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Board of Aldermen 3-31-2020 Page 24

Larry Budreau, Human Resources Director

Our plan year runs from July to the following June so immediately upon signing up effective July 1* you get
the first $1,500.00 the next day and then the second $1,500.00 would come on October 1* unless you
needed it before that in which case we would provide it when you needed it. Does that answer the question?
Alderman Cleaver

Yeah that answers the question, thank you very much. Next is just a comment and not a question but it
seems to me that this issue and this presentation is a ringing endorsement for Medicare for all.

President Wilshire

Are you all set Alderman Cleaver?
Alderman Cleaver

Yes, thank you very much.
President Wilshire

You're welcome. | think | had somebody before you Alderwoman Kelly. Linda, did you have your hand in the
queue.

Alderwoman Lu

| do have some questions OK?
President Wilshire

OK.

Alderwoman Lu

This is Elizabeth.

President Wilshire

OK Linda you go first please.

Alderman Harriott-Gathright

Is it an either or in terms of the different insurances, if you don’t go with the HMO then you have to go with the
HSA is that correct?

Larry Budreau, Human Resources Director

We have offered a third alternative and will continue to; it is a point of service plan. It is considerably more
expensive than either of the two and the whole City has only about 120 people enrolled on it, most of whom
are retirees living away.

Alderman Harriott-Gathright

Another question, the HSA there was somewhere | read that it carries over for or you can carry it over to the

Board of Aldermen 3-31-2020 Page 25

next year. Is that the end of it or does it continue to carry over year after year.

Larry Budreau, Human Resources Director

Sorry Director Kleiner, it is not the end of it. It carries over year after year and when you retire or resign it
becomes your money the instant you first get that $3,000.00 and it continues year after year when you retire
or you resign, you take that with you.

Alderman Harriott-Gathright

OK and my one last question. So for the unaffiliated, that’s their choice to choose one of those three options,
correct?

Larry Budreau, Human Resources Director

Correct.

Alderman Harriott-Gathright

Ok thank you.
President Wilshire
You’re welcome.

Alderwoman Kelly

Yeah, | have a few questions, actually the first one was actually something that you just said Director
Budreau. So you said you would take that money with you when you retire. Does is still stay in an HSA so
you can only access it for healthcare?

Larry Budreau, Human Resources Director

It does stay in an HSA; however HSA’s like other tax deferred savings accounts, you can take the money and
spend it on anything but you do pay the taxes at that point.

Alderwoman Kelly

OK thank you. So my second question is around projections so | know our projects on terms of how much
our health care was going to go up were done you know earlier this year. I’m not sure anyone will be able to
answer this but | am assuming given the state of the world and the crisis we are in that those numbers will
adjust?

Larry Budreau, Human Resources Director

President, may Director Kleiner take that question?
President Wilshire

Yes.

Kim Kleiner, Admin. Services Director

So the numbers that we see, Alderwoman Kelly, are always an estimate and they do fluctuate and we see

Board of Aldermen 3-31-2020 Page 26

that throughout the year. We did speak with WBS today. | think we have some concerns but you can look it
this way; So you saw a big push in elective procedures being canceled because of the crisis, so those costs
weren't realized. What costs we will see now towards the end of the year as a result of the crisis are really an
unknown. So we could actually have a drop in claims for people that have had these elective surgeries now
postponed, or we could see a surge towards the end when we receive them in May and June. We would be
happy to keep the Board informed on that but we do see it fluctuation. And then with Anthem’s change in
reporting this year, that has made things a little different as to when we are comfortable making the projection
and we actually delayed it and didn’t inform the Mayor of the production until later than normal.

Alderwoman Kelly

Thank you. | had one more follow up if that’s ok Madam President. Thank you. So my | think this makes
sense, | know we came to you guys and asked you to look at plan design as a way to potentially mitigate the
cost to the City. My question is, so much of the savings that we are talking about is predicated on people
actually making that shift. So what is the plan that we will put in place, | know you talked about ambassadors,
to help people make that shift? Because we are going to have to build a budget based on a number that we
are not sure we will hit unless those people decide to make the change.

Kim Kleiner, Admin. Services Director

So let’s look at the employee group we are talking about; there are 113 subscribers. 51 of those are already
on the HSA; 59 on the HMO and then 3 on the POS Plan that Director Budreau talked about. We are going to
have a lot of education for those 59 current HMO subscribers to try to switch them over to the HSA for the
next plan year. We can, with this small group of 113, you know, we can really reach out and have those
conversations. With the larger group, the total population as a whole, each Division is having those
conversations. So DPW is talking with their people; Police are actively talking with their people and the
Teacher’s Union is talking with teachers. That's how we realistically think that we are going to drive the
largest shift.

Our budget projection in the Fiscal 21 Budget is the entire increase that we recommended to Mayor
Donchess. So any potential savings that we see as a result of plan change, will be to our benefit.

Alderwoman Kelly

Great thank you very much.

President Wilshire

All set Alderwoman Kelly? Alderwoman Lu. Alderwoman Lu are you there?
Alderwoman Lu

Hello, can you hear me now?

President Wilshire

We can, thank you.

Alderwoman Lu

Thank you, Madam President. Just a few quick questions, the EOB is that Estimate of Benefit?

Board of Aldermen 3-31-2020 Page 27

President Wilshire
That is an Explanation of Benefits.
Alderwoman Lu

OK. Great. So that’s something that you receive to explain how much you owe and how the City picked up,
correct?

President Wilshire
Correct.
Alderwoman Lu

Thank you. On the invitation that was sent to the members of the Unaffiliated Group, it was sent out on
March 9". What date were they invited to come and learn about this proposal?

Kim Kleiner, Admin. Services Director

They received an e-mail from the Mayor directly on the 9" for a meeting on the 12".
Alderwoman Lu
| see, so they had a 3-day notice, but only a few came, right?

Kim Kleiner, Admin. Services Director

No, we had a fantastic attendance, | would say roughly 60 to 70 attended the meeting with the Mayor.
Alderwoman Lu

Oh OK it must’ve been the Director’s Meeting that | am remembering that only a few came to. So 60 or 70 of
the 135 we able to come and discuss it and learn about it? Is that right?

Kim Kleiner, Admin. Services Director

That is correct. Yes it was held in the City Auditorium.
Alderwoman Lu

OK and just the Fire Department it has been mentioned that they have a large enrollment in the High
Deductible. But it is not the same plan is it? | mean we are not talking about the same plan. There are a
Union and they probably have some kind of a slightly, you know, every plan is specific is that correct? So
when we say a lot of them have signed up, we don’t mean a lot of them have signed up for this particular
plan? Correct?

Kim Kleiner, Admin. Services Director

The High Deductible Health Plan with the Health Savings Account is the exact same plan across the City.
Alderwoman Lu

Oh OK is that true of — so going forward is that how these plans work. Are they sometimes, | was under the

Board of Aldermen 3-31-2020 Page 28

impression they are tweaked by the Union or they can be? | mean it is negotiated so they may be slightly
different from one Union to another.

Kim Kleiner, Admin. Services Director

| think the confusion is that the proposed healthcare plan design that is proposed this evening is for
unaffiliated employees that has to be negotiated into any Union agreement going forward with our 17 Unions.
So their HMO would remain the same unless the Union agreed to negotiate that change.

Alderwoman Lu

OK | was just trying to clarify, | was trying to understand what had been discussed about the Fire Department
having highly signed in, but was that comment about this high deductible plan as it is? As it currently is?

Kim Kleiner, Admin. Services Director

Yes, they have been very active with their members in educating them on the benefits of the high deductible
health plan which we think results in the change and the shift to the high deductible.

Alderwoman Lu

OK and just after retirement, | don’t know whether our City employees stay on the health plan after retirement
but do we continue to pay into the HSA’s for retired employees?

Larry Budreau, Human Resources Director

May | respond? Thank you. When employees retire from the City of Nashua, if they retire before they are 65
years old, they are eligible to continue the City’s Health Plans but the employee pays the full premium. They
are able to choose any of the health plans that the active employees have; so they could pick the current high
deductible health plan or the current HMO or the current Point of Service Plan. If they choose the high
deductible plan the answer is yes, we do contribute the $3,000.00 for the family deductible.

Alderwoman Lu

| guess my concern is couldn’t that become an increasingly, kind of like a pension, you know, almost as
though we are building pensions into our retiring, you know, we are adding to pensions almost. So thank you.
And another question is just about that Smart Shopper. So | have been on high deductible plans before and |
understand the benefit of you know healthy living incentives and incentivizing your employees to shop and to
know the benefits, rather to know the cost of healthcare so that they can be an agent in maybe change. But |
wasn’t clear on that slide of the Smart Shopper and whether, is there a commission that we pay for Smart
Shopper or is just part of the package that this WBS offers?

Larry Budreau, Human Resources Director

Smart Shopper is a for profit organization and they generally do business with a per employee. So Smart
Shopper usually is paid on a per employee per month basis. The City of Nashua was reluctant to find
ourselves paying more for the service than we reaped in savings. So we began our relationship with sharing
the cost savings 70% / 30%. So if you were to look at that slide again, sorry I'll just tell you. There was a net
savings of $25,000.00 by Smart Shopper. We actually retained 70% of that, less the 30%. So two thirds of
the way down — oop go ahead.

Alderwoman Lu

So what is Smart Shopper?

Board of Aldermen 3-31-2020 Page 29

Larry Budreau, Human Resources Director

| recall you last asked | think what Smart Shopper and it is is an organization that is constantly mining the
data from Anthem so it knows what facilities have charged how much for certain procedures. And then
through a web portal and also with telephone assistance, when someone has to get an MRI for example, and
| did this before Smart Shopper, when | switched to the Health Savings Plan the first time | was ordered to
have an MRI, | participated in where it was going to be. Now | would call Smart Shopper, they would take a
look at the doctor’s order and they would look at facilities and say, “If you go to this facility, we will give you
$250.00 incentive”.

Alderwoman Lu

Thank you. And am | muted?

President Wilshire

No we can hear you.

Alderwoman Lu

Is that built into the price of the plan; is that service part of the plan?

Larry Budreau, Human Resources Director

| will answer part of this question; Director Kleiner may want to help with the budgeting piece. So the cost of
the plan is only a projection because we are paying claims as they come and we can only guess what they
are going to be. So we have guessed at kind of the high end, they projected the increases from last year’s
and this year we introduced this so we are ostensibly saving a little money from what was projected.

Alderwoman Lu

Excuse me, I’m not sure you understood. | am just asking about the cost of Smart Shopper. Is that paid for
by the cost of the high deductible plan?

Kim Kleiner, Admin. Services Director

No the Smart Shopper, we are realizing 70% of the savings and Smart Shopper is retaining 30% of the
savings. That is not incurred in the cost of the high deductible health plan; it is its own benefit.

Alderwoman Lu
OK alright, | think | understand. OK. And just last of all, Oh CBA strategy you mentioned, since | don’t know
it was quite awhile ago that you talked about the CBS Strategy but | was not clear on what you were referring

to. Charlie, Baker, Adam.

Kim Kleiner, Admin. Services Director

My apology for using the acronym in the first place; Collecting Bargaining. So we have a Strategy Team
between members of management for the City, HR, Legal, and the members from the Employer Boards,
whether it is you know a member of the Fire Commissioners and the Police Commissioners, so when | speak
of Employer Boards that is what | am referring to.

Board of Aldermen 3-31-2020 Page 30

Alderwoman Lu
Thank you.

Kim Kleiner, Admin. Services Director

You’re welcome.
Alderwoman Lu

Sorry that makes sense, | just wasn’t clear. Thank you very much for having this meeting. | think there were
so many questions; we all had so many questions and certainly we needed a meeting. And | hope that in the
future, that we could consider, | think a lot of our questions could have been answered if some of us had the
time, we might have been willing to go to the employee meeting and we would have been, you know, so
much more well informed to even take a vote in the first meeting. But I’m all set, | have no more questions,
thank you.

President Wilshire
Thank you. Anyone else have any questions. Can we take that slide down? Anyone else have questions?

Alderman Harriott-Gathright

Yes. Can you hear me?
President Wilshire
Alderman Gathright.

Alderman Harriott-Gathright

OK lastly, of the roughly 3,000 employees, approximately how many have signed up or could it be a
percentage of it today as of today.

Kim Kleiner, Admin. Services Director

| apologize Alderwoman Gathright broke up a little. Was the question the difference between the HSA the
HMO?

Alderman Harriott-Gathright

No. Well | should have said how many have signed up for the newer program, not the HMO...
President Wilshire
The high deductible plan?

Alderman Harriott-Gathright

Yeah, the high deductible, that one.

Kim Kleiner, Admin. Services Director

So currently out of all of our subscribers, we have 581 on the High Deductible Plan with the HSA.

Board of Aldermen 3-31-2020 Page 31

Alderman Harriott-Gathright

Follow up? And the timeline for this, let’s say 581, did this start back last July, this this plan the high-density
plan? Started 2 years ago?

Larry Budreau, Human Resources Director
Madam President? | believe it was 2013 and it has been a slow growth since.

Alderman Harriott-Gathright

OH | had thought this was something that last year, for myself, | heard for the first time | think in an
Aldermanic Meeting and it was brought up that this was something that we were looking at. So | apologize, |
didn’t know this was something that has been going on for a very long time.

President Wilshire

Anyone else? Sorry Alderman Gathright | thought you were done.

Alderman Harriott-Gathright

| am, thank you I’m all set.
President Wilshire

Yes you are welcome. Anyone else have any questions? Seeing none, Alderman O’Brien, do | have a
motion?

DISCUSSION

MOTION BY ALDERMAN O’BRIEN TO TAKE FROM THE TABLE ORDINANCE O-20-011 BY ROLL
CALL

Yea: Alderman O’Brien, Alderman Klee, Alderwoman Kelly, Alderman Dowd,
Alderman Caron, Alderman Clemons, Alderman Lopez, Alderman Tencza,
Alderwoman Lu, Alderman Schmidt, Alderman Laws,
Alderman Cleaver, Alderman Harriott-Gathright, Alderman Wilshire 13

Nay: Alderman Jette, Alderman Harriot-Gathright 2
MOTION CARRIED

O-20-011
Endorser: Mayor Jim Donchess

Alderman-at-Large Michael O’Brien

Alderman Patricia Klee

Alderman-at-Large Shoshanna Kelly

Alderman Richard Dowd
REVISIONS TO THE HEALTH PLAN SECTION OF THE UNAFFILIATED EMPLOYEES PERSONNEL
POLICIES
Given its third reading;

MOTION BY ALDERMAN O’BRIEN TO RECOMMEND FINAL PASSAGE OF 0-20-011 BY ROLL CALL

Board of Aldermen 3-31-2020 Page 32

ON THE QUESTION

President Wilshire

Is there discussion? Alderman Jette?
Alderman Jette

So | appreciate the presentation that we have received this evening and | especially appreciated getting the
PowerPoint Presentation ahead of time that was really helpful. It gave us a chance to review that before
tonight’s meeting so that we could be better able to ask intelligent questions. But the truth of the matter is
that we’ve just received the presentation in great detail, all of our questions have been answered, but the
Agenda called for just a discussion on this Ordinance and in fact | asked you Madam President whether
there would be any vote on this and you said “No it was just for discussion”. So | don’t see that there is an
emergency that requires that we vote on this tonight. We are having a meeting coming up that would give
us, that was the original plan and that would give us time to implement this if we so choose in time for the
sign up which may, in fact, be extended. There was a lot of information given to us tonight, | would like the
opportunity to digest that and | would like the opportunity to hear from anybody who is going to be affected
by this to weigh in with me or any of the other Aldermen before we vote on its final passage. So | am
opposed to voting on this and | would move to table this until our next regularly scheduled meeting.

MOTION BY ALDERMAN JETTE TO TABLE 0-20-011 UNTIL THE NEXT BOARD OF ALDERMEN
MEETING

Yea: Alderman Jette, Alderwoman Kelly, Alderwoman Lu 4
Alderman Harriott-Gathright,

Nay: Alderman O’Brien, Alderman Klee, Alderman Dowd,
Alderman Caron, Alderman Clemons, Alderman Lopez,
Alderman Tencza, Alderman Schmidt, Alderman Laws,
Alderman Cleaver, Alderman Wilshire 11
MOTION FAILED
President Wilshire
Alderman O’Brien do you have amendment to your motion? It is not to recommend it is for final passage.
Alderman O’Brien
Right | would like to amend my original motion to amend it for final passage, it’s not recommended.
MOTION BY ALDERMAN O’BRIEN FOR FINAL PASSAGE OF 0-20-011
ON THE QUESTION
President Wilshire

So the motion before us is for final passage of Ordinance 20-011. Further discussion on that motion?
Alderman O’Brien.

Alderman O’Brien

Thank you, Madam President. | think we sat in these Chambers and we did hear from the Mayor that there

Board of Aldermen 3-31-2020 Page 33

is someone of some critical need of this. He did have like a timeline that he was dealing with and he kind of
encouraged this but some of my brethren on the Board of Aldermen brought up the good point that they
wanted some information so we delayed it. Well | think the information has been adequately brought
forward and | think that because of the time constraints that are involved, | would recommend to move my
motion forward for final passage.

President Wilshire

Further discussion? Alderman Lopez.

Alderman Lopez

As it is the apocalypse, | thought | should agree with Alderman O’Brien. | think we have reviewed this pretty
thoroughly tonight. We had an opportunity to approach City Employees if we thought there were concerns.
The previous Board of Aldermen meeting was public and the Legislation was posted. So last week | was
concerned that we need to make sure that we are doing our due diligence and engaging in public
discussion so that the public knows we are not just making decisions on a limb but this is two hour’s in.
There’s no way anybody can think we are doing that. So | think we’ve done plenty of vetting of this. |
understand that there may be additional questions that other Aldermen have and | respect that but for
myself | think we can make a decision that is pretty well informed.

President Wilshire

Thank you, Alderman Lopez. Alderwoman Kelly?

Alderwoman Kelly

Yeah thank you. | understand that we have taken the time to vet this as Aldermen and | appreciate that.
The reason that | voted to put it back on the table is that we did say that and | understand that the City has
done a great job of engaging people and getting the information to them. But if something has come up int
this meeting that anyone wants to speak to, | feel uncomfortable not allowing them at least a week. And |
think we did say that next week’s meeting was fine to pass this. So if that is not the case, can someone
respond to me in terms of the timing because | thought that was how we left it, we were going to table it and
bring it back and next week’s meeting.

President Wilshire

We were going to bring it back at next week’s meeting until we had this meeting. | mean it was just being
put off until the next meeting and this happened to be the next meeting.

Alderwoman Kelly

OK.

President Wilshire

Anyone else? Alderwoman Lu.

Alderwoman Lu

Comment please? Yes. Thank you, Madam President. Well my feeling is that we have spent 2 % hours
discussing this. We did receive information five hours before we met but not all of us had the time to look

at it with much advance time before the meeting. So my expectation, | mean | would have hoped that this
information is available to inform us that we can be availed of it sooner than the day of the vote. My