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Home My WebLink AboutMinutes - Health Care Benefits Trust Board - 9/23/2025MINUTES HEALTH CARE BENEFITS TRUST REGULAR SESSION September 23, 2025 KACHINA CONFERENCE ROOM 11000 N. LA CAÑADA DRIVE REGULAR SESSION AT OR AFTER 10:00 AM CALL TO ORDER The meeting was called to order at 10:00 a.m. ROLL CALL Present: Frank Trembulak, Chair Dave Gephart, Vice Chair Harry Greene, Member Mark Parston, Member Jennifer Marek, Member Staff Present: Jennifer Inboden, Board Secretary Andrew Votava, Human Resources Director Sonya Martinez, CBIZ Account Executive Eric Rustand, CBIZ Business Unit President Eric Rustand arrived at 10:32 a.m. CALL TO AUDIENCE - There were no speaker requests. REGULAR SESSION AGENDA 1.REVIEW AND APPROVAL OF THE JUNE 3, 2025 REGULAR SESSION MEETING MINUTES Motion by Member Harry Greene, seconded by Member Mark Parston to approve the June 3, 2025 regular session minutes. Vote: 5 - 0 Carried 2.PRESENTATION AND DISCUSSION OF THE MEDICAL AND PHARMACY EXPERIENCE REPORT THROUGH JUNE 2025 AND THE PREMIUM ADEQUACY REPORT FOR A JULY 1, 2025 EFFECTIVE DATE Sonya Martinez, CBIZ Account Executive, presented the Medical and Pharmacy report through the end of the plan year in June 2025. She started with the Year-over-Year Financials and pointed out to the Trustees that there was a dip in enrollment from 3,773 to 3,737. Total Medical/Pharmacy Claims Paid finished the year very good at 3% higher than the prior plan year at $2.99 million compared to $2.62 million a year ago. The Net Medical/Pharmacy Paid Claims Per Employee Per Month (PEPM) are at $650.51 compared to $631.77 a year ago. The total plan costs were up 4.8% at $3.29 million compared to $3.17 million a year ago which can be attributed to stop loss premiums. Ms. Martinez continued by reviewing the paid claims and administration information through the end of the plan year for all plans combined. The average enrollment is 311. The expected claims liability, which is CBIZ' expected number and the Town's budget number, is $3.1 million. The maximum claims liability, which is the UHC contractual amount, is $4.3 million. The amount paid for medical claims through June was $2.3 million. The amount paid for Rx claims was $681,000 and there have been $229,000 in Rx rebates. The total paid claims are $2.43 million; with admin fees of $858,000 and HSA contributions of $307,000, the total claims and admin fees for the plan year are $3.6 million. The loss ratio for expected claims is 78.3% and 56.8% against maximum liability. The claims and admin fees PEPM is $962 through June. The plan finished at 83% against budget. Ms. Martinez continued to review the report and focused on the High Deductible Health Plan (HDHP). 62% of employees are enrolled in the HDHP and enrollment is increasing. The HDHP finished at 60% of expected liability or 48% of maximum liability. The claims and admin fees PEPM is $755 through June. For reference, the prior plan year ended at $727 PEPM. The HDHP plan finished at 68% against budget; the prior plan year ended at 73%. The PPO plan finished at 112.7% of expected liability or 90.1% of maximum liability with claims and admin fees PEPM at $1,411 through June. For reference, the prior plan year ended at $1,216 PEPM. The membership of the PPO has been decreasing every year for the past few years and is at 118 compared to 143 a year ago. The PPO plan finished at 108.9% of budget; the prior plan year ended at 102.6%. Ms. Martinez added that there were ten large claimants this plan year, and eight of them are enrolled in the PPO which impacted the loss ratio. Next Ms. Martinez reviewed the year-over-year comparison and reminded the Trustees that the numbers on this page are typically very conservative, but now that the plan year is done, all the cushioning is gone. The 2023-2024 plan year finished at $3.4 million; the 2024-2025 plan year finished at $3.6 million which is an increase of 5.3% or $182,000 from the prior year. The PEPM is $962 compared with $905 in the prior year. The PEPM Total Cost History is up 6.3% from the prior year. The Budgeted Claims vs. Paid Claims & Admin is 83%. Ms. Martinez explained the Large Claims Report Over $50k. There are ten large claimants with paid claims between $52,000 and $150,000. The Plan paid $1.13 million which accounts for 38% of all claim expense prior to stop loss adjustment. The Net paid after stop loss reimbursements was $803,000. Ms. Martinez finished by going over the Premium Adequacy Report for a July 1, 2025 effective date. This report includes the comparison of 2024 funding rates at expected liability to the forecasted rate action for 2025 resulting in a decrease of 8.67%. Mr. Votava, Human Resources Director and Plan Administrator, explained the Town's strategy to implement lower premiums spread out over the entire year rather than offering a premium holiday. The savings were shared equally across both plans. UHC's contractual rate was too low since we are expecting a claim reversal. We put our rate structure in place and will run this plan year at a deficit based on our reserve policy to bring the reserve balance into the 6-9 months of reserves requirement. Chair Trembulak asked how the Town's plan is running compared to comparable clients. Ms. Martinez said the plan is running better than expected. Vice Chair Gephart asked about the possibility of exploring the option to self-insure the stop-loss insurance. Ms. Martinez said that the Town has gone out to bid for stop-loss insurance in the past and that she would have her analysts look at self-insuring on a transitional and full basis. Chair Trembulak stated that the Board will look forward to learning the results of this analysis. 3.PRESENTATION AND DISCUSSION OF THE FUND BALANCE REPORT THROUGH JUNE 2025 3.PRESENTATION AND DISCUSSION OF THE FUND BALANCE REPORT THROUGH JUNE 2025 Vice Chair Gephart reviewed the fund balance report through the end of June. Assets increased 16% year over year. The Total Cash is $3.55 million. Total Investments are $812,000 at the end of June for Total Assets of $4.53 million. The fund has $4.87 million in Total Revenues, which is $622,000 higher than a year ago. This is a combination of $3.29 million in employer-paid premiums, $606,000 in employee-paid premiums, $403,000 in cost allocation for the health clinic and pharmacy rebates and $175,000 in investment income. Vice Chair Gephart continued to review the income statement and reviewed expenditures. Outside professional services are $1.05 million at the end of June. The wellness program is $148,000 and claims are $3.1 million. The total ending fund balance is up 17% from a year ago at $4 million. The trust fund remains very healthy, up $600,000, since the end of the last fiscal year. 4.DISCUSSION AND POSSIBLE ACTION TO SET THE HEALTH CARE BENEFITS TRUST MEETING DATES FOR 2026 Motion by Chair Frank Trembulak, seconded by Member Mark Parston to approve the 2026 Health Care Benefits Trust meeting schedule. Vote: 5 - 0 Carried ADJOURNMENT Motion by Chair Frank Trembulak, seconded by Member Harry Greene to adjourn the meeting at 10:55 a.m. Vote: 5 - 0 Carried I hereby certify that the foregoing minutes are a true and correct copy of the minutes of the regular session of the Town of Oro Valley Health Care Benefits Trust of Oro Valley. Arizona held on the _23rd_ day of _September, 2025_. I further certify that the meeting was duly called and held and that a quorum was present. Dated this _26th__ day of _September_, 2025. ______________________________ Jen Inboden Senior Human Resource Analyst