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Board Of Aldermen - Minutes - 3/31/2020 - P3

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
3
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 3

in taking temperature readings from thousands and thousands of people across the country demonstrates
that the social distancing is reducing the overall level of fever, meaning the overall level of Coronavirus and
Flu, both. So all of the efforts that we are undertaking here really are having an effect.

We are definitely going to see more cases grow and we will see the numbers grow in Nashua but not nearly
what they would have been if everybody hadn’t been working so hard. So that will continue. We have
multiple conference calls everyday on various aspects of what we are doing. Everybody, as you know, is
working remotely. And again | want to thank the people who put this meeting together. Bruce Codagnone
and everybody from IT who are enabling us to meet in this fashion.

It is good to see you all, even though it is remotely, | see Alderman O’Brien smiling as usual, so it is nice to at
least have this level of contact. | could go on with more detail but | think you all understand pretty well what is
going on and so | will get to the subject at hand which is the proposed changes to the plan design which we
have put forward in order to encourage people to move to the high deductible plan and will save both
employees and the City considerable money if we undertake this change.

| have talked with you a little bit about the details in the past, but rather than getting into the details now, | will
turn it over to Ms. Kleiner and Mr. Budreau who will fill you in with slides and other information to give you all
of the detail regarding what is before you. So thank you, Madam President, and again | think everybody
should be very proud of our City Employees. | didn’t mention yet our First Responders, Fire and Police
Departments, they are both very involved in trying to keep the community safe as well. So again, thanks to
everybody and | will sign off.

President Wilshire
Thank you, Mayor, and just know that this Board does appreciate everything you are doing and everyone, all
the City employees, so thank you for all that. OK, Director Kleiner and Director Budreau? Who is going to be

up first?

Kim Kleiner, Director of Administrative Services

Good evening President Wilshire, Members of the Board. | am Director Kim Kleiner, and | am going to be
joined by Director Larry Budreau shortly. So we prepared a presentation for you that | believe was delivered
to the Board vie e-mail earlier today. It is hard for me to tell from here if you can see it or not so | will a nod as
yes.

So the first slide is current challenges, so this slide should not be new to the Board. This was actually a slide
that was shared with you back in December. We wanted to show you the actual spend when we talk about
benefits for City Employees. Quite often we hear and we think about healthcare and what our healthcare
claims costing but to have a rich benefits program like the City offers to its employees, it is much more than
just health claims.

This spend, as you look at it and you look at the increase over several years, really relates to the whole fund.
So there are costs to having benefit employees who administer the plan. There is cost for our stop loss, there
is cost for the dental which we often don’t talk about as much as we talk about Anthem and the medical
claims. There are all types of costs. So this is inclusive of all of that which is different than just looking at
healthcare claims.

The next slide, we wanted to show was an internal exercise that we did in turn. So last fall, the Mayor had
asked us, “how do we know that the HAS is saving the City money”. And it is a fair question, we put it out to
WBS our Healthcare Consultant. They prepared an analysis which you will see in a couple of slides down.
But we went back and we started the data here as well. And when | say “we” there has been a group of us
that have been involved in preparing this recommendation for the Mayor. It has been Human Resources and
our Benefits Team. It has been several members from Financial Services including CFO Griffin. It has been

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Board Of Aldermen - Minutes - 3/31/2020 - P3

Finance Committee - Agenda - 2/2/2022 - P52

By dnadmin on Sun, 11/06/2022 - 21:40
Document Date
Fri, 01/28/2022 - 14:16
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 02/02/2022 - 00:00
Page Number
52
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__020220…

Nashua Signs — page 8
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Finance Committee - Agenda - 2/2/2022 - P52

Board Of Aldermen - Minutes - 3/31/2020 - P4

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
4
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 4

certainly Mr. Budreau and all of WBS Team.

So we looked at these claims and we looked at our average claims by employee per plan and that’s what you
see here. This is Fiscal 19 Plans, what WBS had come back and indicated to us was that if the City saw all of
our subscribers move to the high deductible health plan, we would save an estimated $6.8 million dollars. So
went back and did this type of exercise. If you move to the next slide in Fiscal 20, you will see that this year
we had 2,136 subscribers, 745 of those are single, 519 are two person and 872 are family. The family and
the single subscribers are fairly balanced throughout the City. But what this does prove to us is that WBS’s
research, not that we didn’t believe it to be true, they have been spot on. on most everything they have
delivered to the City over the years, but it did prove to us that $6.8 million dollar figure, if all of our employees
converted from the HMO and the POS to the high deductible health plan.

So the next slide is the actual data that we received from WBS last fall. | want to note a couple of things here.
This was early last fall so the claims had only been approximately 2 to 3 months in. You see a large
fluctuation when you look at our health plan. Right now, Anthem has done a shift in reporting. So it used to
be that they reported the claim as the claim came in, excuse me, they reported it as it was paid. And now
they are trying to report it as the claims are received by them. Right now, we only have claims data through
the end of February even though they have been receiving claims through the end of March.

This shows that the high deductible healthcare claim cost for the City has actually decreased 21% since
Fiscal 17, or 7.6% annually, where the HMO costs have increased 24% since Fiscal 17 or 7.4% annually. The
expected difference between the HMO and the HSA Plan is approximately 15% and the current actual claim
differential is about 31%. With that | am going to turn it over to Mr. Budreau for a few minutes.

Larry Budreau, Human Resources Director

Thank you, Kim, may | have the next slide please? Health Maintenance Organizations or HMO’s came into
being in the early 1980’s. They followed historical health insurance which was known an indemnity plans in
which you would go to the doctor and you would pay a portion, say 20% and the healthcare plan would pay
the rest. HMO’s were marketed in the early 1980’s as providing managed care, the thought being that the
patient would have a primary care provider who would direct the patient's care through the medical care
system and therefore do so more efficiently. The trouble became over the next 40 years that the HMO’s were
so convenient, you go to the doctor, pay the $20.00 copay, do what the doctor says. The doctors are
certainly most interested in their patient’s care, but they were not necessarily most interested in economizing
healthcare. HMO Members are really unaware of their claim’s costs in New Hampshire, there is no EOB
provided and they pay $20.00 copay for most services.

An HSA or what we refer to as an HSA is known as a Consumer Driven, High Deducible Health Plan with a
Health Savings Account. It is a type of a plan that is endorsed by the IRS. You have to have a high
deducible health plan in order to have a Health Savings Account. The mechanism here is different. Every
time a patient goes and receives medical service, they do get an EOB. The awareness of that claims cost
and the fact that there is a deductible that has to be paid just fosters a natural interest in consumer
involvement. So the concept between high deductible health plans is it is bringing some elements of
consumerism back into healthcare.

The Health Savings Account is a tax-free savings plan. | read a description today that said it is not taxed
when you take it from your pay, it is not taxed when it is invested, it is not taxed when you spend it. The
balance carries over from one year to the next, so unlike the earlier flexible spending accounts, this keeps
growing and growing and growing. It is portable at retirement or resignation; that means that when an
employee leaves an organization with an HSA, that money is theirs, that account is theirs. In addition to
health claims, the tax-free funds may be used to pay other qualified medical expenses.

Mayor Donchess did an earlier message about this plan and mentioned that someone in the City had said,
“Gee I’ve accumulated a fair amount of money” and that is possible for a number of people who are able to

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Board Of Aldermen - Minutes - 3/31/2020 - P4

Board Of Aldermen - Minutes - 3/31/2020 - P5

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
5
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 5

contribute up to the maximum, as much of the maximum if they like and who don’t spend all that money every
year. That can be a terrific advantage to people because you can carry on beyond retirement to continue to
fund healthcare.

May | have the next slide please? Not exclusive to the High Deducible Health Plan but also available for
HMO participants, Smart Shopper is one of the consumer involvement tools that we introduced in July 1* and
this slide is simply a report to show you that we are progressing better than Smart Shopper would have
expected. So the activation rate, that is the number of the employees who have opened up the Smart
Shopper app and logged in is 10%, versus an expectation based on their book of business of 3% at this point.
Similarly the activated shopping rate, those people who have gone beyond just logging in but actually
shopped for a procedure or a test is 68% comparing favorably to the 47% that they would have expected.
And the shop conversion rate or their term for meaning those people who actually shopped, used the
program and got an incentive was 26%, well ahead of the 8%.

So the total gross savings thus far is $28,000.00, members have received $3,100.00 in incentives so that
netted to $25,000.00 of savings. We have viewed Manchester’s history with Smart Shopper, they had done it
for a number of years before us and it grew slowly and steadily and built and built over the years. So we are
encouraged about the future of this product. The next slide please.

These three bullet points are really the three changes that are proposed to be made to the current HMO.
What we propose is that this July 1* the $20.00 copay is increased to $25.00. The $250.00 or $500.00 two-
person family inpatient and outpatient deductible is increased to $1,500.00 and $3,000.00. That is a
substantial increase, we are well aware of that. And pharmacy copays would increase from $5, $15, $35,
that’s for a 30-day supply at a pharmacy or $5, $30, $70 for 90-day mail order supply to $10, $30, $50; $20,
$60 and $100. The three levels refer to tiers of prescriptions, so generic, brand name, specialty drugs.

Now the next slide? Until now we have had the Health Savings Account Plan for a number of years, but the
contribution that the City makes which is $1,500.00 for an individual member of $3,000.00 for two person or
family has never been committed to in writing sort to speak. It has been our practice since we launched these
plans, but as we were considering this change it became apparent that people were concerned that this was
not memorialized. And so for the first time and we would expect and have openly spoken to Unions already,
if this continues to roll forward, we would at the same time, we ask for plan design in the HMO, also volunteer
to memorialize these contributions to the high deducible health plan. So the contribution is $1,500.00 and
$3,000.00 and the high deductible is $2,0000.00 and $4,000.00.

Effective in July with this change if it is approved, our contribution will be distributed in two installments: one
on or about July 1 and one on or about October 1. We have another slide that we will discuss in a moment
about some of the discussion that we’ve had with employees about this change and one remark or one
concer that was brought forward and the Mayor is meeting on March 12" rang home to us. So what we said
was that we will do that, if you’d have the $3,000.00 contribution we will give you $1,500.00 on July 1* and we
intend to give you the second $1,500.00 in October, but if you experience the need to spend more than that
prior to October 1° just tell us that and we will contribute the remaining 50%. When | say “just tell us” we
would probably ask for some record, but it would not be invasive medical information, it would just be a record
that said they had exceeded the $1,500.00 and we think that is an important improvement that we have
made.

May | have the next slide? Is this my slide Kim?

Kim Kleiner, Admin. Services Director

No, thank you Director Budreau, I'll take this slide. So we understand and we are very sensitive to the cost
that is incurred by our employees. As | stated earlier that slides 2 and 3, the breakdown of our employees
between the single / two person and family plan is somewhat balanced. So in order to give you an analysis
tonight, we just took the most common plan which happens to be the family plan and we thought we could

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Board Of Aldermen - Minutes - 3/31/2020 - P5

Board Of Aldermen - Minutes - 3/31/2020 - P6

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
6
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 6

discuss this and break this out, a little easier for everyone to understand.

So the cost right now in Fiscal 20 for a family plan is approximately $30,590.00; 80% of which is borne by the
City or $24,000.00 roughly for 72%. The employee pays annually $6,118.20. With the Fiscal 21 the
employee cost would change. So what happens when you have plan redesign is as deductibles are raised
the cost of the plan decreases. So in this plan for the HMO Plan, if we were to accept the redesign, there
would be about a 15% reduction from the $6,118.00 in cost to $5,181.36 annually. So roughly that is about a
savings of $936.84.

| want to be careful when we talk about the inpatient and the outpatient exposure because this is a deductible
and an employee is only going to incur this if they have an inpatient experience with being hospitalized or an
outpatient surgery, whether that be a day at the hospital or whether it be at a surgical care center. | reached
out because | wanted to have something to put it in perspective, so | reached out to WBS earlier today and |
asked them if they could tell us what percentage of our HMO and POS population had an inpatient claim.

And they responded very quickly as they always do after doing research. They said in Fiscal 19 only 5% of
that population had a hospitalization claim. What they couldn’t nail down for me in this short amount of time
was how many of those employees had an outpatient, that requires a little bit more detail. But they did note
that in Fiscal 20, to date, that is like | said earlier only paid claims through the end of February, we’ve only had
2% that have had an inpatient hospitalization.

So | think that provides a little bit more of a perspective on what percentage of the population might incur that
$3,000.00 deductible. If an employee was to take their new cost and they did have an inpatient experience,
the savings that they are saving in the premiums, their exposure after that premium change would be roughly
$2,000.00, plus any routine copays. Now we want to note again preventative care is always free, that does
not fit into this model. If you are having an annual exam, whether it is on the HMO or the HSA, preventative
care is free, that is 100% covered.

So move over to the HSA which is what we are encouraging our employees to do. Let’s look at that fora
minute. If you go from the current HMO Plan to the new, well it’s our existing HSA but it hasn’t been
memorialized in our literature before as far as the merit plan. If we look at that, it is 19% savings annually
from $6,118.00 to $5,274.00. Again, the City gives you $3,000.00 for a family which is contributed to your
Health Savings Account. There is a $4,000.00 deductible, so the employee’s exposure after the City has
contributed the $3,000.00 is $1,000.00. But let’s look at that savings that they are getting from moving over
from the HMO, which is another $843.00, that exposure now is $156.00.00. True, again, we want to — there’s
other costs. If you were to go to the doctor during the year, all you are going to incur after that, because of
the $4,000.00 deductible is $1,000.00 less the savings for $156.00. So while we realize we are changing that
HMO Plan it is not to shift the healthcare cost on to employees, but it is to encourage the employees to enroll
in the high deductible health plan because we do believe it is the most cost effective plan and it offers the
same quality of healthcare that our employees deserve.

Next side — and back to Mr. Budreau.

Larry Budreau, Human Resources Director

Thank you, Kim. We are talking about making a change that would only affect the unaffiliated employees on
July 1°, that’s about 135 people. We do know that the conversation is already being broached at least one
negotiating table this spring. But relative to insuring employees had some opportunity to understand what we
were seeking to do. We invited all employees to have a meeting with Mayor Donchess and that invitation
went out on March 9". We also on March 9", aware of the piece of the Merit Ordinance, Nashua Revised
Ordinance 50-3 Amendments, requires that any changes being presented to the Board by the Mayor, to the
unaffiliated plan should be discussed with City Directors and Department Heads, and providing them a
specific opportunity for comment. We accomplished that by inviting them to an open house in Room 208 with
myself, Larry Budreau and Kim Kleiner.

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Board Of Aldermen - Minutes - 3/31/2020 - P6

Board Of Aldermen - Minutes - 3/31/2020 - P7

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
7
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 7

If you drop down to the bottom of the slide for a moment to two people stopped by and asked a couple of
questions and we felt that their inquiries were successfully responded to. On March 12" earlier that afternoon
before the open house, Mayor Donchess led a meeting and spoke at some length explaining the pressures
on this year’s budget and the pressures that healthcare costs had been adding to the budget particularly in
the last couple of years with about a $6.3 million dollar increase to cost over two years | believe. And he let
people know that he intended to submit this Legislation to change the — primarily the deductibles in the Health
Maintenance Organization, that’s obviously the big change. As Ms. Kleiner just said, not as an effort to
impose those deductibles on people which do shift costs but rather to encourage them to move en masse to
the Health Savings Account Plan. That meetings also was cordial and a couple questions were asked and as
| had mentioned earlier, one of the questions led directly to a change in the proposal before it was finalized.
Thank you, Kim, next slide please.

Kim Kleiner, Admin. Services Director

So a number of years back 2014 Governs Magazine had actually done a study, it is certainly not the only
study that has been out there, you know, healthcare challenges, the cost of healthcare, is a challenge both in
municipalities and in private industry. There’s been a number of studies but Governance Magazine’s study
was specifically around municipalities and how do we look at these increasing costs of healthcare? And they
went through a number of steps; we did review that. We realized that plan design by itself is not going to
solve our healthcare cost problem. It takes many measures to make that happen and it can’t be done ina
one-year period, this is a process that the City has to embark on and we need the employees and the
employer boards and everyone to buy into this. But these are some additional measures that we started back
in the fall.

So WBS, Workplace Benefit Solutions, our Healthcare Consultant has been extremely helpful and has been
out to our Divisions, Public Health, Public Works. They have also gone to the Teacher’s Union and had
sessions at City Hall talking to people about healthcare costs and how they can manage healthcare costs and
how we should look at that and how it benefits everyone, both our employees and the employer. Walking
them through the high deductible health plan and the Health Savings Account.

Employee education is a very large piece to solving this problem. We will continue to work with Workplace
Benefits Solutions on further education, on some creative videos. We have been having conversations with
the School District on ways we can engage their workforce which is more difficult when you have 17 schools
throughout a district. But we are very devoted to building our employee education.

Wellness and Alternative Resources — so we are going to continue to look at options that Anthem has as well
as to pools that Workplace Benefit Solution has in their wheelset, whether it is things like telehealth, which
right now is waiving all costs to our subscribers during the next 3 months because of the COVID 19 event.
Whether it is Smart Shopper or Sidney Care or our Employee Assistance Program. We are going to look at
new and creative ways and offer as many programs as we can to benefit our employees. Another solution
that was highlighted was doing a dependent mirror audit. This is important, we realize that day to day as you
are doing open enrollments and you are busy, employees may forget that either in 4 months when a divorce
takes place or to remove a child that is no longer a dependent, one thing we do have in place with Anthem is
they do automatically alert as our dependents are about to hit the 26 year old cutoff. So we feel we are very
good on that, we have very good control systems put in place, but we are committed to do a full dependent
audit next year, during Fiscal 21.

Data upgrades — we just signed a contract with a consultant, Clear Sky, we are working with our Information
Technology Department to build data feeds that will update between our Lawson, HR System and the
Anthem system. Currently there is a lot of transfer of benefit information that is still manually done and we
are looking to improve that efficiency and productivity and we hope to have these data feeds built in time for
open enrollment this year.

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Board Of Aldermen - Minutes - 3/31/2020 - P7

Board Of Aldermen - Minutes - 3/31/2020 - P8

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
8
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 8

The last measure that we have put in place as of November of last year, is our CBA Strategy Team. So this
consists of members of our employer boards as well as members from city management. Last November we
started discussing health and wages. We started looking at how we strategically develop uniformed language
and proposals for all of our union contracts. | have to say that everyone has been very engaged, we have
had good conversations. We do believe that taking this team forward will build a very positive relationship
between not only our City Management and our Employer Boards, but just in how the City delivers wages and
health benefits to our employees.

So we wanted to let you know that while tonight we are talking about Plan Design, there is a lot of other things
that we have and that we are actively working on.

Larry Budreau, Human Resources Director

Could | have the next slide please? Thank you. Before | just rattle this off, | would like to let you know that |
come to this subject with quite a bit of experience actually. | have been a Human Resources Director for over
30 years; 15 years in public sector and 15 years in private. | also have had a high deductible health plan
myself for about 12 years now and | would not have it any other way. So when | come to this decision it is
both with the responsibility to the City, fiduciary responsibility to the City to try to provide employee benefits as
cost effectively as we can and also from the perspective of a user of a high deductible health plan, knowing
that it has been the best deal | ever could have had. Great health insurance, great coverage and the
opportunity for me to amass enough tax free savings that as | have aged and needed new glasses and dental
work and hearing aids, those thousands and thousands of dollars that | was able to achieve on a tax free
savings.

So | urge you genuinely, along with Mayor Donchess and Administrative Services Director Kim Kleiner, we
urge the Board of Aldermen to pass this Ordinance this evening. Thank you and Kim and | are available for
questions.

President Wilshire

Thank you Director Kleiner and Director Budreau, | appreciate your efforts in this and the presentation this
evening. | will open it up to the Board for questions. Does anyone have questions?

Alderman Teneza
Thank you very much Madam President, just a couple of questions just to clarify things to make sure |
understand correctly first about the HSA Plan and the out-of-pocket maximums per year that Director Kleiner

was talking about. The $4,000.00 deductible, that is per household and not per individual, per household?

Kim Kleiner, Admin. Services Director

That is correct.
Alderman Tencza
Ok so their exposure for a whole family or an individual is $1,000.00?

Kim Kleiner, Admin. Services Director

$4,000.00.
Alderman Tencza

$4,000.00 yes but with the $3,000.00 HSA Plan it would only be $1,000.00 out of their pocket?

Page Image
Board Of Aldermen - Minutes - 3/31/2020 - P8

Board Of Aldermen - Minutes - 3/31/2020 - P9

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
9
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/boa_m__033120…

Board of Aldermen 3-31-2020 Page 9

Kim Kleiner, Admin. Services Director

Correct.
Alderman Tencza

And if | may just to — another question. We had talked about this dependent audit and one of the very
important points in the study is that there are no penalties for anybody, any employee who had knowingly or
unknowingly carried a dependent past when they should have. | would hope and | would expect that is going
to be part of any process that the City undertakes next year in looking as to who is, if we may be covering
dependents that we shouldn’t be covering, is that correct?

Kim Kleiner, Admin. Services Director

That is correct.

Alderman Tencza

OK and if | can just say one more thing Madam President?
President Wilshire

Yes.

Alderman Tencza

Thank you. So | too, | get healthcare through the county, through Government or through employee
sponsored healthcare for a long time and had more recently been in high deductible plans for myself and my
family. | just wanted to share for the Board or for anybody who is listening, | went back and | looked at what
our healthcare costs were for the last couple of years. So we are lucky, we are a family of four, and we are all
relatively healthy, but you know my kids have strep throat more than | think is humanly possible, every year
and we have all of our usual trips to the doctors. So | went back and | looked and in 2018 our out-of-pocket
expenses for healthcare was a little over $1,500.00. And then in 2019 our out-of-pocket expenses were a little
under $1,200.00.

To me, the takeaway from that is if | was in the City’s high deductible HSA Plan and $3,000.00 a year was
being put into an account for my family, at the beginning of the third year, we would have about $6,300.00 in
that health savings account that we could use for various health costs and you know, God willing, things kept
going well, you know? | remained healthy, that we just continue to grow, but even if it didn’t continue to grow,
we would be covered for six years without having to pay any out-of-pocket expenses for healthcare through
the City. So | know we are here tonight to talk about the piece of Legislation that is being proposed but you
know | think when Director Budreau and Director Kleiner talk about this HSA Plan and it being a good option
for people, | believe that they are being genuine and honest about that and | hope that employees will take a
second look at that if they have not already. Thank you.

President Wilshire

Thank you Alderman Tencza. | just want to say for the record that Alderman Gathright did join us at about
7:15 this evening.

Alderman Lopez

So | have a question for Director Budreau if | can. Given the fact that we are in the middle of a pandemic
which is specific to respiratory issues, and that this plan also would increase the deductible rate for hospital

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Board Of Aldermen - Minutes - 3/31/2020 - P10

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
10
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Board of Aldermen 3-31-2020 Page 10

treatments, are you aware of any stimulus packages that might provide relief for COVID-19 related medical
treatment?

Larry Budreau, Human Resources Director

No | am not Alderman Lopez. | do know that a couple of Emergency Legislation Acts in both the State and the
Federal Government have actually imposed some mandates that insurance plans provide cost without copay
for COVID 19 testing and initial evaluation appointments. But | have not seen any indication that anyone is
going to help reimburse us for those.

Alderman Lopez

OK well we know an answer | would have liked to hear.

Alderwoman Kelly

Did Linda want to speak? | didn’t want to take her turn; | know she maybe said something but she’s not on
video.
President Wilshire

I'll recognizes her after you speak, thank you.

Alderwoman Kelly

OK just making sure. So | had a question if | could ask potentially for Ms. Kleiner or Mr. Budreau. My
question is around employees in education, it seems like you guys have a done a great job or holding a
number of meetings, but | am wondering if for the record, you could talk a little bit about maybe some of the
most frequently asked questions in terms of switching plan. | know that we also as a family just switched to
the high deductible plan and | personally had a lot of questions. So if they could answer that would be great.

Larry Budreau, Human Resources Director

OK thanks, Ms. Kleiner and | can’t see each other to give cues. Well actually the biggest question that we’ve
heard in Nashua, the number one question that we are seeking to resolve, was because the contribution of
$3,000.00 to the $4,000.00 deductible had not been codified anywhere, people repeatedly asked, “this plan
sounds great, but what assurance do we have that the City won’t change that”. And that actually was the
biggest questions.

There were other questions as to how it works and, in all honesty, it is more of a hassle than having an HMO
Plan. In fact that’s the reason that some people may choose to pay more for health insurance as we go
forward because no EOB’s, $20.00 when you go to the doctor and this does require getting an EOB, taking a
look at how much the insurer paid and then paying the balance bill during the first $4,000.00 if you are a
family. So questions about mechanics and questions about assurance that the City would continue to foot
the $3,000.00 are the two that come to mind the most.

Kim Kleiner, Admin. Services Director

President Wilshire if | could add to that? So many of our employees have questions surrounding the actual
mechanics of it. So like Director Budreau said, it actually it requires you to do a little finance sort to speak and
to investigate those health claim costs. You actually watch and make payments on things that you are not
normally used to making if you’ve been a part of an HMO. Several years ago, the private company that |
worked for instituted the health savings account and a few of us were trained on it so that we could help other
employees walk through that process.

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Board Of Aldermen - Minutes - 3/31/2020 - P11

By dnadmin on Sun, 11/06/2022 - 23:15
Document Date
Tue, 03/31/2020 - 00:00
Meeting Description
Board Of Aldermen
Document Type
Minutes
Meeting Date
Tue, 03/31/2020 - 00:00
Page Number
11
Image URL
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Board of Aldermen 3-31-2020 Page 11

The Police Department has done an excellent job; they actually have a couple officers that are going around
and providing that type of training to their other officers. We can offer that same training right here because

we have our wonderful benefits people down on the first floor and they are fully versed in it. But it is just that
education piece and building it and people catch on and most of them; love the plan.

Alderwoman Kelly

If | could respond please? Thank you, Ms. Kleiner | really like that idea of having people who are almost
ambassadors to the plan so | would love to see us implement that. Everyone knows that HR person can tell
you but when a friend sits down and says, “Hey this is what | did; This is how | did it’, it can be pretty powerful
and helping people to make that shift.

Alderman Harriott-Gathright

Director Budreau, currently how many employees do we have in the City today?

Larry Budreau, Human Resources Director

The School has about 2,000; the City about 850.

Alderman Harriott-Gathright

I’m sorry, the School has what?

Larry Budreau, Human Resources Director

The School District employs around 2,000 people and the City employees around 850.

Alderman Harriott-Gathright

All set so we will round off to 3,000 people, but what we are talking about today is 135 people, am | correct?

Larry Budreau, Human Resources Director

Yes, we are starting with one group.

Alderman Harriott-Gathright

OK | know awhile back when Director Kleiner talked about this process, it was going out to all of the
employees? Am | correct? | am just curious at this point, have we had others that have come aboard.

Larry Budreau, Human Resources Director

May | address that Ms. Kleiner?

Kim Kleiner, Admin. Services Director

Please.

Larry Budreau, Human Resources Director

Well, most of the employees for the City and the School District belong to Unions and the Union Contracts
specify the insurance coverage, the describe the plan design of the current HMO and so the unaffiliated or the
non-union employees are our starting point.

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