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FY20 Paid th ru March 24th Total Claims Paid to Date
30,000,000
eof Plan Total Claims Aveg.Claims/Employee
NP é /Employe 25,000,000
HOHP 6,965,180 10,675
HMO 21,233,021 14,735 | »9 090 000
POS 1,773,657 22,171
Grand Total 25,571,858 13,845 | 15,000,000
# of Employees by Plan 10,000,000
HOHP 615
HMO 1441 2,000,000 -
POS 80
0 »
Grand Total 2136 ADHP EMO P05
* 3-4 Months of Claims still Pending
Ditference In AVG Claims HMO V5 HDHP § 4,055.83 Estimated Savings with 1/2 HMO Population ChangestoHDHP = = § 2,923,079.27

(Based on Avg Claims 2019)

Estimate Fall 2019

City of Nashua
H.S.A. vs HMO Claims

$25,000
$20,326 520,817
$18,239 $18,578 1,695 1,527
. 1,784 Enrolled Enrolled
$20,010 ae Enrolled "
¥ Te _Enrothend = we
$17,768
$15,009 ———— ae 330 aa
Enrolled Enrolled 14,763 $14,389
424 a
$10, Enrolled Enrolled
$5,000
$0 :
FYi7 F¥1e FY19 FYTD20
—H— PEPY HSA CLAIM COST -afh= PEPPY TRADITIONAL CLAIM COST
Notes:

1. HSA Claim Costs include the City's contribution to the employees’ HSA Funes.

2. Traditional Claim Costs have increased 24% since FY17, or 7.493 annually fon average).
3. HSA Claim Costs have decreased 21% since FY17, or 7.6% annually (on average}.

4. The expected (actuarial) difference between the Traditional Plan and the HSA pian is 15%. The current actual claim differential is F236

Why does H.S.A. save $

HMO (Health Maintenance Organization)
HMO members are unaware of their claims cost. $20 copay for most services.

H.S.A. (Consumer Driven High Deductible Health Plan with Health Savings
Account)

Patients receive EOBs. Awareness of claims cost fosters natural interest in
consumer involvement.

H.S.A. is a tax-free savings plan

The balance carries over from one year to the next. It is portable at retirement
or resignation. In addition to health claims, tax free funds may be uses to pay
other qualified medical expenses such as dentistry, orthodontics, and
prescription eyewear.

SMART SHOPPER RESULTS as of February 2020

ro 206

Activation Activation Activated Houscholds
er Lal sturse lone) as

mabe 141

Activated Activated Shop

Shopping Rate eT as HERPES Say pat

Fd = bra) a bra) wi i

Shop Conwersion § Shop Conversion Households Total
| a steals Receiving Incentive #incentives

$27,786 $3,100 $24,686

Total Gross Savings Total Incentives($) Total Claims Savings

Incentive and Savings Summary

Timeframe Gross Savings Incentives Paid($) Claims Savings Incentives Paid(#)
$4,201 $3,576
$6,852 $7,852
$27,786 $24,686

Proposed Changes to the HMO:

Effective July 1, 2020
° $20 co-pay increase to $25

° $250 individual / $500 2-person or family inpatient / outpatient
deductible increase to $1500 / $3000.

° Pharmacy copays increase from $5/$15/$35 ($5/$30/$70 mail
order) to $10/$30/$50 ($20/$60/$100) mail order.

City contributions to the HDHP w/H.S.A. are now memorialized in the
Policy:

The City’s contribution to Health Savings Accounts remain at $1,500
individual / $3,000 2-person or family. The deductibles in the High

Deductible Health Plan with Health Savings Account (HDHP w/ H.S.A.)
remain at $2,000 individual / $4,000 2-person or family.

Effective July 1, 2020, the City H.S.A. contribution will be distributed in 2
installments, one on or about July 1 and one on or about October 1,
provided however that if an employee is required to pay more towards his
/ her deductible than the initial 50% contribution, upon presentation of

suitable documentation, the City will contribute the remaining 50% before
October 1.

BAILEYDONOVAN TEAM 2

Marcia Morgan

Consulting, Copywriting, Search Engine Optimization (SEO) - Marcia
provides marketing consulting, implementation and SEO. She provides
clients with complimentary SEO assessment and specializes in organic
search engine optimization (SEO), helping businesses get found on
the Internet by carefully editing and tweaking the site’s content and

structure for targeted keywords.

Elizabeth Mokas

Elizabeth brings over 20 years of marketing communications to her
work at BaileyDonovan. She helps clients create a voice that speaks

to their target audience. Elizabeth's BA in English has supported her
creation of multi-media, marketing content in the health care, financial
services, business management, retail and publishing industries.

Michaela Olsen

Michaela graduated from Rhode Island School of Design. Her
specialties include stop motion animation, fabrication, illustration and

art direction.

Rob Kovacs

Rob graduated from Rutgers University in 2007 with a degree in
Information Technology and Informatics. He designs and develops
high-quality custom web sites with a focus on user experience.

Stephen T. Marcouillier

Exhibit Builder

Steve has worked closely with BaileyDonovan over the past 22
years as an exhibit designer, fabricator and installer. Steve has
installed exhibits throughout the New England including sites
at MIT, Prudential Skywalk, Public Service of NH and more.
Steve's knowledge of architectural history and his clever
problem solving skills bring integrity to each project.

Bruce Olsen

Interactive Designer, Technology/Computer Specialist,
Mechanical Engineer

Bruce graduated from MIT with a Masters degree in
Engineering and currently works with BaileyDonovan to
develop interactive exhibits utilizing mechanical devices,

electronics, and software to create immersive experiences.

Mary Kiernan

Mary earned a BA in English and Masters in Education. She
brings a varied business, artistic and educational experience
to the BaileyDonovan team. She put her educational
background to use in the insurance industry, followed by work
in a photography studio, then a career in teaching English
and other languages. She is editor for BaileyDonovan.

BaileyDonovan, llc

The primary intent of changing the HMO is not to shift health care costs to
employees but to encourage employees to enroll in the HDHP w/H.S.A., the plan
that has proven to be the most cost effective and well liked.

Family Plan Analysis: In Network
HMO H.S.A.

FY21 Employee Cost: $ 5,181.36 Annually FY21 Employee Cost: $ 5,274.60 Annually

Savings from FY20 Cost $ 936.84 Employer Contribution: $ 3,000.00

Deductible $ 4,000.00 per family

Inpatient/Outpatient Exposure $ 3,000.00 per family
(with Hospitalization or Procedure) Employee Exposure: $ 1,000.00
Exposure after Premium Change: $ 2,063.16 Savings from FY20 HMO Cost $ 843.60

(if contributed into H.S.A.)

Routine Copays $ ??? Exposure after savings: $ 156.40

Employee Engagement:

March 9" — City Employees received meeting invitation from Mayor Donchess.

March 9" — To comply with NRO 50-3 Amendments, City Directors and
Department Heads were invited to an open house on March 12 with Larry
Budreau and Kim Kleiner as an opportunity for them to represent their division /

department and comment on the proposed changes.

March 12" — Unaffiliated employee meeting with Mayor Donchess. Proposal
to split City’s contribution to H.S.A. was amended due to employee

feedback at this session.

March 12" — Division Director/Dept. Head meeting with Larry Budreau and Kim
Kleiner. Two Directors attended — inquiries were successfully answered.

Additional Measures:

1. Employee Education - WBS, our consultant has been to many divisions - Public Health, Public
Works, Police, as well as the Teachers Union and 3 sessions at City Hall over the past 2 months.

2. Wellness and Alternative Resources — We will continue to reasearch additional programs to
combine with Telehealth, Smartshopper, Sydney Care and our EAP program.

3. Dependent Audit — Currently, Anthem alerts employees as dependents are about to hit the 26 years
old cutoff. Committed to a full Dependent Audit next year.

4. DATA Upgrades - Our benefits system, Lawson, does not currently have the capability

to electronically update the Anthem system. This makes the transfer of benefit information still a very
manual system. The city has hired a consultant, Clear Sky, to build these data feeds. These feeds
have high security requirements to meet HIPPA requirements. Our efficiency and productivity will
greatly increase.

4. CBA Strategy Team - Started in November discussing health and wages. Members consist
of employee boards and divisional management. Strategically developing uniform language
and proposals for all union contracts.