Board of County Commissioners - Regular Meeting

like to call the meeting to order. We'll do the pledge sales to have a few words. I pledge algiance to the flag United States of America and to the republic for which it stands. One nation under God, indivisible, with liberty and justice for all. Few reminders before we get going. Please state your name and title when you first begin speaking. Public comment will be loud to the extent that it's on topic. Persons participating via Zoom are currently muted. If you have a comment, please let Mark know via the chat function. Mark will then inform Chairman Trinkle who can take up the comment in a manner that doesn't disrupt the agenda. And if an executive session is needed, then we'll mute and turn off the video. And when we're done, we'll turn everything back on.

Heather, you there? I'm here. Do you hear me? It's very very broken up. Okay. Is this any better? Yeah. There you go.

Okay. Um I have just a couple of things today. I'm going to save one thing for last next week because I know that you have a full agenda. The first thing is 20 uh the the neighborhood revitalization bill was sent to the governor actually on Friday, Friday the 27th. So she has 10 days either sign it or let it become law. So just wanted to give you an update on that timeline. The other thing that I wanted to mention was uh on Friday night, Saturday morning, uh the legislature passed another tax bill that could have some implications on certainly all of um taxing authorities, but from an economic development perspective, especially with the that would limit the flexibility of what the local unit of government could do um because of putting on a revenue cap. So 20 uh House Bill 2745 essentially um puts on a a a cap on the amount of money that you can raise each year through property taxes. So if you're if PR County uh collected $100,000 this year in the future there would be a a cap of how much more revenue you could collect that would be limited to either 3% or the CPIU for the Midwest whichever is lower. So I think last year it was 2.8%. Uh so in that case you could only raise you know 2.8% more funds than $100 because of that provision and um if you wanted to raise more than the 2.8% it would be subject to protest petition um of 10% of the registered electorate on January 1. If the protest petition was um successful, the county's budget would revert to the revenue neutral rate. So, previous versions of this bill had done away with the revenue neutral rate process. This bill keeps it in place.

And so as we continue to move forward with the neighborhood revitalization process, um I think in my opinion things have changed a bit uh and really need to think through um how this is implemented and what the consequences are as we start talking with other taxing uh entities in Pratt County to get everybody on board. Not to say that we shouldn't still go forward, but definitely need to consider does this change the picture or not. Um, I know I've seen some correspondence from cities and counties even this morning related to economic development. If you know a large corporation was to come to town and they needed uh, for instance a road a road paved, there is no provision for like a bond um to increase the revenue amount without going through the protest petition process. Also, the current version of the bill, unlike previous versions, does not allow for a growth factor. So, if the housing development incentive process was successful through PADC and let's say that 20 new houses came to town, the valuation growth from those 20 houses is not able to be realized through the revenue cap process. So, um just wanted to flag that for you. I received another email today about a bunch of things related to bonding uh and economic development related to the bill. So, I just wanted to call that out and then I'm going to be happy to stand for questions.

Uh Heather, on the on the petition side of it, does that include all taxing entities? I mean, yes. I I I I don't understand if they get their their valuation and let's say we stay under our deal, but let's say a school's going over that kicks us back. No, just

No, no, it's it's just for the individual taxing entity. But the way it's going to work is so when the revenue neutral rate letter goes out, all of the taxing entities are on the letter and it says what every individual taxing entity did. So if let's just take um the school district let's say 382 exceeded and 421 did not then on the on the actual RNR letter it would state that and the bill actually states that the there will be a checkbox situation on a form with the RNR letter that will allow that will serve as a protest petition. So if 421 and um Sawyer fire, city of Sawyer, city of Preston, if they all went up, you could check, well, the city of Preston really needs to redo the water tower, let's say. The person could say, well, I'm not going to protest Preston, but I am going to protest 421, for example. So there are some of those specifics built into the bill about how the protest petition has to be laid out. And certainly Sessa has a lot of responsibilities under the new model. And they're still paying for the

They are still paying for the letter. Yes. I think they extended it to 2031 to pay for the letter.

I don't have any questions. I don't either, Heather. Thank you. Thank you. You guys want to come up? You're with Family Crisis. Okay. Good afternoon. Yeah, you might introduce yourself for people on Zoom, please. Sure. My name is Amy Peska and I am the program director for the Domestic and Sexual Violence Center with the Family Crisis Center.

And I am Kayla Bailey. I'm the program director for the Child Advocacy Center. And we are here today to um request um a proclamation be made that sexual assault um awareness month is April um in the county of um Pratt and also it is um child abuse prevention month. Have you had a chance to look at the proclamations or I blank. You did? Okay. I didn't know if you'd like us to read them or if you wanted to read them and then you do have them. Oh, okay. So, in the past, we'd have you guys read it and then they'll make a motion to adopt. Okay, that sounds good.

You have it. Okay. Which one are you doing first? Sexual assault awareness. We're gonna keep you from reading it all. Oh, okay. I think they're gonna have it be both. Put it up and read. Yeah. If you can put it up, we don't have to read it. We can do it. We'll do them one at a time, though. Okay. Unless you want to go ahead and read it. It's up to you. It's what I'm sharing here. There we go. There we go. Bingo. Right one. right on time. Okay. Um I'll go ahead and read it.

Okay.

Whereas sexual violence is a widespread preventable public health problem in Kansas. And whereas sexual violence is any sexual act that is perpetrated against someone's will, which includes sexual assault, rape, unwanted touching, threatened sexual violence, exhibitionism, and verbal sexual harassment. And all types of sexual violence involves victims who do not consent or who are unable to consent or who refuse to allow the act. And whereas one in five women and one in four men experience some form of contact sexual violence in their lifetime. And whereas one incident of rape is reported to Kansas law enforcement every 8 hours 57 minutes 58 seconds. and over 5,300 people receive services for sexual assault from Kansas victim advocacy organizations each year. And whereas these statistics do not represent the true prevalence of sexual violence due to under reporting and sex offenders often targeting people they perceive as vulnerable, less powerful, or less credible. And whereas the offender is known to the victim in the vast majority of cases, 80% in Kansas. And whereas the effects of sexual violence may be felt directly after or for many months or years later. And confusion, anger, sadness, shame, guilt, helplessness, hopelessness, and self-lame are all common reactions to sexual violence. And whereas the Family Crisis Center, Inc. provides free confidential services to victims of sexual violence in Barton, Barber, Comanche, Edwards, Kya, Ness, Ponyie, Pratt, Rush, and Stafford

counties. And whereas the Family Crisis Center, Inc. is also available 24/7 365 at 620-7921885 via phone call or text. Now therefore be it proclaimed by the board of county commissioners of Pratt County, Kansas that the month of April 2026 shall be known as sexual assault awareness month in Pratt County and further the commission urges citizens to participate in this observance.

I'll make a motion to adopt the resol it's not a resolution proclamation proclamation. Thank you for April to be sexual assault awareness month in Pre County. I'll second the motion. It's been moved and seconded to approve the sexual assault awareness month in of April in Pratt County. All in favor say I. I. Oppose. Same side. Proclamation is carried.

Thank you. Anybody want a copy of this, please?

Okay, thank you. Yes, child abuse awareness and prevention months. Find it again. Can you read that stuff on there? I mean, I'm just guessing here. There it is. There it is. There it is. Okay.

And I can go ahead and move that one. Child abuse awareness and prevention month. Whereas preventing child abuse and neglect is a community problem that requires all citizens to be involved. And whereas child maltreatment occurs when people find themselves in stressful situations without community resources, support systems, and don't know how to cope. And whereas child abuse and neglect can be reduced by making sure families have the support that they need to raise their children in healthy environments. And whereas in Pratt County, there are dedicated individuals and organizations that work daily to counter the problem of child abuse and neglect and help parents obtain the assistance they need. And whereas all children deserve freedom from verbal abuse, sexual abuse, emotional abuse, and physical abuse and neglect. And whereas all children deserve to have warm homes, loving hugs, tender care, parents and adults who listen and promote self-esteem, give quality time, provide necessary food, shelter, clothing, and attention. And whereas effective child abuse prevention programs succeed because of partnerships created among social service agencies, schools, faith communities, civic organizations, law enforcement agencies, and business community. And whereas prevention remains the best defense for our children and families. And now therefore, it be proclaimed by the board of county commissioners of Pratt County, Kansas that the month of April 2026 is child abuse awareness and prevention month in Pratt County. and further that the commission calls upon all citizens, community agencies, faith groups, medical facilities, and businesses to increase participation in efforts to support families, thereby preventing child abuse and strengthening the community.

I'll make a motion we adopt the child abuse awareness and prevention month proclamation. Second. Been moved and seconded. We approve the child abuse awareness and prevention month of April in Pratt County. All in favor say I. I. Oppose. Same sign. Motion carried. And if there's anything that you guys advertise, we do have digital displays here now. You can always be that opportunity um for the month of April and we can put that on there.

Great. Yeah. All of our events will be on our Facebook page and so we'll just send a flyer your way too if that's okay. Yep. If you could and we can just post the events. That would be good.

Um the last thing I have is just um for your information. It's our year in review from 2025. And I'm just going to highlight a couple of things that we um served a total of 975 clients last year alone. That has gone up about two to 300 per year since I started in 2022. Um and we have really taken the um lead on prevention. And so we go into the schools in all of the counties we serve and we prevent or we teach um body safety awareness classes to elementary students and then healthy relationships to um the high school students. Um and uh we also have Sarah's blessings in our basement of our um admin office in Great Bend. And we also have a hygiene closet here in Pratt um which is what the second page talks about battle of the badge. We're um collecting hygiene products for that.

And the way we do that is law enforcement versus EMS and buyer to see who can um win the bragging rights or bring in the most amount of hygiene products. And then we just added um the tea. Um we have some prevention tees. Uh those are the colors for the certain months and those are going to be at harvest 54 nutrition here in town. But we will go ahead and send the rest of uh like teal day and blue day um to you so that you could put that up for us if you don't mind. Yes. Thank you so much. Good work.

Thank you. Are you Rhonda? I am. Okay. You want to come on out?

How are you? I'm good. How are you? Good. Brought my computer just in case. Our Yes. Feel like I'm moving in for a minute.

You want to introduce yourself then to I will for the people on Zoom.

Thank you. Thank you. I'm Rhonda Fernandez with PIC Benefit Services. We are an employee benefit consulting firm and we are located in Dodge City. We also have a office in Witchah area and you partner in the Kansas City area. I have been at this for 27 years. I started PIC 27 years ago. Prior to that, just a little history, uh, I worked part-time at Blue Cross Blue Shield of Kansas in the Dodge City, uh, field office and then went full-time and then I worked for Blue Cross and started PIC in 1999. So, I've been at it a long time. Still work really well with Blue Cross. We have a lot of groups across the state with Blue Cross. Um, I have groups that I've worked with my whole career with Blue Cross. uh is still on my books. So um been at it a long time and I had Pratt County was one of my clients when I worked in the Dodge City field office. Um so I worked if you know Elma I worked with Alma years ago.

She was one of my sweethearts. Does she I bet she does. Yes. I remember when I first started working with the county it was it was her. So what we would like to share with you today and I'm not sure it's Harrison Harrison not on there yet yeah we are we're a little bit early let's go through the PIC things maybe first and then kind of what we do um again uh we work well with Blue Cross I know that you currently are enrolled with Blue Cross I don't know that you've ever left Blue Cross maybe you did for a period of time but most of our groups have I did.

Oh, I had the Kansas Oh, State of Kansas employ that was on our other liability and property. Oh, okay. Okay.

Well, if if if you've left, it's probably wasn't for very long before you cross. Just saying. Um well, one of the things um the reasons that I left Blue Cross was to be able to look at the market, look at different things, also help with the human resources side um a little bit. We have quite a a a set of information on that in here. If you'll pull this little card out of your packet and flip it over, this is kind of the I call it the Reader's Digest condensed version of what we do. Uh again, one of the big things with us is those valued relationships. As I said, we have had clients on the books for many years that uh have followed me throughout my career. U one of them is in your backyard. I've had u Barber County pretty much my whole life. I hate to say that. Um and also Ponyie County is kind of in your neck of the woods. Kya County, uh Edwards County. um just kind of all that I can think of that are kind of right here around this area. Uh but again, we want to do what we can to um you know, help you retain employees and that benefit package is what keeps them here. Um the benefits speak loudly uh when you're thinking about maybe changing jobs or wanting to come to work here. Um our industry expertise is uh strong. Again, we have lots of different resources from Blue Cross, other carriers. Um, I find my tax supported entities kind of hug Blue Cross, but we do have large groups that are with other thirdparty administrators. We have u access to lots of different networks and different funding arrangements. Um, and what we're going to talk about today is a funding arrangement that will complement your Blue Cross. uh the employee advocacy side, that's one of the strong things that we uh

think are extremely important. Um just people understanding their benefits and knowing how to use them, knowing who to call if they need help. Um I grew up with single mom and five kids and I had a sister that had lots of medical conditions and I watched my mom struggle on how to, you know, who to pay what and those kinds of things. So, one of the things that we'll do is just tell every, you know, somebody if they've had a large claim or even if it's a small claim, let us go through it with you. We'll spread this, put it on a spreadsheet. This is what you owe the hospital. This is what Bluec Cross paid. This is what you owe Dr. Smith and this is what you because they get those bills in the mail and they don't know for sure if Blue Cross has paid it. Understanding those explanation of benefits and those kinds of things. though being their advocate if they're not happy with your plan I'm going to hear it they may not want to share it with you but I'll in turn say hey this is what I'm hearing if uh you know when we're doing meetings whether they like it or not uh so we can help you make a good decision going forward on tweaking any benefits as needed that HR assistance will help Tesa's office a lot uh keeping that compliance side u our technology based systems that we have our client portal um which is giving her access to an HR hotline and it doesn't have to be benefits uh to call that HR hotline if you're having an employee issue. You just need to double check on some things making sure you're not doing something you shouldn't uh in certain situations. We had um a person up at one of our counties in northwest Kansas. One of the clean employees came in, kind of started tearing up the shop one day, just throwing a fit, and he was a local kid, grew up there. So the county clerk calls me and she goes, "This isn't like him. We know due to ADA, we have to help him,

but how do we help our others, and how do we make sure nobody gets hurt?" So quickly, we got the HR hotline. They gave us instructions really quickly and uh they took care of it, followed it through again, letting him know he needs to get some help and make sure that he does this, this, and this. So, we got more details later on that day, but enough to get things moving. uh turns out that his wife was having an affair with his best friend and you know I mean not that maybe he didn't need to throw a fit but he should have done it at home in his garage but just even something like that you know comes up or uh you know somebody's um you know not

yeah and and making sure that you're doing that part as taking care of your people so that client portal can come in really handy if they can't they feel that hey we need to escalate that issue whatever it might Um, we'll reach out to Hinkle Law Firm. That's who we work with. And then they'll tell us if we need to take more steps and if it's considerably more, I'll come to you guys, visit with you and your county attorney and see, do we want to uh do a letter of engagement to help them see this through? And we've done that on a couple FMLA pieces that that ADA side gets involved and that's where you could have quite a lawsuit if you don't follow it to the TE. So, and we have those resources available to your county as well. Um, and then, um, I guess just a little bit about how we keep you up to date. One of the things that we think is important is being in touch with you all year long. We don't just bring the renewal. We are meeting with you every quarter. On the right hand side of your packet at the back there is a Blue Cross report that Chesha ordered for me. It's a last year full report and this is one that we do every quarter the same information and it just gives you a every year we'll do a full year at the end and then every quarter we'll just add that quarter on and we'll just take a few minutes and go through it. There's certain things in this report that are extremely important. Um, and some things are just because I like to share it with you. It's just kind of nice to see what the average age of your group is. For instance, and if you'll look at page one, just what what are the these are kind of what we call good claims. So, we go through that. I'm going to flip you through here to page three of the cost share, what the plan is paying, and it gives us a three-year history. If you look far at the right in the yellow where I've highlighted under plan paid,

you can see where the claims were for 25, 24, and 23 there for the year. So again, what are we looking at for renewal? How can we start looking at getting with our Blue Cross rep, working on what trends are um working on uh what uh Blue Cross's pool is doing so we can see if there's any way we can get close to what you might need to do for your budgets going forward. And then you've got just conditions, high cost members. I'm going to have you flip to page uh nine. I want you to keep that one open for when Harrison uh gets on. And then just flipping on through to the back page. Go to back uh to we've got your pharmacy utilization in here. And one thing that stuck out to me really big with the counties, most of our counties are in the 40s. I think I shared this with you. Your group is average age is 33, which is lower than Blue Cross's book of business of 36. So, I want to be a part of this group. So, I'm only 33.

Yeah.

So, but that's just again just some of the, you know, kind of fun things to take a look at. Uh, but we do this every quarter so you know what's going on. Uh, we provide you with our in full bloom little uh compliance guide. Anything that's happening um from wellness to uh any um you look I let's see I'm I don't think I have put that in there. uh like met Medicare Part D notices are due. This helps Chesha get everything out. We also assist her in doing all of that. So, just a couple of things uh about us. Um and again, I've got a little bit about our CL client portal on that left hand side for you. Um and I have at the very back, we'll catch that at the end, but kind of our scope of services and some of those kinds of things. But, uh I don't know if Harrison's on to show. Yep. I am here.

Okay. Well, I know what uh Harrison is going to show you I I think is a good uh blend with your current benefit package uh offering the dual option, but I think it's going to save you some money. Uh and the groups that we have it in are really liking how the program works. Uh and it is going to eliminate the two card system. So, uh, Harrison, uh, on the right hand side, guys, you'll have this book, Chesha, and this is, uh, he's going to go through it on the screen. His is updated more than mine, so I printed it too quickly before I left the office. So, um, when he gets finished, then we'll need the back of this to kind of share costs with you.

Okay, Harrison.

Yeah. Uh, great to meet you all. Um, thanks for having me. My name is Harrison Lambert. I am the uh senior consultant here at the difference card out of Kansas City. Um I guess starting off a little bit about us. Uh we we've been around for 25 years and and we work with groups incorporating alternative funding strategies. So um as as you all are well aware um health insurance increases continue to rise and uh we're an alternative solution to help kind of level that out. So um again great to meet you all and just for the sake of time I can just kind of dive in and we'll go and go through what our solution is how it looks for you all and then we can dive in a little bit more on the member experience and what we can provide from that perspective. Um any questions before we keep keep rolling?

Don't think so.

Perfect. Um, so starting off with with our overall strategy, um, we work with groups that are fully insured or level funded and or on rich plans already. And what what we do is we're going to move you from your rich plan design and we're going to move you to the least expensive plan in the same network. So, similar concept to what you guys are doing today where we're trying to reduce the fixed premium that we're sending to the carrier on a monthly basis. And to do that, we're wanting to increase the deductible as much as possible and increase the out-of- pocket maximum as much as possible. So, by making that move, we're going to create a nice savings. We will then take a portion of those savings and we're going to fund what's called a MERP, a medical expense reimbursement plan, which will then be used to cover either all or a portion of the new out-of- pocket exposure for the members. So, we can be completely customizable there. One nice thing, we will give a level premium equivalent. So, you'll have an employee only, employee spouse, employee child, and a family rate, which will be comprised of everything. So the first piece of that will be that new underlying carrier premium. Uh the second piece will be any difference card fees associated with it. And then the third piece will be the amount on a per employee per month basis uh that our underwriting tells us needs to fund the MERP to give access to whatever amount of dollars we choose to uh to build the plan back to. Um, and we got two options for you here. So, any questions on concept before we keep going?

Thanks. So,

okay. So, uh, few statistics on us. So, we we're working with 2,000 plus total clients uh, currently. Um, and I think my favorite number here is going to be the 90 plus% retention rate. U,, that tells me a couple things. One, the plan and the numbers work the way we say it will. And then number two, and almost more importantly, we have a pretty incredible account management team. So, you have a dedicated account executive, and we'll hit on that a little bit more. Um, but we put a big emphasis on open enrollment, education, all that good stuff. Making sure that you and your members feel fully comfortable with the plan. We are a card-based solution, so this makes us pretty unique. Um each member will get a benefits card uh from us and it's just a masterard debit card. So this is what the members are going to be be using um to cover, you know, their medical expenses. So hospital, doctor, pharmacy, they're going to, you know, go to the provider and opposed to pulling out their own debit card, they're going to be pulling out the benefits card from us to swipe to pay for those medical expenses. It is multifunctional. The main thing we'll be hitting on today is going to be the MERP. Um, but it can also handle HSA, FSA, HA, and we can help administer Cobra as well. Looking at a few statistics here and then we can go into to the numbers and how it looks for you all. Um, every time I look at this, it always fascinates me, but this is really just showing us what percent of members are spending what amount of dollars for benefit claims. And 75% of members are spending $4,000 or less on claims expenses, and 63% of members are spending $2,000 or less. So

to this it tells me the story of kind of tying in our whole philosophy of limiting the amount of money that we're sending to the carrier on a fixed basis. So premium and paying for the claims that we're actually using.

So if you'll look at that page nine that we talked about over here just to remind you of this is based on your group. Uh if you'll follow me across in the blue, it says number of uh uh excuse me, distinct me member count. You had 101 of the very last one is total 296 bodies on your plan. You had 101 that had no claims. You had 131 that had less than a,000. So we're now up to 234 of that 296 or less than $1,000. And then less than 10,000 we add another 45 members to that. So you can see again from this report how many people are just not having any claims that really add up to much. So keep that in mind as Harrison goes through. Those are kind of your actual counts in 2025. So

perfect. Thanks Rhonda. Um so looking at design and and and how you know we would recommend that we structure here um this first option that we'll look at here. So there would be two two plan options like you have today. Uh this is the the the one with most of the population in it. But the current carrier plan that you have in force today is going to be a 35 primary co-pay 35 specialist and 250 ER. And then the deductible is 1,500. The out-of pocket is 2,000. So the way it's set up today, it looks like you're enrolling into, you know, $5,000 high deductible health plan and then building in the co-pays, you know, on top of that. What we would recommend is buying down that insurance policy even more. And opposed to buying that $5,000 plan, we would buy the $6,000 deductible 6350 out-of- pocket plan. So, we're going to get a lower starting point by making that move. And the way we approach it is we are going to approach it and we're going to keep the high deductible plan functioning like a high deductible plan. So, we don't add co-pays. So, opposed to going to a primary care doctor and have a $35 co-pay, that's going to be more expensive. But the way we do it is we're going to give everyone that benefits card that will work for the first $4500. So you go to the hospital, doctor, pharmacy, whatever it is, as long as it's covered under that underlying health plan, you're presenting this $6,000 plan. For the first $4,500, you're swiping directly from the benefits card, leaving your deductible exposure the same $1,500. and lowering your lowering your out-of- pocket exposure down to$,850.

Multiply this by two for all the other tiers. So employee, child, spouse, family, they'll get access to the first $9,000. So go back to some of those. Go ahead, Rhonda.

I was just going to mention that first dollar coverage makes a big difference, you know, when people get care. Also, uh, money's pretty tight right now, as we all know, and you will definitely take your kids no matter what, but you're more likely to wait on yourself if you need something. Or maybe I don't want to go to the emergency room because I'll have a, you know, more out of pocket. If they have first dollar coverage, they're going to catch things a lot sooner before it is a big item. So, that's one of the things I like with it. starting with the benefits card paying first dollar, then my deductible comes at the end because we've got hund and some people or 200 and some people not even hitting $1,000. So, you know, that's just showing you kind of how it would work and at least give that person who doesn't use it maybe will go in and use it when they need to or the person who does use it but just waits too long. So yeah, the the way we've designed it again, it'll be dual, you know, dual options like you have today. Deductible exposure will stay the same for each out-ofpocket exposure will go down for each and all of that comes only after the first $4,500 is ex is spent for this plan, first 3500 for the other one. If we go back to those statistics that we looked at, a large majority of the members are going to have zero out-ofpocket exposure, which is pretty incredible. Questions on the mechanics of the plan?

Good. I think so.

Okay. in terms of um you know the financial perspective um just looking at you know your renewal. So the current cost today is 2.3 renewal was 11.8% taking you up to 2.6. Our revised fixed cost which is going to be the cost to get into that $6,000 carrier plan plus any difference card fees takes us down to 2.2. When we look at the maximum amount of claims exposure, so your max all-in cost, that's going to be the dark green here. Your max all-in cost is 2.6 million, which is going to be opposed to an 11.8% increase is going to be a 10.6% increase. This is going to create a guaranteed savings of $28,000. We are backed by assurance. So we put in a maximum amount of claims exposure into this plan. If claims go above what we project, assurance will kick in and they'll pay. On the flip side of that, if there's a surplus left over in the mer, which happens 75% of the time with our groups, those are 100% your dollars. We don't share in any of those savings. If there's a $100,000 left over in the mer, all of that money goes back to you as a county. The expected cost, so where we would expect you to come in, um, again, 75% of our groups are receiving some sort of a surplus, we would expect your cost to be at about 6.8% opposed to that 11.8. expected savings for you all would be about $118,000.

The positive worth Yeah. Go ahead, Rhonda.

The positive thing, the reason that we chose to work with this vendor with the difference card is because of the stop-loss that's protecting the county. Uh we do a lot of self-unding. I think I put self-unding in this group with Blue Cross years ago. And uh when you self-fund, you need some protection and that money that you're putting in that MERP, you're self-funding those claims. So by having a reinsurance, which Assurance is a uh reinsurance company, steps in and says, "Okay, at this point, you're not on the risk anymore for any claims. We're going to pay those." So I mean, it's it's if you hit that, you know, you're kind of having a rough year, but it's nice to know that you're not going to pay another dime out of your pocket at that point in time. So there is a stop on what you can your exposure is for the county. The twocard systems and some of those others that we see do not have that situation in place where you have that reinsurance that's saying, "Hey, we've had enough. We're done here." And assurance will take care of it. Any questions on the savings or the financial aspect here?

I have a question. Yeah. How do you how do you get paid? Uh yeah, good question. So we are a our PPM, a per employee per month fee is is how we get paid. All of that is built into these numbers. So these numbers that we're looking here is the all-in cost. Okay. So I'm sure you guys are aware that if you're not aware we use freedom claims which is a competitor I assume. Um so other than what you just stated about the assurance what are the differentiating factors you know why choose you?

Well I think the transparency and cost. So flip to the back page on here. Harrison I'm going to take them to that summary. Sure. Yeah. 26. Uh page 26. Okay. the difference card. Harrison, you want to go through your three three fees that you have there? Uh, yeah. Do you want to just roll through those really quickly?

Sure. I What I see from usually any two card system is a risk fee, a management fee, a percentage of savings, a uh I mean there's just fee after fee. Uh, one of the things with the difference card is you'll have an admin fee of 37.45 per person. You'll have your stop-loss fee to pay for that reinsurance that's going to protect you when you hit a certain amount of 3577 and then your uh card fee of 150 per person. So $74.72 is what you will be build for every month per person on the plan. And there's no difference if I have a family or single or child. It's just that 7472. Boom. So that's exactly what you'll pay every month. Now, right below that, if you'll look, you'll see estimated claims funding. This is the county money that's going in an account that you own. Uh Harrison, you want to jump in on that account?

Yeah. So, yeah, the the big things from from my perspective, yeah, it would be the return of reserve. So, when we're funding um the account for the medical expense reimbursement plan, those are your dollars. So, we're I don't know how you have it set up today, but we're we're going to if there's a surplus left over, 100% of that goes back to you. We don't keep any of that. And then you own the bank account that it's in.

Yeah. You own the bank account that that the dollars go into. Um the other piece, you know, away from the financial aspect and being able to enhance the savings and potential for more through the through the surplus return. The card um the user experience on having that debit card, a physical card to pay for your your expenses with. It takes away a lot of having to provide EOBS and all that stuff. the member experience um especially from the counties that that we've been incorporating this with has been second to none. So you just again when you get your EOB from Blue Cross and your bill from the hospital bill, you just run your card through just like you would work your own that you're paying for it. If you're at the pharmacy, you just swipe your card and it pays for the prescription.

So who's watching that? Is that something you guys do or is that something Ces going to have to go through and make sure each transaction is actually tied to a medical bill?

Yeah, really good question. So, that that's going to come back to the to the power of having that physical card. So, the card is medically coded. If you go to the pharmacy um and you pick up your prescriptions and you're also picking up a bag of Skittles, it's going to work for the prescription. It's not going to work for the Skittles. that'll get declined. So, the card's medically coded. It knows where to work and what to work for. Um, so it does a lot of the auto substantiating itself. Good question.

The other part of this is we will have the financial report for you and the other reports every quarter with your blue cross reports. So, and Chesha will have access to those reports. Their admin team is fabulous. They'll go through so she knows how to look things up. If she if you guys need a report really quickly, you know, there's a way to get it. Uh if I need to come in more often, we will do that. You know, the first uh quarter, we want to have a follow-up meeting with all of your staff, your employees, and those kinds of things. But again, it's your you have access to ongoing information as needed.

Okay. Hold on.

What happens if the business doesn't accept medical cards? For example, the state payment processor that something's in the way that the county uses uses does not accept health, medical, credit card. It's a master card. So anybody that takes a master card will take it. It's a master card. Okay.

Yeah. So it just functions as a masterard debit card. So as long as it if it takes that then um you know we're good there. Uh worst worst case scenario and I can show later on in this presentation. Uh we can provide EOBS for those off off chances of that. We'll go back to maybe the booklets and show those reports. Harrison, on your renewal costs for the county as a whole, you got us up 11.8%. Is that correct from last year? Yeah. Yes, that's correct.

How come Blue Cross said we were up 14? the um let me see the the the actual blue cross plan I believe is up 14 your renewal with what you have in place today I believe is 11.8 Okay. Thank you. That higher understand. Yeah, I got it. The hard thing to not work with the county is the fees are charged to the cars. I don't know what fees you're talking about. The credit processing I'm I'm guessing is the credit card processing fees. They usually charge like a flat rate to use a card like 2.5%

to use that card to pay. Um, and that's usually on the customer, not the county, because the county is not going to cover all of those fees. It's on the customer, not the county. But since it's not a credit card and it's a debit card, it's it's still charged with the card and places like Walmart and stuff, they just eat those fees to

Yeah, I believe that usually goes back to the provider is what we typically see. Um, and so, so if there is a, just out of curiosity, if there's a situation where a card isn't going to function and they need to still access that, um, 4,000 that they have, is there another way to access that and get that paid for them?

100%. Um, we we have a we can dive kind of go into this here really quickly, but we uh member experience is top of mind for us. So, customer care and we go through this in open enrollment and education which we will do on site if that's how you all are doing it. Um, we always recommend they give us a call. So, there's a there's a phone number on the call. We actually track this. We have an average pickup time of 30 seconds talking to a real life human on the other end. So, if they're at a provider and they have any sort of issues, 99% of that can get taken care of right away just with a quick phone call. We have a team that can talk directly to providers. If there's an issue with the card, we can go ahead and just pay it ourselves.

Not sure where we ended up in the booklet, Harrison, but yeah. Yeah. So, I can go go back um maybe

try to hit on a yeah a few few things here that I know I don't want to run out of time. I want to have some time for questions too, but this has been good. Um in terms of reporting, so we're going to provide as much access to data as we we can. Um you're going to have, you know, your own portal where you can get access to the data. This is one of our our best ones that we get the most feedback on and it's just showing us where the cards are being swiped. Really really beneficial if we do we just did a three-month follow-up. And if we do we do a lot of three-month follow-ups and if we're if we're seeing a lot of let's say ER swipes, well, we can go in and we can re-educate, okay, when do we go to the ER, when do we not go to the ER? Um, just little things like that that we can get some data from to just kind of get ahead of things to hopefully help the renewal with Blue Cross in the future. Monthly budget funding report. So, this is another really good one. So since we are giving that level premium equivalent and that stays level throughout the year, uh you can see just on here as long as the uh enrollment stays the same, the amount that's being funded month over month stays the same as well. This group ran on a surplus month over month. They ended up with a $53,000 surplus. They got 100% of that back. If that was in the negative, that's where assurance would kick in and they would pay.

And currently, I believe, you know, a lot of times with the two card system that you're paying weekly claims. This is you're funding it once a month. You're just putting that check in that bank account. So, it just keeps keeps going with that monthly budget. And I think that's a lot easier to manage for a lot of the groups that we have than the twocard system is. Plus, there's no provider confusion. It's a debit card and my Blue Cross card

member experience. So, we will provide um summary benefits to the members. They'll know exactly what their overall benefit is from the carrier, what the difference cards responsible for, and then what the the members ultimately responsible for. Like I said, if you're doing your open enrollment on site, we will be on site with you. Um, we can create customized videos, bilingual. Um, you'll have a dedicated account executive, so you'll have one, you know, great point of contact there. Um, we can create micro sites. We can do all of that to give your, you know, you and your members the confidence in the plan

and they can log in and pull an EOB if they need to prove to the provider that it was paid. Those kinds of things. they have access to uh the app on their phone if they need it. But I think being able to go in and pull information if they need to is really important. You know, our goal and feedback that we've got is we're you know, we're looking to take some some off the plate of you know, of your of your team and um you know, just be another re resource for you all.

Yeah. Um if for if for whatever reason uh they forget to use the difference card and they use their own debit card. Um I sell this and I've done this before. Uh you can you know upload take a picture of your EOB or your receipt directly from the app. Uh put in your bank information, you get reimbursed in one to two days. So again very user friendly. Um but through you know education and open enrollment they'll be they'll be confident to use the difference card and then yeah in terms of our implementation um we we start off with an implementation kickoff. You'll you'll work with a dedicated implementation specialist. We'll get everything built out the way the way you know you're you're wanting it. Um, then we'll go through open enrollment where again we will be on site to run that process with Rhonda and her team and then finally we're up and going and and then we make the introduction to your dedicated account executive that uh can be your main point of contact.

Well, our biggest problem right now happened late Friday night into Saturday morning with the Kansas legislators. If this bill goes through, we're not going to receive any more extra money basically. And I know health insurance keeps going up and we've got to have a renewal before we know where this bill's going. Yeah. I don't know what this looks like. This is whole new territory for for us being capped. uh because our property insurance went up, health insurance is going to go up. We have no way to raise the money. Thank you. Yeah, I think you know going going back to that and you know being able to generate a guaranteed savings of 28,000 with the idea that we have the expected savings of 118,000 it um you know hopefully we can take take some of that burden off you

and that education piece for us we always hold open enrollment meetings Uh we usually do obviously one really early. Uh we use uh usually do two so the courthouse staff can rotate out that kind of thing. Uh we make it mandatory. We understand things come up and usually if that happens we'll try to plan an afternoon or a morning for a makeup meeting just a mini meeting here for those uh you know who missed that kind of thing. Um and we want to do that every year. the groups that we have been working with the difference card on about 90 days in we are holding a just a mini meeting for you to come and ask questions or just revisit if you haven't used the card yet. That education piece again is really important to us. Uh the other things that we do is um we do provide a benefits guide every year. Um and this is posted on our website can be posted on yours if you have a spot that has your for instance your blue cross in it. Uh then we post uh we have the uh compliance guide that keeps everybody legal. And then this is kind of a sample of the difference card uh packet that that uh we've been doing. I'll just start this kind of going around again. U this is a group that added the difference card recently uh for this year. Um see

I think Barber County did Barber County. Yes. Um, January one, we just did our quarterly meeting down there last Thursday. We did a lunch and learn and u employees we did two meetings. Uh, we did part of that was uh the difference card. Um, and um the other part of that meeting we had the Blue Cross Medicare uh person come in. So we kind of split those meetings. We try to do that uh you know two to three times a year. We want the open enrollment meeting, but maybe a couple other meetings if there's some things we feel employees, you know, find helpful. Uh, and just again something short. U Harrison and I don't what we have maybe about a 40-minute meeting between the two and then

you know people could grab their lunch and go. So we did a 11 and a one uh that way people could eat in between and kind of get to see each other too. We'll start these going that way if you guys Tennessee again county and Clark County um

yes they did they were able to come and so they're considering it as well um but again I I think the confusion uh of cost and how to use the cards when you have the two card system there's you know lots of fees uh PIC our fees are separate we do not get any commission on uh anything from the difference card, we keep those things totally separate because you need to see where your costs are. Uh and I think that's kind of a big miss today is uh you know, if we're going to put in something else, if there's commission in it, we're going to tell you and explain why we need commission. If our consulting fee needs to be changed, we'll change it uh give you a 90-day notice. And our consulting fees lock in for three years at a time. So, and depending on the I mean sometimes we don't change it. It just depends on what's happening. We've been known to take our fees down when groups have had rough years and then uh you know gradually take them back where we need them. So, uh again, our goal is long-term relationships so we can constantly be involved with our clients. When is our renewal date?

Um June 1st. Yeah, June 1st is the renewal.

And depending on what uh for instance, our we have our consulting agreement and and uh that depending on how much notice you need to give uh the time is limited on that with I mean ours is like four months out. If you just let us know, we're going to finish out our term and move on. Uh but if you don't, you could get locked in or have to pay a get out fee. So we always make that clear when we meet for that third quarter. Are we staying together? Are we making changes so nobody gets caught in that? So, one of the other things that um I forgot this Harrison that that I do personally is uh I I meet with every hospital in the area. For instance, for Barber County, I met with the one there. I met with the one down at med uh Iowa Kansas and then I went to the Pratt hospital because people come up here. Uh and we also meet with the pharmacies to let them know how the program works. Uh the pharmacists that I've talked to are like oh it's just like a flex card. We we're good with that. So you know you just run that card through and go on. So we want them to have our number have the number to call the difference card if they need to. So we have a leave behind that we leave with the pharmacy two or three of them for them to lay around and then also make sure the employees have that same page so if they go in they can take it with them so they don't have to take the whole book they can take the one page.

So do you have any clients that are high usage? Oh I have a lot of clients that are high usage. Uh but again the when you're looking at that spread of risk when we look back at that that uh claim stratification uh report those are the two and three or four people at the top unfortunately uh that are going to u you know hit that

out of pocket max really quickly because it may be on one prescription for instance uh but then they'll have their deductible either the 1500 or the 3500 whatever they choose. Uh but yes, and that's again also having that report regularly so you know where you're at. It's access to information I think is extremely important. You know, if if uh Chesha calls, you know, we can both get online and look at it or pull it up or we can send it to her for you guys to have or I'll get on your agenda because I'm coming through here all the time to somewhere in the to go somewhere in the state. But uh and you'll find back here on the left hand side of your packet and Chester I will get you the consulting agreement in electronic format so we can send because you'll probably want to read that uh with our exhibit a uh a in here kind of gives you a little bit more detail on our services. Uh that compliance piece is big that we provide. you have a letter uh from me thanking you and then I have listed a few references. If you want any more, please let me know. Um and our fees are on page three and I have a consulting agreement. We have a business associates agreement. So we're HIPPA compliant. Um and let's see if I put And again, we bill our fees monthly and here's those come monthly and that you so you have those fees. Here's a paper copy if you

Thank you. Right behind it, you'll find the VA at the back. And you did say you partnered with I couldn't remember the law firm law firm. Yes. We work with Eric Namy and Brad Schlloman and um Jim Spencer over there on the compliance side. That's what I've said too. What's that? Oh yeah.

I when I started PIC um Blue Cross was using them for some things and I said okay I'm a little company but you will you guys take us on and they did. Uh, so we've worked with them for 27 years as well. So, anybody have any other questions right now? Anyhow, not right now. Okay. We thank you for coming. Well, I appreciate your time and later. Yeah, um, you've got my cell and I will I've got a few other meetings. So, if you need me to run back by before I leave town, I'm probably going to be here for a little while. So,

all right. Yeah. Or in the, you know, if we need to regroup, we can in the near future, too. So, but I appreciate your time and Harrison. Yes. Great to meet you all. Thank you.

More computer bags to go. I need to get one. I don't even have I just hand that everywhere. Well, this has gotten so heavy because I the HDMI as well because you just never know what you're gonna get. Yeah. Thanks again. It's been a pleasure. Good. Take care. Good. Well, how are you guys? Good. How are you? Good. Good to see you. Good to see you, Jim. He's staying out of trouble.

Okay, good job. Have a good rest of your day. Last day, it almost last day in Pratt. Had a good talk this week, though. Yeah, we did. I was thinking this was your last last day, is it not? It's Wednesday is my last. Okay. So, almost close. Have a few days. Thank you. if you guys don't mind introducing yourselves for these people on

Yeah. So, my name is Patrick Brown. I'm the group sales consultant for your your group for Bluec Cross Bush Kansas. So, what that ultimately means is I'm the one that has worked with you when there's questions or needs that arise throughout the year, but then also that comes on days like today and presents the renewal. As we kind of uh mentioned, I am taking another opportunity in a different industry here soon. Jim Lommy has been with Blue Cross and Blue Shorty Kansas for many years and um has other groups in in the Pratt community and I don't remember if you've worked with them directly before a couple of years ago. Yeah. Before you came on board.

Yeah. So Jim uh will help in that interim until they fill the position that I have currently. Anything else you want to say? That's it. Perfect. Maybe. So, my understanding, and I know we're gonna have a little less than 30 minutes. Um, I tried to That's okay. So, my understanding is I'm coming today to walk through the Blue Cross renewal and where kind of give some insight on where the increase is coming from. Is that correct? My

Okay. So, I am going to go fairly quickly over some parts, but you can stop me at any point in time. So I always like to start these meetings by saying at the end of the day, this meeting is for you all. The only thing that's important to me is that you get out of it whatever you need. So if I go over if I skip past something for the sake of time, but you want to drill into that piece, just ask. Okay? Okay. It's also going to be important we all stay on the same page. So I'll fairly frequently lift the book up and kind of show you where I'm at.

Okay. The first page there is simply showing your existing plan with the renew renewing the exact same plan and breaks down the premium differences. So you'll see the overall increase is almost right at 14%. The numbers behind that increase are at a later page. So there's really no reason to hang out here unless you all have questions. This is if you keep everything the same, this that plan will cost 14% more starting at your renewal date of 61. Okay. The next page is where we'll spend the vast majority of our time. This is your uh utilization review page. This is your group utilization report. And this is essentially the the bulk of the math behind the renewal. Okay. So you'll see up towards the top it'll list health contracts as well as dental. So across all of your plans and health contracts just count the employees. So whether you have a family or it's just you, you count as one. So at the time our team worked this renewal, you had 102 people enrolled in the health plan and 97 employees enrolled on the dental plus all their dependents. Okay. I will spend very little time on the dental renewal today because it's half a percent and it's smaller dollar amounts anyways. What you care about is predominantly, I'm sure, the health plan.

So, if you look at line two, you'll see the experience period. So, we look at the same 12 months of February through the following January each year for your renewal. We're always looking at 12 months at a time. The reason we look at 12 months that are further back in time, so to speak, than your than your actual plan is so we have time to do the math, put it together. You have time to plan. Okay. So, the 12-month period we're looking at for this renewal is 21 of 2025 through 131 of 2026 for your renewal plan year of 61. Everybody's with me? Okay. When we get to line three, that starts to pull in the factors that are applied as we calculate that math for the renewal. So you'll see there's factors A through D. Cross is inpatient. So you think hospital, if you're inpatient hospital, that is what gets captured in the cross. The blue shield is your outpatient. So think like doctor's office visits, things that are done in the outpatient setting. Dental is pretty self-explanatory. And then drug is the medications specifically ran through the pharmacy side of the benefit. So medications you're picking up at a pharmacy getting through a mail order pharmacy is the RX side of your benefits. Okay. You'll see the admin expense listed for each of those lines which is really quite low. And then you will see estimated IBNR. IBNR stands for incurred but not reporting or not reported. So, if you and you'll see like the cross is a higher percentage than the shield. What that calculates is when we've looked at when we're looking at those 12 months, there are still claims out there for that 12-month period that haven't been build to us from the provider, processed, applied to member benefits, etc. We've been doing this for over 80 years. We have a pretty good idea in a groupy year size how many claims on average are are still out there. So, we factor that in at the renewal. And it makes sense if you look down across there. The highest is a

hospital, right? If if I go to the hospital, oftent times a hospital will hold on to that claim until I'm released and basically they put it all together and submit it for the days I was there. Everything that was done. I said I said most um we probably dealt with

the um I'm gonna just keep right on trucking. Um the the doctor's offices typically bill those claims a little bit quicker. They're smaller claims is a shorter encounter. Dental is is quicker yet. And then drug is almost always instantaneous. So far most of pharmacy is what we call point of sale. That claim process happens essentially as you're picking up the the prescription. So what that's showing is for each of those different lines that is typically what we see how many of those claims are still out there and haven't come in. So we factor that in. And then trend is the next line. I wish those had a percent uh indicator be beside them. They are percentages. So trend is a combination of medical inflation and utilization. How much is the cost for goods and services going up year-over-year because unfortunately a few things go down. But then also what is the utilization rate? So think is somebody on is the average person on two prescriptions or one and a half prescriptions versus if last year they were on one for instance. So it's a combination of those two. And then retention is on top of a base the base admin all the things we do for your plan and what it costs to to kind of run business our business. It's not a high uh metric at you know 7.76%. Uh but that's all of the things that Blue Cross does for you. Prints ID cards, manages a provider network, customer service that's local based here in Kansas. All of those things. Then when you look continuing across that line, you'll see the desired loss ratio. So where we would like you to land. Loss ratio represents out of every dollar coming in to us for premium, how many dollars are going out to pay claims. So if you ran at a 92% loss ratio, that would mean for every dollar that you paid us, we paid out 92 cents for a claim, which would leave us roughly 8%

for retention for admin for all of those things. It's important to keep in mind if you hit that number spoton, if you were at exactly a 92% projected loss ratio, you would still likely see an increase because of trend, but that would essentially cover the administration and retention, those pieces. You would just essentially at that point be taking on trend. And then the credibility factor. Credibility is an actuarial term that in layman's terms I think is best described as predictability. So a group your size if we in a bad year if we gave you credit which doesn't wouldn't sound in a not in a good way almost if we said hey we think your claims are going to predict themselves are predictive of exactly the same claims occurring next year if we were putting our full prediction based on your claims and your hundred employees you would never fully recover from a really bad year. What we know is what actuaries know is you have to be a much larger group, 500, maybe a thousand before you're really that predictable. You have enough people in premium to offset the premature baby or somebody having cancer, those sorts of things. So half of your renewal is calculated based off of your group. Half of what we're predicting for the future, if you want to think of it that way, is based on your claims. the other half is averaged from our book of business, which as you can imagine gives a more stable backdrop to to work that against. So all of that then to factor down to the following lines, which I'll go through relatively quickly because the line that we're working towards that tells the most on this sheet is line seven. But before we get there very quickly on line four, you'll see total bill charges, total allowed charges, total payments. The difference between build charges and allowed charges is our provider network discount. So we obviously work with providers to get the most fair pricing that we can

for your group. The difference between allowed charges and payments is what members paid and deductibles, co-pays, etc. versus what the plan itself paid. So your plan Blue Cross on your behalf paid out $1.8 million1826 um for claims this year. Okay. If we look down at line seven for where your projected loss ratio is, when we take into account where claims are at today, plus those claims we know are still out there that incurred but not reported, your projected loss ratio is just under 108%. So when those claims are fully accounted for, we will have paid out more $1.78 for in claims for every dollar they came in in premium. I may not be a math major, but I can tell you anytime that number's not in your favor, unfortunately, it means that myself or Jim or one of my colleagues gets to come tell you in order to run the same plan next year, it's going to take more dollars. So, that not to skip past everything else on the page. Obviously, down at the bottom it says 14.1% which you already knew from what you saw a minute ago and you guys have seen this before, but that's where that's coming from. there will be more dollars paid out than were paid in this year to Blue Cross. On top of that, you have to account for a trend, which we talked about, and that combined is what gets us to that 14% increase.

So, you're saying they paid out 1.8 million? That is what Blue Cross has made in payments on behalf of the plan for that 12-month period at the time they worked this renewal. And our premium's 2.3 million. So your actual premium on line five there it is is 22 2141 for the same period.

The the difference in that will be absorbed pretty quickly. And I'll part of what I'm going to show you is some of the high claims that you have right now, which I you probably saw potentially in in the reporting that either Rhonda went through with you or Freedom Claims has. U but that difference will be statistically speaking will be absorbed and then there will be more above that that ends up coming in from those claims that are still incurred but not yet reported. I mean the the easest the way I think about it is look at their desired loss ratio. Look at our projected loss ratio. That's that's why it's up.

Correct. You can see why I'm not a math manager. Yeah, it is it is at the end of the day it is a math equation. That is really all that it is. And um yes, you're exactly right. There's a significant difference this year between your desired loss ratio and where you're actually at. And that is indicative of the increase that you're seeing. I promise I much prefer to delivering flats or decreases. It's much more fun. We have a party. Yeah, we don't ever have a party. We did last year. I mean, we might have high five, but it wasn't

a you did have a good renewal last year. Any questions there before I take you to another page? Okay. Where I would like you to flip to is a page that looks like this one here. So, it's always important to remember and I feel like for me to preface, there are people behind these numbers and those people are not having an enjoyable time in their life right now. they're going through a medical events that require treatment and support and ultimately that's why you have a health plan.

The reality is we look at all of these numbers because like we talked about at the end of the day it is a math equation for making the plan work financially. What is unique to your group this year isn't that you have a list of people with claims in excess of 25,000. If I sat down with any group your size anywhere in Kansas, almost all of them, if not all of them, will have some people with claims over 25,000.

And again, that's really insurance how it's intended to work, right? Everybody pays in. You use it on the people that need it that year. What's unique about your group this year is the number at 16. To have 16 people in a group of 100 employees enrolled plus their dependent, but to have 16 people that have crossed that $25,000 threshold is not normal. I would say on average for a group your size it' be half that. Six, eight, you know, nine somewhere in that range. That's a good percentage over 102. It is a good percentage of 102. I mean, it's almost a quarter, but it's a little less.

Yeah. 16%. Let's just say even round down a little bit. 1415. more I I guess maybe importantly or also to to to to further drill down on that. Once we get to line seven, everybody from there on is north of 50,000. Once we get to line 12, everybody from line 12 through 16 is north of 100,000. And that one down at the bottom is 247,000. The total across those 16 people that Blue Cross has paid is 1.2. So, of that 1.8 that's been paid so far, 1.2 was on 16 people.

You can imagine that doesn't leave a lot of premium then for everybody else in the plan. Yep. Now, everybody on this page at the time we work this renewal is still active on the plan except for one. One person number six is no longer on the plan. Statistically speaking, hopefully, quite likely, you won't have all the same people on the plan next year or not even just on the plan. Some of these procedures won't need to be repeated. Sure.

Right. So, this doesn't mean, oh, we're going to see this year-over-year, but this year, the vast majority of your cost is driven by a small percentage of the people who needed a lot of care. Does that make sense? Yeah. Yeah. I always try to be really respectful in these meetings, especially when it's open to the public. I don't like to get down into details. um in a I'm from a small community in Kansas. A lot of times even though nobody's identified, if I start talking about conditions or certain med medications, sometimes it makes me feel like it's easy to make guesses. Yeah. Don't go there. Yes. So,

we understand. If you want that information, not the actual person's name, but the information, that reporting is available to you that says this is the medication that somebody's on and this is what it cost. again deidentified by all means, but that information is available to you. I would prefer not to dig into it in this setting if that's okay. Yeah, that's I think we have it. It's just that we're not we don't ever talk about Sure. Yeah.

which I respect. So, with that being said, questions, thoughts. Do you want to run me out of Pratt? the last time here just for you know where do we put our picture? No, it's just you know like I said earlier that the legislators are really if this thing goes through it's going to be a nightmare. It wasn't a good year for me to come in with extra bad news. That's right. Yeah. But I mean, but I mean,

just look over the last 5 years, health care costs are going to go up. They're going to keep going up. We have no way to raise revenues to keep that up. So, I don't even know what this looks like, right? Going forward. Uh, I mean, this first year is just going to be a hope and a prayer if this bill gets passed up there. The current pace feels unsustainable. Yeah. Yes. Yeah, I do have a question. I don't mean to put you on the spot. So, last year we engaged Freedom Claims. Has the relationship with Freedom Claims been okay from your perspective?

Yeah, from from my perspective, Freedom Claims is a great business partner. I have nothing but positive things to say about my interactions with them. Um, Rhonda Fernandez is a good business partner. I don't have anything negative to say about my You can say what you want. I'm getting ready to leave.

I appreciate that. Uh the reality is, you know, I'm limited in what I feel like I can say in this environment. I'm certainly open to a, you know, closed discussion if you guys want to, you know, to dig deeper. But the truth is from my perspective, Freedom Claims is a great business partner. Rhonda Fernandez is a great business partner that I have no problem saying and it being recorded and you know all those fun things. So, um yes, I have no concerns whatsoever. So, you do have some different options here. Did you want to go those or

So, there is a different option in there. It's in a similar renewal page. Uh, it's the $6,000 deductible. Yeah, it's still a high deductible health plan. It's virtually the same as the 5,000 except for that different deductible. And you'll see uh it it does result in a 9% increase, right? But of course, with any MER plan, you are also then taking on an extra $1,000 per person or $2,000 per family in liability. would you make that move? Does that make sense? Assuming you don't change anything else. Yeah.

So, there is also we do have a another plan that is a 6350. So, instead of having a different a deductible and then you know you have prescription co-pay so you meet your max out of pocket, we do have a plan that's just 6350 period like whether it's pharmacy, medical or combination. It's 6350. Your deductible and your max out of pocket are the same. That's not in here. But if um either of whatever direction you guys go, if you want to see something like that, it's uh would take mere minutes to put something like that together. It's available.

Yeah. I don't know truthfully exactly how this works in you guys' meetings or how you do it. If you are you wanting to have a more candid discussion about to the extent that that discussion would happen, I would reach out to you and I would communicate back to my commissioners. Okay. Sure. I just want to make sure that I'm meeting. Yeah. We're just waiting for that bill. This How much longer are you going to be with us? Till the end of Wednesday. more days. Absolutely. Yeah, I'll leave my card. Okay.

You might have Jim's card in there somewhere. He might. Yeah. Also, Sasha Christina, it will still be the consistent so you can also reach out. Okay. It must have been three years ago. No, not at all. I always just tag team. I always tell I always tell people just put us both on there. Whoever sees it first will help. Yeah, that's perfect. Bag and one of these deals. Thank you. Other this may be the first time I've ever got through a meeting on or ahead of schedule. So, uh, we have one more minute of my aotted time. Should you have other questions or thoughts or

We appreciate you coming down. It's helpful for public also here to see exactly what's we know you wanted to see us for you. I did. I did the opportunity. Yeah. I I told Sasha I said I can come down or on this day or somebody else can come down a later date. And and uh yeah, I I have enjoyed working with you guys. I know your job is not easy and it just got harder or potentially just got harder. Um I agree the current path feels unsustainable um with with how cost and utilization to be quite honest have have risen in this this space. So I don't like delivering that news but I yeah

I but I feel like it's important to explain the why um behind it. We appreciate not only to us but to the public, right? Sure. Absolutely. You don't hold the record. I think what was it that one year? 36% increase. Is that what it was? You know, there's some records I just don't really He doesn't keep track. Don't care to hold. No, no, no. I'm good not having that. So, if you guys need any Yeah. If you do need anything, feel free to reach out. Sure.

In the interim, you know, until I move on, I will be more than happy to help. I'm happy to have open conversation. Whatever you guys need. And then um Jim has not only been a great um co-worker, but I consider him a mentor and certainly anything that I could do for you, Jim can do as well. Sounds good working with you. Yes. It's been great working with you. Thank you. Do Yes, likewise. Do you need an additional copy for anybody or is everybody here? Nobody. No missing commissioners or anybody today. Okay, perfect. All right. Thank you. Thank you. Thank you. I appreciate it. You guys enjoy the rest of your meeting.

Yes. Good working with you. Yes. Good working with you. Take care. Best of luck to you wherever you're going. But you'll do I'll do my best. Right. Yes. Stay out of my Is he rolling toward you? 300 lb book bag. If they ever figured out what's wrong with that guy, we wouldn't be overutilization so much. It's the stress. Don't Don't get into it. He's lost all his hair. So,

well, I'm curious where the other gentleman's going. I see he needs two. Patrick could be a good coworker. You got anything else, Doug? Besides Okay. Did you get a hold of Jim Bob or have you called him yet? Meet with him in the morning. I got to thank you from when I called you the other day on that one. Oh yeah, we got it. I mean, he thanked us good. Yep. I mean, we got to it. Just need some moisture.

High traffic and moisture is not combination right now. He's just He's just shabbering. He's just rambling. No, I was I I'm here on appointment. He He comes in here and he just starts rambling. We don't know what to say. Just random. It must be the farmer in him. Yeah. So BJ would request an executive session for non-elected personnel to discuss salaries for how long? 10 minutes. Five minutes. 10 minutes. Okay, I'll make a motion we go into executive session for non elected personnel discuss salaries

possibly for second. How long did you say? 10 minutes. 10 minutes. Been moved and second to go into executive session for non-elected personnel to discuss salaries. All in favor say I. I. Post. Same sign. We will be in executive session.

and make a motion come out with no action taken. Second it been moved and second and we come out of the second session with no action taken. All in favor say I. I post same sign back and no concussion. Make a motion we go back into executive session for attorney client privilege to discuss the 911 funds. I'll second that motion. Been moved and second to go back into executive session for 10 minutes again. Oh, sorry. I didn't get the time today. Probably be in that 10. What? Fine. 10 10 minutes for non-elected personnel. Discuss

attorney client. attorney client for 911 funds funds. All in favor say I. I oppose any sign. Motion car.

things like that session with no action taken. Seconded. Been moved and second. We come out of executive session with no action taken. All in favor say I. I. Oppos. Same sign. We're back in open session. All righty. Thanks, guys. Thank you, DJ. session. I would request an executive session for returning client privilege for 14 minutes to discuss the for 13 minutes to discuss the PRMC lease and also insurance health insurance.

I'll make that motion. Second been moved in a second. We go into attorney client privilege to discuss hospital and insurance for 13 minutes. All in favor say I. I. Both same sign. will be in executive session.

Okay, I'll make a motion we come out of executive session with no action taken. Oh, second. Been moved and second and we come out of executive session with no action taken. All in favor say I. I. Opposed? Same sign. We're back in open session. Terry, you're up. Okay. I've got two drivers who have been with me for 6 months. So, I'm requesting a 50% raise for both of them. 50 or 50 cents? There's a difference there.

Okay, let me dial that back. 50 cent raise. I don't know what I said. I'll make a motion that we uh excuse me increase Sean Fleming and Julian Harris to get their six months 50 cents to 1121 and a half. I'll second that motion. That's the one that I if you want to use that one. We approve the 50 cent increase for Sean Fleming and Julian Harris for their six month All in favor say I.

I. Oppose. Same sign. Motion carried. Thank you.

And then I've got um a request to fix a bus. It was hit uh it was at a stop sign and it was hit from the behind. And the person that hit us didn't have insurance at the time. So, I waited a little while to see if they'd turn in their insurance and they did not. So, I finally um got our insurance company through it to look at it and um they said that they would send I got the estimate when they said that they would send us the um bus has a $1,000 um deductible. So, um,

they'll pay they'll pay the rest of it past the $1,000, which I did receive a check today from C for the W480. Um, which should have been 1,000 less deductible. Yes. $1,480 is what? Yeah. Yep. And that's how much the check was. Okay. You just let me know once they decide once they'll consider this um how you would like to pay that. I can reimburse that back to whatever account. Yeah. You just want to put it in the COA account. Is that where you'll be? Yeah, that's all I would be taking it from. Okay. But you did contact the insurance.

Yes. And they said that they would um then uh try to get them to collect from the other party. Collect from the other party. That's how it works. So I don't know if we'll ever get it, but we'll see. We do have an accident. Would you let him know? Oh, yes. Just for just in case our fault. Yeah. Which it was not. No, it was not our fault. Well, he still needs to know. He needs to know. Okay, I'll you on the one to Willie then. You want authority to spend $2,480 to fix the Yes. the bus?

Yes. I'll make a motion to uh pay Van Slag Body Shop $2,480 for a repair to the bus that got rear ended and insurance is going to pay a thousand of that. second motion. We don't need to sign be the opposite. They're holding a thousand and they'll pay the rest. So they'll pay. So yeah,

been moved and seconded into a van site body shop 2480 for fixing the van that was rear ended. All in favor say I. I. Same sign. Motion carried. Say it. I did say that. Yeah, the other way around. Well, I'm glad I'm not the only one saying wrong things today. August. August. Yeah, you remember that one.

Um I will say that one of our other buses is still um having a hard time getting parts to be fixed. So, it still hasn't been fixed either, but it's still drivable. Um, so we've been driving it, but it's through um Doug Ray that we got the estimate. So that's why we went to Vance like to see if we could get something a little faster then a little faster. We'll see if this one's any faster. Um, it hit a pole Walmart. Yeah, I remember you telling us that. That was a while ago.

It was a while ago. Yeah, we've been waiting a while on it. So, just so you're aware, it still hasn't been fixed and it'll still come about at some point. Jared had a driver hit his pickup here in town, took it to Doug Ray, and they had it for three weeks and sent him home because they couldn't get parts.

Wow. Well, I mean, I will say that it is hard to get parts for these buses because not the one that I I don't know why the one from Doug Ray or that at Doug Ray is taking so long, but um I think mostly is they they are using those parts to make the vehicles and so they don't have any extra parts to like fix them. Um, you know, we're still Well, I figured you know, the China turnaround stuff.

Maybe that might be it. Some of it, too. Um, I haven't been told exactly the reason why the parts are so hard to be getting, but um, so hopefully this one just needs a bumper. Um, so hopefully it gets quicker is my my hope. So, it's being able to be driven as well while until it gets fixed. So, we're not doing too bad in the vehicles. We don't have any that are actually down. So, okay. All righty.

Okay. Thank you so much. on the irrigation quote. Jared was on that. He heard you guys talking about that. He said, "Hey, you want that too?" I have talked to Munis and I talked to C and NAR. I don't know if they've got you yet, but they are spo those two companies are supposed to. Okay. because this is about what was last night. I don't Yeah, it was close to I think we Yeah, I don't know when they're going to but I talked to both of them

and it was just so I can keep an eye out for it. It was DNR services and you said you Yeah, you guys want to talk about the lawn care notice that I sent you? Oh, yeah. Yeah, I read it looked good to me, but I don't see you to reason, you know. Okay. If we want to run that twice, SA, so put in the date uh the Monday following the last run on it. Does that make sense? You're looking at me like that doesn't make sense. So, you run it twice. Are you talking about putting it on the agenda? No. Run it in the paper twice, right? And then the date in there that's currently says insert date, I think, would be the date

after the second run. the Monday after the second run. So, it's going to be you need to talk to the paper about what Yeah. So, if you don't get it in this week, it'll run the week of the 9th. I see what you're saying. I was missing out on that second open bid on the 20th. I think the cut off is the Tuesday before the next week. It's I mean, you have to get it in early to get it. So, I'll call find out put it in that. And then if you want to just distribute it out to the locals, that's fine too. Like hopefully they see it. But if you want an email, I don't know if you have email contacts for everybody, but Okay. I can do that. We'll display it too. Um, our publications, we'll get that displayed. Um, and so you want the Monday after the center. Yep.

Okay, I can do that. Do you need a motion for that? If you want a motion to give her authority to publish the notice, that's fine. I'll make a motion we give session uh permission to run the public notice for soliciting bids for lawn care and related services for the courthouse. Second the motion been moved and seconded. Give sasha permission to run the public notice for soliciting bids for lawn care and related services around the courthouse and LAC. All in favor say I. I post same sign. Motion carry.

Do we need do we need to put something in there? Because if we do get a sprinkling system that's going to cut down on time. Yeah, I wondered about that because that water as needed. I believe I wouldn't be in favor of the sprinkler system at this time because what Okay. Wait, wait till fall when you can replant the grass and Yeah. See what happen. will know what we're to peak budget wise. Yeah. And and see how many sidewalks we tear up. So on that note, I'd request an executive session for attorney client privilege to discuss uh proposed legislation at the state level.

I'll make that motion. For how long? Uh 15 minutes short. I'll second that. We'll have a been moved and second to have an executive session this attorney client to discuss legislative matters for 15 minutes. All in favor say I. I oppose. Same sign. We'll be in executive session.

Okay. I'll make a motion we come out of back in session with no action taken. Oh, second it. It's been moved and second we come out of executive session with no action taken. All in favor say I. I. Oppos. Same sign. We are back in open session. Uh Do you have anything else s minutes or we have um Oh, we already took care of those. So, yep. Minutes. Okay. We'll make a motion we approve the minutes for March 23rd, 2026. I'll second.

Make a been moved and second we approve the minutes for March 23rd, 2026. All in favor say I. I. Post. Same sign. We approve the minutes.

It was um Sheriff had Oh, okay. I stuck that in a back too. I snuck that in just one.

Thank you. So, we had a deputy go to part-time and he needs another full time. I think I could reach I I think that's what they're doing there. I wasn't told who they were replacing. I could find out. She asked if I'd bring that to you guys.

I'll make a motion for a new hire of a deputy Alarand Alondo Miguel Dismina. I'm sorry, dude. I screwed that up. I already know. I'll second the motion. for 2450 an hour. It's been moved and seconded. We hire a new detective or new road patrol. Road patrol for the sheriff department for 2450 an hour. All in favor say I. I. Post. Same sign. Motion carried. I think it's Alandro, isn't it? I didn't try it. I did not try it.

You did not try. No one's about to drive. Was there another one for that one? Going back to part time or um I think this I Oh, that covers it. Okay. I think Yeah. Yeah. Can't afford any new hire. Hires. Yeah. Don't you have anything else? Vouchers. Do you have anything? I don't. I'll make a motion we approve the vouchers. I'll second it.

We move and second we approve the vouchers. All in fog say I. I. Post. Same sign. Pay the vouchers. There you go, sir. Okay. Can I just grab some more sign here? Stickies to keep down here.

Like it is too. I was looking at our budget. He's gonna meet with department head on the 7th. So maybe we'll know something. He is our first presenter at Sandborn tomorrow at 8 a.m. sharp Scott Lloyd. I'm hoping he just doesn't pick on me from there. Start boopping him on his way. I'm serious. It's going to be tough this

We know the surve I'm sure he's hearing from. Yeah. and he he does a good job about staying staying up on a lot. So, I'm yeah, kind of anxious to see uh I've never heard him speak other than Canary. So, and then also Gilmore Bell is going to be there um and doing like an um a session on bonds. Cool. Where you going again? Which show? Uh Manhattan and I'll be there till Friday, I think. Is that Kevin or was it somebody else? Wasn't Kevin? I didn't recognize the name. Yeah, I was hoping it was Kevin, but went to law school. Who are the guys that are in there now?

Oh, I wonder Mitchell and Tommy were at the very top of the class. I was They probably, but I wasn't up in their world. You're the one that was always at the board. I wasn't. Even if he was, I don't think he'd admit it.

I never saw you in the library, Jason. Where did you go to school? Um, thought that's doing establishing internal controls. And then um on day two is

oh way officer tell me is it NEA? Yes. Hey, Jay Hall's gonna be there. Like any that's a site. Um, very good. Yeah. Yeah. Jal, who's he there with any

Mitch Walter? Yeah. Yep. He's good. Okay. Oh, he's one of the ones you went with. Okay. Bring back some stories. Okay. Yeah, I will. See if you can dig any dirt up. Okay. Believe it or not, I was in my joke amongst my roommates. I would go to my room. They called it cave. It never leave. Did you ever lock in your No,

I don't have locks. PlayStation deny that was What are masters? I've heard that before. Exactly. Oh, yes. Yeah. I think your school just pull that to the top. Okay.

Somebody that I guess. I don't know. I think it's a I don't know. But it was like a professional group, you know. is on top. Yeah, there was a payroll too this morning. But I think we have AC on again. So that's exciting.

Thank you. Yep. from Trooper Ben. Is he the one that has the Facebook Kansas State Trooper guy?

Who? Trooper Ben. Yeah. Okay. He's going to be on Facebook. Not going to not me. No. Our conference is at the same place where we're staying. So that makes it nice. Yeah. I noticed the spring conference is in Hutch or KC. Oh, I saw that at the new hotel there. a long time to build it.

Other than Garden City, the one I have to go to with the end of April one city is their new venue. Thank you. Started with

one more. One more. Yeah, that is what was hold the chats on here is what was Yeah, I clear. Okay, I didn't on mine. Anything else? Anybody? Make a motion we second move and second we adjourn. All in favor say I.