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HomeMy WebLinkAbout1979.02.21 CITY COUNCIL MINUTESMINUTES OF THE CITY COUNCIL MEETING February 21, 1979 State of Idaho). County of Madison(SS City of Rexburg) A meeting of the City Council for the City of Rexburg, Madison County, was held on Februa: 21, 1979, at the time of 7:30 O.M. at the City Hall. Present were the following: Mayor: John C. Porter Councilman: Barton Jensen Jim Morris Warren Porter Nile Boyle Morgan Garner Also Present: RE: APROVED THE MINUTES Brent Moss, Acting City Attorney Rose Bagley, City Clerk Nile Boyle moved that the minutes of February 14, 1979, be approved, Jim Morris seconded. RE: MOVIE THEATER MOVING INTO THE SMALL MALL. Ve Ann Clark was present requesting permission to bput a movie theater in the Small Mall. Family type movies and some of the movies of the past would be shown. It would be on the ground level at the far north side. Movies would be shown Wednesday through Saturday. The name of the theater would be Cinema 16. There would be a matinee and evening shows. It would have 117 to 130 seats. The council advised her that in order to open the theatre she would have to arrange for parking and contact Mayor Porter. The Council agreed that she could go ahead with the theater after she had arranged for parking. RE: SELF FUNDING INSURANCE PLAN Mrs. Ann T. Kerr from Blackfoot was present to present a Self Funding Insurance Plan, for the employees. The council will study the information given to them about the insurance and make a decision at the next council meeting. RE: GEORGE WILLMORE Mayor Porter told the council that George Willmore had paid for 10 water & sewer connects for his apartment house right after the flood and now he has decided that he only needs 4 connects. He does owe the City a bill for sidewakk repair that he damaged when he was demolishing the old Creamery building. The City paid for replacing the sidewalk and he needs to in turn pay the City. Barton Jensen moved that the City give ham a plumbing refund less the amount that he owes the City, Morgan Garner seconded. All Aye. RE: BILL FROM REXBURG MOTOR COMPANY Mayor Porter gave the council a bill from Rexburg Motor Company for the difference between the 1978 Garbage Truck that was bid and $he 1979 truck that they delivered. Attorney, Brent Moss felt that there was a legal protalem because it had been bid. Rexburg Motor Company had a legal obligation to meet the bid. If he could not meet the bid, it would not make him low bidder. Mayor Porter will check the other bids and contact the attorney. RE: NORTH HIGHWAY WATER AND SEWER PROJECT Earl Kemp was present to report on the North Highway water & sewer project. H&K was having problems on getting the work done at this time of year and deverting the water. RE: COMPLAINTS ON NORTH 5TH WEST. Mayor Porter stated that he had had some complaints on the road on North 5th West. RE: BOR CLAIId Mayor Porter stated that he had talked to Hugh Fowler, who had looked over our BOR Claim. He told the mayor that there might be a problem on them paying the city crews, because they thought the city should have paid them. He said that if they turn it down to send the claim to the Federal Disaster Unit and they will pay. He advised ,; _,, the Mayor to make a survey on the loss in tax revenues. RE: BILLS Barton Jensen moved that we pay the bills Morgan Seconded. All Aye. RE: AUDIT REPORT Merril Rudd and Joe Call presented the audit Report. They gave recommendations. Mary Smith is to check on delinquent LID's and the council will then either take action on them or write them off. Auditors also gave the Council a copy of recommendations, which they will study and discuss at the next Council. Morgan Garner moved that we accept the audit. Barton Jensen seconded. All Aye. RE: ADJOURNMENT Barton Jensen moved that the meeting be adjourned. Morgan Garner seconded. All Aye. n ~, John C. Porter -.-, ,~~, ~ .. .r.2~ l CITY Clerk, Rose-;Bag,,Jey ~' INTRODUCTION Over the last few years many corix~~atii~n;~ have evaluated the increasing costs associated with their :3roup medical insurance programs and have sought ways to improve cash flow and economize on employee benefits. This has given rise to the self-insured concept. Corporations have proven to themselves that by paying their own medical claims and reinsuring for catastrophies, a substantial cost savings can be realized. Self-insured may be on a fully or partially self-funded basis but in either case an insurance company assumes the risk for cat~strophy type expense while the employer assumes the risk for basic first dollar benefits. THE CONCEPT OF SELF-FUNDING In the long run and most often in the short run, an insured group health plan will. be self-supporting. Through the con- tinuous cycle of claims paid an premiums deposited and the re-establishing of yearly "actuarially determined" rates, no insurance carrier will continue a contract if it does nat make a profit. A profit to an insurance company is created by establishing a formula in which income is expected to exceed expense. Such expenses are: A. Expected Claims (risk} B. Administrative Overhead Expenses {10-18$} C. Commissions (5-I0~) D. Premium Taxes (2.2 - 5~) E. Reserves for Claim Fluctuations {30-45~} F. Contingencies for Inflation and Increased Plan Utilization The concept of partial self-funding was designed to elimi- nate or substantially reduce the majority of these expenses while, through a third party plan administrator, improved claim processing can add further reduction in overhead and administrative expense. Companies such as City of Rexburg have found it to their advantage to self-insure under the following Partial Funding Method: A. Under the Partial Funding Method, an employer purchases a high deductible insurance contract, {$500, $1,000, etc.) B. Claims that do not exceed the deductible limit are paid from the employer's reserves, claims that do exceed the limit are paid by the insurance carrier. (Such limits are $500, $1,000, $1,500). C. Life insurance coverage is totally insured by the stop-loss insurance carrier. ADDITIONAL REASONS TO CONSIDER SELF-FUNDING A. Control of your own reserves. B Retention cost may be eliminated entirely. C. Greater claim control and flexibility. Claims processing and administration may be adapted specifically to your own requirements. D. Constant monitoring of claims and the effective- ness of benefit dollars spent. E. Flexibility of plan and benefit design. F. Improved employee understanding and appreciation of their employer. G. Realistic opportunity to see an end to constantly changing insurance carriers and "putting your program out to bid." SUCCESS OF PROGRAM The real key to success under a self-insured program lies with the third party administrator. It is this service that will, more than anything else, assure employee satisfaction with the program. It is proposed that City of Rexburg initiate its own partially self-funded Group Medical Insurance Program. The establishment of such a program is accomplished in the following manner: City of Rexburg forms an Employee Medical Benefit Fund. Allpremiums being paid to its present carrier are deposited into this fund. The fund then purchases an override insurance policy. This policy has a $500 individual calendar year all cause deductible (maximum two per family). The policy will then pay 80~ of the next $2,500 of expenses and the balance at 100$ to a $250.,000 all cau:~e maximum, thus insuring the fund against catastrophies. The cost of the override policy compared with the premium now being paid is as follows: Override Policy Rate Total Life and A. D. & D. Rate $.44/1,000 Volume $540,000 Premium $ 237.60 Medical Insurance 16 Single $13.20 $ 211.20 12 two party 35.30 423.60 11 Family 35.30 917.80 $1,552.60 Difference = $1,403.80 per month. Approximate annual difference = $16,846. Present Plan Rate Total 26.50 $ 424.00 59.80 717.60 69.80. 1,814.80 $2,956.40 This premium difference remains in the fund thus accumulating a balance from which the company will help fund the $500 deduc- tible and/or 20~ of the next $2,500 of expenses incurred by its employees. City of Rexburg may maintain the same benefit structure afforded its employees by its present carrier, or it may redesign its benefit structure in order that the employee helps fund some of the deductible and co-insurance portions. It is recommended that the plan be designed so that the employee would pay a one-time calendar year deductible of $100, then 20~ of the next $1,000 of expenses. Thus the employee would pay $300 of the maximum exposure of $1,000 to the medical fund. This arrangement reduces the liability and should help hold down claims exposure. 3. Prepares all required government reports such as: EBS-1, 5500, etc. If employee monies go into the medical fund, the fund must be trusteed. The admin- instrator will handle this procedure as well as making initial submission to the Internal Revenue Service. Administrative services do add some additional cost to the program. However, since the administrator usually charges much less than do insurance companies, a savings is still realized in this area.. The administrative fees charged by Smith- McMullin & Associates are some of the most competitive in the business and for your account will be 8$ of the monthly billed premium with a one-time initial claims set-up fee of $700.00. ~~ i This. deductible and co-insurance provision should replace employee monthly contributions toward the plan. If employee contributions are collected, the medical fund has to be trusteed. Claims are handled by the third party administrator in the following manner: 1. Medical ID cards are issued to employees (Exhibit A). If employee insured his dependents, a card is also furnished to the spouse. This card informs hospitals and doctors to bill the administrator directly for services performed. 2. When statements are received by the administrator, they are adjudicated according to the schedule of benefits communicated to City of Rexburg employees. Claims are handled within two (2) days of receipt and a personalized letter (Exhibit B) is sent to the employee explaining how his benefits were calculated and how much if_ any he owes for proce- dures performed. 3. Each claim is entered into a computer system by claimant, type of claim, dollar amount, etc. This claim information is then available when statistical or actuarial information is required. The administrator, in addition to claims handling, performs the following services: 1. Collects monies for the medical fund by billing City of Rexburg monthly. This list billing (Exhibit C) indicates who is covered and what coverage he is entitled to. The billing can be broken down by department, location or cost center as well as by line of coverage. It is recommended that the rates established under the aggregate stop-loss policy be used as the medical fund depo- sit. However, City of Rexburg could deposit any amount desired, as well as running the program on a "net" basis. 2. Reports monthly as to all transactions occurring during the month in regards to the medical fund. This report (Exhibit U) shows deposits made, interest earned, premiums paid for stop-loss and life insurance coveraye, monthly administrative fees, and all claims paid. The report then shows how the fund is held, either in checking, savings, or investment accounts. The administrator tries to keep all funds invested in conservative liquid investment and all interest is posted to the City of Rexburg account, The following is an estimated projection of the Medical Fund for the period February 1, 1979 to January 31, 1980: _ Total Deposits to the Medical Fund $35,477..00 ~6 Less: Override Insurance Premiums 18,631.00 One Time Set-up Fee ~T0"il""00 Administrative Fee 2,838.00 Claims Paid $32,639.00 Claims Lag 8,955.00 $23,684.00 Ylus: Claims Reimbursed 17,502.00 Net Claims 6,182.00 Interest Earned 356.00 Total Estimated Fund 21~ of Premium Deposit $ 7,482.00 :_ .y 0 ° ° o 0 a 0 0 0 0 .o r ~.+v `P wrrP d ~ ~.,WO o ON W1`O w Np w NO o P - OeWrOONON•O G? ^O'VNrr O NNO N.pra WO rrr rWr t NO O V J~ d T P N P V w .1 P r o •D O T t/~ l` O O d? w W m N P O .0 W •+ ~+ J~ W P M P N .1 O r O D s s Z 5 < 1n C 2 2 3 x 3 r L Z T Tt %1 y A r G~ W N J~ T C1'~ P j< V~ N V 3 r ^~ f1 f1 A C~ C! R! 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