Homeless Issues Committee - Regular Meeting

Calling the meeting to order. Linda, could you who call roll, please?

So

I'm just gonna read off what I already have. Kristy Kabowski, present. Joshua Kotelier, present. Carrie Meyer, excused. Marissa Burek, present. Angela Tabato, present. Misha, dancing waters, present. Scott Crocs, absent. Has, Cassandra Riley in lieu in attendance. Travis Thomas present. Tina Knights present. Scott Drummond present. Brian Tusher present. Patrick Schellenberger present. John Bowman present. Arlen Halverson present. Jeffrey Glazer present. Matt Valdezan absent. Dean Julian absent. Heidi Fogo present.

Kathy Andrews present. Derek Wallace present. Kay Grivel present. Cassandra Riley present. Connor Stone present. David Freeman absent. David Neep present. And the minutes were approved with a correction of changing the cochair to vice chair. Movement was by Derek Wallace, second by Travis Thomas.

Thank you. And then the brief recap on the dental RFP was that we have five respondents to the RFP. We need two graders for that. We are requesting, anyone who's interested in serving as a grader for the dental RFP to submit your name to me by email by the end of the week. If there's more than two, we will do a randomized lottery to pick. We're gonna end up with three, so we end up with an alternate in case something happens to the two. Am I missing anything?

No. That's it.

Okay. Great. Thank you. Now we are back to you, Heather, for the report from Dean for it feels like me. Now the third time.

Third time's a charm. Right?

We are golden here, Heather.

Alright. So just a reminder on a couple of the issues that did come up, during the migration to the new claims and enrollment platform platform for January 1. There were duplicate ID cards sent out, so some of you may received more than one copy of that new ID card. Does that new member number, new group number on there, so hopefully everyone is using those. The HMO plan, there was a setup issue with the copays and coinsurance on that where they were set up with the incorrect mounts that amounts that was discovered on February 3, and all claims were reprocessed that needed to be, by February 5, and the system was updated.

So if someone paid a co pay, I think it was set up, like, at a a dollar, If they paid that instead of the $5 co pay, then, you would work that out with the provider. But the system was was corrected on February 5, and any claims, impacted were reprocessed. There was also on the prescription side, Dane County has that unique thirty four day supply instead of a third day supply for drugs that was identified on February 17, that it was set up for the thirty day instead of thirty four. That was fixed by Navitas on February 19. And the couple of issues, or people that were impacted that were brought to my attention, we did work directly with the, Costco Pharmacy to get those, corrected and additional pills mailed out.

So that was updated as well. Member documents were not immediately available in the member portal. So if you're looking for, like, your SBC member certificate, those are member documents that are available within your own individual member portal. Those are updated now in in that system for you to access. Ambulance balance billing, if anyone had issues with getting billed for an, balance billed for an ambulance bill, meaning that you're being billed a portion of the claim instead of, deemping the whole amount.

Those, are being addressed as they are brought to my attention too. I think we're caught up on all of those that have come in. So if someone does have, one that a member brings to your attention, you can just send that to me, and I'll I'll have it reprocessed, if it has not been already.

Heather, quick question on that. Were those being automatically re like, searched out by Dean and reprocessed, or were they only when people expressed a concern and brought it to you?

That was only when they were brought to our attention, Marissa, because it was not global that people were balanced billed. Was not some providers recognized the EOPs and what they meant and didn't balance bill the member because they know they're not supposed to. So it was not an issue for everybody. That's why there wasn't a global reprocessing because we wouldn't know which ones did and did not get balance filled. So we are just addressing those when they are brought to our attention.

Heidi, did you have a question on that? Okay. We'll let you go on, Heather.

Okay.

Oh, sorry, you guys.

No. There you go.

Before we get any further, when you were talking about Costco and working with Navitas, you were talking about the three months supply of of medications. Correct? Thank you.

Yes. I believe that's all I had on my notes, Marissa.

Okay. The other thing I had we had talked about in March was the kind of the, specialty pharmacy issues related to prior authorizations. There were people that had, you know, prior authorizations in 2025 that then didn't have that carryover.

Oh, yes. Right. Yes. I do remember that. So that was not anything global, as well. So if there was a prior auth in the system that would have been effective in 2026 as well, those should have automatically well, it was a manual process, but they carried over into the new system. And there was a handful of individuals that were brought to our attention where that didn't happen. Various reasons for that depending on the situation, but those were addressed as they were brought to our attention as well.

Okay. Think one other thing you and I had talked about within the last few weeks was an issue with GHC balance billing, and I know you were having folks looking at that a little more. I don't know if you were able to talk a little more about that just so everybody's aware.

Sure. And that again is with a new claims platform, there's a lot of moving pieces to how things process that might be a little different. So we are having some operational folks look into that a little bit further, Marissa. So if if that is an issue, if something comes up where a member's getting balance billed for something that they wouldn't normally be, just send those to me, and and I'll have them looked at individually. But I know there's some folks looking at the claims system and and how specific things process. So, more to come on that.

Marissa, did you mean Unity? Because we I didn't know that we could see GHC deck. POS. POS.

Sorry. Yeah. POS plan. Yeah. It doesn't happen if you're using an HMO provider. It would only be on the POS plan and help providers where that might come up sometimes.

And the other issue that came up that you helped me with that was also new information to me was that the UW Northeast clinic is within the HMO network. So that was I just wanted to share that with people because I wasn't aware of that.

That it it is part of the Dean network now?

I believe Heather, can you talk any further about that?

Which is I don't recall that off the top of my head, Marissa. Is

It was a I know, Heather. I'm sure you get a lot of a lot of these. It was the UW Northeast Clinic. I had somebody who was on HMO and has gone there for years because that specific UW clinic is within the HMO network, and they're able to go there. So that was just a a fun fact, I thought. Yeah. I don't

think that was well known. Yeah.

Let me there are a couple of UW Health clinics that are in network for primary care only, not like, the UW Health Verona Clinic is the one. I I'm just gonna double check something real quick here. I can look at a map quick and just verify that clinic. I want to say that it is off the top of my head, but I don't wanna be wrong. So, let me just take a quick look here.

Do you know the location of that? The UW Northeast? Yeah. It's, like, right off of Right across from McDonald's. Right across from where I work, actually. Yes. We're on the North Side.

Yeah. Right by the when you turn commercial to go

to North. Yeah. That's right. Actually, North is. I didn't know if you meant Northeast. Can you call me?

Oh. It's one of big problems. Sorry.

And that's it is. I just looked at our map. The UW Health Northeast Clinic, and I it doesn't give me an address. It just says UW Health Northeast. That is an HMO clinic in network, and I don't think that's new. That that's not new. It's always Just unknown. It's been

that way. It was just new. It was a new fact for me, and so I thought other people might be interested in knowing it. So thank you.

Heather, do you know about the UW Verona Family Practice Clinic? Is that in network?

It is. Yes. UW Health in Verona. So but just as a reminder, you can see those you can go to that specific clinic, but it's a UW clinic. So if they if you're on the HMO plan and they refer you to a specialist over at the UW hospital, that is not in network. So you can go there to those couple of UW health clinics that are in network, but it's for, like, basic services, primary care. But you wouldn't be able to utilize the UW health system in general for any additional care on the HMO plan.

And then if they referred you for an MRI or something, you would if you're HMO, you would need to make sure you have a prior authorization so you don't run into that any issues there.

That's fine. And they're probably not gonna approve it, Marissa, because we have the capability to do those in network. So you probably have to go to an in network provider if you needed, like, an MRI. So what you can see, those couple of clinics for primary care, that's that's pretty much it. But, yes, if you had an approved prior authorization, then you'd be alright.

Yeah. That I mean, I would caution people about that because it would be easy to get caught into the Yeah. The idea of, oh, I'm gonna refer you to a heart doctor. You go to the heart doctor. You have your appointment, then you find out it's not covered. I mean, I would really caution people splitting their primary out of Dean.

Appreciate it.

And then, Heather, I know we've talked about this before, but we have some new faces. So just to reiterate, if somebody's on POS and they're trying to figure out where they can go, where they're, you know, kind of securely not gonna be balanced billed, would you recommend that First Choice network, the website?

Well, it's if you're on the point of service plan, you can still use our regular HMO providers. That's gonna be your best option because the costs are lower and you are staying in network. You don't have to worry about balance billing or anything. But if you're on the point of service plan and you're electing to use a non plan provider, so someone outside of our HMO network, if you use the First Health Network, then we have a special contract in place, which means those providers won't balance bill you. So you're able to access that from our website.

If you click on find a provider, you would scroll down to where it says find a PPO provider. That does take you out then to the First Health Network, and that's a large national network that we do use for our out of area PPO product. But it also allows you, if you're on, like, a point of service plan using an out of network provider, if they're part of that First Health network, then that would eliminate any chance of being balance billed.

Heather, would that include, like, the, UW system where we're not getting balance billed, or is that a separate, like, gentleman's agreement?

Believe I don't know off the top of my head, Shanna, but I believe the UW is part of the First Health Network. Although it might not be every provider MVP within the UW Health System, but, I believe some of them are in network for First Health. Yes. And members can always call member services. They can help navigate that with them if they want to look something up or just confirm that they're looking at it correctly on the website.

Heather, one other question for you that you and I have talked about over the last few weeks is about the this is actually gonna be a good segue for Virginia, but the retirees and the retirees who are on Medicare. I know you and I had talked about if the health plan was doing any kind of double check on those enrollees to make sure they actually, if eligible for Medicare, add Medicare, you know, because they and I'm just wondering if you were able to learn anything more on that topic.

There isn't. So it basically falls on the member to make us aware if they've got Medicare. There are some things that might come through, like an audit or something, just things we get from Medicare from time to time that might show up where we would be aware of it then. But we don't specifically, like, reach out or or try to obtain that Medicare information. So the member, if they elect Medicare and have that as their primary insurance, they really do need to let Dean know, and so we can update our system so that claims will process correctly.

What if they don't?

We'll process claims probably wrong, Shannon, and it turns into a a challenge to sort that all out down the road.

Yeah. Generally, the carriers will process as if the individual had Medicare. Yeah. If they want to retire and they're over 65 Oh, sorry, Heather.

No. Go ahead. You were right, Jerry. Like, a lot of times we'll process

For the record, thank you, Heather. No.

Yeah. No. Seriously, jury's too. I said Jerry was right.

Yep. Thank you. Would pay as if you had Medicare. So in other words, they pay the 20%. And then all of sudden, once you receive the bill, you owe the individual, then they would go, you know, go back, notify the carrier, then claims have to be reprocessed. And yeah.

Well, I think this had just to catch people up, this had come up because we were looking at, you know, kind of enrollments of retirees pre Medicare age and post Medicare age, and then separately looking at the medical loss ratio numbers. And I was trying to figure out a better understand why the retiree's loss ratio was as high as it is if half the group has Medicare, and so the plan should only be paying 20%. And so, Heather, what I had asked, and I'm not sure if this data is available, is running that medical loss ratio report by the pre the 65 and the 65 separately. Right because now, we only get it for the whole group.

Right. And we would not be able to release that, Marissa, because of the low numbers on in those specific groups. Like, there is I think at the last census I looked at, there was less than 50 of each on the point of service, like no Medicare, people with Medicare. So we can't break it out into that level because we won't release any financial type information like that on anything less than 50. So that's why it's lumped together.

Remember sometimes that what claims are involved. If we've got a very small population of people, we're not collecting much in premium either for that specific group of people. So if there's, you know, a few high claims in there or just general utilization, the premium just doesn't support the claims. So that's when you get the kind of upside down loss ratios.

Okay. Thank you. Other questions folks have for Heather before we let her go and move on for our next item?

I'm not sure this is a Heather question or not. I'm not really sure to who to address it to, m three Dean directly or, or Dean, the health insurance. So we have somebody who, had their health care cert go to the unit at Dean that does those. And they then sent it, but they attached it to her son who she's proxy for. Her son is over 18 and has disabilities, so she's also on his but her health information is connected to his MyChart, and nobody can tell her how to get it off of there.

So it's probably not a Heather question, but, she's called MyChart. They've been very less than helpful. She's tried to call Dean, clinics or SSM Health, and they've been not helpful. So but she does not want anybody to be able to access her health information through her son's account. And she's got an ex husband. I don't know if he's also got information, but he may not have access. But I think at the end of the day, she wants it in the right place, and nobody can help her. So I don't know who to con I don't know how to help her is my

I would've that, Shannon you're right. That's not a Dean Health Plan issue because we don't manage MyChart. I would have said she needs to reach out to the MyChart support. I believe that's and it sounds like you said she tried that, but they would be the ones that would I think should be able to help her. There's a number on, I believe, the the technical number from MyChart. But, unfortunately, yeah, we wouldn't be able to update that on our side. I

don't Maybe I'll delete it, maybe start it, Do a new one. Or Yeah. I don't know. Does that sound too simple? Delete the current one? Are you able to do I I don't know if do that.

I

Can they resend the proxy? I mean, that must happen that people resend

the proxy. But it shouldn't have happened

at all. Yes. I would agree. Because her name was on

that document that shouldn't go to his account. It should go to her account. It had nothing to do with him. So they need to fix that problem for anybody. I mean, because she doesn't wanna resend the proxy. She needs to be his his guardian. So, well, I'll I'll tell her to try again with my chart. She was just hoping that we had some sort of connection that we

could be with. Unfortunately, I I don't have anything I think that would for that.

Okay. Does she escalate? I mean, just keep going up and up in my chart to

a supervisor. If they ever actually answered the phone.

Alright. Is there, like, a a chat option too maybe? Maybe she could try if there's a

don't yeah. I

know. Yeah. I'll ask her.

I know

she's not very happy

about stuff.

No. I understand.

Okay. I'll I'll I'll get back to her and see what we can figure out.

He has his hand up. I don't know if that's related to

I can't see hands if somebody has their hand up.

It's it's not related to Shannon's. One thing that we talked about at the last meeting was members calling customer service and being told they're not in the system. And so you clarified for us, Heather, that if it's a $20.25 claim, call that number. And if it's $20.26 claim, call that phone number on the back of the card. I just wanted to make sure that was in the notes.

Sure. Yes. If it's if, like, if if a member's calling in and it's about claims or benefits related, to 2025 and prior, you would call the the old member services number, like, on your prior ID card. And then if it's anything for 01/01/2026 and after, you would call the member services number on your new ID card.

Right. Thank you. And then, I have a question. I've had several members, reach out to me, and there's been some significant price changes in medications like Wegovy, and now there's Wegovy tablets available, pill form. I'm curious if there's gonna be any changes on coverage for those.

If it will, a, stay as only for type two diabetes. And the next question I had is, is there any change on, the medicadine side about those being approved for obstructive sleep apnea? And, of course, will the Wegovy pill be covered because it's so cheap?

Yeah. I don't have any specifics at this time, Heidi. It's to my knowledge right now, we are not changing coverage on the GLP one type medications. They will continue to only be covered for the, type two die diagnosis at this time, but that's continually being, reviewed. So it it could change at some point down the road. I'm not aware that it's changing in the near future at least.

Okay. And then I just wanna be clear that this is the chain of events that, a member should, do if they're trying to get this covered. For something other than type two diabetes is their provider can send in prior authorization request for coverage. And then if that is denied, they can follow the, like, further step of of going up the ladder to discuss that further. Correct?

Yes. That's correct.

Okay. I thank you for making sure that I was on the right tech

track. I appreciate it. No problem.

And, Heidi, real quick, to expand on Heather's comment. I did have conversations with the other carriers because I'm sure as user aware, ETF is looking at covering some some GLB ones for weight loss in 2027. As of conversations, I think it's late last month, early this month with courts and GHC, their stance is the same as Dean. No one has come out and said, hey. We're looking at adding an option to cover GLP ones for weight loss to our commercial formulary even as a as a buy up. So we just haven't seen that hit the market yet.

Okay. Thank you. You said quartz EFT, and was there someone else?

So the employer truck the ETF plan from the state is adding this. But as of '27. 2027. But no commercial carrier is doing it for their book at this point. So we're gonna put some ports and GHC or the other ones we talked to. Kind of our our local carriers are are not doing this yet.

Okay. I I appreciate the information. Thank you.

Just one quick addition to the minutes, for those who may have thrown out their old ID card. The old number was 802791301. So for claims processed, was that 2025? Yes. So that would be the number. And I'm not sure whether or not the the Dane County specific number of 6088282880 is still in effect? It is, Brian. Yeah.

Okay. Thank you.

Thank you, Brian.

Martha or Jerry, Nate at m three, do you need Greg and I to stay on then for the remainder of the meeting, or what's preferred?

I don't think so. Marissa,

you're think so either. Let me just double check. There are no more questions for you, Heather, before we let you go about your day. Any other questions for Heather? Any other questions? No. Thank you, Heather, for joining us. Heather. Enjoy your day.

Thank you, everybody. Have a good rest of the day. Bye.

Linda, for the record, I did see supervisor Beltran come under the meeting a little while ago. Just wanted to alert you. Alright. So moving on, our next presentation for this meeting is Virginia, who I think is with us on Zoom. And I think I understand Virginia may have a hard stop at ten, if I'm correct. Correct. Christina?

Good morning. Good morning. Hi. Thanks for having me. I'm gonna share my screen a little bit, and I apologize for sharing it earlier.

I was getting ahead of myself. Just wanted to share a couple of slides and talk a little bit about the Medicare and retiree coverage. I know we've been talking about this for a while, so I thought I would go through some slides with everyone so that I could give you a little bit of updated information, kinda talk through the reasoning about it, and then, you know, just get your questions answered in regards to retiree coverage and Medicare. So I'm just gonna share a few things. There are some numbers in here I'd like to talk through to give you an idea of the cost, and then, of course, make sure we get all of your questions answered.

This is just something we throw in. This is my team to let you know we are in Minnesota. We are in Illinois. We are in Wisconsin and Michigan. So we have you covered throughout the tri states.

What I really wanna talk about in regards to Medicare and how it works with the retiree option is when you generally think of having retiree coverage as an employer and as offering this, everybody must have part a and part b as a retiree. So when I am no longer an active employee, right, I get to enroll in part a and part b as it becomes that primary payer, which means it doesn't matter whether they take a supplemental plan, an advantage plan, everybody has to have the same part a and b. And in regards to the part b, everyone has a premium for that monthly. So as these individuals are retiring, they they all have to join the same part a and part b program and pay a part b premium. But the other options they have outside of that, right, are to join the retiree option if my employer has one available, which are usually much higher in premium, or they have the option of searching for insurance on their own such as supplemental, the Medicare Advantage, and the prescription drug plan.

A lot of people aren't aware of the special enrollment periods that individuals have. So when I turn 65, I am eligible again to enroll into Part a and Part b, and then I can join whatever plan it is that I would like based on, you know, the coverage that I'm looking for. That is called a special enrollment period. When I lose my job or lose my coverage, I can also enroll into any plan that I want to. The loss of employer coverage or retiree coverage.

And this is one thing Nate and I have been talking about for a while because I don't think a lot of individuals understand that even if I'm on a retiree plan, I actually can voluntarily come off of that policy and join any other plan that I would like, whether it's Advantage or Supplement. So if I'm on a retiree plan, prices start increasing, I can absolutely leave that policy and join another policy anytime during the year because my loss of coverage through the group plan, whether I'm employed or on a retiree plan, allows me a special enrollment period. So if the employer discontinues the plan, if I voluntarily wanna come off the plan, I can do that anytime during the year and go on to another policy guarantee issue. And a lot of people aren't aware of that, and so I think that's really something, to discuss and educate the retirees or the employees on, whether they're active or not active, to discuss those options that are available to them. I wanted to put out some cost for you because as a retiree, the options you have based on your retiree plan, which I know is very pricey because I've worked with a lot of Dane County employees.

If someone were to pick, let's say, a Medicare Advantage plan, they would have Part a, they would have Part b, and the average premium for an Advantage plan is $18 per month per person. Now these plans will always have additional out of pocket costs, such as co pays and deductibles and maximums just like you have on your current plan, and those would be specific to each individual. But a lot of times what we would do, obviously, would be to compare those options to the current retiree plan. But think of $18 a month versus 1,602,000. A Medicare supplemental plan, which is another option they would have, average employee at age 65, and it kind of depends on where you live, that premium, again, is about a $180 per person per month.

So minimal, right, compared to the retiree option. Also, supplemental plans offer this national network of providers, and it also, generally speaking, allows you to pick and choose where you wanna go to. Now these costs do raise based on your age, but it nowhere would get near to, you know, what they pay on the retiree option. And I think, again, this is just based on education to the retirees in regards to the options they have available. In a supplemental world, you have one little deductible, excuse me, of about $283 for the year, and that's it.

And then the supplemental pays that 20% that Medicare doesn't cover just as the retiree plan does. They would also require a drug plan for their prescription drugs, and the average cost of a drug plan is around $34. So if you took any of these options and compared them to the retiree plan, most of these retirees would save a significant amount of money in regards to premiums. But, again, I think it goes back to educating the retirees on what is available besides the retiree option. Because as an employee, generally speaking, working many, many years with an employer, a lot of times they think that may be the only option.

They're scared to leave the retiree plan, right, because they aren't sure they're going to get as good or even better coverage in some scenarios. And, you know, I think it's it's more fear that, oh, I'll never be able to come back to the plan. What am I losing? You know, it's not really about, you know, what they would be gaining. So these are the things that we try to educate the retirees on and walk through this information with them to compare, you know, apples to apples.

And generally speaking, if you have time to sit down and go over those average costs, most retirees or individuals will their eyes will get really big knowing the amount of money they might be saving. And we'll generally I would tell you probably 80% of the clients I work with, once I sit down with them and talk through the differences between the options, would absolutely move off the retiree plan. But again, it's that fear and it's more about educating them in regards to cost and coverage and probably more high level with numbers, you know, versus just saying these are available. And I think that's what most retirees are looking for, is that trust and to have someone to educate them and walk through the process and compare apples to apples. So these were kind of the slides and information I really wanted to talk about with you guys to let you know the options that are available, the timing, and the fact that they can come off of these policies, whether it's involuntary or voluntary, and enroll into any other Medicare policy guarantee issue based on the fact that they have a group employer plan, whether it's a retiree plan or whether it is you know, they're actively employed.

So I would be happy to take questions.

Yeah. I think there's a a number of questions. We'll start with Shannon. Thank you, Virginia. We appreciate you taking the time to be with us, and I think we will I'm glad we have some time for questions. So actually, my question

is, I'm retiring in June, and I'm 65. My husband is 65. Are you saying that if we choose to stay on the Dane County plan with the the Medicare, you know, for two, but on the Dane County Dean health insurance, and we stay on that plan that a year or two or three years from now, we would be able to be guaranteed issue under the under a Medicare supplement if we choose to stop our our Dane County plan?

You would be based on the fact that your loss of group coverage allows you to enroll into a supplemental plan without going through Medicare questions. Correct?

Virginia, this is kind of, I appreciate the conversation because that, you know, I have kind of a different understanding of this, and I'm, you know, curious if do you have a link or anywhere to that what that SEP would be? Because my I guess my prior understanding, and I very well may be wrong, is that you have to have either an active employer plan or to have an involuntary loss of coverage in order to create a SEP. And so

Yep. I can share that with you. Generally speaking, what happens as, the carrier when it comes to a loss of coverage, as long as you enroll within sixty days, if you have a group health insurance policy, whether you leave voluntary or involuntary, you have what's called guarantee issue within that sixty days to enroll into a supplement plan, and I can share that with you. I've been doing that with a lot of people on retiree options even with Dane County, and they are they are guarantee issue without answering medical questions.

Would that be the same for, COBRA?

It would be the same for COBRA. Correct. Because it's considered a group option. You're still on a group plan. However, you're paying the full premium.

Okay. So what I mean, this is very interesting because I do think it presents opportunities, and this is, kind of a conversation we've been having, you know, over the last year and beyond. And so just to catch people up, you know, when we're look talking about our retirees, we've got I think it's close to about slightly over 200 retirees on the plan as of last year, and somebody can certainly correct my numbers. But when I'm looking at the enrollment at the end of last year, we had about 200. Half of those perhaps were without Medicare, and about half were with Medicare.

And so part of our conversations over the past year have been how can we reach these people because the county no longer has connection with them. They are, at this point, dealing directly with Dean. And so when their annual renewal comes up or when their opportunity to when they turn 65 and go on Medicare and they would have an option to to take a supplement, many people are missing that is what we're seeing. And so, you know, part of our conversation conversation has been how can the county help educate and inform people? Because even though the county is not paying for the retiree's benefit, the retirees are part of the group, and so their utilization is impacting the group.

And, Jerry, is there any way to coordinate with Dean in regards to maybe when these retirees, you know, turn 65, and and I'm not sure how we share that if we can share that information. But is there any way that we can find out when that population is turning 65 that we can be in front of that?

We could ask because I know, like, the carrier dean deals directly with them in that we could ask to see if there is at least, you know, hey. This month or quarter, these people are. I can reach out to Heather and and double check. I don't wanna say yes and and overpromise, underdeliver.

Right. So I know Virginia, you offer Nathan shared the link with me. You offer periodic seminars for people, and I know you're very willing to meet one on one with folks. And, you know, we've heard good feedback about that. And, you know, I think this could be a a win win opportunity because I think what, you know, we're what we're seeing is that people are spending a lot of money for the retiree plan.

And so just, again, to give people the recap, I think for this year, the for a single person who's a retiree, they are paying about a thousand dollars a month to stay on the county's plan plus their Medicare b premium, which would be about 200 depending on their income. And then I mean, so that's a huge amount of money every month. And I think one of the issues that makes it hard to compare is that there's not a max out of pocket with Medicare plus a supplement. So is there any data on what somebody's average annual costs are when they're on a supplement?

So there there actually is kind of a max out of pocket on a supplement if you buy a full plan. So it's kind of you know, in Wisconsin, we're a little different. We're in a seven states where we don't call it like a plan g or plan f. We have riders that are attached so you can pick the riders off to reduce premiums. But if you have a full plan that's the standard option like a plan g, there is really only one deductible in that scenario, which is $283 So the max someone would pay in a year in regards to a supplement if everything's covered under Medicare is $283 and that can change from year to year, obviously.

So as Medicare pays primary, the remainder is sent to the supplement. Once that deductible is met, they generally have a 100 coverage after that. So, really, their max is that deductible, and then, you know, you would include those premiums. I always look at it as I add the premium in with the deductible, and this is really what their risk is, right, for that year. So in a supplement world, if they pick a standard plan, that would be their max.

And are there any, like, nice charts or anything that would you know, if you think about health care literacy and how people struggle to read and understand things, are there any currently designed documents that we could be sharing with retirees?

Well, the hard part about that is you have documents in regards to how a supplemental plan works. But and and I could probably put something together and get that over to you. But in an advantage world, obviously, there are so many offerings. It's very difficult to put a full chart together with all the carriers and different offerings. So that's where it becomes a little unstable for individuals because sharing that gets even more confusing.

Because imagine going out, you know, working for someone for twenty years, and now I have to go out and find my own insurance. And, Jerry, I laughed a little bit about that for one of our colleagues yesterday. When you're out there considering finding coverage and you have, you know, 50 different plans available to you, that's where it kinda gets sticky. So that that one would be difficult. But I think in a supplemental world, we could kinda put something together to show those costs and coverages.

And I think that's what we'd be most interested in because I think that would be the most comparable for people. And in some ways, they actually would offer them more flexibility than they have now because I think one of the things that we were really concerned about last year with all the discussions about the plan design changes for Dean was the retirees being impacted and not even kind of realizing it. But for a retiree on HMO, they're limited to dean. And then when the dean when the county changes their contract to somebody else, the retiree is kind of following that network. While if they were on Medicare plus a supplement, they, in theory, would be able to stay within they would have more Yeah. Network choices. Is that correct?

Absolutely. They would have a national network of providers. So any physician that accepts Medicare, the largest network available in the country. And

I don't think people realize that. And so I think the education and information is a has been a goal for this group, and I think we just need to figure out how to execute it. I do have another question, but I see John, our newest retiree joining the committee and has a question. So welcome, John. Yeah.

Thank you, and thanks for for inviting me to join the committee. I hope I can help over time. So I'm in the six m 62 and have three more years before Medicare. So I'm in that group of 100 ish people. And I just wanna clarify, Marissa, the cost. And I wish it was 1,000 a month. That'd be great. It's $1,400 and change a month for a single HMO policy. So pushing about $17. So I you know, there's certainly a benefit, I think, to to switching off of that.

You know? Certainly, when I hit Medicare age and and for most folks in my in my category. You know, I think the the the more information, the better and and how to reach people like me after, you know, a number of years being retired is something for Amy, I suppose, and and and maybe Shannon to to figure out. But, you know, in addition to prompting that, you know, this change could benefit by x amount of dollars or or whatever, you know, any resources for how to select supplements or who to talk with? And I talked with a lot of of folks who get overwhelmed by, the Medicare, options once they hit 65.

So any kind of info, I think, would be, certainly beneficial for folks to make that decision.

Thank you, John. And just to clarify, John and I are, both talking about retiree rates. John mentioned the retiree rate without Medicare, which is $14.19. The amount I was referencing is the retirees with Medicare. They're paying a thousand 14 plus the Medicare Part b. So that is the the $400 difference there. Thank you, John.

Hey, Marissa. Just so you just so everybody on IAC sub or committee knows, we do have that retirement guide out on DCI net, and it's posted for the retirees. I did add in Virginia's contact information in that guide for retirees. So I know when Shannon and Carol meet with retirees, they get a copy of that guide. So that information will be in there and available to them if they keep the guide as well.

Yes. And I think thank you, Amy. I think the retiree guide can be helpful. I think, you know, the other concern has been that some people are retiring, you know, as John just mentioned, years before they're 65. And so people may lose something or forget something by the time they actually turn 65 and have that opportunity to switch off the county's plan and onto a supplement, and how can we reach them then? And so I think what we keep hearing is that Dean is the master of that list at that point. And so or Nate and Jerry are going to try to

Yeah. I I emailed sent out an email to see if there's some type of way they could notify county, get in front of it. So more to come.

Okay. And would that not only be just the employee, but their spouse as well?

Yeah. And

then that is a question I had for and I don't know if this is a Virginia question or an Amy or Shannon question, but so I think one of the things we come across commonly are spouses that are of different ages. And so one person becomes eligible for Medicare sooner. And so let's imagine that, Shannon, I'll use you as an example. So let's say Shannon is gonna retire and she's 64 and her spouse is 62, so they both go on the retiree plan. When Shannon turns 65, can she leave and get a supplement and leave her spouse on the plan, or does the only way the spouse stays on the plan is if Shannon stays on the plan? I

think I have to stay on the plan.

And so then, I guess, what Virginia is saying would be new information because my concern before had been that Shannon would then miss out on her guaranteed issue by staying on the plan until her spouse was 65. But now what you're saying is Shannon would not lose her guaranteed issue. Right? She could stay on the plan and then leave when spouse turns 65, and they both could have guaranteed issue to a supplement. Is that correct?

That's correct.

That's a big change.

That's a that's new, so that's good. Yeah. You can send me that link. I would love it. Virginia, because I work at the Aging and Disability Resource Center, and I get this similar question a lot, and so that would be helpful to know for for my other job. Thanks.

Absolutely.

Supervisor Baldwin?

Thank you. I'm sort of in the in this area too. I've retired my wife, Lisa, worked for the city for lots of years, has is actually I'm still working, so she's on my plan. But for the retirees, Virginia, I just wanna direct this to you. If they stay on the county's plan, they're only paying the thousand a month with the supplement, but they have to be on a, right, if they're 65? Because I I'm actually 65 myself.

So generally speaking, most people will take part a because it's a $0 premium, but they are not required. And this is something a lot of people are not aware of. The government does not require you to, enroll in part a unless you are collecting Social Security benefits. Okay. So individuals that continue to work that have a high deductible HSA plan and make contributions into those policies, they actually cannot be on Part a and or Part b either and still contribute.

So, I think it's it's true that most people will go on part a. It's a $0 premium option, but you are not required to do so unless you are collecting Social Security, which a lot of people are not aware of.

No. I thought you had a b on a. But, so they're so can they have are they gonna get a better premium then if they're off the county plan, if they're retired? I mean, obviously, it depends on coverage. Right? That's the other part of

it. Correct.

So 1,000 a month Yeah.

Plus the $2.83, that's it? So when when you when you enroll in Part

a and Part b, everybody has Part a at zero, and then the Part b premium is based on income, but the average is $2.00 $2.90. So they're paying that whether they're paying the thousand dollars or not on the retiree option. So let's say I have the 202.9 no matter what, but I wanted to go to a supplemental plan. If I go to a supplemental plan, maybe that premium is only $180 or $200 a month plus a drug premium, let's say 300 total, I mean, you're saving $700 a month in premium to do supplement plus a drug plan, and you only have that one deductible out of pocket. So that's a significant amount of money for individuals in regards to those premiums per month.

I mean, it's $700 per person, and you do really only have that one out of pocket. So those are the kind of things that, I think are missing for most individuals is to understand that difference that you can have and still have a fabulous plan in regards to coverage. So those are great questions, and that's why we like to keep talking about it.

If they're not on the county plan.

If they're not on the county plan.

Savings. Okay.

Correct.

And this might be a question for, I'm sorry, from m three. What is there does the the retiree group kinda affect the whole group on because of usage?

Yes. Yep. So the county

is significant?

It depends on the year. It's so the county is looked at as one all the segments, so active, retirees, you know, pre 65, post 65, but it's all one large pool of claims. Does That make sense?

Yes.

So I think currently when we were looking at the numbers, Nate and Jerry and Brian and I were looking at numbers recently just for fun. And, I think the retirees were about 4% of the total group Yeah. Is my recollection. But when you add when you look at the medical loss ratio across the group without the retirees And then with the retirees, it was about 1% difference.

And the medical loss ratio again is the premium paid by the county compared to the dollars paid out by Dean for the claims.

And so the county, just to recap, is not paying anything for the retirees, but the retire the inclusion of the retirees does impact the county's overall experience.

And there's been years when it's it's it's been a, it's like a better positive, but there's also been years where it's you know, as they break out the claims we look at, it's you know, we'll see retirees are sometimes over a 100%, generally over a 100%, sometimes below. But, yes, it is one large pool.

Well, this is really helpful, Virginia, because I guess I'd always been kinda worried about the a 100 plus retirees that were with Medicare on the county plan thinking these people were destined forever to be kinda stuck with us and not have this opportunity to shift off, which could be a win for them, honestly, because it would help their part of sick leave and their medical trust go further if they were paying for a supplement. And I think some of the people, particularly those on the POS, don't probably realize that they have this opportunity to have almost a POS experience. So So I think educating and informing would be

a, you know,

a really nice thing that could be a a win win. Another question. Well, Nate, did you wanna share this? I don't know if it's that you sharing your version.

I I I shared this just real quick just to show you that your memory was spot on at 4% of the overall population. And you'll get that loss ratio, you know, they're running for every dollar that they are paying in terms of premium. Dean is spending a dollar 21 on claims. So the retirees. The overall group is running better at every dollar paid in. Dean is paying a dollar 5.

Thank you. One question I had, and I'm not exactly sure who this go goes to, but when we're looking at kind of the current contract, we've got I know we've got the active employees, the retirees, and then there's those Medicare carve out rates for active employees. Mhmm. When we looked in 2025, there was only one person on POS who fell into that category. The rates are lower Right. For those subscribers. Is there a and so I guess the county in order to put people into that pool, the county would have to encourage people or require people to go on Medicare.

Is that correct? Because it's a and I'm gonna go insurance, nerd talk here from them, but they call it one over, one under, two over, you know, like that. So depending on if the end one of the individual spouse generally has a Medicare plan, then they may pay less because Medicare, depending on the situation, could be primary for that individual.

But for active employees, that's never been an option because Correct. You know, they have the full coverage until the employee retires.

And Virginia, please to go

on b until such time as that employee retires. Yeah. And I don't think we're looking to change that. Right? Right.

No. No. But it's in it's listed in the with the rates, and so I was curious

in terms of just They'll

have those carve out rates. And, Virginia, please correct me if I misspoke, but I don't think anything has changed on that.

Has not. You're correct.

Alright. That's twice today I've been writing. Again.

Yes. Again.

Sorry. Yeah. Other questions?

Other questions for Virginia. Derek?

I'll take a stab. So someone who still has a couple decades to go to retirement and, also someone not as familiar with, working with retirees at the ADRC. I just wanna kind of see if I'm understanding this. There's a lot of potential benefit here. I mean, not a lot of reason, I guess, for folks to for anyone for folks who are 65 Medicare eligible to stay in the county's plan, except maybe with the exception of folks who have a younger spouse, who may need to stay on the county's plan. Is that kind of a general a decent synopsis of Yeah. It comes

down to in my opinion, you know, it's individual choice. You know? I think it was just talked about earlier people that have worked for the county and only you know, they, yeah, they don't wanna give up the coverage. And as we've continued over the years and bring Virginia in to educate people on the differences where it could be similar saving a lot of dollars, you know, because, I mean, the plan is a very solid plan, and a lot of people, you know, generally don't wanna give that So it's gonna depend on their you know, the individual employee and spouse's situation.

And I think we would see a shift if it ended up that we had somebody else getting our book of business than Dean. You know, anytime there's a shift, if people would then probably say, oh, I have to go to a supplement so that I can stay with the Dean doctors. But who knows if that'll ever happen? Right.

But if they go on to supplement now, so the ability to stay with the Dean doc or become an knowledgeable Medicare or whatever. They'll still be able to do that

right now.

I think the biggest thing they're right is that people are afraid of what is. They're they don't understand the supplement world. They don't understand Medicare world, which is why refer people to Virginia so that she can explain it to them because, they need to see it on paper. Like, you need to see the premiums, what you're gonna be paying, and you need the black and white, and that she can give them. You can talk to people all day about, you know, the supplement will save you money, but people think I've got all this all this money in the medical trust. It's gonna last for a long time until it doesn't. So that's the piece that people need to realize. I mean, I I'll be honest with you. I'm retiring in June, and I am terrified to go off of the county plan. Terrified.

In fact, now knowing that I could go off the county plan and get on a supplement in a year or two, I'm actually like, oh, maybe that's what I'll do. Where before, I didn't think I really had that choice. I figured I had to get on a supplement. So I'm you know, it's it's comfort. That's really what it boils down to Or continuity of care. Right? I mean, you still have to change the insurance process at the clinic. You have to show you new cards. You have to get all that taken care of. But, you know, it's just changed. People are set in their ways.

Okay. So it's kind of maybe having a a younger spouse, maybe, you know, being worried about going through the the, you know, the essentially, the administrative tasks of setting up new insurance. I guess, well, yeah, for folks at m three, like, are there any other, you know, situations where, you know, personal preferences, you know, said for other reasons? I mean, obviously, not being individual as and providing confidential information, but, like, are there other reasons folks have said that, hey. I wanna stay on the on the dean plan?

You know, from my ex I think it's just a lot of employees, that's that's all they've known. You know? And one thing is over the years, a lot of people retire and, know, we well know the snowbird term. Right? Hey. I'm gonna be up in Wisconsin six months elsewhere. You know? And then as Virginia had mentioned, you know, the Medicare network is the largest one in the country, you know, so for people that are going that way. But I I think it just really comes down to people not knowing what they don't know, and I don't mean that in a bad way at all. You know, Medicare, that's why Virginia is so awesome, her and her team of what they do because with the gut, things change all the time, you know, and that so I think it's just that education.

Sometimes it takes two, three years to educate people on that because they have this great plan, and I just don't wanna let them know. You know, I think, Shannon, you made a good point. You have a lot of money in that trust fund until you don't. Right. You know? I hope that makes sounds good in here. I hope hope that's making sense. I just I think it's, you know, education and then people just saying, okay. Well, this is I've been on this plan for the last twenty five, thirty years. I don't know if I wanna go off it. You know? Then, Shannon, to use you again, you just said, well, hey. Maybe, you know, in a couple years, I could do that.

And then the other part of me is like, well, maybe I will use my one off at this point and go on a supplement. And if I hate it, then come back.

Then come back because you had that ten Yeah.

Ten year window. Yes.

And and you also have to look at like, Brian and I like, we have a lot of people retire that aren't old enough to go on Medicare. Correct. And I can list off probably one of your retired deputies that are not on Medicare that have the state on the plans. Yep. It's probably a significant number of them are

are people.

And I think that is that's probably across the board in any municipality or or, you know, with with, law enforcement in that fire. So it's yeah. It just really comes down to, you know, if people plan ahead for it, that's that's good. And, also, you know, what medical condition conditions may they or their spouse had. It's there's a lot of uncertainty and, you know, changes change whether it's good or bad.

And the marketplace for under 65 is expensive.

Yeah. And, yeah. And to find a plan in the marketplace like this plan, not to be the negative Nancy, but you're not gonna find one.

That's why a lot of people stay on this until they're 65 and get Medicare.

Correct. Yeah. Usually, what I've been hearing from people is if it's an affordable plan, it's a very high deductible. So they may not be paying much in premium

per month.

But then yep. But it's offset by if they have any significant medical issues come up. Right.

Does the medical trust pay for, the premiums to the supplemental plans in that?

They Medically related expenses. So premiums, deductibles, co payments, long term care, dental premiums, dental co pays, deductibles, anything that's medically related. If you could run it through an FSA, you could probably, through a flex plan, you could probably run it through the trust.

The one thing I know you can't do is, say, for example, you're retiring and you're gonna go on to a spouse's insurance and that spouse is having the premiums paid out pretax out of their pay, then you cannot use the money that's in that account to pay for those premiums.

Yeah. That's why I asked because

I use it to pay for co payments

from that plan. Co payments, deductible.

The thing

to think of is is the money coming out of your pocket? If it is and it's post tax dollars, you could probably run it through. If it's being paid by somebody else and it's a pretax situation, you cannot run.

Nate or Jerry, something we've talked about, I think, at the RFP subcommittee, but I just wanted to bring it up here so everybody hit here, was doing the possibility of doing a separate RFP for a group supplement. Can you talk about that if it's a possibility, if it's something that exists?

I've I've never done one of those, you know, before for because, you know, the the supplements are individual policies in that.

Would, like, Benastar fall in that category?

Benastar could. I know they come in and talked. They're individual, but the yeah. They're you know, I can get some information. So Benistar is is a company like that. I gosh. I think they may have come in and talked ten, fifteen years ago. You know, it's it's that's probably about the only one I know out there.

Yeah. Jerry, I think Benistar could be an option in regards to, a group supplemental policy that would also hold a group drug plan. Usually, Navitas, I think, is the group plan. So what happens in that scenario is generally, everyone pays the same amount of money for, like, the Part d plan, which is usually much higher because when you're putting a drug plan into a group policy, you're looking at 3 or $400 just for the drug plan. The supplements are actually cheaper than the drug plan.

So they do offer it. It's just kinda dependent on the cost. And sometimes you're pushing those numbers much higher in regards to a group plan, again, versus what they would have individually because it's based on their own individual medications, their you know, what type of plan they're looking for, but I think it is an option you could look at.

Right.

So

what you're saying is it may not be beneficial to the individual to be part of a group supplement as opposed to an individual supplement. Correct.

Correct. I will yep. And I can reach out to Ken Peterson. He's our our rep and, ask him to get send some information on that that I can share with, Amy to share with everybody else.

Be great.

Yeah. I mean, there's there's there's so many options out there again, which is why, you know, Virginia and her team are are so good at what they do. You know? But, he's got information. I know he's been around. Gosh. I've known him for, yeah, probably about twenty years. So I can gather some information. As far as an RFP, I I don't know. I mean, I understand the county has processes and guidelines, but they're still individual plans. So I'll grab some information on that.

No. I appreciate that. We're we're trying to just gather information and learn as much as we can here. Other questions for Virginia while we have Virginia?

Well, I think we also wanna remind people that Natalie is available for the 65

as well.

Natalie. So she will work with people to find, plans through the marketplace or wherever. She kinda does what Virginia does, but she does it for the 65 where Virginia concentrates more on the 65. Although I do understand that if we have a dual couple that either one of you can handle that. Is that right, Virginia?

Oh, if we have a dual one over one under, I would handle both. Yeah.

You would handle both. Okay.

Thank you. Generally speaking, it's just easier to do it that way. So but Natalie is our counterpart and wonderful with people that aren't quite 65 yet, so she would have, you know, the same information that I would have for that market.

Okay. So she is available and just wanted to remind people of that as well. And her information, I believe, is also in the retirement guide. Yep. Right.

Question. I think this might be for Amy for the retirement guide we're giving out to people. Do you know if the, form people need to give, when they retire, if they're over 65, there's a form they would need to give Social Security in order to enroll in Part b without a penalty to prove that they had coverage. Is that form included? It is not. Okay. Should how many people are retiring over 65?

I mean, we get the forms kinda regularly, but, really, it's when Social Security asks them for it, then they ask us for it, they usually fill out the top, and then we finish it. So, now if I'm working with somebody and I mean, I've technically fill out the form for them. I mean, I have a cop a blank copy of the form that if somebody says I need this, I can certainly do it electronically and send it to them. So, but it's not part of the packet because it really doesn't pertain to everybody.

Is it linked or referenced in the packet? Do you know?

I doubt it because it's really a Social Security form. It's not ours. I mean, it's it's something that, you know, they would need to gather when when they go off of, or apply for b late.

I'm just trying I'm anticipating when you retire, how we can best, support the people that are coming later who won't be having you fill out the form for them. True.

Yeah. I I that's a good question. I mean, could we put the form in there? I mean, I just what I worry is that people will fill out the form, send it to Social Security, and have no purpose.

Or just reference it in there if you're 65 and going on Medicare because some again, people don't know what

they don't know. But Social Security tells them right away.

But that's if they contact Social Security.

Well, if they apply for Medicare Part b, they're told they have to fill form up. I mean, I'm just saying it's not gonna get lost because they can't get b until such time as they, unless they want penalties. And most people are pretty pretty fast at responding when somebody says you're gonna get a lot of penalties unless you fill out this form or have your employer fill out this form. Yes, sir. You have to have a form for each individual. So if it's a husband and wife, you need to do a form for the husband. You need to do a form for the wife.

Sir, anywhere else that the retiree benefit language lives, you know, in this information besides the packet?

You know, some of, like, the REP and the the, precision, and that that's all in the handbooks as well. Really, the retirement guide is just for things I mean, that's also included in there, but it didn't it includes other things that

Like the ten year rule, for example. The ten year rule that you can come back. Is that written down anywhere else besides that handbook, that guide?

I don't know. I don't know. That's a good question.

The ten year rule is in every handbook and in all the collective bargaining agreements.

Okay. That was my question. Thank you, Amy. Alright. Other we have six minutes left unless Virginia did Virginia leave?

She's right up there in the corner.

Oh, I see you. Sorry. Alright. Any other, last minute questions for Virginia?

And if there's no, I I just really wanna thank you, Virginia, for all the help you've given our employees. You've been a godsend, for me anyway. If I I can refer people to you and feel very comfortable that they're gonna leave there and understand what's going on. And I know I've referred a few very difficult people to you over the years, and you have served them well. So I I just personally wanna thank you for that.

You're so welcome. And I'm gonna miss you when you're gone. I mean, you I hear great things from everybody I meet with. So you're on top of the game, and they really do appreciate you just so you know that as well. Thank you so much. You're welcome.

Virginia, thank you for your time. We really do appreciate you joining us this morning and for this presentation.

Absolutely. I appreciate you guys having me, and just keep me posted on what you need. I'll put together some info and get it over to you. And if you need anything, just give us a holler.

Great. Thank you so much.

Thank you. Have a good day, guys. Thank you.

You too.

Alrighty. I

was referring to you. I just want as a difficult person, you know that. I'm sure you understand I was not referring

to you. For the record.

Present cup. I was not.

Alright. Next item on the agenda, we have the reports to committee. Brian is gonna give us a brief recap of the RFP subcommittee and the happenings there.

You said that we didn't have a quorum so we couldn't meet. Right. That's what happened last time. And we meet tomorrow.

Alright. We're gonna come back to to Brian. I think the RFP subcommittee has just met a handful of times, and we were plagued the last time with a Zoom issue. So the IAC and IAC subcommittee both have gotten somewhat cursed. Got my notes here now. Alright. He has his notes.

Alright. So we discussed the past RFP process from 2016 and 2024. Noted issues were finding a vendor that can accommodate the size of our group. We discussed whether keeping the strict requirements of the current RFP process could be modified. Right now, one of the things that we feel might be hanging this up is that a requirement of having to meet the current plan or better, might be keeping some people from participating in the RFP process.

We discussed the option of the county self funding insurance, and m three was gonna be putting together kind of a self funding one zero one for the subcommittee to explore the cost as well as the pros and cons of the county transitioning. We discussed potentially potential savings to the county plan by educating retirees on how, changing off of the county insurance could possibly benefit them, which we've just had a pretty long discussion about. So, that's all I had for my notes.

Thank you. And so I think the RFP subcommittee, due to our technological debacle of last earlier this month, is meeting tomorrow, the twenty third, for our April meeting. And we'll be reviewing the mandatory requirements in the RFP currently to see if there's any opportunity to come up with a mandatory list and a preferred list. And then separately, the same subcommittee's next meeting is May 6. It meets monthly on the first Wednesday.

Those are public meetings, so anybody's always welcome to witness them or watch recordings. And that is the meeting where I believe we're having the self funding presentation from m three. Alrighty. Thank you, Brian. Next on the agenda, we have a report on the wellness committee. I think, Linda, you were offering this for

Caitlin today?

That is correct. So just be where I can try to answer questions, but she couldn't be here because she's at orientation. So we mentioned the, on-site chair massages. We did do that for about five months. And for the moment, we will not be doing them.

For October, November, and December, we had to pay out out of out of the wellness fund a total of $1,086.50. And in January, February, it was a total of $768.50. And that amount was based off of, spots that were not filled, so we did have to pay for that. Quarter one, wellness lottery, we had a total number of employees that submitted, was six forty eight. Of that, 648, a 107 were selected, which is basically 17%.

Of that, the number of employees that were selected who submitted documents was 88. That's 82% of the one zero seven. And those who did not respond was around 19. The number of employees selected that weren't selected, in 2025 lottery were 69, so that was an increase. As for quarter two wellness lottery, submissions ended on Friday, April 17, and she received a total of 690.

Now that is currently the quarter with the highest submissions since we've started the wellness lottery in quarter three of twenty twenty four.

And Thank you, Linda. Yeah. Any questions for Linda on wellness? Okay. So next, we're gonna move on to our discussion items. We have

Marissa well, Matt has a question. Matt Belton.

Oh, I'm sorry.

Yeah. Sorry. No. Yeah. I just threw and it doesn't have to be for, I'm sorry, speaker. Is who limits that? Is that Dean that limits that? The the folks that have to get in a lottery?

Are you talking about so I think we're given a certain dollar amount from Dean and then have decided how to allocate it and what for. We previously had a subcommittee that was the wellness committee, and now, this the IAC committee

Right.

Gave Caitlin some feedback on how to deal with these reimbursements. Is that the question?

Yeah. I just it seems like this whole lottery thing I mean, is there a way Jerry, is that typical of of big groups where there's a dollar amount cap on it?

Yeah. There is. And then the individual groups will, you know, figure out how to best allocate.

Okay. So so there's really no plan for large groups that just has sort of unlimited like, whoever wants to put in gets their money.

Yeah. It's unique for a carrier to say, hey. We'll give the employer x dollars every year to use for wellness. As part, you know, in the contract. And, therefore, then the county determines the employer determines how to best allocate that.

They split it up over the quarters so that more people have an opportunity to

I get all that. I just it always seems like this, like, everybody has to, like, beg for pennies or, you know, for a few bucks, and I just this seems like a better way to do that, but maybe not without a large amount of money coming in. So

Our total our total wellness budget for the whole year is $50,000. So if you gave every employee money out of that $50,000, I think it ends up to be about $15 a person.

And what's the average person then get from that?

Their max per year is one fifty total.

So then if you did one fifty times every employee, that's what a real a realistic total would be.

Right. We have it capped at one fifty. If you submit right now and have a $150 worth of spending, you're done for the year.

I get that. Yeah. Yeah. Yeah. Okay. Thanks. Yep. And

just thank you for the question. And just to you know, the 50,000 in wellness funding is part of the RFP process under the mandatory requirements.

And I think too, it should just be added that Linda had mentioned the numbers being up for this quarter. I think a lot of that has to do with the fact that the IAC put together the plan that we did for the lottery Because for a while, we had the same people year after year, quarter after quarter getting it, and it had discouraged many people from even putting in. They just felt like, what's the point? I'm not gonna get anything. So we've got numbers up now, and I think that that really speaks to all the work that was put in by the committee to do the lottery.

Yep. And just to to piggyback on that, I think Caitlin has said anecdotally, she's seen a lot of new names of people who haven't submitted in the past because previously, it was kind of folks that had a desk job that were able to most quickly submit, their their form who were getting approved, and people who were out on a snowplow or out at the airport were not able to have the same access, and now they are. So I think we've overall been happy with that outcome.

Thanks for that. Yeah. And I've heard that in this committee before. Yep. Thank you both.

Thank you. Any other questions for either for the on the reports to committee? K. So next, we're gonna move on to discussion items. We have correspondence. Before we do that quickly, I wanna just last time our prior IAC meeting that didn't really happen in March. Shannon, do you we had talked briefly in in this section about the Unum long term care correspondence that people had received. Would you just give a brief update on what people received in case other people have heard questions about the long term

care insurance rate increase? Sure. We had received notice from Unum that they were raising the rates for the long term care policies that were in place and and future, up by 54%, which was kind of a shock. And then, initially, we get a letter telling us it's gonna be 54%, but they don't tell us what that is. Right. But we finally did get a letter recently that showed us what the new rates were. The new rates have been put in. People have been notified, and, really, we've had no not much feedback, which is actually surprising to me. I thought people would be like, what the heck? Now some people have chose to reduce or cancel.

If you're talking to somebody about their, long term care, have them consider contacting one of them and talking about their plan because there are ways to reduce the cost without actually canceling it. Some people think it's one or the other, but it's not. So definitely have them reach out to them and talk about what their options is. That's not something that I can do or anyone in our office can do. We don't we don't know the ins and outs of the plan, but they should contact you. So far, really not a whole lot of feedback, which I am totally shocked.

They aren't reading their mail, perhaps.

That's probably true. The first deduction

is probably coming out this next pay period. So

And so just to recap, this was not something the county did or a county contract change. You explained that this had gone from the insurance company to the state.

Right. The, state insurance commissioner approved the rate increase.

They had asked for a bigger one. They're asking for for years. Yeah.

Thank you for that recap. Okay. So moving on, we have received correspond this committee has received correspondence from the county executive, and also from the director of administration. Shelby is here to join us today to, further discuss. So we'll turn it over to you.

So last year, I think we went into those conversations and asked Dean directly to give us ways to save money. Right? We gave them a target number. They gave us ideas, and then I think we all know the trajectory of events after that point in time. Looking at the deficit for 2027 and the the cost that continue to raise, I think health insurance is still a way to save money for the county, and we want to open those conversations with Dean again.

But what we heard were their ideas from this committee that we could take to Dean potentially for them to explore to give us some cost saving alternatives. And I know that is it a menu of ideas that came from this committee to say, what would it save us if we did this, if we did an opt out benefit, if we did just a premium, if we went back to the plan. But instead of just bringing three kind of fully fledged ideas forward, we wanted to open the conversation here to see if there's something else we could take to Dean for them to explore with Grant.

So zooming out a little bit.

You know,

we had the 2025 well, last year, was 2026 budget. So it was $31,000,000 deficit to ask, you know, employees to get back essentially with $6,000,000, savings of $6,000,000, which why you get back to $6,000,000. So then beginning of this year in the original memo, the similar deficit of, you know, 31.8, a little higher actually, I think, than last year. And so then we had the the my most accounting executive, I think, back in March said, you know, somewhere between the range of 6,000,000 to $10,000,000 is what we're looking at. So now, we've I think all the employees and county board supervisors got an email Friday saying, hey.

It's actually not 31,800,000. We're actually looking closer to 15,000,000. So how does that, I guess, with that updated information, is there a different ask for our to, you know, of savings, right, for the

Sure.

Health insurance.

That's still the target we are asking for for options for savings. So that's for a few reasons. The the biggest one being that a lot of what we did in 2025 for the 2026 budget was the low hanging fruit. Every single department cut that four Most departments cut that 4% or had a cut. So the ways in which we can meet a $15,000,000 deficit across departments is not as easy, and it wasn't easy last time because we've already kind of cut the things that weren't being used.

We already take out we already took out a good number of vacancies. So the levers we have to pull for savings to meet the 15,000,000 are lesser because we already pulled them for the budget. So the ask would still be to look at around savings about $6,000,000 to see how we can still do that and how we create financial stability for the long term to hopefully, in the future, bring back our COLAs and restoring the wage reduction and how do we serve our employees in other other ways while still meeting these increasing costs that are kind of driving that

deficit. Okay.

And so part of I just wanna make sure too that understanding because instead of doing the the health insurance you know, the we did essentially furloughs, which, you know, 1% wage reduction, which is the I think costs around $2,000,000 or saved $2,000,000 for the county. So that $15,000,000 reflects adding in that 1% again.

I think I see Chuck on the call. I think I know the answer, but he's the one that will for sure know the answer. So I'll kick that to him for the actual savings of furloughs.

Yeah. It does include restoration of the 1% reduction that occurred in 2026.

Okay. Thank you.

And so you said, you know, we've already kind of done a lot of the low hanging fruit, pick a lot the low hanging fruit with the the 4% cuts in last year's budget and and other cuts made in the executive's budget last year. So I guess if so $6,000,000 and then at least $9,000,000, if my math is correct. Any sense of where that would come from now?

We're still waiting for budget instructions and looking at what we'd ask departments to do and where those other avenues of savings could come from, but we won't have that finalized until we get budget instructions.

Okay. And we can expect those in May?

I think we're still aiming for the normal timeline of around May. So in the next few weeks, we could have something.

Well, I got for now.

Okay. Thank you. And, Shelby, we appreciate you coming to to be here with us in person today to chat. One of the things I'm hoping for some clarification on you know? So, you know, we understand, the large rising cost of health insurance.

I think we all can probably agree too that this is not just a Dane County issue. It's a national issue of how entire country's health care system is structured, and it's, you know, something we're all reading headlines about every day. I'm a little confused when I'm looking back. I'm gonna rewind us to 2025, and we had resolution one forty six, which was authorizing an addendum to update the contract to provide the health insurance. And at that point, the current estimated annual cost for our health insurance from last year to this year was 86,000,000.

And that's what's in the fiscal note. That's what's in the addendum. That also is what was in the the documentation when we were looking at last year '25 compared to options a, b, or c for this year. Option a had kept the contract essentially the same, but was just to refresh everyone's memory. It had been adding premiums to employees.

And at that time, you know, again, it was about 86,700,000. I am hoping to understand the going back to the budget memo that was issued earlier this year, I believe it was February 20, the total health insurance cost, the estimated health insurance increase listed in that memo was 6,900,000, which was about what they were projecting last year. However, also in that memo, it says the countywide budget for health insurance for 2026 is 77,700,000. So can you help me understand the

think that is a Chuck question if he's willing to take that. Yeah.

I I don't have the documents in front of me that you're referencing, so that's making it. You you'll have to give me some more detail.

I need to give you more detail, Chuck, or is that something you wanted to give?

I'm sorry. I'm sorry, Marissa. I'm not, like, I I don't have in front of me. You're looking at your computer comparing this, so give me some if you maybe just repeat the question so that I can anchor what you're asking to the documents.

I so the question is that last year when we were having discussions about health insurance, our health insurance last year was projected to go up by about, you know, a certain amount. And the project the new contract that is in the fiscal note and was in the addendum was 86,000,000 86,700,000. However, then in the memo issued earlier this year, it said the county wide cost for health insurance is 77,000,000. And so I'm trying to understand the, approximately $9,000,000 difference between those two numbers. I'm just trying to better understand that and hoping somebody can clarify.

I'll have to I'll have to go back to my notes that that those are based on.

Okay. Otherwise, I can tell Shelby,

like, you wanna position to reconcile those numbers right now.

We did we just found 9,000,000 for Shelby, though.

What? We

found million.

9,000,000.

Here we go. Woah. I don't know what would drive that. Yeah. So we'll we'll look into that. Give an answer back.

Is there something that you

No. I just was I was saying could that be

the retiring premiums or some of the pieces there in terms of the final spend?

Not no. Because this was you know, part of the resolution was not looking at, you know, subgroups. So

email me what it is exactly that you're looking at, and we'll have to get back to you.

Okay.

Do you have other questions?

And so, Shelby, I think that, you know, I think, you know, again, we appreciate you being here. I think one of the things that, you know, jumped out in the memo was that, you know, I know that the county executive was looking for plan design changes again. And You that is one way to impact health insurance in the budget. You know? But as we've heard here today, retiree benefits, and we've talked about a number of other things. And so I'm wondering if and you mentioned an opt out benefit, for example. Have there been other options that are being contemplated by your office that aren't kind of the direct employee givebacks that we're

We We have not progressed on any conversations because I think that it very was clear last year that getting ahead of that and not bringing it to this group first is was a sticking point. It was we wanna make sure we're not advancing something getting ahead of this, meeting until June, right, and then being under that same time crunch where it feels like a decision has to be made if we're gonna make one, and this this body hadn't had an opportunity to weigh in. So this really is the first time we are opening these conversations for what we potentially take to Dean and what we'd be considering outside of what we how we did it last year or premium changes, plan design changes, the details of that could be nuanced.

I mean, some of this may involve being, and some of it may be internal. Yeah. And so other things that we've been talking about in the RFP subcommittee and that we've already, you know, tried to start scheduling information sessions on such as retiree benefits are, things like self funding. You know, we've been looking at other counties that are supporting self funding. We've been talking about opt out benefits.

We've talked about expanding the pool. You know, I think we keep hearing that the Dane County book of business is so big. You know? In some ways, we could talk about making it smaller, but you could also talk about making it bigger and how that impacts things. And, you know, having that folks at m three, educate us more on an ICRA, which is an individual coverage health reimbursement arrangement.

And so I think this committee has you know, is dedicated to learning more about a lot of different options, and my hope is we can come up with some creative solutions, you know, or menu of different options. Just to keep everyone informed on this, you know, Brian and I have been chatting with Amy and m three on different kind of topics that you know, all these topics. And so if people can think of other topics besides the ones that we've listed already, please shout them out or email us. And then the folks at m three are able to schedule speakers and presenters on a number of these. And so I think the hope is that we're gonna have a series of special meetings, dates to be determined on a number of these topics coming up in the next few weeks.

Shelby, what is your timeline?

I think these things need to be happening in tandem. So when it was last year, that timeline was incredibly crunched and not useful for any of us, honestly. So I would think that we would need to approach Dean for savings potentials and what it actually gives us for, like, for each item or for each plan that they could change for 2027 within the next few weeks. We probably need to sometime mid May. We need to go to Dean and start having those conversations. And that doesn't necessarily mean we come back here with finalized idea, but we do need to start opening that door to to what that could look like for consideration while you guys are also at that RFP subcommittee exploring other ways internally to save.

I think having an idea of what the options are is will be beneficial. But I think one of the things that this committee is hoping for, and I think the EGRs in general, are that the one magic solution isn't going to be the give back by employees, but rather a maybe a combination of what other options can we pursue to chip away at that number to make it a little more palatable. And and I think we all realize it may not be chipped all the way down to zero, but if we can make it anything less than the 6,000,000, that's what I think we're all hoping for.

Travis? Yeah. Thank you. And it kinda speaks a little bit to what Brian said there, and maybe this is the venue, but we have you here. So, I'll just ask it.

Are there other pursuits that the county has right now to try to lower numbers other than just health insurance? Is there other plans? You know, I I I hear this a lot from coworkers about increasing revenue by selling buildings or selling county land or or doing a a just kind of a a mixed bag of things that can bring that number down that doesn't just automatically include, you know, asking us for 6 to $10,000,000, asking us for roughly the same ask from when the budget was twice as bad. Like, the deficit was twice as bad a year ago. Are there other avenues this the county is searching currently to bring this number down that just doesn't involve health insurance?

At all? And we're looking at every single avenue we can, right, to alleviate this. And like we said, like Chuck confirmed, our budget numbers include restoring the 1% wage reduction because we are committed to to different ways of helping our workforce, but also still meeting the financial moment that we're in. The county executive put out the survey to hear from all county employees if they have ideas on ways to save that we can explore. I feel called again to address that selling buildings and changing capital cost doesn't actually save our operating costs.

This is an operating deficit, not a capital deficit. And I know that I think we've all had those conversations, but I think it's important to reiterate going into this year too is that that's not we can't sell something and take that money and put it towards our operating budget. It's just not how the finances work. But to answer your question, yes, we're exploring everything. We're looking at how departments could meet this. We have the hiring freeze that's continuing, so we have additional avenues. Unfortunately, the biggest drivers of costs in a workplace are our health insurance and our people. And so it's very hard to cut programs that serve our community when those are the driving costs. But, yes, we're not just depending on five to six million dollars of health insurance and then washing our hands of the rest of the deficit. Everything will be pursued just like we did last year.

But at what point does the the freezing of positions I mean, that has such a negative impact on the people that are still working in areas where they have three, four, vacancies. Mhmm. I mean, is there any consideration being given to filling some of those ahead of the the freeze, the sixteen weeks, just because we have, you know, like I said, some areas that which people contact me. Like, what why are is our department not gonna hire? And it's just like, I explained the freeze and everything. But, I mean, at some point, the more people that are leaving are going to other positions, and some units are really struggling to to even do their daily work. What is what is being considered as that for that?

Not all positions are held for the sixteen weeks. Okay. And those conversations are had with the department heads and the managers. Because if a if a unit of six is down three, that's a different configuration than a structure that has 30 of the same classifications and is down three. Right. Right. So those considerations are given in that freeze. So not everything is held for the sixteen weeks

for those considerations.

Okay. Do you see that continuing next year?

I don't know yet.

I I know it was probably not fair,

but I thought I'd ask anyway.

I know this has been brought up before, but I think it bears repeating. One of the issues that came up when we were discussing the 1% wage reduction is how that impacted people at different levels. And one of the things is is I understand the county is budgeting in to return that 1% wage reduction. But if we significantly change plan design, there may be people who that little bit that they'll be getting back is going to go out three, four, five fold in what the new insurance costs will be. So just something to to consider.

Absolutely. And that's why we're starting this conversation early. Right? So any of any of the nuances of any solutions that could save us on health insurance can can have that same conversation and the luxury of a little more time.

Scott has his hand up on the Zoom.

Thank you, Marissa. So one of the things that the county did during this last year is offered the early retirement package. And I'm just curious if Shelby's able to share any information on how that how successful, I guess, that was utilized by, people during this year and whether they are including plans to, include some sort of package in the future, you know, to to address this next year's situation, and whether it would make any sense to modify or change that package if they are planning to offer it in the future in light of the experience of this last year.

I can't speak to any plan to do that next year. I don't know if there is one or if there will be one. Those conversations will be had as we get deeper into budget season. We have had higher than average retirements at this point in the year. We have we'll see how that goes, and then we are finalizing the q one numbers and memo that controller Hicklin is putting together that will have a little more information on that that should be available in the next few weeks.

And and would that information be shared with with the committee? Because I it seems like that number would be an important factor.

Yeah. I believe that number will be public.

Great. Thank you.

Yep. So, Shelby, in your memo, you mentioned kind of, you know, one of your you know, you recognized, you know, the concerns of last year and appreciated the feedback that you wanted to address the two top concerns, one being transparency and the second being the short timeline. I do want noted that I would probably highlight a third concern, which was breaking a contract mid, you know, the midterm. And so that was something we heard a lot from employees that they kind of were feeling secure in something and knowing that we had a three year contract with Dean and that it wasn't gonna be broken, that they could at least rely on this for the next three years, and have that stability. What would your response be to that concern?

I Dean did not change the contractor come to us and ask us to change the contract. Right? We asked for ways to save, and then and one way to do that was to amend the contract for that year. So that was us approaching them to alleviate concerns that we were having. It was not breaking a contract or the terms of their contract. It was just how it was paid by the county themselves. So I don't know if that

Well, but it is modifying it with, like, plan design changes, for example, are a change to what an employee would perceive as a you know, they think they've got a deal. They think they've got something that they can count on for three years. And so, you know, I understand there may be, like, technical lingo behind the scenes, but from an employee's perspective, how would you explain? I understand it wasn't Dean approaching the county, but then how do we explain to an employee that their employer is trying to change something that they thought they had secured for three years?

I can try and speak to that a little bit. Just I I think the key thing is is the perception. I think it's part of health insurance is a bit of a black box for, you know, every other employer group that we work with, health insurance is an annual piece. Where it is you are purchasing contract, you're purchasing a contract for one year, insurance carrier is gonna give you a renewal at that point in time based on where that risk is coming in and what they feel is appropriate for the next year. The county has been able to exert some control over our carriers and negotiate multiyear contracts where there's a not to exceed piece in there where we don't know exactly what things are gonna look like next year, but we know that for your current plans, it's only going to be x percent above current.

And that doesn't impact the the plan design piece of it. There is the ability to change that. And, again, to your point, that is an insurance technicality to a the member. Here's a three year contract and thinks nothing is gonna change for three years, but there is that piece of you're guaranteeing you're saying we're gonna offer this this piece. It's gonna increase by no more than this much, but there is a an opportunity every year to tweak that.

Mhmm.

I think I think it's important for me to say too that I don't know it goes to the perception. Right? Like, there's no good way to solve a $30,000,000 deficit that doesn't cause uncertainty and a little bit of stress. I think that's normal for all of us, and we all felt it last year, and we all feel it this year too. So and that and those conversations were being had with ways to try to insulate the workers as much as possible to create less impact to prevent to save jobs.

That was the big drive last year is what do we do to save our workforce and not have any layoffs? And that's what we were looking at for 2026. And so this was one of those levers that asking everyone to accept a change that they didn't expect. And I don't to meet a moment that was hard for everyone and continues to be a struggle, let us or we were hoping to let us preserve stability in other areas. So I don't know. I don't I can't fully alleviate those concerns because they are are stressful.

I think one of the biggest concerns last year too was that we had just completed meet and confer.

Sure.

And then the this came out, like, a week or two later, and it was it was a shock because that is why people felt like, okay. Meet and confer is now done. Mhmm. This is finalized, and then boom. Sure. So I that's the kind of thing that I hope doesn't happen again.

And that's I think I think all of this goes to that point in transparency. Right? At what point was everyone brought to the table on this? At what point did we know? Like, that was a big conversation. What I'm hearing now is how do we speak to employees if a change happens again? That to me goes to transparency or even feeling like we correct me if I'm wrong, but the feeling that we intentionally did something after me and infer, which was not the intention and not at all intentional action. But that perception of it, I think, still goes to the transparency of those conversations and how they were.

So I'm just thinking a little again, zooming out a bit. With you know, we had the last year budget deficit, $31,000,000. You know, at the end of the budget cycle at the at when we finished the budget, it was like, okay. Well, we didn't really make any progress or made it worse because it was a higher deficit. And now, you know, we're, again, kinda back to half the that amount now.

And I just it sounds like there might be, you know, I'm sure that's due to some of the, the savings and, you know, that were position cuts and whatever. A lot of positions that were cut, eliminated, or unfunded last acquisition, but also or last budget. But then, you know, presumably, there there's we have to I think in the memo was something about, I don't know, if there were revenues, new revenues, and if I'm just trying to get a better sense of, like, you know, obviously, there's still a deficit of $50,000,000 for for 2027. But then, you know, the longer term prognostic of things for, you know, 2028 and beyond, are we are, like, you know, sales tax revenues going up? Is, you know, interest income holding steady?

And are those things that, you know, if we're going in that general direction, you know, I think that kind of, you know, in you know, has a impact on where the employees are gonna be thinking about as far as, you know, do we do something that's more temporary, right, as a solution, if things are going in the right direction versus, you know, a structural, issue as we've kind of been, you know, discussing for the last, you know, year or more. So I'm just trying to get a better sense of, you know, the overall financial picture given the the the, you know, the news that we've gotten in the last week or so.

And that's back in Chuck's world of expertise of actual pressures on that budget.

So let me rephrase the question and make sure that I understand what you're asking. So your question is, we've had deficit going we had a significant deficit in for 2026. We have a a less significant deficit for 2027. Are you asking for the crystal ball for '28 and beyond? Is that your question?

Yeah. I I think to some extent, I mean, obviously, it's you know, I understand it's gonna be difficult to to project with any sort of definitive answer given the fluctuations that we see in the instability of the county budget and revenue sources in general and what's going on at the federal level. But I think in the memo from

You don't need to keep talking. Let me if I understand your question, I will proceed to try to attempt to answer it.

Sure.

But do I have a fair understanding of your question here? I think I do. You know, we budget annually based on, you know, information that is current, and that information changes, you know, from now to the end of the year. Well, you know, there are certainly risks that I wish didn't exist, things like the war in Iran and how that, you know, raises food prices, raises gas prices, moves household spending from spending that might be taxable under our sales tax to food and gasoline that are not taxable under the sales tax. There are always there's always those kinds of risks and fluctuations that occur.

I think the challenge for Dane County and really the challenge for most local governments in Wisconsin is that the inflationary pressures on our most basic costs are going up. Those inflationary pressures are pushing those costs up faster than the allowed revenue, the the available revenue increases that we can realize. For the county, you know, sales tax is not growing as quickly as some, you know, some of our costs. And, clearly, property tax revenue of you know, increase of, you know, 3.2 to 3,400,000 and a sales tax increase of, you know, 2 to 3,000,000 gets us 6, know, $67,000,000 a year of new GPR. And over the last couple of years, the increases in staffing and

Chuck, we lost you.

Chuck is gone.

It's like everybody froze.

No. No.

Let's see.

Oh, okay.

Still there, but he's not there.

Unless John's also truly still.

Chuck, we can't hear you if you're still talking.

Someone's on the phone chime in just to make sure that we're still getting audio.

Yeah. Amy? Yep. I can still hear you.

Okay. Good. Can you,

I don't know. I guess it would I was obviously starting to answer the question, but I think, you know, the the memo that came out on Friday was a lot less detailed than what came out in February. So just, you know, more more specifics on that on how that change came about, I think, would also be helpful for for this committee and for employees to understand in general.

And piggybacking on that, and I'm not an accountant. I'm not a controller. But my question, you know, I understand that we have now kind of, been able to resolve some of this by by, you know, closing the books, so to speak, on '25 and recognizing surplus and additional money. Is there such a process that is expected to happen midyear, you know, looking at that because with the hiring freeze and all the vacancies, I would anticipate some of those were budgeted, and there would be surplus from that.

Our vacancy rate is about what it was last year, and it's lower than it has been in previous years. It's been a percentage point change, point 9% change. Again, we'll have the final numbers. And to keep in mind too that we shrunk our workforce last year, and then some of those vacancies will need to be filled too. Right? So we're seeing more vacancies because of our freeze, and then what do people need and what they do not need. There could be some additional savings for this year, but how it affects next year, we'll have to see midyear. But there is no, like, closing the books or some new information that will change some of those projections. Like Chuck said, we'll respond as we get more information about sales tax or inflationary factors or how things work like that, but not as concrete as closing the books on a year. Right?

March those February projections were always a little earlier because they are based on projections. I hope I did that justice without Chuck being able to chime in and tell

me or not. So

Let's do it.

Talk might be bad.

Chuck, can you hear us?

Not hear

you if you're talking. I guess we'll go to Heidi and then maybe come back to Chuck. I don't know if Chuck joins on the public link, then Linda's able to make him a panelist again. Would that work?

He's a panelist.

He is. Yeah.

He said he's

on the attendees list, so maybe that's what he means by that text to me. He's that he rejoined via a link and needs to be promoted. Yeah. So he says he joined on his phone. So if

we can

He's he's showing up as just a phone number. So if that's him and you need me to block him up, I can do that.

Yeah. It's 8936, I think, Linda.

One second.

Thank you.

It will not allow me to promote as panel, but I can give him he has permission to talk. So

Alright. Chuck, do you wanna give it another try?

And it look it's it's looking like he's muted.

I'm still not able to hear you if you're talking, Chuck.

He's muted. I asked him to unmute. Okay.

Try to

unmute a phone.

Don't know

if you can maybe initially merge the profiles. Think Zoom used to want you to do that joined.

I I can't merge profiles.

I'm not sure if he's able to or not.

Alright. I think we'll go to Heidi for the moment unless your question was for Chuck. Otherwise, we can go to Heidi and then come back to Chuck.

I don't know that

my question is specifically for Chuck. One of the questions that I have many employees talking about and asking me about is, the staffing. And so, it's come up that, there was an huge increase in staffing needs. Many people were hired, and now we have the retirement, and that's kind of shifting things. And it's also coming back around that, you know, we're gonna need to hire for some of these positions.

So the question is, in looking at, you know, the amount of hiring that's been done in the last, you know, however many years that it's five to ten, that the staffing has increased dramatically, what is the what are those numbers that specifically divide out between frontline staff and management? How how does that balance out? Like, was there you know, if you hired a 100 people, were there was it fifty fifty? Or, like, how what is that looking like? And I think that will help people, folks understand things a little bit better.

Yep. We did pull those numbers last year, and I can see how quickly I can search my Outlook's inbox, which is From my recollection and while I search on this to confirm it, our workforce is about 13% managers, 87% frontline staff not managers. And in the increases, managers increased by about 16%, and then all other staff increased by the of that. So, again, about an 80% increase. So the ratios of managers to frontline staff and the increases we saw over the last few years are roughly in line with our actual total workplace.

So 13% make up a 16% increase in managers over that time, 87% frontline staff or nonmanagers, then a slightly decreased 80 to 83% increase in nonmanagers. And I'll pull those final numbers, but that's what it looked like in the past five years.

Shelby, what were those what

was the time on that? The the time span you said?

Let me

The one year, two years?

Let me pull up the information. I believe we I believe it like, a five year span of time when we saw that big shift up. But, again, let me confirm that while we're sitting here so that way we all have the same information, and the the recording reflects the reality of that. So let me look it up.

Thanks. The thirteen eighty set percent eighties avenue, right, that you're talking about?

Yeah. We're about 13% managers, 87% non managers.

So I think I've rejoined the meeting. Is that correct?

Hey. There you are. Yep.

Okay. Shelby, I just have one

quick question. This committee is more jinxed on Zoom than I agree

on that.

Totally. So I I I I wasn't able to listen to what other questions came up as I was struggling with the tech, the the different alternatives to try to rejoin. But I can go back to the I think I cut out in the middle of my answer to Derek's question at some point. I saw people

Yep. Shelby, do want

to me, and I was con I continued talking. So

That's alright.

So did you wanna finish your thought, or did you wanna go to Chuck and

And that would be helpful so I can make sure I pull the right information, and I don't

know if

I need the follow-up, and that's Sure. So, Chuck, we'll

Mhmm. Probably missed much of what you said in response to Derek's question, so we'll let you take it away.

Okay. Thanks. So I think general generally, budgets are gonna be a challenge for the county going forward and at least over the next few years. You know, we have revenue growth that we don't have a lot of control over. So we can only increase our tax levy by a certain amount, and we're we always increase it to that limit.

But we don't have a lot of control over sales tax. We can't increase it above the amount that's authorized under state law, and our receipts are really a reflection of the spending patterns within the community. And, you know, though we've had a period of economic expansion that lasted a long time, at some point, you might guess there might be a recession, I hope, not a self imposed one based on the country's foreign policy, but to the extent that those uncertainties and that instability changes consumer behavior and people spend have to spend more money on energy and less money and more money on food. Those are categories that are not subject to the sales tax, you know, and that displaces spending that might otherwise increase our sales tax receipts. I think in given inflationary pressures around energy, we don't I think interest income will probably be remain steady.

We're not seeing rate reductions that would diminish that source of revenue. But when you take together our primary sources of increases in general purpose revenue, which would be sales tax and property tax, on an annual basis, we're lucky if we get $6,000,000 out of those two. And our cost to continue county operations with respect to, you know, absorbing these insurance cost increases and steps and longevity, things of that nature, you know, I've been running 8 to 10,000,000 a year. We have other financial pressures, you know, contractual increases and utility increases beyond just personnel, other kinds of insurances that also grow. So it's, you know, it's gonna be tight.

I don't I think I hope that, if we close this $15,000,000 deficit with real reductions that will continue into 2028, we've got a chance of stabilizing our finances such that we won't be looking at those sorts of deficits for '28. But we have to budget year to year. That's that's just my best projection or assumptions going forward.

May I ask or go ahead. Give me Greg, go ahead, Shelly.

So I pulled the numbers that were ran in September of last year, so he's probably updated. The span of time was from 2017 to 2025. 16.3% of the new positions were managers. 83.7% of those were nonmanagers. The biggest change we saw was in social workers with 94, and then a 154 professionals are eighteen seventy ones, forty seven sixty fives.

Those are the biggest changes. But in all, to total it up, there were four hundred four hundred and forty one employees added. 369 of those were nonmanagers. I think the same question came up last time. So I can also throw it in here too for the top 20% of earners of not from for nonovertime salaries, 60% of our top earners were in nonmanager classifications. And that eightieth percentile cutoff was one fifteen seven hundred. So that's kind of the breakdown of what we see versus managers, nonmanagers, salary, and increases.

So, I mean, you were going over the booked and play groups. So how many were hired in 07/20?

See if I have it broken out by 07/20 got 61.

We're talking about new positions or positions that were hired?

New positions.

Shelby, could you please give the breakdown of the new positions and employee groups again? I would appreciate that. Sure.

Attorneys got five. And, again, this is from 2017 to 2025. This is span we're talking about. New positions, a total of 369 nonmanagers, five in attorneys, seven zero five lost eleven, seven twenty got 61, confidential employees lost one, sixty five got 47, Eighteen seventy one got a 154. Trades lost one. Social workers got 94. Eight ninety five got 20. WPPA nonsupervisor got one.

Yeah. I mean, some of those for 65 could go back to the amount of, positions that were eliminated in 02/1910.

I don't have any context on a range

or a Yeah.

That's just the new positions added after '27 to 2025. So it wouldn't have taken in this would not include the budget changes that were done in 2025 for 2026.

Looks like we have a question from Kate.

Thanks. Just a quick question. So, of those positions, Shelby, do you know which of those are non GPR funded? No. Okay. Because I'm I'm just thinking that many of the positions, for instance, in CCS, that have been added, are non GPR positions. So I think that's also important to note when looking at this. So so if there's a way to to provide that information at some point, that would be great. I don't need it now, of course, but I'd I'd I would be interested in knowing that.

Thank you.

Appreciate the question.

So maybe going back to and or did you wanna

Well, I mean, I can come. So I think, you know, I appreciate you digging up the numbers, Shelby. I know there's a lot of pressure on the spot to try to wait through the outlook. Like, we could you know? But we appreciate that. I think one thing we would you know, when I I was actually also looking at numbers of staff, our employees across the board, you know, as part of looking at the health insurance enrollment. And so one of the things that did jump out at me when I was looking at you know, when we look at the health insurance enrollment, we can look

at it by group. You know?

And it's the same groups you just mentioned. Attorneys, seven zero five, seven twenty, etcetera. When we were looking at that from the enrollment in terms of total group, you can look at everybody enrolled in health insurance and then people not enrolled. So presumably, that's everybody who exists as an employee. One thing of note, I thought when we looked at the change from the prior year from '25 to '26, we saw the shedding of a lot of positions in the lower wage groups such as seven twenty, which by my count, lost 27.

But then in the manager's job last from when we look at '25 to '26, we saw a gain of 13. So I don't expect you to have, you know, an answer on that now, but it might be something

worth looking or new positions? This is total group size. And so it's So those enrolled in insurance, not the actual not position side, but numbers of enrollees by group. And including non enrollees. So, presumably, it's all employees. Sure. So,

you know, it totals, slightly over 2,700, so I believe that's about how many employees at the county. Sure. So

Yeah. That's a

so, I mean, that's

just his divorce is I gave up my state insurance and came over. So I don't know how we get to, like, enrollees by group.

This is so that would be, as Nate and Jerry would call, belly buttons.

Highly using sure it's term.

I didn't say it. Typical. So I'm not talking belly buttons here. I'm talking Employees. So the numbers that I'm looking at are showing a shedding of jobs from 25 to 26. K. And I we can you know, I can show you this separately.

Yeah. That's between yeah. Enrollees and positions, I think, is where I'm getting hung up on what number we're actually talking about and the change of it. So I'm talking employees. So So 13 increased managers last year. Newly created managers. I I have no idea. So that's Sometimes,

I mean, I'm not sure if you're there's reclassifications of positions. So I'm not sure if those might not be

Yeah. I think we have to I think we'd have to do a lot more digging on what that's showing.

So, you know, certainly appreciate your willingness to come here with, you know, open perspective, open open to ideas. And I think you've I mean, I think this body wasn't on at the time, but you've been asking motions saying, hey. Like, let's not try and affect the health insurance, make plans and changes. So that's something that you guys would like to keep an option on the table. But, I mean, it sounds like there's some ideas that you guys have talked about it. I see the subcommittee that I mean, the goal of that committee is to kinda look at, you know, going up to bid for 2028, for or potentially

going happen early next year or end of this year for the following year.

Yep. '28 through '32.

K. But I guess my question may be for to you, chair, or to Brian, our vice chair, is, like, what and I think you maybe touched on this when we were at the beginning of discussion. What other options that we could or that you guys have discussing in that subcommittee that we could potentially use as vehicles for, you know, savings related to insurance that aren't employed givebacks?

Thank you. I mean, I think it's a you know, as we've talked, it's, you know, not one magic answer. And I think that's what you know, and it's not an easy answer, you know, again, because this is a national issue. And some of this is, you know, getting problems beyond any one of us. I think that part of what we're trying to do is look at all these different options and how to, you know, kind of reduce the negative impact on people while having a positive outcome.

And that's one of the things we've talked about today with the retirees. You know, how can we create a win win that actually may be something that could save some money, could reduce the cost of the contract, and actually end up being a win for the retirees. You know, we don't wanna harm anybody. That's certainly not the intent. You know?

But we have a lot of concerns about the plan design changes, of course, and how that would impact employees financially. Other options and discussions, you know, the RFP subcommittee does have, you know, somewhat limited scope of looking at the RFP and what changes could be made to that. And so one of the things we're talking about tomorrow, this is quite a week, Brian, is, the man the you know, what's in that RFP that's mandatory that could be shifted to a preferred. So that's gonna be part of the discussion tomorrow.