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HomeMy WebLinkAboutMinutes - Health Care Benefits Trust Board - 3/10/2026MINUTES HEALTH CARE BENEFITS TRUST REGULAR SESSION March 10, 2026 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 Sonya Martinez, CBIZ Account Executive CALL TO AUDIENCE - There were no speaker requests.   REGULAR SESSION AGENDA   1.REVIEW AND APPROVAL OF THE NOVEMBER 18, 2025 REGULAR SESSION MEETING MINUTES    Motion by Chair Frank Trembulak, seconded by Member Harry Greene to approve the November 18, 2025 regular session minutes.  Vote: 5 - 0 Carried   2.PRESENTATION AND DISCUSSION OF THE MEDICAL AND PHARMACY EXPERIENCE REPORT THROUGH DECEMBER 2025 Sonya Martinez, CBIZ Account Executive, presented the Medical and Pharmacy report through the end of the second quarter in December 2025. She started with the Year-over-Year Financials. Total Medical/Pharmacy Claims Paid is $1,774,943 compared to $1,170,407 a year ago. Pharmacy rebates are $96,448 compared to $114,773 a year ago however there is a three-month lag in the reporting of these rebates. The Net Medical/Pharmacy Paid Claims are at $1,634,179 compared to $1,055,634 a year ago which is a 56.3% increase. The fixed costs are unchanged compared to the end of the second quarter last year. The total plan costs are up 40% from last year at $2,060,574 compared to $1,486,199. Ms. Martinez continued by reviewing the paid claims and administration information through the end of the second quarter for all plans combined. The average enrollment is 310. The amount paid for medical claims through December was $1,391,520. The amount paid for Rx claims was $383,424 and there have been 03/10/2026 Minutes, Health Care Benefits Trust 1 through December was $1,391,520. The amount paid for Rx claims was $383,424 and there have been $96,448 in Rx rebates. The total paid claims are $1,634,179; with admin fees of $426,395 and HSA contributions of $157,833, the total claims and admin fees for the plan year are $2.2 million. The loss ratio for expected claims is 127.7% and 84.6% against maximum liability. The claims and admin fees per employee per month (PEPM) are $1,194 through December compared to $962 at the end of the prior plan year. The plan is running at 121% against budget. Ms. Martinez continued to review the report and focused on the High-Deductible Health Plan (HDHP). 65% of employees are enrolled in the HDHP. The HDHP is running at 99.7% of expected liability or 79.7% of maximum liability. The claims and admin fees PEPM are $922 through December. The PEPM a year ago was $761. For reference, the prior plan year ended at $755 PEPM. The HDHP plan is running at 97% against budget. The PPO plan is running at 178% of expected liability or 142% of maximum liability with claims and admin fees PEPM at $1,773 through December. For reference, the prior plan year ended at $1,411 PEPM. The membership of the PPO has been decreasing every year for the past few years and is at 111 compared to 116 a year ago. The PPO plan is running at 160% of budget; the prior plan year ended at 109%. Next, Ms. Martinez reviewed the year-over-year comparison and reminded the Trustees that the numbers on this page are typically very conservative. The 2024-2025 plan year finished at $3.6 million; the estimated annualized cost for the 2025-2026 plan year is $4.38 million, which is an increase of 21.8% or $785,000 from the prior year. The PEPM is $1,179 compared with $962 in the prior year. The PEPM Total Cost History is up 22.5% from the prior year. The Budgeted Claims vs. Paid Claims & Admin is 119%. Ms. Martinez explained the Large Claims Report Over $50k. There are six large claimants with paid claims of $567,000 through December. At this point, only one claim has exceeded the $150,000 stop loss threshold; there has been $44,000 paid back to the plan as a stop loss reimbursement. The Plan paid $523,000 which accounts for 32% of all claim expenses prior to the stop-loss adjustment. Two of the large claimants are no longer on the Plan. Ms. Martinez finished by letting the trustees know that UHC is going to need data through March before they have a renewal offer for the new plan year. Stop-loss insurance is typically the last item to be finalized.   3.PRESENTATION AND DISCUSSION OF THE FUND BALANCE REPORT THROUGH DECEMBER 2025 Vice Chair Gephart noted that the strategy for the 2025-2026 Plan year to lower the fund balance to get within the reserve range is working. He reviewed the fund balance report through the end of December. Assets are down $600,000 or 13% since June 2025. The Total Cash is $3.567 million. Total Investments are $292,000, down from $812,000 at the end of June. The fund has $2.05 million in Total Revenues, which is $236,000 lower than a year ago. This is a combination of $1.44 million in employer-paid premiums, $231,000 in employee-paid premiums, $191,000 in cost allocation for the health clinic and pharmacy rebates and $78,000 in investment income. Stop-loss revenues are $78,000, up 3300% from a year ago. Vice Chair Gephart continued to review the income statement and reviewed expenditures. The wellness program has expenditures of $32,500 and claims are $1.88 million, up 55% compared to the end of the second quarter a year ago. The total ending fund balance is down $426,000 from the end of the prior plan year. Chair Trembulak expressed concern about rising healthcare cost trends and suggested revisiting our reserve policy in conjunction with considering CBIZ’s stop-loss self-funding recommendation. Vice Chair Gephart noted that despite increased claims, the trust fund remains healthy and is still about $100,000 above its FY25 starting balance.   ADJOURNMENT   03/10/2026 Minutes, Health Care Benefits Trust 2  Motion by Member Harry Greene, seconded by Member Mark Parston to adjourn the meeting at 10:42 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 _10th_ day of _March, 2026. I further certify that the meeting was duly called and held and that a quorum was present. Dated this __12th_ day of _March_, 2026. ______________________________ Jen Inboden Senior Human Resources Analyst 03/10/2026 Minutes, Health Care Benefits Trust 3