Homeless Issues Committee - Regular Meeting

We'll go ahead and call it to order. Linda, could you call a roll?

Marissa Burak? Here. Brian Tushar?

Here.

Scott Drummond is excused. Jay Brower?

I think he just came on.

Yep, I see him. Tommy Rylander? Yep. Amy, you'd say is excused. Shannon Meyer. Yeah. You have a quorum.

All right. Thank you. All right. So hopefully I can do justice to these meetings, this meeting today. I don't know if I will do as well as Marissa, but I'll try. Consideration of minutes.

I was just looking at them and I thought we had a vote to, I don't know, Nate, if you can pull them up or if you have them. But we had an action item about the mandatory and preferred requirements for the RFP process were discussed. I thought we did a vote to, we finalized those and then we made a vote to recommend those be sent to DOA and PNF.

That sounds correct.

I'll have that corrected.

If anyone else has any other issues, questions, concerns, otherwise they would entertain a motion to accept with that correction.

I'm sorry, who did the first motion? Thank you.

All right. Any other further discussion? All those in favor, say aye.

Aye.

Any opposed? All right. Minutes are accepted. Action items, we have none. Discussion items, we are set to review the disability insurance RFP.

Brian, if I could just interrupt real quick and just note that I'm present here. Sorry, I wasn't here for roll call.

Yep, we got you Jay, thank you. Nate, do you have that?

Go ahead and pull that up. was curious about to derail us immediately. But I guess any thoughts or feedback on the last full full meeting and those medical options we presented?

That's worth Oh, I think we're not gonna I think we have a special meeting planned on the 30th. Because some of the committee members here are not everybody here doesn't overlap with IAC. So I think right at this moment, Brian and I are probably the only two here. Well, Tommy, you were at, I think, well, I think, I guess my point is everybody here wasn't there, so.

Totally fair. I just thought I would ask. I was technically a couple hours away from being on that committee last time I held that meeting.

Yes. I was like in process during that. So for this, I had asked Amy, and I know Amy's not here. You know, I was trying to have her pull out. have me pull out the mandatory requirements the same way that we have in the healthcare RFP, but it didn't quite exist in the same way as Simply. And then this was an 11-page document, so I said, let's just send everybody the whole thing and we'll go through it. I felt like it wasn't going to take too long, but there were different little components throughout it that I thought we could look at that weren't you know, kind of neatly in one list the way the health insurance was. And just for everybody to recall why we were doing this one, it was because this was the next up, next to be up for review. And then, so Brian presented this to the full IAC when we were there last month, and the full IAC expanded the scope or purview of the RFP committee to include this, just to catch everyone up.

In my review of it, the first section that I saw that maybe would be fall under the category of mandatory or preferred would be 2.5. So needs the insurer must provide benefits that duplicate or exceed the two present plans described in the RFP. So I don't know if anyone else caught anything prior to that, but that was kind of the first one that I saw. Yeah.

And I think we had pulled that from the health RFP more or less health dental.

There may have been one other before. Okay. Well, and maybe.

Actually, but 2.4 where, you know, I think with the deputies as it talks about, you know, his own job, that's a little different, but that's, yeah. Okay. It needed though, I think definitely.

And then the other thing I think Shannon, you and I, we've talked about in the past that is in here as well is about the open enrollment piece. So I want to make sure we cover that, but we could start with what Brian's talking about.

Yeah. So I would say that just as we did with the health insurance, that that's probably should be moved to a preferred versus a mandatory. I think I like the idea of it being at least part of a quote in the RFP so that we can compare. But I don't think that we have to make it mandatory where it's the only people that can put in are the ones that are going to meet or exceed.

Yeah, that would make sense. And Nate, correct me if I'm wrong, I think over the years that we've done this, I don't think we've had many carriers that haven't more or less met

The one thing I was thinking was that open enrollment piece for that. Allowing an open enrollment system. I thought there was still the situation where folks that got EOI declined. would need EOI still if there's a carrier change or? I thought it was, certainly I thought it was with the incumbent. Incumbent, yeah. Maybe I'm thinking back to when it was Hartford.

Hartford, yes. Generally, when you change carriers for life and disability, there's an open enrollment. But yeah, I think incumbent, if somebody was declined, if I was declined, before I could not open and roll again. And that we'd have to go back and double check because with Hartford, when it moved from Hartford to Standard. Yeah, and someone would reach out with Dan. Yeah.

And this is kind of my, you know, biggest area of concern. And Shannon, can you recall how many people we have I mean, not enrolled. I mean, so this is the people that end up during open enrollment kind of missing their window for whatever reason or making a choice not to take the disability insurance and then later realize they should have. And then if they try to go through underwriting and don't pass it, they're denied, and then they have a problem even when we go through open enrollment, correct? Yeah. Shannon, you're muted. Still muted, Shannon.

Unmute. Okay, is that better? Yep, we got you.

I don't know. The student trying to do it on the phone is a pain. So I think that the issue was that then why would anybody sign up until they needed it? If you could always get it later on, I mean, the purpose of it is to have it, and they don't really want just people coming on who are likely to need it, like if somebody starts with a health condition and then they decide, because then that's going to drive your rates, too. So but we probably only had three or four people who have been gone through underwriting and been denied, as I can recall. And what I always told people was, if you have a health condition that you could be denied, don't do it because you'll be denied and can't re-enroll. But if there's an open enrollment, then you will be able to enroll. But if you get if you go through underwriting and are denied, you lose that right. I'm guessing that that's probably what most carriers have, but I'll defer to Nate or Jerry on that.

Yeah, no, you're right. I mean, that's very standard because like you say, you know, getting, having people on the plan, it builds up those reserves and keeps the rates more stable on a year over year basis or contract over contract.

Could those be split into two things? I mean, are these kind of two separate things that we're lumping together or

What do you mean? As far as?

I mean, the first line, the insurer must provide benefits that duplicate or exceed the two present plans. That seems like a kind of one point. Yeah, yeah. And then open enrollment seems separate.

Yes. I'm sorry. I wasn't following. But yeah, those are two separate things.

So maybe that. And then I guess for Nate and Jerry, are either of these components separate? You know, are there any things that when we're going out for bid with disability that have been flags in the past that you can recall?

No, not this second one for everybody and just how it deals with the declines is the one that jumps out there. We can double check that both the number of folks have been declined and how that's been handled.

Sorry, I didn't mean to cut you off, Jerry. No, no, no, you didn't cut me off. No, I get that. But I mean, outside of the scope itself, there have been things, but yeah, we can double check with Standard when we made that move just to see. But I don't recall, you know, Shannon, there were a handful of people that were declined, but I don't recall any, how do I say it, big issues with that, if that makes sense.

Right. I mean, I think the other thing that we have to remember is that the standard, the last couple of times that we've done open or had renewed the contract, they've done open enrollment where most other providers, I mean, for the first probably 20 years of my existence within county, you could not sign up if you didn't sign up at hire. So, I mean, the standard has already taken it a step further than the carriers in the past were willing to do.

Yeah. And that's fair. And, you know, carrier discretion as well.

Yeah. Yeah, I think that was those conversations we had with standards basically said, hey, we don't want it to incentivize people to move to a new carrier based on an open enrollment. Right. I'm just reading these two bullets and I feel like there's some. The insurer must allow for open enrollment for all active employees, whether or not they are currently enrolled in a county plan without undergoing any health underwriting. There's no time frame or kind of piece there. And the second one says open enrollment without underwriting shall be allowed thereafter at each contract rule or contract extension and for any new employee applying for the insurance within 30 days. To me, this first piece is kind of tied to this. Yeah, that's just new hire.

Good point, Nader. Yeah, I mean, really, and yeah, for any new employee, that's just kind of standard and given. Okay. I don't even know if that would really need to be in there, but it doesn't hurt, if that makes sense. Mm-hmm. Okay.

I guess my biggest concern on this is that our whole goal to this is to try to get people that may have in the past kind of overlooked us as a potential client because of something we had in here right if these haven't been road bumps then yeah i don't know that we need to do a lot to eliminate them but we need to figure out i think over the you're on the right path going on the preferred makes sense you know it hasn't been as much of a roadblock as say with the health insurance over the years yeah i would say there's a much more um

competitive ecosystem in the life and disability space. And you've got 30 logos that could potentially handle, you know, with less than that, that are really like focused on public sector and kind of go better fits, but there's a lot of carriers that play in the disability space.

Yeah. With the current, you know, so we talk about the current benefits within health. Is there anything within our current, I don't know if plan design is the right word, but I know we have, you know, like the waiting period and how much benefits they pay out. Is all of that pretty standard or do we have any anomalies there?

I would say the majority of it is standard for the public sector.

Okay. Okay. Nothing like the 34-day prescriptions. That's hiding in the health. Okay. Because I think we've also talked about making sure we're comparing apples to apples.

Yep.

Yeah. Okay.

Yep. In your line, as far as the percentage of benefit, you know, it's way back in the day you had the WEE plans that had 70, 80% of predisability earnings, which really, you know, people would say, well, why would I go back? Per se, I'm not saying county employees would, but that, you know, as WEA, you know, had lost business and that, but still employers, you know, you guys are kind of right spot on. I think as far as it keeps people afloat when they need it, and then they're able to come back to work.

You guys okay with the kind of how I rewrote this little section?

New hires can enroll.

Oh, yeah.

I mean the meet meet or exceed is actually you know kind of a interesting statement because some of the plans are designed so differently like some plans will start after seven days versus waiting for the six weeks is that meet or exceed or is it because the the the Structure is different. It's not going to meet or exceed the plan that we have. I mean, do you see what I'm saying? That's kind of a hard one for this because there's so many different types of disability plans. And because right now, employees have to use benefit time for the first six weeks, period. And so maybe there's a plan that's structured differently that doesn't necessarily meet or exceed what we're asking, but that would meet or exceed the needs of our employees. Right. Right.

You know, and you're right, because again, I think with this, taking that verbiage directly out of the health RFP, you're right. It's kind of trying to put a square peg into a round hole.

Well, I think in the health RFP, we ended up having a lot, there is a line that says something about any variations, you know, to the current plan design must be described in your attachment or something.

And I think there's similar language here. So let's keep plugging away at some of this stuff. Yeah. to that. If you want to tweak the meter exceeds, it is important to say here's the baseline for this contractual level. See where that goes to.

So is that six month waiting period? Is that a carrier issue or is that something that the county is kind of imposing in order to kind of keep us away from the, oh, I'm just going to open enroll and then immediately start getting benefits.

That's the latter. There's a county is that it's a county piece where you don't always have a six month waiting period essentially for the benefit, but that does really help keep the rates in check too. Yeah. Employers can vary on that.

Okay.

And that might be, is that handbook language, Shannon? Do you recall?

I don't, I don't recall. I mean, I think the other thing is that kind of matches technically like with probation. Yep, for most groups. Right, and the wellness hours are based on having at least six months in before you're entitled to any wellness hours.

Yeah, I think that actually goes back and looks at your prior year of sick leave usage.

It does, but what I'm saying, so anybody who is newly hired, If they sign up for the disability insurance, they don't pay premiums for this first six months. They start their premiums at six months, and those premiums are based on overusing sick because we have nothing to compare it to. So they're paying 100% of their premium, which is why we encourage new employees to sign up for the wellness because they are going to pay their premium anyway, and then they get the hours to offset it. So it's technically a win-win for them.

So, Shannon, did I catch that right? For the first six months, they don't pay disability premiums?

That's correct. They don't start paying until six months. Okay.

Well, unless they – doesn't it depend which A, B, or C choice they take?

No, no. You're not eligible for disability insurance until you've been here six months. You sign up at open when you are hired. Okay. But you're six months waiting. So if somebody were – So if somebody signs up during open enrollment, there's still going to be that six month wait. Okay. Yep. Unless we're transferring carriers, then I suppose that doesn't apply because we've would have all met that criteria. Those are who were signed up, but anybody who is newly signing up to the disability plan would have a six month wait. Does that make sense? Yes. Yes.

And disability insurance is a provision in the handbook, and it does say no employee shall be eligible to participate in the first six months of employment. And it has the waiting period. So that's handbook language.

Yeah. And I think for a lot of reasons, that's probably not the worst language to have. Yep.

Yeah, I agree. Yep.

So 2.6, the payment of premiums, this really is a county decision there.

I was going to say, it doesn't seem like this is a carrier issue so much. I think kind of the next issue that I saw. Sorry.

No, go ahead. This was put in probably 20 years ago, maybe. This was because it used to be that you had the premiums were paid just on the structure of sick leave usage. But then the wellness hours were added to allow people to get something in exchange for that. And then the individual pay their own premiums. So that was like a deterrent to using sick leave if you didn't need to, because there's a benefit at the end of that. But this wasn't this was definitely designed by the county.

Does it need, is it of interest to the vendors, Nate and Jerry?

Yes. So generally like there's different ways to handle sick leave. And there are some, you know, some contracts like the city of Madison, where in order to receive any benefits, you must exhaust your sick leave. And so there's, there's different ways there. And then essentially the underwriters are going to keep this sort of thing in mind, um, It impacts utilization if there's incentives for folks to really jump on the plan or not or how sickly it was handled. So it's good to share it.

And we definitely don't want to have the city's plan.

Right.

Well, just because we don't want people to have to burn all their time. I mean, can you see an employee like me if I got sick in the last six months? I'd have to burn all my time and I wouldn't be eligible for short-term disability, which I paid for for 40 years, right?

So, Shannon, there is a provision in catastrophic leave that requires us to use all of our sick leave prior to that, correct?

Correct, yep.

right so i guess yeah i'm not seeing anything else then unless anybody else is until we get down to 2.7 and i think this is kind of a repeat of 2.5 language-wise under general requirements yep equal yep equal to or exceed the current benefits plan yeah and in there oh sorry it's good to have the errors and omissions you know as far as compliance and that's that's standard yeah yeah And then this does also separate out the standard or the short-term and the long-term. Right. Because there is a standard and a standalone.

Correct.

Yeah. So that's good to have.

Yeah. Yeah. And generally for life, for disability coverage, you don't have an ID card. Correct.

No, you just have to call in and...

I think a lot of these are probably part of the purchasing standard, if you will, RFP process. So streamlining it for our purchasing department. Shane, you remember when we started working with the guys about 20 years ago and doing these, and we weren't trying to overstep our boundaries, but it was kind of like as we're going through the city of Madison now, they have a very similar process. process and procurement um um department but you know i think it's really come a long way in that so we were just you know basically adapting to what the county has okay so do we still need that about id cards or could the whole thing be struck i mean i think i'll highlight it there's no real reason to

to get an ID card for these benefits?

Yeah. That if the vendor does not currently use ID cards, then they don't have to have them. Right. But what if we, what if a vendor signed on that they do require an ID card? Wouldn't we then want them to have to provide them?

Honestly, in my opinion, probably not because I always want to make sure I know where my health insurance ID card is. But with this, in the 30 years I've been doing this, I've never had a situation where for a disability to receive anything, I've had to show an ID card. The employer generally supplies all the information as far as coverage.

Yeah, there's no circumstance where you – I can't think of where you'd ever use an ID card for disability insurance. Yeah. And no one's going to make one. I mean, there's no harm in that language, to your point. It says either all or none. Right. And the answer is none. But, you know.

And Pete may have to weigh in, because, again, I don't want to, you know, overstep and say, yep, throw it out. You know, I'm not sure, even after all these years, what the full requirements are for the RFPs to have language in there. Obviously, 2.7.6 is self-billing. Yes, we want to have that. Okay.

And would that be something that we would want to have as a mandatory requirement?

the self-billing or is that something that yes yeah okay yeah well that that's payroll speaking so yes what happens is we end up having to reconcile with their books rather than them having to reconcile with ours okay and i think i mean the the verbiage there is mandatory that you must accept the self-billing oh are where we build people for uh for the vendor Right. Maybe this isn't the piece that I was thinking of. So when it says vendor must accept Dane County's self-billing, is that self-billing of employees like on leave or are you talking about the billing? And then when it comes in, they have to accept what we say we have on disability. Okay. Then we definitely want it.

Premium, not benefit. Yeah, the premium.

Then we definitely want it.

Yeah.

For 2.77, booklets and phone numbers, is this kind of out of date? And should it be talking about a website instead? Or should we include?

I don't know many people that do pamphlets or booklets anymore.

Generally, it's all out of date. Back in the day, it was. Yeah, we'd bring 12 boxes of pamphlets.

Although, is that where we get the information for orientation?

Yeah. Yeah. It's those things. It's provided employee booklet slash plan documents. So it's basically saying you need to give us plan docs is how I'm reading that. Right. And plan documents is a benefit summary, which it's good to have.

So Shannon, you're saying they get paper copies at orientation, but all the 2,700 other employees do not get, we don't get paper documents every year.

No, we don't. No, we would only be at new employee orientation because it's available to everybody else online.

That's my question then. And the health insurance one, we have language about their website having, like you can log into your portal and get access to your plan documents.

Right, but again, orientation is before anybody has access to any of that, so we need to have it at orientation. Otherwise, there's not going to be an easy way for people to look at what that benefit is and decide whether they want to take it or not.

And this doesn't actually say paper, so it could just be giving people a PDF or giving a county a PDF.

And then to send out to an employer, put it on the site. Right.

Yeah, but it is on our site, yep.

Yep. And then, I mean, if it would be in a PDF format, we would be able to print off whatever you would need for an orientation.

Right. Yep.

But do we want to add anything about the website and the portal here?

If we're going to, I think that's where it would make the most sense.

Nate and Jerry, are there any of these companies that don't have A login for people to be able to log in and look at their benefits?

That don't have it generally, no.

I mean, they're... I mean, that we... It's like log in and look at benefits. There's usually an employer portal and a claimant portal. Yeah, and the claimant portal would have. And usually it's going to call out some of that.

And I think the only time that an employee would go to that is if they filed a claim. I don't think there's really any other information available to that prior to that. Because... Um, there's really nothing to look at. If you want to know what your benefit is, you can call employee relations or payroll or ask your payroll clerk and they can say, this is what you've got. But I mean, we do send that out. They send that out every year too. When, um, when we get to, uh, April for the May 1st disability signup. So, um, but yeah, I don't know. I don't know when they would have to have like a specialized website for us because it really isn't, um, people can just call in and file their claim over the phone, which people really like being able to do.

No, you're right. And I think Amy updates the Dane County website every year with link to the documents.

Yep.

So looking at 278, you know, claim filing. So online, telephonic, paper.

I think we want to keep that because there's also that ease of being able to make a phone call. And some mail may require that you mail in an application. I don't know. And we wouldn't really want to have that be the standard for us. I mean, I mean, it was always wonderful when I could say to somebody I was talking to that's out on leave and they're meeting their six weeks and I could say, you could just call them and start your claim right now. And they're usually quite surprised. Oh, I can just call them? Yes, you can call them. So, I mean, but if they're going to have, I think we have to know from them which way they're going to accept their claims.

And really all three of those will be acceptable for any carrier. It's more like The preferred method is generally telephonic or the online submission. But they'll still still take paper if it needs to be done.

Can you explain the next one to us?

subrogation? Yes, please. I alluded that and it was only because I don't know what that means. I understand that it's a legal process to separate out, but I'm just wondering how that impacts, why we have that in there, I guess. I'm not 100% sure. Okay.

Yeah. And I mean, I think as we going way back, you know, and there's similar language as far as subrogation with health insurance and that, um, basically it's, you know, saying, so if there's an, obviously somebody has, is hurt, injured, you know, subrogation generally comes into play, but it's just basically saying that, you know, standard, whoever the vendor is, you know, cannot, they have to pay the claims as, as written in the contract. I think a subrogation is like a totally separate, what do I want to say? What's the term? I'm trying to find it. But process, because a lot of those could drag out forever and ever and ever. So this is stating that, you know, the carrier, while Jerry's out on leave, depending on how long his claim is in subrogation or, you know, workers' comp, but heavy subrogation, he's still going to receive his benefits from the standard over the carrier. Okay.

So we would have two groups of employees, I guess, if they were, one would be maybe somebody who was injured outside of work or contracted an illness outside of work. Another one was it happened at work. It's work related. So they're filing a worker's comp claim. This is basically saying that just because someone is injured and files a worker's comp claim doesn't mean that the short-term, long-term disability vendor could say. We're not paying it.

So they need to continue paying, which is protecting the individual.

That makes sense, Nate? I think that's fair. It's not something I'm super familiar with. I know we've always had that requirement.

That's not correct, though. Sorry. The standard denies claims that are workers' comp active or workers' comp pending. And then we have a hard time when somebody's denied their workers' comp, say, three or four months down the road, and the workers' comp stops. They still want to call it a workers' comp injury. Therefore, they're not entitled to pay. We've had some fights about that. Not fights. Discussions about that.

Okay, that is news to me because, I mean, down the road, that's because usually some of these can drag out for months, obviously. Yeah.

Right, right. We usually have to, like, I have to get them, or I would have had to have gotten them the information from Joshua, the workers' comp, you know who I'm talking about. He would have to provide the medical documentation or the denial information from workers' comp and why it's not covered by any longer. Like, maybe they've reached end of healing but still can't return to work. And then they could we could look at moving to short-term disability, but they certainly can never claim both at the same time for the same time.

Yeah, right. You can't double dip. That is correct.

And the thing is, is that, I mean, I think we want to just make sure that the language is going to protect the employee, that if their workers' comp is denied, they then are eligible for short-term disability or long-term disability should they have that plan. Because that has been, we've had people who've gone months without income.

Okay, and I apologize because, yeah, they cannot receive both workers' comp and disability. Right, right. Yes, but okay.

How often do you think that happens, Shannon?

Well, you know, WMIC is certainly not protecting the employee, so they are definitely protecting the employer. I would say probably in the last year or two, I've probably had seven people maybe affected by that, and it's usually deputies.

Okay. And I apologize. I mean, I'm not aware of these ever kind of filtering up to Nate and I.

Well, I think because they quote the language in the... So somewhere in here, there must be something about... Maybe that's what she's reading this as, is subrogation. But usually we have to document it because...

True, right. I think the subrogation language is coming in basically saying that if there's payments made by the workers' comp company, Standard can't come in and reallocate those or claim them as an offset to this.

Oh, okay.

Gotcha. We can take that as a follow-up and look at the history of that provision, but I think it's more like to stop...

standard for fighting with your workers comp company over payments standard and workers comp company don't ever talk to each other that's it goes through the county things right okay yeah we'll get the exact language but it's i mean it is there to protect the employee but let's get the we'll get the exact from dan lynch our guy and okay but i it's worth keeping the language in there yeah and like i said we usually end up getting it worked out but it's a process okay

All right, so that one's worth flagging to come back to. And it sounds like Nate and Jerry are going to.

Yeah.

There might be language, other language that, because this seems very specific to not being able to have them offset, right? This isn't really maybe what I was referring to. I guess I don't really understand subrogation. So.

Yeah. Circle back on it.

Perfect.

Now, does this go back up to the top? There was one right before 2.5. I think it was 2.4 that you said mostly applied to the deputies. Do we need to look at these together?

2.4 applies to the deputy.

It's the own job.

Own job, right. That's not just deputies. That's everybody. So it's, for example, if a highway worker gets hurt and can't drive his truck anymore, he's eligible for the first year because it's his own job. If they take short-term, this only applies to short-term disability. And then or if a clerical worker is now no longer able to use a computer due to, say, eye problems for a while or something, it would cover their own job. We want that in there. That's really important because that first year, you know, what we're hoping is that people will recover and be able to come back to work. Go ahead. No, that's OK.

No, I think that's something Shannon, like in the early 20 teens, we had changed that. So I think it was own occupation, but we changed it to own job and using just deputies in there as an example. But yeah.

Yeah.

Yeah. It's giving employees more protection versus saying, well, you know, sorry, you can't go on patrol anymore, but you can do a desk job. So you're not, you're not eligible for disability.

Right.

Right. Okay. Got it. Shannon, how does that interact with the stay at work?

Well, the stay at work program. So the stay at work program, it was just something that was set up so that would help offset some of our claims to short term disability by allowing people to work in a job with certain restrictions for a temporary amount of time. Plus, it would also help people not have to do that six week wait. So that's definitely a benefit that we want to hang on to. But for the sheriff's department, they probably do. Oh, so all of a sudden restricted duty rather than stay at work. Yep. So there's different things for different areas and some and it's stay at work does not have to be approved. So that's that's the one thing that maybe in another life you can get better language about that. But.

There's a proposal in last meet and confer session for it to move from APM to Handbook. Okay, perfect.

But the own job is 100% necessary for the short-term disability. Long-term, it's any job. But when you're on short-term disability, it's for the first year. And during that year, they're hoping to look at trying to get you retraining or anything else to try to be able to get you to a point where you're employable again. But at the end of that, if at 90 days you're unable to work at all for long-term disability or the year if you have short-term, long-term, then if you're not able to work at all, it's not likely that you're able to make the standard of living, then they would continue on with the payments. Now, those payments, you were also required to then also apply for, like... disability retirement through WRS, or you know, if you're not able to be able to work at all again, but once you're eligible for the long term disability, they're going to supplement those other payments if if you're making less than you would have under the long term disability program.

So probably more than you wanted to know, but no, it's all good.

All right, moving on to 2.8. And I feel like the first two are standard. Year-end cost analysis, I'm guessing that's standard as well. 1099 forms. Moving on to 3.0.

Yeah, that's county, I would say.

Yeah, I didn't really see anything in here that I flagged. Nope, yeah. Anybody else see anything?

I think that's pretty standard language. And how they have to submit their proposal.

Okay. Major Jerry, do you know how many vendors we normally have applying?

Oh, it has, we've never had a shortage of it, if you will. Gosh, I'd say contenders, we're probably looking at maybe four to seven, eight. I think, Sharon, when we started grading these back in that room on the third floor and that, there were days, you know, with the big binders, we probably had eight or nine.

Yeah, we roll the two cards and like, oh my goodness.

Yeah, we've never had again, not to be comparing to health insurance, but it's never been like, oh, these carriers aren't going to, you know, aren't going to submit a proposal. You know, I would say we have a wider pool of carriers to select from and that, but then we really try to focus in on those that are very prominent in the public sector. That makes sense, Shannon? The coffee's kicking in.

Yep, perfect sense.

Wow. Okay.

So then looking back at what we've just gone through today, it seemed like the biggest flag was what Shannon was mentioning that Nate needs to look into and that I could not provide an accurate recap on right now. But about the coordination of those benefits or something. Is that fair? And making sure we don't have language in here that is somehow causing a problem.

Right. Yep.

And that that historically has mostly impacted deputies.

No. No.

No, I think that that's just an example that was given in here, but it definitely is outside of just covering deputies. I think that there's going to be a lot of people that would be helped with that language.

Seven cases in the last year where there had been issues.

Yeah, with the workers comp piece of it, but it's not, I mean, we've had highway workers definitely impacted. The nice thing about the Sheriff's Department is if somebody's on workers' comp, they will try to find restricted duty so that there's not that issue. Highway will not. Highway will only let you work at 100%. So technically, it's probably going to be more of an impact on them overall because the Sheriff's Department does do restricted duty. And that might be something that 65 can work on with the highway.

I think the highway has a provision about a CDL license, though.

The CDL, yeah, but they don't have a provision. For example, we had somebody who couldn't do like the jackhammer or whatever because of the issue with their shoulder or something. They couldn't return. And the highway department was saying, well, unless they can come back at 100%, they can't come back. So then workers' comp is saying, well, they can work, which they can because workers' comp, you know, they are able to work. They maybe reached end of healing or whatever, but then they're not able to go back to work because the county and highway department's not willing to put them on like a stay-at-work program that would allow them to avoid having to do jackhammer even if they hadn't done it in the last year, which is ridiculous, but that's a whole other discussion.

Is that probably because they don't have enough other work programs that can be done that would meet restrictions like not being able to use certain pieces of equipment?

I mean, I think there's some things that might fall into that. For example, if they can't drive a truck, well, there's always people riding with other people driving a truck, unless it's snowfall, of course. or they can be maybe a flag man on the highway when they're having to stop traffic and so on for safety and that. I mean, there's nothing that would restrict them necessarily from doing some of that. I think it would depend on what the injury was, because if it's just related to having to use a couple of different pieces of equipment that are jarring, like a jackhammer, they should be able to accommodate that. There's really no reason they can't assign that to somebody else. But they're saying if they're not 100%, they don't want them on the job.

Well, and then having stay at work then in the handbook would help kind of solidify some of those options.

Well, if the wording changed, because stay at work, the way it's written is up to the employer. Okay. Yeah. So just having it in the handbook isn't going to change that unless you change that language.

Yeah, we've had some occasional issues with that as well with the restricted duty. where some people feel it's assigned not very objectively, but.

Yeah, I would agree. Sometimes it seems like who likes who, then they get different accommodations, but that's just me on the outside looking in.

All right, so Nate, it looks like you've now pulled up one of the attachments.

Yes. Yeah, it might make sense to look at the insurance questionnaire. So it's one of the very last item mentioned on the actual RFP where it's, you know, asking for some additional detail. I think it's worth looking at, at least.

Yeah, and we didn't, we didn't get this ahead of time. So let's, if we can look at it, that would be helpful. Do any of these questions jump out at you, Nate, as being onerous?

Not immediately. Quick squirrel question. You don't drive a gray SUV, do you, Brian? Sorry, the front desk is messing with me saying, hey, there's a car that they're trying to open.

Oh.

Oh. Yeah, so some of these, you know, location, your servicing group, that's important. You know, employees, customer service, toll-free number, kind of how long you've been in this space is an important consideration.

Six is very important.

Yep, so claim processing time, asking when will we have documents, explaining the service model. This is when we get a pretty big answer generally. Yeah. claims processing and error questions about how to review the claims, cost management reporting, outline the process to make a move. You know, kind of additional thinking back to some of those other questions, part of what I want to bring this up is the tie-in. So, you know, offering open enrollment to county employees, regardless of their insurance status, re-asking it, how do you handle late enrollees? So explaining, you know, if you miss this, is EOI, the appeals process, size of their book, retention number, get updated, kind of financial strength, service guarantees, double check of, are you going to match the current definition of disability? Got some questions on the reporting. And then this gets more into the claim intake piece we touched on. So, you know, saying, do you have a phone number? Do you, and so there might not be, you know, a dedicated number to Dane County. We've seen that kind of hair be split before. You know, it's a work for LTD. What are the hours operations? How do you handle late calls? You know, looking at statistics for it. You know, how good is your call center? Claim filing process. Who does what where? And we're supporting there. And then we start getting into the clinical resources and claim evaluation piece here. Do you have some separate call-outs for kind of mental health? It's, you know, under the bucket of psychiatric claims. And also how LTD is handled. If nurses are leading it, does that transition over? What does that transition look like? Historically, that's kind of a frustrating pain point with a lot of vendors. My head goes to Hartford and some conversations with different carriers of it rubs employees the wrong way when they're kind of collecting a lot of the same information again. Yeah. And that is standard process in the industry, but I think it's good to have this really laid out here in the RFP response so we are able to gauge differences if some folks are more accommodating.

Right, and if I can add to that, it just basically will explain, okay, if it's not going to be the same rep on long-term or short-term. At what point do they realize, hey, this claim is going to go to long-term disability. We're going to start internally transferring all the data over to avoid from the employee, oh, God, I have to start back over at zero.

Shannon, are there other things that you see with that transition right now? No.

It's really been pretty seamless from what I understand. I mean, sometimes people don't follow through with like getting, you know, authorization signed or whatever, but that's not on the company. Really, the transition from short term to long term is pretty seamless. I think the standard does a good job of making that happen and introducing them to the new rep and, you know, that type of thing.

Good. Okay. That's what we like to hear. Yeah, absolutely. Absolutely.

I think overall these questions are good. I don't have any changes. I just wanted to call out that there was a lot more that goes into kind of our ask of the carrier than is just that first part of the RFP.

So I noticed this was attachment B, but was there also an attachment A that was up a little bit? Yeah.

Wait, before we go on from that, was there anything in attachment B about appeals?

Yeah, there was. Yes. Okay. Sorry, go back to it. And that's very standard too.

And then my other question was about the social security. How does, if somebody's eligible for back pay for their social security, if they get approved for SSDI, how does that, is there anything in here about, you know, having to pay any of that towards what they've gotten out on? Yeah.

That's usually included in a submission without us having to basically straight out ask for it. Because a lot of times it does take a few attempts to be approved for full social security disability. And the carriers will generally help the claimants with that process.

Right. And then the individual has signed a repayment agreement that if they become eligible for the social security and it's backdated to cover the time that the standard has paid, then anything that the standard would be entitled to back would have to be repaid to them.

Yeah, and that's standard across all carriers in this segment.

Yeah, and that helps align incentives too because that helps essentially standards wants your people to qualify and go through that process to support them. So it's good to have that language there.

And the carriers usually are very well versed at the, shall I say, the hoops per se. You have to go through, not to sound negative, but it's good to have the carriers on that side more so than Nate and I are with that process.

Do we ever have people who end up going with an attorney for that, who then end up owing the attorney a portion of their back pay and have to repay to the...

Possibly. Possibly, yeah. I've never heard of it. Possibly, yeah. And that would have to be between the individual and their attorney.

Okay.

Yeah.

Yeah, I don't know. I've never had anybody do that. As long as I can remember. Because usually the standing is helping them.

All right.

And if they're denied, then the standard continues to pay, right? So it's really in the standard's best interest to help them so that they don't have to go get an attorney. But if somebody chose to, I guess there would still have to be an offset.

Yeah, there's certain levels of, you know, kind of appealing when you've been denied initially. So I didn't know if the standard only helps at kind of the certain levels or how high of an appeal. There's more than one level of appeal.

I'm sure things like that have occurred, but generally it's never gotten back to us.

Okay. Me either.

Okay. Yeah. And I would say of that, it'd probably be more likely Shannon would come back to you or somebody in your role.

Right. I've never had that issue come back. Now, again, that may not be handled at the county level because the attorney, if they have an attorney, is probably working directly with the standard as well.

Yeah. Yeah.

So maybe they have some agreement that the attorney's fees come off and then it's the balance. I don't know. That's something that I guess would have to be talked to with standard. But again, it's not, I've never had any issues with employees saying, Hey, I'm getting screwed here or whatever.

Yeah. That's a very highly used insurance.

I'm among friends. Yeah.

See, I think the one that I was talking about, Nate, is the attachment A vendor information. I can't think of any reason why that would be an issue. I imagine that's going to be pretty standard.

Yeah, I would agree. Let's see, anything else? Yeah, the rest of this list is just kind of the combination of, you know, FAQs, that is us getting ahead of basically looking back at the last time we ran this RFP, what questions did we get? Sometimes it's saying like, you know, what commission level should we pay this app? Standard, like,

running through some of those things that may have basically the history of stuff.

So what is the current agreement? Let's include that. What is the renewal piece? You know, sharing a census of folks that are enrolled in the coverages, you know, with PHI redacted, looking at renewal history, reporting, and then we get into policy documents. And then the coverage highlighters are what we kind of talk,

talked about earlier those benefits summaries so if folks are seeing that to cover you know what it is and what it looks like you know more digestible you're gonna have to be really careful about though when you are doing the rfps because that's really where the nuts and bolts of the policies are is in the certificates and and um the policy itself so just i'm just pointing that out because that's where the apples versus oranges are going to appear

Agreed there. And that's something where it's, I like the approach of saying, here's the current plan docs, match them versus us rewriting and saying, here's the current plan docs and a 20 page summary of important provisions inside those. We're dealing with that with a different group right now where they kind of liked calling out all the different pieces and it makes the RFP really hard to read where it's a 20 page breakout and saying versus saying, no, you need to match the provisions in the certificate. And then we can do contract comparisons and drill down on specific things.

Okay.

Yeah, that's a good call, Shannon, because that is really where the meat and potatoes of what carriers are looking at and doing. So you noticed we went through this whole thing without referencing. I think there's one reference to a 65% benefit or what the payout is.

Exactly. All the provisions of the policy itself. So, I mean, if somebody comes in with a policy that's going to be better, then obviously that is something to be looking at, but, you know, all relative to what the benefit itself is.

Yeah. All right. Is anybody else seeing anything else before we move on? All right. Reports to committee. I don't believe we have any, but I will open it up in case anybody has anything to say.

I will just, at the beginning, before we started recording, I did mention that Nate Shannon and I, along with Virginia of M3, still have our mission to pursue a presentation for the retirees. And so I said I would meet, send out a message to them to get a meeting on the books between us to figure out our next steps on that.

Sounds good.

Perfect.

Thank you.

Anything else? All right, future meeting dates. Our next one is set for August 5th in person here at M3 and virtual.

Yep, and if people have agenda items or suggestions for that, please email Brian or me.

Actually, I do have something I want to just point out to the committee so that everyone's aware about the finality of the appointments to IAC. Accounting Executive Agar did not appoint me to the IAC. She felt that she needed a retiree that's been retired for a few years who's coming on board with absolutely no experience on the insurance end of things, which really disappointed me. And I did have a conversation with her about that, but she was unwilling to change her mind. I do... I am committed to the RFP subcommittee at this point and helping with the transition for retirees with Virginia and Marissa and Nate. But I also want to point out that at some point, if I'm not having any ability to speak at IAC meetings other than during public comment, that'll get a little tiring for me. And I'm not sure that that's how I want to play this game. So I just want to point it out because I do think that it was really unfortunate that my experience and background did not turn into a spot for me on the IAC. So whether that will happen in the future, who knows. Whether in the future I'll be interested, who knows. But I wanted to point it out. I didn't go down without a fight. But it is what it is. And she made her decision and was unwilling to.

change her mind after speaking with me so i just wanted to point that out and have that on the record well i'm sorry to hear that shannon i think that decision yeah yeah yeah thank you shannon i'm you know and i want to say i do really appreciate your willingness to continue working with us on this commit the subcommittee and also on the separate side project we're doing with the retirees because i know that out of everybody you've worked with the most people slated for retirement from the county. And so I know that you have that inside look on what that experience has been and how we can help best talk to people. And a lot of those folks have met with you over the years. And a lot of the retirees we have on that plan know you and are going to trust you. And so having you part of that is going to be helpful. And so I know you are retired now and congratulations on that. And, you know, I think we do appreciate your willingness, even though that appointment didn't work out how any of us had wanted or hoped that, that you're still willing to help us on those, those other components, because I, I know you're going to be helpful.

And I do that for the employees, not for her. That's also on the record. Thank you. I just wanted to point that out.

Shannon. Oh, I'm sorry, Marissa.

No, I just want to acknowledge, I know Shannon, you have, you know, you are retired now and you have choices on how you can spend your time and every minute. And so thank you for, you know, I know that you're helping the employees. Absolutely. That's been the theme of Shannon Meyer for 40 years. So you can't resist. Yeah.

And when you get a chance, Shannon, would you just email me your contact information? Because you still kind of stuck with me. It's been 20 years, so I'm not going anywhere.

Sure. Yep. All right. So public comment or such other business is allowed by law. Hearing none, I would entertain a motion for adjournment.

So moved.

Second. All right. Marissa and Shannon. All those in favor? Aye.

All right.

We are adjourned. Thank you very much, everyone.