Retiree Health plan documents, effective January 1, 2020.

 

On June 4, 2019, the Board approved the third amended and restated Sharewell Choice Health Plan and fourth amended and restated Sharewell Retiree Health plan documents, effective January 1, 2020.

 

On August 22, 2017, the Board approved the third amended and restated Wellwise Retiree and Sharewell Retiree Health plan documents, effective January 1, 2018.

 

On August 22, 2017, the Board approved the third amended and restated Wellwise Choice Health Plan and second amended and restated Sharewell Choice plan documents, effective January 1, 2018.

 

 

 

 

FINANCIAL IMPACT:

 

This action is requesting approval to correct the 2020 plan documents. The correction will maintain the current 2019 co-insurance for the out-of-network DME benefit, resulting no financial impact to the County or the member.

 

 

 

STAFFING IMPACT:

 

N/A

 

ATTACHMENT(S):

 

Attachment A Redline Changes Sharewell Choice Health Plan Document
Attachment B Redline Changes Sharewell Retiree Health Plan Document
Attachment C Redline Changes Wellwise Choice Health Plan Document
Attachment D Redline Changes Wellwise Retiree Health Plan Document