Jul 09, 2024 Commissioners Court - Special Meeting & Workshop

[1. CALL TO ORDER]

[00:00:06]

>> IF I COULD GET EVERYONE TO STAND FOR THE INVOCATION AND

THE PLEDGES. >> COMMISSIONER MAREZ WILL DO

THE INVOCATION TODAY . >> DEAR HEAVENLY FATHER, WE THANK YOU FOR THE BLESSINGS YOU HAVE GIVEN US IN THE COMMUNITY.

WE THANK YOU FOR SPARING US THE COST, BURDEN, DESTRUCTION OF THE HURRICANE. WE PRAY FOR OUR FELLOW TEXANS TO THE NORTH OF US AND NO THAT WE HAVE BEEN THERE AND WE WILL DO EVERYTHING WITHIN OUR POWERS AND ABILITY TO HELP SERVE AND SUPPORT THEM IN THE DAYS AND WEEKS TO COME. DEAR GOD, WE PRAY FOR TODAY THAT YOU GUIDE US TO DO THE COUNTY'S BUSINESS AND THAT YOU GUIDE US TO FIND THE HEARTS THAT YOU HAVE GIVEN US FOR LEADERSHIP AND ALSO TO BE SERVANTS AS WELL. DEAR GOD, WE PRAY THAT YOU GUIDE US AND PROTECT OUR FAMILIES IN YOUR

HOLY NAME, AMEN. >> I PLEDGE ALLEGIANCE TO THE FLAG OF THE UNITED STATES OF AMERICA, AND TO THE REPUBLIC FOR WHICH IT STANDS, ONE NATION UNDER GOD, INDIVISIBLE, WITH LIBERTY AND JUSTICE FOR ALL PERIODS

>> HONOR THE TEXAS FLAG ; I PLEDGE RELIGIONS TO THE , TEXAS, ONE STATE UNDER GOD, ONE AND INDIVISIBLE.

>> THANK YOU . PLEASE BE SEATED. IT IS TUESDAY, JULY 9TH , IT IS 9:06 A.M. WE ARE AT, 901 LEOPARD STREET IN THE COUNTY COURTROOM. WE HAVE THE COUNTY JUDGE AND THREE COMMISSIONERS PRESENT. MR. GONZALES WILL JOIN US LATER. I CALL THIS MEETING TO ORDER. ARE THERE ANY DISCLOSURES OR CONFLICTS OF INTEREST? ANYTHING ANYONE CARES TO ANNOUNCE? IF NOT , WE WILL MOVE ON , WE CAN BRING IT UP AT THAT TIME IF

THERE IS SOMETHING. >> PUBLIC COMMENTS. IN ONE SIGN

[1. The Commissioners Court will conduct a Workshop to discuss and receive a presentation related to authorizing and approving Nueces County’s Employee Self-Funded Group Health plan employee and employer contributions for the plan Year of 2024-2025.]

BEGIN. >> IS IT 9:07.

>> I SAID 9:06 AS A START TIME.

>> BUT WE STARTED AT THE WORKSHOP AT 9:07.

>> GOOD MORNING. , JUDGE AND COMMISSIONERS. FIRST, I WANT TO ACKNOWLEDGE AND THANK THE COUNTY AUDITOR'S OFFICE, THE INSURANCE COMMITTEE, IAN MCGRIFF INSURANCE SERVICES FOR THE HARD WORK THEY PUT FORTH IN COMPILING THIS INFORMATION AND PROVIDING EXPERT ANALYSIS TO THE COURT TO DECIDE WHEN OUR INSURANCE PREMIUMS, BASED ON CURRENT DATA, AND FORECASTING.

WITH THAT BEING SAID, I PROVIDED EACH OF YOU A PACKET OF THE PRESENTATION THAT WILL BE DISPLAYED TODAY. CAN WE GET

THAT ON THE SCREEN? >> FIRST , WHICH ONE ?

>> FIRST , I WANT TO START OFF WITH THE EXTERNAL AGENCY BENEFIT CENSUS. THAT ONE RIGHT THERE. I WANTED TO REQUEST, FOR THE COURT, WAS TO BE ABLE TO PROVIDE SOME DATA IN TERMS OF HOW MANY EXTERNAL AGENCIES THAT WE HAVE. HOW MANY EMPLOYEES ARE CURRENTLY ENROLLED IN OUR INSURANCE HEALTH PLAN IN OASIS COUNTY AND SOME ADDITIONAL QUESTIONS THAT WE WILL ADDRESS LATER. I ALSO WANT TO THINK THE A COUNTY ATTORNEY'S OFFICE FOR THE DILIGENT WORK THEY DID ON THIS AND WRITING LEGAL COUNSEL FOR US TO CONSIDER. LOOKING AT THE EXTERNAL AGENCY COUNT, THE CENSUS BEFORE YOU, WE HAVE A GRAND TOTAL OF APPROXIMATELY FIVE EXTERNAL AGENCIES THAT TOTAL ABOUT 213 EMPLOYEES WITH

[00:05:07]

PROVIDE MORE COUNSEL ? >> GOOD MORNING, TIM. JUST A QUICK ORDER OF BUSINESS, MY ASSOCIATE ALICIA IS STILL ON THE WAITING ROOM IN ZOOM SO MAYBE SOMEONE COULD ADMIT HER TO THE MEETING. REALLY, TO YOUR POINT, TIM , THE COUNTY , IN OUR OPINION , IT REALLY IS COUNTY DISCRETION ON WHETHER TO EXTEND COVERAGE TO THOSE ENTITIES WHO HAVE SOME LEGAL STRUCTURE WITHIN THE COUNTY. THE COURT, IN OUR MIND IS UNDER NO OBLIGATION TO EXTEND COVERAGE TO THOSE ENTITIES .

CERTAINLY , THE COURT IS ABLE TO TERMINATE THOSE WITH PROPER NOTICE , IF THE COURT SO CHOOSES. I WOULD SIMPLY ADVISE THE COURT, OR RECOMMEND THAT THERE IS SOME LEGAL STRUCTURE BETWEEN THOSE ENTITIES AND THE COURT. THERE IS SOME AFFILIATION , AND I WOULD DEFER TO THE COUNTY ATTORNEY FOR THAT TYPE OF CLARIFICATION. REALLY, IT IS THE COURTS DECISION ON IF THEY WANT TO CONTINUE TO EXTEND COVERAGE TO THOSE THIRD PARTIES THAT HAVE SOME AFFILIATION WITH THE COUNTY. I WOULD ALSO RECOMMEND , IF THERE IS A ENTITY THAT HAS ABSOLUTELY NO AFFILIATION WITH THE COUNTY , THERE IS NO LEGAL REQUIREMENT, THERE IS NO STRUCTURE , IT IS A SEPARATE AND COMPLETE ENTITY, I SEE NO REASON FOR THE COURT TO CONTINUE COVERAGE FOR THOSE PARTICULAR ENTITIES AND THOSE INDIVIDUALS COVERED . THIS HAS BEEN, OBVIOUSLY PRIOR TO MCGRIFF COMING ON, THAT IS THE ADVISEMENT WE WOULD GIVE ANY CLIENT, CERTAINLY IN THE PUBLIC ENTITY SPACE OF EXTEND COVERAGE TO THIRD-PARTY ENTITIES AND MAKING SURE THAT THERE IS PROPER LEGAL STRUCTURE AND COURT APPROVAL FOR COVERAGE. AND THE PLANNED DOCUMENTS TO

REFLECT THAT. >> THERE IS ALSO, I WOULD LIKE JENNY TO ANSWER THIS, THERE IS ONE ENTITY THAT WE HAVE NO LEGAL AUTHORITY TO ALLOW THEM TO USE. I THINK WE ARE NOT ALLOWED LEGALLY TO HAVE THEM ON PLAN. THAT IS THE ONLY ONE.

[00:10:04]

>> WE FOUND 2010 ADVISORY TO THE COURT. WE AGREE WITH ITS FINDINGS REGARDING THE CREDIT UNION AND WE DON'T FIND

AUTHORITY TO HAVE THEM. >> WAS THAT WHEN THEY ARE INCLUDED AS WELL IN 2010? WHEN DID THEY GET INCLUDED?

>> THAT I DON'T HAVE OFF THE TOP OF MY HEAD.

>> CREDIT UNION, PERHAPS . >> I'M SORRY, JUDGE, I DID NOT

HEAR THE FULL QUESTION . >> THERE IS AN OPINION THAT SAYS WE CANNOT ALLOW THAT EVENT OUTSIDE ENTITY UPON A COUNTY POLICY , THEY ARE LEGAL HAS REVIEWED IT AND AGREES WITH THAT OPINION ON THAT CREDIT UNION ONLY. I WAS WONDERING AT WHAT POINT ARE YEAR DID WE ALLOW THE CREDIT UNION TO JOIN WITH 2010 OPINION AGAINST IT AND THE CURRENT ADMINISTRATION AGREEING THAT WE DO NOT HAVE THE LEGAL AUTHORITY TO EVEN

OFFER IT TO THEM. >> APPARENTLY A LONG TIME.

>> REALLY? >> IF WE GOT THE ADVISORY IN 2010, THAT WAS BEFORE ANY OF US HERE WERE HERE. IT MUST'VE BEEN BEFORE THAT. I DO NOT REMEMBER US ADDING ANYONE SINCE

THEN. >> -- THE POLICY WAS THE MOST RECENT ENTITY AND THAT WAS WITHIN THE LAST FOUR YEARS.

>> NOW IT APPEARS ON THE AGENDA 2019 AND PERIODICALLY BEFORE

THAT. >> THERE WAS DEBATE OVER THAT

IN 19. >> THEY WERE ALWAYS ON A WE JUST FINALIZED IT? WHAT WAS THAT?

>> THERE ARE AGREEMENTS , AND THEN THERE ARE HEARINGS , THE COMMISSIONERS COURT IN 2019, I BELIEVE THE COURT WANTED TO INCLUDE THEM AGAIN BUT WE DO NOT HAVE THAT ACTION BY THE

COURT. >> WE WOULD LIKE TO STATE THAT MY TEAM DID DO A LOT OF DEEP DIVING TO FIND THE MEMORANDUMS OF UNDERSTANDING, WHICH WAS PRESENTED TO THE COUNTY ATTORNEY'S OFFICE AND ALL WE WERE ABLE TO FIND IS WHAT WE PROVIDED TO THE COURT THIS MORNING, I WAS UNABLE TO FIND ADDITIONAL DATA REGARDING YOUR REQUEST THIS MORNING , JUDGE.

>> NEVERTHELESS, MOVING FORWARD , IF THIS ALL CONTINUES, WE NEED CURRENT MEMORANDUMS OF LETTERS, CURRENT DOCUMENTS TO MOVE FORWARD , I MEAN JUST MOVING FORWARD TO CLEAN THIS UP WHERE WE HAVE SOMETHING THAT WE CAN FIND.

>> WHAT IS CSCD ? >> THAT IS COMMUNITY SERVICE

SUPERVISION. PROBATION. >> THERE ARE 213 POTENTIAL EMPLOYEES THAT COULD BE ENROLLED AND ONLY FOR -- ENROLLED, THERE ARE 215 POTENTIAL EMPLOYEES THAT COULD

BE ON THE PLAN? >> THAT IS INCORRECT. CSCD IS NOT ELIGIBLE. THERE WAS SUPPOSEDLY A CALL HIM COLUMN THAT SAID ELIGIBLE AND IN ELIGIBLE.

>> IT SAYS NOT ELIGIBLE. >> I DO NOT HAVE THE CONFIDENTIAL PACKET. IT DOES SAY NOT ELIGIBLE. CSCD IS NOT

ELIGIBLE. >> I JUST GOT THIS TODAY, WHERE

DOES IT SAY NOT ELIGIBLE? >> THE ONES INCLUDED ON THE AGENDA INCLUDED INFORMATION , I PRINTED THIS THIS MORNING.

>> SECOND TO LAST PAGE. >> WHERE DOES IT SAY ELIGIBLE

OR NOT ELIGIBLE? >> IT DOES NOT ON THAT ONE.

>> THIS IS ALL THAT I HAVE. OKAY, CCSD IS NOT ELIGIBLE ?

>> RICK. >> THE 213 NUMBER IS TOTAL OF EMPLOYEES. WHAT LISA IS STATING IS THE NUMBER OF EMPLOYEES

ELIGIBLE TO PARTICIPATE. >> BUT IS CSCD ON THE PLAN?

>> NO >> WHY ARE THEY ON THE LIST?

>> I ASKED THAT QUESTION GRIEVOUSLY I INCLUDED ALL OF THE EMPLOYEES IN THE ACCOUNT SO SHE CAN SEE THE INFORMATION.

>> I DO NOT NEED THAT. THAT IS CONFUSING. LET'S GO BACK AND DO SOME MATH. WE HAVE TO ADD DISPUTE RESOLUTION , WHAT I HAVE GOT, I DON'T KNOW WHAT ELIGIBLE AND INELIGIBLE THING IS. I HAVE 215 WOULD BE THE TOTAL . THEN I SUBTRACT OUT 142 FROM CSCD BECAUSE THEY ARE NOT ON THE PLAN. THAT MEANS THERE

[00:15:07]

ENROLLED. >> PLUS DEPENDENCE.

>> PARDON ME? >> PLUS DEPENDENCE.

>> THAT WAS MY NEXT QUESTION. IF I GET THIS FIGURED OUT, I TAKE UP THE 42 CSCD, THAT LEAVES 73 ELIGIBLE EMPLOYEES INCLUDING DISPUTE RESOLUTION, 50 OF WHICH ARE ENROLLED, PLUS FAMILIES , IF THEY DECIDE . IS A 50 PEOPLE OR IS THAT 50

EMPLOYEES PLUS PLUS. >> TOTAL INCLUDING DEPENDENCE

AMOUNTS TO 130. >> WE ARE COVERING 130 PEOPLE THAT ARE NOT NUECES COUNTY EMPLOYEES OTHER THAN MAYBE THE PARCEL NUECES COUNTY SALARY FROM THE TEXAS A&M AGRICULTURE WHICH IS FOUR. IS THAT A CURRENT ASSESSMENT?

>> YES . >> IS IT CORRECT , WE TALKED ABOUT LAST TIME , LISA CONFIRMED LAST TIME FOR ME AND I WANT TO RECONFIRM AGAIN, OF THESE 130 PEOPLE , THE ENTITY PAYS , THE OWNER -- NOT THE OWNER, THE INSURER AND INSURED PREMIUMS ARE PAID BY THE ENTITIES AND OR THE EMPLOYEES, WE AS THE COUNTY ARE RESPONSIBLE FOR ANY CLAIMS . IS

THAT CORRECT, LISA? >> THAT IS CORRECT.

>> WE SIT HERE TODAY, AS A COUNTY , WE HAVE BEEN LUCKY, WE HAVE NOT HAD A ADVERSE EVENT --

>> I NEED TO PUT AN ASTERISK NEXT TO THAT. THE 800 SURPLUS DOES NOT INCLUDE ANY PRESCRIPTION PAIN MEDS. WE WERE NOT ABLE TO GATHER THAT INFORMATION. WITHOUT HAVING THAT INFORMATION, I CANNOT CONFIRM OR DENY IF THERE IS ACTUALLY A SURPLUS. THIS IS JUST MEDICAL EXCLUDING

PRESCRIPTION PRICE . >> THAT'S FAIR. LET'S SAY

THERE IS ANOTHER LARGE CHUNK. >> THAT IS AN EXTREMELY LARGE

CHUNK. >> MAYBE IT'S NOT 800,000.

MAYBE TODAY WE ARE EVEN. AT THE END OF THE DAY IT HAS NOT BEEN HORRIBLE AS FAR AS WE CAN TELL. WE ARE STILL SITTING HERE TODAY WITH THE EXPOSURE FOR 130 PEOPLE WHO ARE NOT NUECES COUNTY EMPLOYEES , OTHER THAN THE PARTIAL PAY AT THE A&M SYSTEM , I DO NOT THINK THAT IS WISE, OR APPROPRIATE IN ANY WAY, SHAPE OR FORM. I DO NOT SUPPORT GOING FORWARD WITH THAT AT ALL. WE HAVE TOUCHED ON THIS BEFORE, HONESTLY , THERE WERE NOT THE VOTES IN THE PAST TO DO ANYTHING ABOUT IT. THAT IS AS CLEAR AS I CAN SAY IT. THAT IS NOT JUST THE LAST COUNTY JUDGE, THAT WAS A COUNTY JUDGE BEFORE HER. TO BE COMPLETELY FAIR, REST IN PEACE , I LOVE THE MAN VERY DEARLY BUT HE WANTED TO KEEP THEM ON. AT THE END OF THE DAY , SOME FIGHTS YOU FIGHT AND SOME YOU JUST -- AT THIS POINT IN THE POSITION WE ARE IN AS A COUNTY WHO IS STRUGGLING EVERY YEAR TO MAKE UP SURPLUSES IN INSURANCE, TO HAVE 130 ADDITIONAL PEOPLE ON THE COURTS , ON THE COUNTY'S POTENTIAL LIABILITY LIST IS VERY SCARY.

IF ONE OF THOSE, THAT IS 130 CHANCES ARE, IF ONE OF THOSE, GOD WILLING, GOD FORBID , HAS A HORRIBLE CLAIM IN THIS COUNTY HAS TO PAY FOR THAT, THAT IS NOT FAIR TO THE OTHER COUNTY EMPLOYEES. THAT IS NOT FAIR TO OUR CONSTITUENTS. IT IS NOT RIGHT TO DO IT. I AM NOT UNSYMPATHETIC TO THOSE ENTITIES THAT ARE ON HERE. THEY NEED TO BE PUT ON NOTICE IF THIS COURT SO CHOOSES , IF THEY DON'T, THEY GET TO STAY. THEY NEED TO GO LOOK FOR OTHER INSURANCE AND THEY NEED TO FIGURE OUT HOW TO DO IT. THAT IS JUST NOT WHAT WE ARE SUPPOSED TO DO. IN MY OPINION IT IS TIME TO TAKE A STAND AND MAKE A DIFFERENCE AND BE FAIR TO THE CONSTITUENTS THAT WE REPRESENT AND BE FAIR TO OUR EMPLOYEES. IT IS JUST NOT RIGHT. I DON'T KNOW WHERE TO GO FROM HERE AS FAR AS WHAT WE CAN DO AT THIS TIME. I AM NOT GOING TO VOTE FOR ANYTHING THAT INCLUDES THESE 130 . I MIGHT BE THAT MINORITY, THAT'S OKAY. I DO NOT MIND BEING IN THE MINORITY ON THAT , IF THAT'S WHAT IT IS. I THINK IT IS SOMETHING WE NEED TO DISCUSS AS A COURT. I WANT TO SAY, I APPRECIATE THE HECK OUT OF THE WORK THAT YOU ALL DID, ESPECIALLY THE INSURANCE COMMITTEE AND COMMISSIONER

[00:20:01]

>> BASED ON THE MEMORANDUMS OF UNDERSTANDING THAT WE HAD BEFORE THAT US , ONE OF THEM STATES, WE CAN ELIMINATE THOSE EXTERNAL ENTITIES. AT LEAST IN ONE MEMORANDUM OF UNDERSTANDING THAT WAS , JENNY CAN CORRECT ME IF I AM MISTAKEN. HOWEVER, WE WOULD BE PROVIDING SUFFICIENT NOTICE TODAY, JULY 9TH , AND THEY WOULD, SEEMINGLY , IF YOU PROVE TO REMOVE THEM , IT WOULD GO IN EFFECT OCTOBER 1ST. THEY HAVE AN SS IN ESSENCE 2.5 MONTHS TO FIND ALTERNATIVE CARE. I WOULD AGREE WITH YOU, COMMISSIONER, EVEN THOUGH , WE HAVE BEEN FORTUNATE FOR THE PAST FOUR YEARS WITH HAVING A SURPLUS , OR POSSIBLY NOT ONCE PRESCRIPTION COST COME INTO EFFECT , WE HAVE KIND OF DODGED A BULLET, JUST LIKE WE DID WITH HURRICANE BERYL. IT DOES NOT MEAN THAT GOING FORWARD THAT WILL NOT BE THE CASE OR CONTINUE TO BE THE CASE THAT WE WILL HAVE A SURPLUS. EVEN ONE CLAIM COULD BE EXORBITANT . I THINK THE COURT SHOULD TAKE THAT INTO CONSIDERATION AS WELL.

>> I ALSO THINK, NOT HAVING THOSE PRESCRIPTION COSTS ON HERE, I KNOW IT LOOKS LIKE , IN THE LAST FIVE YEARS, THE ONLY YEAR WE WERE UNDER WAS LAST YEAR THAT WE HAD A DEFICIT IN THE AMOUNT COLLECTED AND CLAIMS PAID OUT WITHOUT PRESCRIPTIONS BEING INCLUDED. THERE ARE THREE OTHER YEARS, IF YOU ADD PRESCRIPTIONS TO THAT, THIS GETS -- THEN YOU HAVE TWO OTHER YEARS , I WAS NOT INCLUDING LAST YEAR, THERE ARE TWO OTHER YEARS THAT IT IS A LITTLE TOO CLOSE WHEN YOU HAVE 70,000 THERE AND YOU HAVE 80,000 THERE. I AM QUITE CERTAIN THOSE PRESCRIPTION COST BRING THAT UP BECAUSE I SEE THOSE AMOUNTS THAT COME THROUGH MY OFFICE ALL THE TIME . IT IS A LITTLE TOO CLOSE FOR COMFORT. I UNDERSTAND THE LEGALITY OF NOT HAVING ONE OF THE ENTITIES IN THERE AND I AM NOT SURE WHAT THE REST OF THE COURT THINKS ABOUT THIS. I THINK NEXT YEAR , AS COMMISSIONER MAREZ AND I WERE IN THOSE MEETINGS AND WE HAD HOPED TO GO OUT FOR BIDS, WE PLANNED TO, NOT HOPE , I AM NOT SURE WITH THE MO USE , AND GIVING NOTICE AND SOME OF OUR MAJOR PARTNERS IN THE HOSPITAL DISTRICT, THEY DO A LOT FOR HEALTHCARE. I DON'T KNOW THAT I WOULD BE WILLING TO KNOCK THEM OFF AT THE LAST MINUTE FOR THIS WITHOUT SOME NEGOTIATIONS GOING ON BETWEEN US. NOT JUST A NOTICE TODAY IN COURT LIKE YOU

ARE DONE. >> THE HOSPITAL DISTRICT, OF ALL PEOPLE, THEY GOT MORE MONEY THAN WE DO. THAT IS THE ONE THAT I AM MOST SYMPATHETIC TO BECAUSE THEY DO SO MUCH FOR THE COUNTY, THEY REALLY PARTICIPATE IN A HUGE WAY WITH THE COUNTY.

WITH ALL DUE RESPECT TO THE REST OF THESE , THEY ARE THEIR OWN ENTITIES AND THEIR OWN THINGS AND THEY OUGHT TO BE ABLE TO STAND ON THEIR OWN AND GET WHAT THEY GET. THE HOSPITAL DISTRICT LITERALLY HAS MILLIONS IN RESERVES AND THEY CAN BE SELF INSURED BETTER THAN WE COULD, THEY HAVE MORE RESERVES THAN WE , THEY COULD HAVE A MILLENNIAL PERCENTAGE POINT OF

THE EMPLOYEES. >> I WONDER IF OUR MOUS CAN REFLECT CLAIMS OVER A CERTAIN AMOUNT AND REVERT BACK TO THE ENTITY FOR THEM TO PICK UP THAT TAB. I AM THINKING --

>> JUDGE, ARE YOU SAYING LONG-TERM OR SHORT-TERM? I AM GOING ON , THIS IS YOUR PREMISE THAT WE NEED TO DO ONLY , YOU ARE THE ONE WHO HAS GOT ME ON THE TRACK BECAUSE YOU MADE THIS STATEMENT REPEATEDLY AND I AGREE. WE NEED TO DO WHAT WE HAVE TO DO. WE HAVE TO STOP TRYING TO BE THE SAVIOR FOR

[00:25:02]

>> SHORT-TERM , I WAS WONDERING IF THERE IS ANYWAY WE COULD DO THAT BECAUSE WE HAVE TO GO OUT FOR A DIFFERENT PLAN NEXT YEAR, ALL OF US WILL BE CHANGING WITHOUT THROWING THIS ON AN ENTITY AT THE LAST MINUTE. I WANTED THESE NUMBERS BECAUSE I WAS CERTAIN THERE WAS A LOT OF MONEY BEING PAID OUT, UNFORTUNATELY , WE DO NOT HAVE THE EXACT NUMBERS IN FRONT OF US ON WHAT THE COUNTY IS PICKING UP THE TAB FOR AND THAT BOTHERS ME A LOT. IF WE WERE TO WORK OUT SOMETHING TO KEEP THEM ON FOR NEXT YEAR, IT WOULD HAVE TO BE WITH A CURRENT MO YOU, SOMETHING THAT REFLECTS AFTER THEY GO OVER THERE PREMIUM AMOUNT AND THEY CONTRIBUTE THEY WOULD HAVE THAT ENTITY FOR THE NEXT YEAR WHILE WE ARE WAITING FOR THIS. TO ME I THINK THAT'S HOW YOU MOVE FORWARD IS REVERT THE COST BACK TO THE ENTITY.

THEY MIGHT AS WELL GET THEIR OWN. ABSOLUTELY.

>> WE COULD TRY THAT, JUDGE. THEY WILL PROBABLY SAY WE CAN'T DO IT, THE HOSPITAL DISTRICT PROBABLY COULD, BUT THE OTHERS WILL NOT COVER IT, THEY WILL HAVE TO GET THEIR OWN

PLAN . >> THEN IT IS AN OPTION WE GIVE

THEM. >> I DO NOT EVEN KNOW IF IT IS

LEGAL . >> WE WOULD HAVE TO FIND OUT WITH A MOU . JOHN, I DON'T KNOW IF YOU KNOW MORE.

>> I AGREE THAT WE HAVE TO GET PLENTY OF NOTICE TO THESE GROUPS. WE NEED TO BRING THEM IN , IF NOT TODAY , SHORTLY AFTER THE PROCESS IS COMPLETE THAT WE ARE LOOKING AT SEPARATING THEM FROM OUR PLAN SO THEY CAN START EXPLORING THEIR OWN OPTIONS. THIS SHORT AMOUNT OF TIME NOT BEFORE THE NEW FISCAL YEAR BEGINS, IT IS TOO QUICK OF A TURNAROUND FOR MOST ENTITIES I THINK IT IS LEGITIMATE POLICY ARGUMENT.

SHOULD WE TAKE ALL OF THESE GROUPS? SOME HAVE MORE OF A CLAIM THAN OTHERS. DEFINITELY -- ALSO, LET'S GET SOME CLARIFICATION. WE HAVE A LEGISLATIVE SESSION COMING UP NEXT YEAR . THESE ISSUES COULD BE RESOLVED SIMPLY BY THE HOUSE AND SENATE AND GOVERNOR APPROVING AND PASSING AND SOME OF THIS COULD BE WORKED OUT ITSELF. MAYBE THAT IS SOMETHING THAT WE COULD PUT ON THE LEGISLATIVE AGENDA IS TO HAVE THESE ISSUES CLARIFIED. WE KIND OF HAVE ELUDED THAT THERE ARE SOME WHO HAVE MORE OF A CLAIM, OR MORE OF A REASON TO BE PART OF THE SYSTEM WHILE OTHERS DON'T. LET'S NOT GUESS , LET'S HAVE THAT ESTABLISHED , LET'S HAVE YOU AND YOUR TEAM GET US THE SPECIFIC GROUPS AND PROVIDE US THE LIST OF WHO DEFINITELY SHOULD BE INCLUDED AND WHO SHOULD NOT AND THE REASONS WHY, THAT WOULD BE HELPFUL. FOR ME , AS LONG AS WE GIVE ENOUGH HEADS UP, THEN I TOTALLY UNDERSTAND COMMISSIONER CHESNEY'S CONCERNS. AS I HAVE SAID BEFORE , THERE ARE OTHER SYSTEMS IN THE STATE THAT HAVE DONE MUTUAL INSURANCE. MAYBE THAT IS HOW WE DO IT. IF THERE IS SOMETHING IN THESE LANDS THAT ALLOW FOR ANY OF THESE DEPARTMENT OR ENTITIES TO PUT MORE SKIN IN THE GAME SO THEY ARE COVERING A PROPORTIONAL SHARE OF THE CLAIMS, MAYBE THAT IS SOMETHING THAT WE WOULD CONSIDER. ONCE AGAIN, MY LIMITED KNOWLEDGE OF INSURANCE IS WHEN YOU ADD TO THE NUMBER OF EMPLOYEES IN THE PLAN, IT MAKES IT A STRONGER PLAN OVERALL BECAUSE YOU CAN GET OTHER INCENTIVES FOR THE EMPLOYEE POOL. YOU ARE DEALING WITH A LARGER NUMBER. THAT HELPS INCENTIVIZE THE COMPANIES THAT PROVIDE THE SERVICES TO GIVE US A BETTER RATE BECAUSE YOU'RE DEALING WITH A GREATER NUMBER. THAT IS MY ONLY CONCERN, YES , I HEAR YOUR CONCERNS AND I SHARE THEM. IF ALL THINGS STAY EQUAL, YES , PERHAPS WE DO NEED TO CUT THIS.

ONE, I WOULD SAY THAT WE NEED TO GET PROPER NOTIFICATION. I THINK 2.5 MONTHS OR LITTLE OVER 2.5 MONTHS IS A SHORT TIMEFRAME. ALSO, IF THERE IS A PROPORTIONAL WAY THAT THESE ENTITIES CAN PUT IN, IF THEY ARE, LET'S MAKE SURE WE CLEARLY SPELL THAT OUT OR HOLD THEIR FEET TO THE FIRE A LITTLE MORE AND MAKE SURE THAT THEY PAY A BETTER PROPORTION BECAUSE PERHAPS THEY ARE MAKING A MUCH LARGER CLIENT POOL THAN WHAT THEY ARE PUTTING INTO. THOSE ARE ALL THINGS THAT I THINK WE NEED TO LOOK INTO OVER THIS PERIOD OF TIME. AS THE JUDGE

[00:30:03]

OF MY BIG BRIEFINGS . >> I AGREE. MOVING FORWARD, LIKE I SAID, IF WE NEED TO DO THESE BEFORE THIS GOES INTO EFFECT, THESE MOUS, THE ONLY WAY THAT I WOULD BE WILLING TO STILL ALLOW THIS, IF WE CAN ADD LANGUAGE INTO THEIR MOUS OVER THE CERTAIN AMOUNT. THOSE ENTITIES PICK UP A PORTION OF THEIR EMPLOYEES OR THEIR DEPENDENTS.

>> I DON'T THINK SOME OF THEM CAN. THE DISTRICT IS NOT GOING TO PAY $1 MILLION CLAIM. WE HAVE ENTITIES INVOLVED THAT DO NOT HAVE MONEY TO DO IT. HOW MANY EMPLOYEES DO WE HAVE AN NUECES COUNTY? I'M NOT SAYING THESE PEOPLE, WE HAVE ABOUT

3000 EMPLOYEES? >> IF YOU EXCLUDE CSCD, ACTIVE EMPLOYEES NOT INCLUDING VACANCIES WE HAVE 1100 TO CURRENTLY. IF YOU INCLUDE CSCD AND MPO WE ARE AT 1250.

>> THAT AUTO GIVE US PLENTY OF ABILITY TO DO WHAT YOU ARE TALKING ABOUT WITH REGARDS TO HAVING A LOT OF PEOPLE IN THERE TO GET MORE BENEFITS AND SO FORTH AND SO ONE. WE ARE TALKING 50, 1250 THAT ARE OURS. WE ARE TALKING 50 EMPLOYERS TAKING 50 OUT OF THE MIX IS NOT GOING TO AFFECT HOW GOOD A BENEFIT YOU GET OR WHATEVER. IT IS GOING TO TAKE OUT 130 PEOPLE BECAUSE IT IS 50 PLUS , PLUS, PLUS THAT WE HAVE EXPOSURE OF THAT COULD BE MILLIONS OF DOLLARS. IT COULD BE NOTHING, IT COULD BE MILLIONS OF DOLLARS. I AM NOT WILLING TO ROLL THE DICE. I HAVE SAT HERE RIGHTLY THROUGH ADMINISTRATIONS BECAUSE I COULD NOT GET ANYWHERE IF I CANNOT GET ANYWHERE THIS TIME, GREAT, I AM 100% AGAINST NOT WAITING. I AM 100% IN THE FAVOR OF DOING IT RIGHT NOW, PUTTING THEM ON NOTICE AND LETTING THEM GO SEE WHAT THEY CAN FIND AND THEN MAYBE RING BACK SOMETHING TO US AND MAYBE HAVE A DISCUSSION. TO SAY, LET'S WAIT AND PUT LANGUAGE IN A MOU AND THEN GO OUT FOR BIDS NEXT YEAR SCARES ME BECAUSE WE WILL BE HAVING THIS CONVERSATION AGAIN NEXT YEAR AND NOT GIVING NOTICE AGAIN . IN MY OPINION, THERE NEEDS TO BE ACTION TODAY OF WHICH, AGAIN, I HAVE NO PROBLEM IF I LOSE, WE ARE ROLLING THE DICE WITH OUR EMPLOYEES INSURANCE AND WE ARE ROLLING THE DICE WITH OUR COUNTY TAXPAYER INSURANCE WHEN WE HAVE NO ZERO, ZERO, ZERO LEGAL OBLIGATION TO DO SO. THAT IS NOT THE PREMISE WE OUGHT TO BE WORKING OFF OF. I THINK WE OUGHT TO GIVE THEM NOTICE NOW AND SAY GO FIND WHAT YOU CAN FIND IT I BELIEVE MOST OF THEM CAN FIND SOMETHING THAT THEY WILL DO AND PUT THE ONUS ON THEM, NOT ON US, THE ONUS ON THEM TO COME BACK AND SAY WE LOOKED AND WE COULD NOT FIND ANYTHING AND WE LOOKED AND THIS IS THE BEST WE COULD COME UP WITH. WE CANNOT SIT HERE AND HOPE THAT THEY WILL FIND SOMETHING, THEY ARE NOT UNTIL WE TAKE ACTION. THEY WILL NOT UNTIL WE MAKE A DEFINITIVE MOVE AND SAYING WE WILL TALK ABOUT IT AGAIN NEXT YEAR, WE WILL NOT BE ABLE TO. IF THEY GO OVER THERE POLICY AND THERE IS A HUGE CLAIM, THEY ARE NOT SELF-INSURED, THEY DO NOT HAVE ANY MONEY. THE HOSPITAL DISTRICT IS AND COULD AND THEY ARE THE ONLY ONES WHO CAN. THE REST OF THESE DON'T. NO OFFENSE, I DON'T THINK PUTTING LANGUAGE IN A MOU THAT SAYS YOU HAVE TO PAY THE EXCESS MEANS DIDDLY SQUAT , THEY WILL SIGN IT ALL DAY LONG AND THEN WHAT HAPPENS THEY WILL SAY, WE DON'T HAVE NO MONEY IT HAD WE PAY FOR IT? THE HOSPITAL DISTRICT IS THE ONLY ONE I WOULD DO THAT WITH BECAUSE I KNOW THEY CAN AFFORD IT. AGAIN, I DON'T KNOW, WE CALLED A SPECIAL MEETING SO WE COULD GIVE PEOPLE NOTICE. THAT IS THE THING I ASKED WEEKS AGO, IF WE COME BACK IN JULY WILL THAT GIVE YOU ENOUGH TIME TO OPEN ENROLLMENT AND GIVE PEOPLE NOTICE AND YOU SAID YES THAT WOULD BE GREAT I SAID OKAY. TIM, I SAT HERE IS THAT IF YOU'RE GOING TO WAIT AND NOT CHANGE STATES, THAT'S ON YOU IF THIS COURT MAKES A DECISION , I LAID IT ALL OUT THERE AND I SAID THIS IS WHAT WE ARE TALKING ABOUT DOING --

>> COMMISSIONER I HAD A DISCUSSION WITH BOONE CHAPMAN AND THEY AGREED WHETHER OR NOT WE CHANGE THE RATES IT WILL NOT AFFECT THE DATES OF OPEN ENROLLMENT --

>> I HAVEN'T EVEN GOT TO THE GRANDFATHER QUESTION. WE HAVE NOT EVEN GOTTEN TO THAT. I WOULD LIKE TO KNOW ALL THAT INFORMATION AND WHETHER OR NOT WE SHOULD EVEN GRANDFATHER

AGAIN. >> IF I MIGHT ADD, I DID DO RESEARCH WITH MCGRIFF WITH REGARDS TO IF WE ELIMINATE THE

[00:35:02]

YOU CAN ADD MORE. >> CORRECT, 130 EMPLOYEES PLUS

DEPENDENCE THAT'S A >> IT'S 50

>> 50 PLUS DEPENDENCE. >> 50 EMPLOYEES PLUS DEPENDENCE A TOTAL OF 130 BELLY BUTTONS, COMMISSIONER, IT IS LESS THAN 5% OF YOUR TOTAL POPULATION. YOU HAVE JUST SHY OF 1000 EMPLOYEES ON THE PLAN PLUS DEPENDENCE , CLOSE TO 3000 FOLKS OF EMPLOYEES AND DEPENDENTS .

>> I KNEW THERE WAS A 3000 NUMBER IN THE SOMEWHERE. WE ARE ENSURING 3000 PEOPLE WITH ALL OF THE DEPENDENTS AND

EVERYTHING ? >> YES, JUST SHY OF 3000.

>> THAT IS A BIG NUMBER . >> TOTAL EMPLOYEES AND

DEPENDENTS . >> I KNEW 3000 WAS STUCK IN MY HEAD FOR SOME REASON. I WAS THINKING HOW DID I GET THAT? SORRY, I DID NOT MEAN TO INTERRUPT YOU.

>> AS YOU CAN SEE THE EXTERNAL AGENCIES, 50 EMPLOYEES AN ADDITIONAL AID WITH DEPENDENTS. YES, THAT NUMBER IS INCREDIBLE.

>> I WANTED TO GET THIS INFORMATION OUT TO YOU, JUDGE.

I DID ASK THE COUNTY AUDITOR'S OFFICE FOR ALL CLAIMS FROM THE PAST FOUR YEARS AND I WAS PROVIDED WITH CLAIMS AND ALSO THE PREMIUMS PAID. TO THE COUNTY AUDITOR'S OFFICE , THE DESCRIPTION WAS NOT INCLUDED IN THOSE AMOUNTS. WE CAN GET THAT TO YOU SOON AND WE CAN FURTHER CONSIDER. TO YOUR POINT , WE COULD REALLY TURN THAT NUMBER OF 849,000 UPSIDE DOWN VERY QUICKLY. ANY ONE PRESCRIPTION COULD COST HUNDREDS OF DOLLARS, UP TO 1000 AS WE WELL KNOW. WE SHOULD TAKE THAT INTO

CONSIDERATION AS WELL. >> AS I SAID, THERE ARE THREE YEARS HERE THAT ARE WAY TOO CLOSE AND ONCE YOU ADD PRESCRIPTIONS TO THAT, THEY ARE VERY CLOSE TO BREAKING EVEN OR

COST. YES. >> IT SHOULD BE NOTED THIS LIST ALSO INCLUDES RETIREES . SO THEY ARE NOT REALLY A SEPARATE ENTITY, THEY ARE JUST NOT CURRENT EMPLOYEES THEY ARE

FORMER EMPLOYEES. >> THAT IS CORRECT .

>> FORMER EMPLOYEES CAN BE ON THE POLICY FOREVER? IS THAT

PART OF THE RETIREMENT ? >> JOHN, CAN YOU SPEAK MORE TO THAT QUESTION WITH REGARDS TO RETIREES ON THE HEALTH PLAN?

>> WHEN I SAW THAT DOCUMENT, THAT IS NEWS TO US. WITHOUT RETIREES COVERED UNDER THE COUNTY PLAN AND COUNTY EMPLOYEES , THAT MIGHT BE AN AREA THAT THE COUNTY WANTS TO NEGOTIATE WITH THOSE ENTITIES, RETIREES , OR THE PLAN IS EXTENDED COVERAGE ONLY TO THOSE WHO ARE ACTIVELY WORKING .

RETIREES WOULD NOT BE ELIGIBLE . I WOULD HAVE TO DEFER TO THE COUNTY ATTORNEY ON THAT PARTICULAR ISSUE. IT APPEARS , WE DO NOT KNOW IF THEY ARE 365 , OR THOSE THAT ARE ELIGIBLE FOR MEDICARE 65 PLUS. I WILL ASSUME THEY ARE PRE-65 RETIREES NOT ELIGIBLE FOR MEDICARE , WHICH IS ADDITIONAL EXPOSURE THAT THE COUNTY IS TAKING, EXTENDED COVERAGE TO RETIREES TO NON-COUNTY ENTITIES IS AN ADDITIONAL RISK TO THE COUNTY.

>> THEY ARE NOT ON THIS RISK LIST FOR CLAIMS AND COST

ANYTHING LIKE THAT. >> HOW MANY OF THEM ARE THOSE?

>> 13 DEPENDENTS SO 17 A TOTAL.

>> TIM, WOULDN'T RETIREES BE INCLUDED IN THE DOCUMENTS THAT MICHELLE WAS ABLE TO PUT TOGETHER?

>> IT DOES NOT BREAK IT OUT AS SUCH.

>> MICHELLE IS HERE. MICHELLE, DO YOU HAVE INFORMATION REGARDING THE CLAIMS FOR THE RETIREES?

>> PROBABLY DID NOT ASK IT. >> THANK YOU. CAN YOU HEAR ME? THAT WAS NOT REQUESTED. I WOULD HAVE TO REVIEW THE PLAN DOCK AGAIN AS FAR AS COVERAGE BEING EXTENDED TO ANYONE FROM THE OUTSIDE ENTITY IF THEY HAD RETIRED. IN MY TIME HERE WE HAD

[00:40:07]

ARE NOT. >> THAT ARE FROM NONENTITIES?

>> NO. WE DO NOT HAVE ANYONE CURRENTLY ON OUR PLAN, WE HAVE NOT HAD ANYONE ON THE PLAN FOR THE PAST 10 YEARS, I CAN ONLY SPEAK TO THAT BECAUSE I HAVE BEEN HERE THAT WILL BE IT THEY ARE NONENTITY RETIREES, THEY HAVE BEEN FORMER EMPLOYEES.

>> THEY ARE FORMER NUECES COUNTY EMPLOYEES.

>> IF THEY WANT TO, CAN THEY? >> RACING YOU DON'T KNOW BECAUSE YOU DID NOT ASK THAT QUESTION?

>> YES. >> WAS THAT DONE TO DO THIS TO RETIREES ? WE DO NOT HAVE A MOU OR CORE ORDER DISCUSSION ON THAT , THERE'S NOTHING ON THAT.

>> NO. I WAS ONLY ASKED TO LOOK AT THE EXTERNAL AGENCIES AND THE CLAIMS HISTORY. I DID NOT TAKE INTO CONSIDERATION THE CLAIM FOR THOSE RETIREES AND TO MICHELLE'S POINT THAT WAS NOT REQUESTED. THEY WERE FORMER EMPLOYEES .

>> THAT IS NOT PART OF THE COUNTY POLICY WHEN YOU RETIRE THIS IS AVAILABLE ? THAT YOU ARE AWARE OF?

>> NOT THAT I AM AWARE OF. MICHELLE CAN YOU SPEAK TO THAT?

>> JUST THE POLICY MANUAL. WHEN THEY GO THROUGH HR THEY HAVE TO STATE WHETHER OR NOT THEY ACCEPT OR DECLINE.

>> IF THEY DECLINE WE KEEP THAT ON RECORD . I WANT TO SAY THE PRACTICE HAS BEEN ONCE YOU DECLINE INITIALLY YOU DO NOT GET TO COME ON THE PLAN AFTER YOU RETIRE AND REALIZE YOU WANT

TO COME ON. >> IF, HOWEVER, THEY DECIDE TO BE ON THE PLAN, THERE IS NO AGE RESTRICTIONS SAYING THAT YOU HAVE REACHED AN AGE YOU ARE DROPPED, THERE IS NOTHING LIKE

THAT ON THE PLAN DOCUMENT. >> EVENT FOR THE RETIREES , IF AGE WERE A FACTOR, THEY SHOULD BE AVAILABLE TO APPLY FOR MEDICARE AT A CERTAIN AGE. I DO NOT BELIEVE IT WOULD BE A ADVERSE IMPACT IF YOU WANT TO GO WITH THE PLAN AS WELL.

>> I THINK YOU HAVE TO TAKE INTO CONSIDERATION FOR ACTIVE EMPLOYEES WHO ARE MEDICARE ELIGIBLE, THERE IS NO RESTRICTION FOR THEM IN THE PLAN AS WELL, IF YOU CONSIDER

AGE RESTRICTIONS. >> JUST FOR CLARIFICATION FOR THE COURT, ANYBODY THAT IS ACTIVELY AT WORK , MEDICARE ELIGIBLE AGE 65 AND OVER, THE COURTS PLAN IS PRIMARY. THAT IS A LONG STATUTE PASSED IN 1986 CALLED THE WORKING AGE PROVISION OF COBRA. THAT IS SOMETHING THE COURT CANNOT CHANGE . BUT THOSE THAT ARE NO LONGER WORKING, THE COURT CAN DECIDE WHETHER THEY WANT TO EXTEND COVERAGE TO RETIREES PRE-65 AND I WOULD DEFER TO ANY STATE STATUTE THAT REQUIRES THE COUNTY TO PROVIDE THAT TYPE OF COVERAGE.

>> I THINK WE CAN CERTAINLY LOOK AT THAT, I DON'T KNOW IF WE ARE PREPARED TO DO ANYTHING WITH THAT TODAY. I WAS NOT EVEN AWARE THAT WAS SOMETHING TO DISCUSS. I THINK WE HAVE ENOUGH ON OUR PLATE TODAY TO DEAL WITH. I HAVE MORE QUESTIONS BRETT I WILL COME BACK TO THIS AND LET EVERYONE THINK ABOUT IT AT SOME POINT I WILL MAKE A MOTION WIN OR LOSE.

>> WE ARE JUST IN THE WORKSHOP, WE WILL COME BACK.

>> AT SOME POINT. >> MY QUESTION REGARDING THIS IS THE GRANDFATHER CLAUSE. WHAT ARE THE PROS AND THE CONS OF STAYING WITH GRANDFATHER? THE CON IS WE CAN ONLY INCREASE RATES TO A CERTAIN AMOUNT. WE KNOW WE ARE NOT INCREASING ENOUGH AND WE WILL GET HAMMERED AND CONTINUE TO GET HAMMERED AND WHAT IS THE ADVANTAGE OF STAYING WITH THE GRANDFATHER ?

>> GOOD QUESTION. WE HAVE THAT INFORMATION AVAILABLE FOR YOU AND IT WILL BE PROVIDED TO YOU.

>> SINCE THE EXTERNAL AGENCIES WERE SUCH A BURNING QUESTION, I STARTED OFF WITH THAT FIRST , NOW WE CAN MOVE INTO A DISCUSSION REGARDING THE GRANDFATHER CLAUSE. AND THE

[00:45:05]

>> UNLESS THE COURT HAS ANY OTHER QUESTIONS?

>> I READ WHAT YOU PUT IN THERE, THE PUBLIC DOESN'T READ EVERYTHING THAT WE PUT ONLINE, WHAT ARE THE ADVANTAGES AND

DISADVANTAGES? >> COMMISSIONER, THANK YOU.

>> LET ME MAKE A COUPLE COMMENTS AND I WILL ASK MY ASSOCIATE TO PROVIDE ADDITIONAL CLARITY. THE PLAN CURRENTLY IS A GRANDFATHERED PLAN. HOWEVER, THE PLAN HAS ADOPTED MANY OF THE ACA COMPLIANCE ISSUES OVER THE YEARS . YES, THERE ARE RESTRICTIONS ON HOW MUCH YOU CAN CHANGE EMPLOYEE CONTRIBUTIONS , YES, COMMISSIONER, THERE ARE RESTRICTIONS ON HOW MUCH YOU CAN CHANGE THE PLAN ITSELF BY RAISING A DEDUCTIBLE OR COPAYMENT. IN THE CONVERSATIONS WITH TIM, THE AMOUNT OF INCREASE THAT THE COUNTY IS CONSIDERING FOR EMPLOYEE PREMIUMS IS SUBSTANTIALLY LESS THEN THE CLAUSE. THAT REALLY IS NOT AN ISSUE. THE COUNTY IS NOT INTERESTED , AT THIS POINT, IN CHANGING ITS PLAN . THAT REALLY IS NOT AN ISSUE . IN ESSENCE, THE GRANDFATHER STATUTE REALLY DOES NOT REFLECT ONE WAY OR THE OTHER THE FLEXIBILITY , OR LACK OF FLEXIBILITY OF THE COUNTY. LISA, WOULD YOU ADD ADDITIONAL

CLARITY? >> JUST TO ECHO THOSE SENTIMENTS, THE INSURANCE PREMIUM RESTRICTIONS DO NOT APPLY TO A LARGER EMPLOYER GROUP. YOU DO HAVE THE FLEXIBILITY TO MAINTAIN THAT GRANDFATHERED STATUS . WHEN YOU GET AWAY FROM THE GRANDFATHER STATUS, YOU HAVE MORE RESTRAINTS REGARDING THE DOCUMENTS THAT HAVE TO BE PROVIDED. YOU CANNOT INCREASE YOUR OUT-OF-POCKET MAXIMUMS WHEN YOU ARE GRANDFATHERED MORE THAN 15%. IT IS MORE PLAN DESIGN VERSUS ANYTHING ELSE, REALLY. YOU DO NOT HAVE THOSE CONSTRAINTS ON YOUR CONTRIBUTION. EVEN THE PERCENTAGE IS 15% , WE ARE STILL WELL WITHIN THE

CONSTRAINTS OF THAT. >> I THOUGHT THAT WAS PART OF THE REASON WE DELAYED THIS THE LAST TIME BECAUSE YOU SAID WE COULD NOT INCREASE RATES ANYMORE THAN WHAT WAS BEING PROPOSED . I KNOW FOLKS LEFT AND WE SHOULD NOT HAVE LET THEM LEAVE, MAYBE I'M NOT REMEMBERING RIGHT , I THOUGHT WE WERE TOLD THAT , THEY ARE SAYING SOMETHING DIFFERENT THAT WE CANNOT INCREASE THE RATES ANYMORE .

>> I MAY HAVE MISSED UNDERSTOOD WHAT WAS STATED IN THAT AREA, THEY ARE THE EXPERTS AND SPECIFICALLY ON THE GRANDFATHERED PLAN. THEY HAVE HERE TODAY TO GIVE US COUNSEL ON THAT MATTER. ONE OF THE MOST SIGNIFICANT DISADVANTAGES THAT I FIND WITH THE GRANDFATHER PLAN IS OUR ABILITY TO PROVIDE A DEFINED HEALTH AND WELLNESS PLAN, WHICH WE WERE RESTRICTED UNDER THE GRANDFATHER PLAN. IN ESSENCE IT IS PREVENTATIVE MAINTENANCE. IT HELPS PEOPLE TO IDENTIFY POTENTIAL CHRONIC DISEASES AND ILLNESSES EARLY ENOUGH TO GET TREATMENT BEFORE THEY BECOME CHRONIC . WE WON'T BE ABLE TO OFFER THOSE TYPE OF INCENTIVES IN OUR HEALTH AND WELLNESS PLAN BECAUSE WE ARE PREVENTED FROM DOING SO . IT CANNOT HAVE ADVERSE IMPACT FOR THOSE WHO DON'T PARTICIPATE. IN OTHER WORDS, WE CANNOT INCREASE THE RATES FOR THOSE PARTIES IF THEY FAIL TO COMPLY

WITH . >> IF WE CREATED HEALTH AND WELLNESS TO MAKE OUR PEOPLE HEALTHIER AND THEY DON'T PARTICIPATE YOU CAN DING THEM AT A HIGHER RATE?

>> THAT IS CORRECT. JOHN, CAN YOU CONFIRM THAT STATEMENT ?

>> THERE'S MORE FLEXIBILITY AND THE INCENTIVE THAT ONE CAN

[00:50:06]

>> THAT IS INTERESTING . >> HARRIS COUNTY, DALLAS COUNTY, TARRANT COUNTY, DALLAS COUNTY, COLLIN COUNTY, DENTON COUNTY, MIDLAND COUNTY , LUBBOCK COUNTY, THOSE ARE NON-GRANDFATHERED CLAIMS THAT THEY HAVE MOVED AWAY AND ADOPTED ALL OF THE PROVISIONS OF THE ACA. THE TRADE OFF IS ADDITIONAL FLEXIBILITY IN THEIR PLAN DESIGN CONFIGURATIONS, ADDITIONAL FLEXIBILITY IN THEIR PREMIUM STRUCTURES . AS I MENTIONED, THE COUNTY HAS LARGELY ADOPTED , OVER THE YEARS, THE COUNTY HAS ADOPTED MANY OF THE ACA REQUIREMENTS AS PART OF THE PLAN. IN ESSENCE, IT IS SORT OF A MOOT POINT.

AGAIN, OUR RECOMMENDATION IS, AT THIS POINT, ATTACK THAT ISSUE DURING THE RFP PROCESS AND FOCUS ON THE ISSUES AT HAND WITH RESPECT TO APPROPRIATE FUNDING , OBVIOUSLY STRONG OPEN ENROLLMENT, GOOD COMMUNICATION AND PREPARE FOR THE RFP FOR THE

UPCOMING FALL. >> HAD WE DO THAT AS AN ACTION? DO WE HAVE TO TAKE ACTION TO DIRECT THAT X YOU CANNOT PUT OUT A RFP. I KNOW WE HAVE HAD THESE DISCUSSIONS, WOULD THAT BE THE TIME TO DO IT DURING -- FOR THE COURT TO SEND US OFF WITH THAT DIRECTION WITH HOW YOU WANT US TO GO FORWARD WITH THE RFP, WE WILL DO THE PROCESS EARLY. THE ATTENTION IS FOR DECEMBER SO WE CAN HAVE THAT REQUEST FOR PERMISSION TO GO OUT RFP, WELL AHEAD OF DECEMBER, GIVE THE COURT PLENTY OF TIME TO DISCUSS THAT AND GIVE US THE DIRECTION.

>> COMMISSIONER MAREZ AND I WERE IN THE CONFERENCE AND THAT WAS RELAYED TO US, NOBODY DOES THE GRANDFATHER CLAUSE ANYMORE, BUT THAT WAS NOT SOMETHING. IT IS NOT NECESSARY.

>> BASED ON THE LAST CONVERSATION I THOUGHT WE

[00:55:02]

>> IF I MIGHT ADD IN REGARDS TO HEALTH AND WELLNESS INITIATIVES I AM SPEAKING OF THE TOP FOUR CATEGORIES MOST CLAIMS ARE COMING FROM CANCER, HEART ATTACK, STROKE AND DIABETES. BY HAVING A PREVENTATIVE HEALTH AND WELLNESS PROGRAM IN PLACE THEY CAN ADDRESS THOSE OPPORTUNITIES EARLIER AND GET TREATMENT BEFORE THEY BECOME CHRONIC AND TERMINAL. BEING ON A GRANDFATHERED PLAN UNDER THE ACA WE CANNOT RAISE RATES UNDER THE HEALTH AND WELLNESS PLAN IF THEY FAIL TO COMPLY WITH REQUIREMENTS OF DEFINING THE HEALTH AND WELLNESS PLAN WHICH REQUIRES THEM TO GET PARTICULAR EXAMINATION EACH YEAR AND

THAT'S WHAT I MEAN. >> PREVENTIVE MEASURES THEY ARE NOT REQUIRED TO DO NOW. JOHN HAS JOINED, HE HAS ASKED , ARE

YOU LIMITING YOURSELF? >> EXCUSE ME.

>> GOOD MORNING. >> YES SIR. I ASSUME YOU WANT TO SPEAK ON BEHALF OF THE HOSPITAL DISTRICT WITH DISCUSSIONS ON POSSIBLY CANCELING THE INSURANCE FOR OUR

OUTSIDE ENTITIES? >> THE HOSPITAL DISTRICT IS ON THE COUNTY'S OR USES THE COUNTY HEALTH PLAN BECAUSE WE DO NOT HAVE A LOT OF EMPLOYEES AND WE DO NOT HAVE THE , THE BREATH OF THE NUMBERS OF PEOPLE, NOR THE , TO GET THE DISTRICT, YOU KNOW THE RATES, WE TRY TO DO THAT SEVERAL YEARS AGO AND WE COULD NOT GET ANYBODY TO GIVE US A PROPOSAL BECAUSE WE DID NOT HAVE ENOUGH EMPLOYEES AND OUR EMPLOYEES WERE, WE DO NOT HAVE MANY YOUNG EMPLOYEES, MOST OF THEM ARE

MIDDLE-AGED AND SO >> IN SAYING THAT WITH THE HOSPITAL CONSIDER FUTURE WITH A MOU ON INCREASING OR AT THE END OF THE YEAR PAYING ANY ADDITIONAL COST TO THE COUNTY FROM THEIR EMPLOYEES AND THE DEPENDENTS THAT GO OVER THE AMOUNT OF PREMIUMS PAID INTO THE STOP LOSS AMOUNT.

>> JUDGE, WE WOULD BE INTERESTED IN TALKING WITH YOU ABOUT THAT. WE WOULD LIKE TO GET SOME HISTORICAL INFORMATION TO LOOK AT WHAT THE COST MIGHT BE MOVING FORWARD.

>> THAT IS A PROBLEM WE HAVE RIGHT NOW.

>> WITH A STOP LOSS, THE DISTRICT WOULD CONSIDER IF THE COUNTY NEEDED TO ELEVATE ITS PREMIUMS, TO COVER THAT.

SOMETHING SO WE WOULD HAVE SOME ABILITY TO BUDGET FOR THAT OR

PLAN FOR IT. >> I UNDERSTAND.

>> IF THE NUMBERS ARE RIGHT THE HOSPITAL DISTRICT MAKES UP HALF OF THAT 50, THAT IS A BIG NUMBER TO GET AND I WAS SAYING EARLIER THEY ARE THE ONLY ENTITY ON THE LIST THAT IS A TRUE PARTNER AND I DON'T MEAN THAT RUDELY, BUT REALLY TRULY SOMETHING , THEY WORK WITH US, WE COULD NOT EXIST WITHOUT THEM AND THEY HAVE THE ABILITY , IF WE HAD THE MOU LANGUAGE WHICH YOU TALKED ABOUT WITH COVERING EXCESS CLAIMS, THEY HAVE THE ABILITY TO DO THAT BETTER THAN WE DO WE HAVE LESS ACCESS THAN THEY DO. SO, I HAVE NO ISSUE WITH, IF ALL OF THEM WERE FINANCIALLY SOUND AS THE HOSPITAL DISTRICT YOUR LANGUAGE WOULD WORK, BUT THE OTHERS ARE NOT.

>> NOW THAT IS A QUESTION. THE DRAINAGE ISSUE YOU COULD ARGUE THEY DO A LOT ON BEHALF OF US. THE PREVIOUS HURRICANE , THE TROPICAL STORM BEFORE THAT, THEY DO A LOT AND IT MAY NOT BE THE ENTIRE COUNTY, BUT A PRETTY GOOD CHUNK OF THE FLOOD PRONE AREAS THAT WE HAVE WHICH COVER PRECINCTS ONE, TWO, THREE AND HEART OF THAT. SO THEY SERVE A GREAT PURPOSE AS WELL.

>> THEY ARE THE ONLY FUNCTIONING DISTRICT.

[01:00:04]

>> THEY PROVIDED VALUE LET'S NOT FORGET THE VALUE THEY PROVIDE, THEY HAVE BEEN VERY GOOD PARTNERS ESPECIALLY IN PREPARING FOR THIS. LET'S BE CAREFUL IN THAT LANGUAGE. I UNDERSTAND WHAT YOU ARE SAYING IF WE CAN AFFORD AND THAT IS ONE THING, I DON'T KNOW THE FINANCIALS ON THIS BUT LET'S KEEP IT TO VALUE BECAUSE THAT'S HOW ALL OF THESE GET IN. BECAUSE THEY ALL PROVIDE VALUE OF SOME SORT, WE DON'T WANT TO LEAVE ONE EMPLOYEE WHO WORKS IN THE CREDIT UNION SERVING A VERY IMPORTANT COUNTY FUNCTION FOR COUNTY EMPLOYEES, BUT THEY ARE LEFT ON THEIR OWN. THAT IS HOW ALL THE OTHERS GOT.

WHAT YOUR INTENT IS COULD WORK IN REVERSE, THAT'S HOW WE GOT HERE OVER THE YEARS. I AGREE ONCE AGAIN, THE COST, WHAT YOU CAN PUT IN, WHAT THE GROUPS CAN AFFORD AND PAIN AND MAYBE THEY CAN OR SHOULD DO ON THEIR OWN, BUT WE ARE HEARING FROM JOHN ALSO , OBVIOUSLY THEY COULD HAVE ANYONE BUT THEY PREFER THE LARGER PLAN BECAUSE THEY WILL BE ABLE TO GET ONTO IT MORE ROBUST PLAN THAT THEY COULDN'T DO WITH 22 EMPLOYEES AND HELD

FOR MANY DEPENDENTS. >> YOU CAN ARGUE THAT FOR ALL OF THEM. MY 93 OR FOUR YEARS AGO AND WE SAY WE ARE NOT LETTING ANYBODY ELSE IN YET WE HAVE ONE ESD THAT'S IN SO THAT'S THE PROBLEM WHEN YOU LET ONE HOW DO YOU STOP AND START? MY COMMENTS ON THE HOSPITAL DISTRICT, THEY PROVIDE THE COUNTY MILLIONS OF DOLLARS OF SUPPORT, NOBODY ELSE DOES THAT AND THAT WAS THE POINT I WAS MAKING. I APPRECIATE THE OPPORTUNITY TO CLEAR THAT UP, THE DRAINAGE DISTRICT DOES, ESD DOES, THEY ALL DO THINGS FOR THE COUNTY. THAT'S HOW THEY GOT HERE BUT THEY ARE NOT NUECES COUNTY EMPLOYEES NOR IS THE HOSPITAL DISTRICT EVEN THOUGH WE COULD NOT QUITE FRANKLY SURVIVE WITHOUT THEM, THAT'S ANOTHER DISCUSSION.

JOHNNY AND I HAVE HAD CONVERSATIONS ABOUT HOW WE NEED TO WORK TO BE MORE INDEPENDENT THEN WE ARE FROM THE HOSPITAL DISTRICT. SO, WE HAVE TO PROTECT THE NUECES COUNTY EMPLOYEES, THE CONSTITUENTS THAT WE HAVE AND AT THE SAME TIME WE HAVE A MITIGATE LOSSES AS MUCH AS WE CAN AND YES THE HOSPITAL DISTRICT IS A BIG PART OF IT AND WE SET A STANDARD WHAT IS FAIR FOR ONE IS FAIR FOR THE OTHER, IF YOU COME PAY THIS PART AND THIS PART AND YOU PAY THE EXCESS WE WILL CONSIDER YOU, THAT WILL ELIMINATE A LOT OF PEOPLE.

>> IT MAKES IT A CHOICE AND IF THEY CAN'T DO IT, THEY GET THEIR OWN. UP TO THE STOP LOSS THEY SHOULD PAY FOR THEIR EMPLOYEES AND DEPENDENTS, THE COUNTY SHOULD NOT BE FORKING

OUT THAT MONEY. >> UP TO THE STOPLOSS WE HAVE

TO COVER. >> WHAT I AM HEARING, IT ALL

DEPENDS ON THE BUDGET RIGHT? >> THEY HAVE A CHOICE TO JOIN

WITH THAT OR GO GET THEIR OWN. >> HOW THEY SPEND THEIR MONEY? I THINK THEY ARE THE ONES THAT MIGHT WANT TO LOOK INTO IT AND SEE HOW THEY CAN SAVE SOME MONIES. YOU SAID YOU HAD TWO ACCOUNTS FIRST STARTED AND YOU DO NOT HAVE A CHANCE TO PUT

THEM IN THE PACKET? >> TWO ACCOUNTS?

>> TWO NUMBERS THAT WERE NOT IN THE PACKET. WHEN WE FIRST

STARTED. >> THE EMPLOYEE COUNT? THOSE ARE JUST ACTIVE EMPLOYEE . I WAS ASKED THIS MORNING HOW MANY CURRENT ACTIVE NUECES COUNTY EMPLOYEES THERE ARE. 1100 TO NUECES COUNTY EMPLOYEES AND IF YOU ADD CS CD AND MPO THE

NUMBER IS 1250. >> IS THAT THE CORRECT NUMBER? I THOUGHT YOU SAID YOU WOULD GET BACK WITH US ON THAT.

>> I GAVE THAT NUMBER , I GIVE THOSE TWO NUMBERS A UNIT AGO.

THEY WERE CORRECT. >> WE FIRST STARTED YOU SAID YOU HAD TWO ITEMS THAT WERE NOT PRINTED IN THE PACKET THAT YOU

WOULD GET TO US. >> I SAID THAT , THIS FORM , I WAS TOLD THAT THERE WOULD BE A COLUMN ADDED THAT SAYS ELIGIBLE

AND INELIGIBLE. >> I HAVE THE INFORMATION.

>> I DON'T HAVE ACCESS. >> ALL I AM ASKING IS WHEN YOU DO GET THOSE NUMBERS, WILL THAT MAKE A CHANGE TO WHAT WE'RE TALKING ABOUT? MORE OR LESS EMPLOYEES?

[01:05:02]

>> WE HAVE ENOUGH EMPLOYEES IT WOULD AMOUNT -- NOT MAKE

CHANGE. >> IT WOULD NOT CHANGE THE CONVERSATION WE ARE HAVING NOW?

>> NO. >> DID YOU HAVE ANYTHING ELSE YOU WANT TO ADD OR ANY OTHER QUESTIONS WE WANT TO ASK ABOUT

THIS? >> I DID NOTICE THAT THERE IS A COUPLE OF MATHEMATICAL ERRORS ON THIS. AGAIN, THEY SAID IT

DID NOT MATTER. >> WE DON'T HAVE THE TOTAL ON THE PRESCRIPTION DRUGS. THERE ARE VARIABLES WHICH IS WHY I WOULD SUGGEST THE BEST WAY MOVING FORWARD FOR THIS YEAR IN SUCH SHORT NOTICE TO OUR PARTNERS IS IF WE CAN ADD A PARAGRAPH, A PIECE OF LANGUAGE THAT MAKES THE ENTITY FOR THEIR INDIVIDUALS AND THEIR EMPLOYEES AND FAMILY MEMBERS , UP TO 475

, 475? SOMEBODY CORRECT ME. >> FOUR AND 50.

>> I WAS TOLD FOR 75 IN A MEETING THE OTHER DAY.

>> CAN YOU CONFIRM THE STOP LOSS PAYMENT COVERAGE?

>> 475,000. >> THAT'S WHAT I THOUGHT.

>> AND THEN SECONDARY INSURANCE KICKS IN?

>> YES. >> WHAT I WOULD SUGGEST IN SHORT NOTICE FOR THOSE OF US WHO DON'T WANT TO DROP PARTNERS AND APPRECIATE THIS STUFF , THIS YEAR ON SHORT NOTICE WOULD BE ANYONE THAT IS WANTING TO CONTINUE, HE WOULD HAVE TO SIGN CURRENT MO USE WITH THAT LANGUAGE THAT THEY ARE RESPONSIBLE FOR THAT PORTION OF THEIR EMPLOYEES AND THEIR DEPENDENTS IF THEY GO ABOVE OR UP TO THE 475 THAT THE COUNTY, WE JUST CANNOT TAKE ON EVERYBODY'S PROBLEMS. THE RISK IS TOO HIGH FOR THE COUNTY GIVEN THE SITUATION WE ARE IN OR THEY CAN REFUSE AND GO OUT TO GET THEIR OWN. THAT'S A CHOICE THEY WOULD HAVE TO MAKE IF YOU WANT TO SIGN ON WITH THAT PARAGRAPH, TO ME IT SEEMS LIKE THE EASIEST SOLUTION FOR

US RIGHT NOW. >> KEEP IN MIND ON THE NEXT AGENDA OUR STOP LOSS INSURANCE IS FOR RENEWAL BY THE END OF MONTH. PUT IT ON 7/17 COURT AGENDA WITH RECOMMENDATIONS PRESENTED ON WHAT WE SHOULD DO WITH THAT.

>> IS THAT NUMBER NOT INCLUDED IN THESE PREMIUMS? DO THEY PAY

FOR THAT? >> CAN YOU ANSWER THE QUESTION?

>> TO OUTSIDE ENTITIES PAY THEIR PORTION OF THE STOP LOSS INSURANCE PREMIUMS? THAT OUGHT TO BE INCLUDED .

>> I DON'T BELIEVE THE ANSWER IS YES.

>> THEY DON'T. THE STOP LOSS PREMIUM, THAT IS A FEE TO THE

COUNTY. >> ALL PARTNERS, LET'S BE CLEAR IF YOU'RE LISTENING. THIS IS , WE PREVIOUS COURTS HAVE MADE THESE DECISIONS WE ARE NOT TAKING THE SITUATION LIGHTLY. IN LIGHT OF THE COUNTY BUDGET WE HAVE BEEN FACED WITH IN LIGHT OF WHAT THEY ARE TELLING US THE INSURANCE IS GOING TO BE LACKING AND THIS YEAR NEED FUNDS PUT IN AND THEN THE NEXT ANTICIPATION, WE HAVE TO DO SOMETHING. WE CANNOT

CONTINUE SALES LIKE THIS. >> OKAY WHAT YOU ARE SAYING, IF

YOU ARE SAYING THAT. >> I THINK THEY SHOULD PAY TOTAL PREMIUM WHATEVER IT IS AND THEIR PORTION OF THE STOP LOSS AS WELL AS A COST TO THE COUNTY.

>> AND ANYTHING OVER THE STOPLOSS?

>> OUR CLAIMS RIGHT NOW IF YOU HAVE A HOSPITAL STAY 350,000 THE COUNTY DOES THAT. IF IT GOES OVER 475 THE OTHER

INSURANCE KICKS IN. >> RIGHT, IN OTHER WORDS HOW DO

YOU WORD IT? >> THEIR PORTION OF THE STOPLOSS PREMIUM IS EASY. WHERE IS IT WE GET HIT THAT WE HAVE TO COVER THEM OVER THE STOP LOSS.

>> STOPLOSS COVERS EVERYBODY. WE GET HIT WITH ANY CLAIM UP TO

THE STOPLOSS. >> THEY WOULD PAY THEIR PORTION OF THE PREMIUM AND ANYTHING NOT COVERED AT THE STOPLOSS, WHATEVER THE GAP IS THEY HAVE TO PAY THE GAP.

>> YES, FOR THEIR LIABILITY. >> YOU WANT US TO NEGOTIATE WHERE THEY PAY PREMIUMS? FOR THE PLAN, STOPLOSS PREMIUM PORTION , CORRECT AND THEN ANY AND ALL CLAIMS UP UNTIL THE

[01:10:06]

>> I THINK IT'S ONLY FAIR. >> I WOULD SUPPORT THAT FOR A YEAR UNTIL WE GO BACK OUT AND HAVE EVERYBODY HAVE TIME BECAUSE IF THAT'S OKAY WITH EVERYONE I AM WILLING TO DO THAT BECAUSE THAT MITIGATES LIGHT ABILITY. IT GIVES THEM TIME TO LOOK. NO OFFENSE JOHNNY I WAS GOING TO COME BACK TO YOU. I HAVE A REALLY NICE PLAN AND I DON'T HAVE 25 EMPLOYEES ON MY PLAN, I HAVE 25 OR 30 EMPLOYEES NOT ALL ON THE PLAN AND I HAVE REASONABLE AND GOOD INSURANCE AND I THINK THERE ARE PLANS BECAUSE YOU HAVE 23 PEOPLE HOSPITAL HAS 23 ON THERE SO I WOULD HOPE YOU WOULD GO LOOK AGAIN AT LEAST, BUT IF WE CAN DO THAT AND YOU'RE WILLING TO SUPPORT THAT TO MAKE A MOTION TO SAY LOOKS, STARTING NOW WE WON'T CUT YOU OFF THIS YEAR, MAYBE THAT'S WHERE WE ARE HEADED , BUT IF WE SAY THEY HAVE TO PAY THE EMPLOYER AND EMPLOYEE PART WHICH THEY ARE PAYING AND THEY ALSO HAVE TO PAY THEIR PREMIUM PER STOP LOSS AND HAVE TO PAY THE NUMBER UP TO THE STOPLOSS. THOSE PORTIONS OF THE CLAIMS, GREAT. I DON'T THINK SOME OF THEM CAN DO IT MEANING WENT TO CHECK FINANCIALLY TO SEE IF THEY CAN DO IT BUT I DON'T THINK SOME OF THEM CAN DO IT. BETTER THAN NOTHING IN THE HOSPITAL DISTRICT WE WOULD REDUCE HALF OF THE LIABILITY BECAUSE I HAVE 23 OF THE 50 EMPLOYEES. 23 EMPLOYEES, I DON'T KNOW WHAT THEY TOTAL. THEY ARE ONLY 56 OF THE 130 SO WE ARE HANGING OUT WITH A LOT OF EXPOSURE. IF THEY'RE WILLING TO DO IT AND THEY CAN FINANCIALLY DO IT THAT'S BETTER THAN WHERE WE ARE NOW.

>> THE 475 IS THAT GOING UP? >> WE ARE NOT SURE. THAT WOULD

BE OPEN. >> THAT'S WHY IT IS GENERIC

LANGUAGE. >> THAT PORTION, WE SPREAD BECAUSE OF THE NUMBERS BUT THE COUNTY SHOULD NOT PAY FOR THAT

SOLELY. >> SO, YES CALL ME LATER I WILL HELP YOU FIND A GOOD INSURANCE PERSON IF YOU NEED ONE. MY PLAN IS PRETTY GOOD. I DON'T HAVE AS MANY EMPLOYEES AS YOU DO NOT

ANYWHERE NEAR. >> MAYBE THE COUNTY EMPLOYEES SHOULD GO TO THE HOSPITAL DISTRICT.

>> 56 COVERED PEOPLE I DON'T HAVE THAT MANY AND MY PLAN IS PRETTY GOOD AND PRETTY REASONABLE.

>> IT WAS A WHILE BACK AND WE WERE LOOKING FOR PLANS THAT HAD DEDUCTIBLES PEOPLE COULD AFFORD. WE WILL WORK WITH THE COURT TO DO WHATEVER YOU WANT TO DO.

>> THANK YOU, WE APPRECIATE THAT.

>> DO YOU HAVE A MOTION? >> WE HAVE TO COME OUT OF

WORKSHOP. >> THE WORKSHOP , I CAN ASK

DURING THE REGULAR. >> READY TO GO TO THE REGULAR?

>> WE STILL HAVE TO DO THE PROPOSALS.

>> WHAT PROPOSALS? >> THE RATES.

>> OH, YEAH SORRY. >> SOMETHING EXTRA. WE STILL HAVE ANOTHER TWO HOURS OF DISCUSSION ON THOSE.

>> IT IS WHAT IT IS. I DON'T THINK WE ARE CHARTING OFF ON THE RATES BUT I'M NOT GOING TO ARGUE ALL DAY LONG. IT WILL BE WHAT IT IS OR WE GO UP, BECAUSE THE QUESTION FOR LISA OR WHOEVER WAS AT THIS INCREASE IN RATES DIDN'T WE HAVE A BIG PROJECTION ON WHAT THAT WOULD PUT US IN THE HOLE? NOT EVEN CLOSE TO CHARGING WHAT WE SHOULD BE CHARGING TO ANYBODY.

>> THAT'S CORRECT. IT HAS BEEN STATED IN SEVERAL COMMISSIONERS COURTS LONG BEFORE THIS THAT YOU WANTED TO KNOW ABOUT THESE UNANTICIPATED BIG TRANSFERS WE HAD TO DO AT THE END OF THE YEAR AHEAD OF TIME. THE ONLY WAY I CAN TELL YOU ABOUT THAT IS TO PROJECT NOW WHENEVER WE SET THESE RATES. WHENEVER YOU SET THESE RATES, THAT DETERMINES HOW MUCH MONEY YOU WILL HAVE IN THE SELF-INSURANCE FUND AVAILABLE. IF WE DON'T HAVE ENOUGH TO COVER THE CLAIMS THAT'S WHEN WE HAVE TO PULL AND TRANSFER FUNDS FROM THE GENERAL FUND TO COVER. IN ORDER TO PREVENT THE UNKNOWN TRANSFERS AT THE END OF THE YEAR YOU HAVE TO SUFFICIENTLY BUDGET PREMIUMS AT THE BEGINNING OF THE YEAR. FOR EMPLOYEES AND EMPLOYERS.

APPROXIMATELY 3 MILLION . >> 3,150,000 WITH THE SUGGESTED

[01:15:01]

>> I BELIEVE IT WAS A 3 MILLION DEFICIT. JOHN, CORRECT ME.

>> WE NEED TO STOP SAYING JOHN.

>> I HEARD LISA EARLIER. >> WHAT, WHAT ARE YOU SAYING?

>> MR. BASS PLEASE CORRECT ME. 3 MILLION DEFICIT?

>> FOR THIS PLAN YEAR ENDING 9/30/24 THE DEFICIT IS PROJECTED TO BE APPROXIMATELY 2.5 MILLION. CLARIFYING STATEMENT. WHEN WE CALCULATE THE NECESSARY RATES TO FUND THE PLAN, WE CALCULATE ALL EXPENSES TO THE PLAN , NOT JUST CLAIMS. WE CALCULATE ADMINISTRATIVE EXPENSE, STOPLOSS INSURANCE, MEDICAL AND PHARMACY CLAIMS AND THE OTHER ADMINISTERED OF COST GOES INTO THE CALCULATION OF PREMIUM RATES. IF YOU SET YOUR PREMIUM RATES CORRECTLY INCLUDING STOPLOSS. THEN YOU CAN CHARGE THE OUTSIDE ENTITIES THE APPROPRIATE AMOUNT FOR ALL SERVICES. SO, THAT IS , THE COUNTY IS SELF-INSURED, YOUR FUNDING YOUR OWN PLAN NOT PAYING TO A THIRD-PARTY. IT IS AN INTERNAL BUDGET PROCESS AND WE ARE SIMPLY SHOWING WHAT THE COUNTY NEEDS TO ALLOCATE FOR THEIR SELF-INSURED PLAN.

CERTAINLY, FOR THE UPCOMING PLAN YEAR.

>> WHAT ARE YOU SHOWING THAT TO BE? WHAT IS YOUR RECOMMENDATION THAT WE NEED TO BE DOING ? TO PROPERLY FUND?

>> I CAN SHARE MY SCREEN OR WHOEVER IS SHARING, I CAN GO THROUGH A COUPLE OF SCENARIOS.

>> THINK ABOUT THIS ONE WHAT'S THE OPINION GOING OUT NOT SELF-INSURED SINCE WE ARE SPENDING SO MUCH ON INSURANCE WE WOULD BID THIS OUT AND NOT BE SELF-INSURED. THAT'S ANOTHER QUESTION I FORGOT I HAD.

>> TIM, WHICH VISUAL SHOULD WE BE LOOKING AT?

>> IF YOU WILL GO TO THE FIVE-YEAR LIGHT PATH SHOWING THE DEFICIT WHERE WE ARE IN REGARDS TO OUR CURRENT PLAN.

>> WHICH PAGE IS THAT? >> I KNOW I GAVE THAT TO YOU IN THE PREVIOUS COMMISSIONERS COURT.

>> THE PAGE YOU WERE JUST ON, THE 2025 WAS THE NUMBER I WAS

USING. >> FIVE-YEAR GLIDE PLAN?

>> WHAT WE ARE INITIALLY ASKING IS WHAT IS THE COUNTY BUDGET FOR NEXT YEAR ANTICIPATION? THE PORTION.

>> I WANT TO KNOW WHAT HE RECOMMENDS SO WE DON'T LOSE

OUR TALES AGAIN. >> THAT'S WHAT WE ARE GETTING

READY TO GET INTO. >> THAT RIGHT THERE. THERE YOU

GO. >> GO BACK, OR WEIGHT.

>> THE FIVE-YEAR LIGHT PATH MAY 2024 SHOWING THE PROJECTED

DEFICIT. >> YOU HAD IT. THAT IS FINE

RIGHT THERE. >> THAT WHEN YOU CAN SEE THE 2025 DEFICIT. SAYS UNDER 2025 THEY PROJECT 3,449,000 AND THAT IS WHAT. THAT IS THE AMOUNT THAT IS UNDER FUNDED OR ANTICIPATED. IT COULD BE MORE, BUT THAT IS HISTORICALLY.

>> WHY DOES IT GO DOWN SO MUCH IN 26 AND 27? YOU ANTICIPATE

THE RATE INCREASE? >> YES.

>> SORRY WHAT DO WE NEED TO DO IN YOUR OPINION TO AVOID THE $3.5 MILLION LOSS IN 25? IT'S THAT SIMPLE.

>> THE GLIDE PATH SHOWS THE DEFICIT GOING LEFT TO RIGHT , IT SHOWS THE PROJECTED DEFICIT , WHAT IT WILL BE FOR THE PLAN YEAR ENDING 9/30/24. $2.5 MILLION IT WILL NOT COLLECT

[01:20:01]

UNDERFUND THE PLAN. >> WHAT IS IT GOING TO TAKE? YOU CAN SAY 3.5 MILLION, WHAT'S YOUR SUGGESTION ON HOW THAT BREAKS DOWN BASED ON YOUR KNOWLEDGE OF THE COUNTY BUDGET AND THE EMPLOYEE RATES AND SO FORTH? WHAT IS THE RECOMMENDATION? OBVIOUSLY 7.5% IS NOT GETTING US THERE SO WHAT IS YOUR RECOMMENDATION FOR THIS?

>> LOOKING AT THE 2025 COLUMN, WHAT WE ARE SUGGESTING IN THIS CHANGE EMPLOYEE CONTRIBUTIONS. SO THE PREMIUMS THAT THEY DEDUCTED FROM THE PAYCHECK TWICE A MONTH, THOSE DO NOT CHANGE, THE COUNTY MAKES UP THE ENTIRE DIFFERENCE WHICH IS ROUGHLY A 29% INCREASE TO THE COUNTY PORTION OF THE PLAN.

>> THAT IS YOUR RECOGNITION? >> THE INCREASE ZERO EMPLOYER, THE COUNTY CONTRIBUTION INCREASE.

>> I AM ASKING WHAT YOUR RECOMMENDATION IS. WE HIRED YOU TO MAKE A RECOMMENDATION, YOU ARE RECOMMENDING WE EAT EVERY TIME -- DIME OF IT AND EMPLOYS DON'T? IS THAT YOUR

RECOMMENDATION? >> THIS IS ONE SCENARIO COMMISSIONER. ON THE NEXT PAGE THERE IS A SECOND PAGE. AND AGAIN WE ARE GETTING DIRECTION FROM THE INSURANCE COMMITTEE.

>> THAT'S NOT WHAT I'M ASKING. I AM ASKING YOU. YOU ARE A PROFESSIONAL WE HAVE HIRED TO HELP US THROUGH THIS.

WHAT IS YOUR RECOMMENDATION? YOU SEE THIS ALL OVER THE STATE OF TEXAS. YOU RATTLED OFF 10 COUNTIES YOU HAVE KNOWLEDGE OF, WHAT DO OTHER COUNTIES DO, WHAT IS YOUR RECOMMENDATION? I JUST NEED TO KNOW WHAT YOUR RECOMMENDATION IS. I GET IT, BUT I NEED TO KNOW WHAT YOUR RECOGNITION IS?

>> MAYBE GO THROUGH SCENARIOS FIVE AND SIX. WE HAVE SALARY BANDED RECOMMENDATIONS TO HELP GET OUT OF THE DEFICIT. JOHN AND I WORKED ON THIS TIRELESSLY TO GET THAT INFORMATION SO YOU WOULD HAVE ENOUGH INFORMATION TO MAKE A DECISION.

>> ONE OF THE OTHER SUGGESTIONS FROM THE INSURANCE COMMITTEE WAS IT IS TOO LATE THIS YEAR, BUT AS COMMISSIONER MAREZ HAS BEEN TRYING TO PUSH FOR THE LAST COUPLE YEARS, US GOING OUT FOR BIDS AND GETTING AWAY FROM THIS.

>> GOING OUT FOR BIDS TO NOT SELF-INSURED? I THINK WE ALL

LIKE THAT IDEA. >> THE SUGGESTION WITH THIS ON 7.5% WAS IN THE MEETINGS JUST TO GET US THROUGH THE YEAR AND CHANGING NEXT YEAR, BUT WE HAVE TO HAVE ENOUGH TIME TO GO OUT

FOR BIDS. >> THIS IS STILL SHOWING $3.5 MILLION CONTRIBUTION AND I KNOW GIVEN THE DIFFERENT SCENARIOS.

I AM ASKING BASED ON WHAT HE HAS SEEN IN OTHER COUNTIES AND WHAT HE RECORDS TO CLIENTS, WHAT IS HIS RECOMMENDATION? I

AM ASKING YOUR OPINION. >> WELL, COMMISSIONER, TO ANSWER YOUR QUESTION, IF THE COUNTY DOES NOT WANT TO RUN A DEFICIT FOR ITS SELF-INSURED PLAN, AND NEEDS TO INCREASE ITS CONTRIBUTIONS INTO THE PLAN THROUGH PREMIUM RATE INCREASES.

SUBSTANTIALLY TO THE EMPLOYER PORTION AND WE RECOMMEND INCREASING EMPLOYEE CONTRIBUTIONS BY 7.5% , A

MODEST AMOUNT. >> YOUR RECOMMENDATION IS THAT THE COUNTY , THE COUNTY COME UP WITH I'M TRYING TO GET TO THE 7.5%. WE WOULD HAVE TO COME UP WITH HOW MUCH MORE AND EMPLOYEES WOULD PAY HOW MUCH MORE?

[01:25:02]

>> THE COUNTY WOULD COME UP WITH $3.2 MILLION FROM COMING A COUPLE HUNDRED THOUSAND FROM THE EMPLOYEES. YOU CAN RAISE EMPLOYEE CONTRIBUTIONS IF YOU WOULD LIKE. COMMISSIONER I'M NOT DISPUTING YOUR COMMENT, I'M SIMPLY SAYING THAT THE COUNTY HAS UNDERFUNDED ITS SELF-INSURED PLAN FOR A NUMBER

OF YEARS. >> DOING IT AGAIN THIS YEAR. IN THIS WE FIND THE MONEY IN OUR BUDGET TO FUND. 3.2 OF THE 3.5 WE NEED TO PUT IN 3.2 AND THE RECOMMENDATION BASED ON OTHER COUNTIES IS THE EMPLOYEES SHOULD PAY 250,000 SO LET'S SEE. LET ME DO THAT REAL QUICK. 250,000 DIVIDED BY 250,000÷3 .5 MILLION. COUNTY OUGHT TO PAY 93% OF THAT. EMPLOYEES SHOULD PAY SEVEN AND WE SHOULD PAY 93, THAT'S YOUR RECOGNITION TO THIS COURT? THAT'S WHAT YOU'RE SAYING, YOU WANT US TO PAY 93 AND COUNTY EMPLOYEES TO PAY 7%.

>> THE COUNTY HAS DISCRETION IF IT WANTS TO INCREASE EMPLOYEE

CONTRIBUTIONS MORE THAN 7.5%. >> I GET THAT, I'M ASKING FOR YOUR RECOMMENDATION, WHAT OTHER COUNTIES DO? I GET YOU DON'T WANT TO ANSWER THE QUESTION, BUT ANSWER IT. I GET 3.5, YOU ARE RECOMMENDING TODAY A 7.5% INCREASE BASICALLY THE COUNTY PAYING 93% AND EMPLOYEES PAYING SEVEN IS THAT YOUR RECOMMENDATION? YES OR NO? IF NOT, WHAT IS IT? I'M NOT ASKING YOU, I'M ASKING FOR MR. BASS, PLEASE LET HIM ANSWER THE QUESTION. I HAVE ASKED SIX TIMES AND HAVE NOT GOTTEN AN

ANSWER. >> COMMISSIONER YOU CANNOT FUND THE DEFICIT TO EMPLOYEE CONTRIBUTIONS. EVEN IF YOU DOUBLED EMPLOYEE CONTRIBUTIONS THAT WERE NOT COME CLOSE TO FUNDING YOUR DEFICIT. OVER THE YEARS THE COUNTY HAS PICKED UP THE VAST MAJORITY OF THE COST SHARE FOR SELF-INSURED PLAN. SO EVEN IF YOU RAISE THE EMPLOYEE CONTRIBUTIONS, IF YOU DOUBLE

IT. >> WHAT IS YOUR RECOMMENDATION? YOU DON'T NEED TO KEEP EXPLAINING, I UNDERSTAND. WE HAVE GOTTEN OURSELVES IN THIS BOX. WE HAVE NOT HAD THE POLITICAL WHEREWITHAL TO DO IT SO WHAT IS YOUR RECOMMENDATION TODAY SO I CAN MOVE ON FROM THIS QUESTION, WHAT ARE YOU RECOMMENDING BASED ON WHAT YOU SEE ALL OVER THE STATE AND ALL THE COUNTIES YOU WORK WITH, COULD HEDGING, JUST ANSWER IF YOU DON'T WANT TO SAY IT TO SAY I DON'T WANT TO MAKE A RECOMMENDATION. I NEED A RECOMMENDATION OR A NEED YOU TO

SAY THAT I'M NOT MAKING ONE. >> I CAN'T MAKE A RECOMMENDATION BECAUSE I AM PUTTING SCENARIOS IN FRONT OF THE COURT TO REVIEW TO DETERMINE WHAT IS THE APPROPRIATE , THE APPROPRIATE PATH FOR AT LEAST THIS NEXT PLAN YEAR. THE BOTTOM LINE IS, THE COUNTY, IF IT DOES NOT WANT TO HAVE A DEFICIT FOR THE NEXT PLAN YEAR, THE COUNTY WILL HAVE TO SUBSTANTIALLY INCREASE ITS PORTION OF THE PREMIUM RATES IN ORDER FOR THAT DEFICIT TO GO AWAY.

>> OKAY WE CAN MOVE ON. HE DOES NOT WANT TO ANSWER MY QUESTION, THAT'S FINE. THAT'S NOT A RECOMMENDATION, THAT'S THE EXPLANATION WE ALL KNOW. YOU'RE JUST PUTTING OUT SCENARIOS AND WE HAVE TO CHOOSE WITHOUT YOUR RECOMMENDATION. THAT IS NOT HELPFUL BUT OKAY THAT IS YOUR POSITION.

>> IF I MAY, I DID ASK JOHN TO GIVE A BREAKEVEN ANALYSIS FOR US WHICH WOULD ADDRESS YOUR QUESTION. CAN YOU SHOW THAT INFORMATION FOR THE BREAK EVEN ANALYSIS? WHAT THE COUNTY WOULD HAVE TO PUT INTO THE PLAN TO ACTUALLY , I KNOW THAT, THAT WASN'T MY QUESTION BUT THAT'S OKAY. 3.5 MILLION IN SOME WAY

SHAPE OR FORM. THANK YOU. >> WE PRESENTED SEVERAL SCENARIOS BEFORE THE COURT TODAY TO DECIDE HOW YOU WOULD LIKE TO PROCEED. WITH EMPLOYEE RATES, WE ARE AT A SIGNIFICANT DEFICIT WILL CONTINUE TO BE SO OVER THE NEXT FOUR OR FIVE YEARS LAID OUT BEFORE US SO WE NEED TO DECIDE TODAY IN CONSIDERATION OF OPEN ENROLLMENT OCCURRING IN LESS THAN TWO WEEKS, WHETHER WE WILL RAISE EMPLOYEE RATES, INCREASE EMPLOYER CONTRIBUTION OR LEAVE IT AT THE SAME RATE THAT IT IS.

[01:30:01]

DEFICIT THAT WE HAVE BEFORE US. >> THAT BECAUSE OF LACK OF POLITICAL WHEREWITHAL. IT HAS BEEN VERY INTENTIONAL AND DELIBERATE AND IT GOES ACROSS THE LYRICAL PHILOSOPHY. IF ANYONE WOULD'VE TOLD YOU AS THE INSURANCE UNDERSTANDING WHY HE KIND OF SET THE POLICY AND EVEN COUNTY JUDGES AND COURTS BEFORE THAT AND IT HAS BEEN CONTINUED. NUECES COUNTY DOES NOT PAY ITS EMPLOYEES THE RATES IT SHOULD BE ACROSS THE BOARD PERIOD. THAT IS THE LIVER ACTION WHETHER INTENTIONAL OR UNINTENTIONAL, WHEN WE HAVE TAKEN IN THE BUDGET YEAR AFTER YEAR WE HAVE NOT TAKEN ON A BIGGER BURDEN TO ENSURE EMPLOYEES ARE PAID THE WAGES THAT THEY SHOULD ACROSS THE BOARD COMPARED TO SMALLER COUNTIES IN THE AREA BECAUSE THEY ARE NOT BEING PAID WHAT THEY DESERVED TO BE. THAT IS PART OF THE PROBLEM. WHAT WE TRY TO DO IS MAKE THAT UP BY SAYING WE GET WE WILL NOT PAY YOU WHAT YOUR JOB SHOULD BE PAID CLOSER TO, INSTEAD WE WILL MAKE UP THE DIFFERENCE WITH HEALTHCARE. PAID OFF ONE WAY OR THE OTHER, THAT'S WHY WE ARE HERE. NOT BECAUSE WE HAVE BEEN DERELICT IN WHAT WE SHOULD HAVE OR HAVE BEEN DOING AS A COURT, WE HAVE KNOWN GOOD AND WELL BY REDID THIS. I AGREE IT HAS GONE ACROSS THE POLITICAL SPECTRUM NO MATTER WHAT. WE SEE THIS AS, THIS IS A GIVE WE TRY TO GIVE EMPLOYEES. UNFORTUNATELY WE ARE IN THE TIME WHERE THE NUMBERS, THE TAX RELIEF WE WOULD GET FROM BIG INDUSTRY HAS NOT BEEN ABLE TO KEEP UP. WE HAVE HAD PROTEST FROM LARGE INDUSTRY, LARGE PRETTY TAXPAYERS IN OUR COMMUNITY THAT ARE NOT MAKING UP THE DIFFERENCE SO NOW WE SEE A HUGE BURDEN ON THE REST OF US. SO THAT'S HOW WE ARE FACING WHAT IT IS. THERE ARE SOME BIGGER ISSUES WE NEED TO LOOK AT, YES . AT SOME POINT WE SHOULD STOP AND NEED TO SAY YES WE CANNOT KEEP PAYING AND ASKING THE COUNTY THIS AMOUNT, TAKING THE BURDEN AWAY. WE HAVE DONE IT TO SOFTEN THE BLOW BECAUSE WHEN YOU ONLY GET A SMALL PERCENTAGE INCREASE OF A SALARY INCREASE IF WE GIVE ONE WHICH WE HAVE DONE THE LAST SEVERAL YEARS ESPECIALLY IT IS NOT KEEPING UP WITH INFLATION OR THE GROWING RATE AS IN OTHER COUNTIES. IT IS A MIXTURE OF THINGS. I WOULD SAY NOT THAT WE PUT THE BLAME ON OURSELVES, IN THE END WE COULD HAVE TAKEN BETTER STEPS AS A COUNTY. WE HAVE WANTED TO HAVE TAX RELIEF, EVEN THE MORE PROSPEROUS TIMES AND TIMES NOW WHERE IT IS MORE DIFFICULT, IT HURTS EVEN MORE. ONE OF THE ONLY SOLUTIONS TO THAT WOULD BE LOOKING AT BRINGING SOMETHING MORE EQUITABLE TO BE TO KEEP THE BUDGET THE WAY THAT IT IS AND CONTINUE TO GROW. EVERYTHING IS GOING UP, NOTHING IS GOING DOWN SO THIS IS ONE OF THOSE THINGS, AS WELL. I THINK WE ARE ON THE RIGHT PATH WITH THE DISCUSSION . WE NEED TO LOOK AT HOW MUCH OF A BURDEN DO WE PUT ON THE EMPLOYEE, HOW MUCH DO WE PUT ON THE OTHER ENTITIES THAT HAVE BEEN PART OF THE PROGRAM FOR SO MANY YEARS. THOSE ARE ALL LEGITIMATE CONCERNS AND I THINK WE NEED TO WEIGHT THOSE OUT, BUT GIVE ADEQUATE NOTICE. ONLY ONE MONITORING WAS IN CHD BUT THERE WILL BE OTHER PARTNERS AFTER FOLKS ARE TAKING NOW INTO THE FUTURE WE DO OUR BEST TO INFORM THEM THAT THEY NEED TO BE AWARE OF THE STEPS BECAUSE THIS HAS A DIRECT IMPACT AND BURDEN ON THEIR BUDGETS. THEY MIGHT NOT BE REALIZING THE RUG WILL BE PULLED FROM UNDER THEM.

BECAUSE OF POLICY WE HAVE CARRIED THROUGHOUT THE YEARS.

IN CONCEPT I AGREE WITH A LOT OF WHAT WAS SAID. HOW WE GOT HERE IS UP FOR INTERPRETATION. BUT I WANT TO SAY BE MORE RESPONSIBLE, WE SHOULD BE, I KNOW THAT WE DO NEED TO HAVE EMPLOYEES PUTTING IN MORE, BUT HOW DO WE DO THAT IF WE ARE NOT INCREASING THE SALARY? IT IS ALL TIDYING. NOT JUST ONE SECTION OR ANOTHER. I KNOW IT IS DIFFICULT AND NO MATTER WHICH CONSULTANT WE HAVE TODAY, IT WOULD BE DIFFICULT FOR THEM

[01:35:04]

BUDGET LATER THIS YEAR. >> GREAT COMMENTS AND IT BRINGS A BOY -- DEBATE I HAD YEARS AGO WHICH WAS COUNTY EMPLOYEES WILL NEVER KNOW HOW MUCH WE ARE SUBSIDIZING THEIR INSURANCE , BY MILLIONS OF DOLLARS ALL THEY LOOK AT IS THE BOTTOM LINE WHICH GOES INTO THEIR POCKETS. THEY LOOK AT THE RATES AND SALARIES AND BENEFITS. HE WAS DEAD SET ON DOING IT THIS WAY, BUT I ALWAYS SAID, THE COUNTY EMPLOYEES ARE NOT GOING TO HEAR IT LOUDLY AND CLEARLY HOW MANY MILLIONS WE ARE SUBSIDIZING INSURANCE , THEY JUST WANT RAISES.

>> GETTING A RAISE WITH INSURANCE PREMIUMS GOING UP BUT WE HAVE BEEN COVERING THE COST.

>> RIGHT AND THEY DON'T GET IT BECAUSE THEY DON'T WATCH THIS OR LISTEN TO EVERYTHING THEY JUST SAY I'M ONLY MAKING THIS AMOUNT OF MONEY, BUT IF THEY KNEW HOW MANY MILLIONS THIS COUNTY WAS SUBSIDIZING THEIR INSURANCE, THEY MIGHT THINK DIFFERENTLY OR IF WE STARTED DOING, WILL NOT BE SITTING HERE TO SUBSIDIZE AND WE COULD GIVE MORE RAISES. I'M NOT SAYING WE SHOULD OVERBURDEN THEM WITH INCREASE. I WAS TRAINED TO GET THE GUY TO ANSWER THE QUESTION SO WE CAN MAKE AN INTELLIGENT DECISION BASED ON WHAT OTHER COUNTIES DO WHICH HE HAS NOT DONE FOR ME YET AND WON'T DO AND I'M NOT GOING BACK THERE.

THAT WAS A DEBATE BOARD WOULD SAY I WANTED TO INSURANCE AND IT WAS A THEY WON'T GET IT OR UNDERSTAND HOW VALUABLE IT IS.

THIS IS A PRIME EXAMPLE. IF WE DO THIS BASED ON THE SCENARIO GOING 7.5% AND THEY GO UP 200,000 AND WE PUT IN 3.2 MILLION DO YOU KNOW HOW FAR THAT WOULD GO IN RAISES? INSTEAD WE HAVE TO DO IT SUBSIDIES AND INSURANCE THAT A LOT OF THEM, THEY DON'T , THEY DON'T KNOW. THEY DON'T EVEN KNOW THEY'RE GETTING THIS BECAUSE THEY DON'T SEE IT IN THEIR PAYCHECKS AND I DON'T BLAME THEM. I DON'T KNOW HOW WE GET WHERE WE ARE GETTING OR GET TO WHERE WE ARE GOING BECAUSE WE CAN'T COME UP WITH $3.2 MILLION. WE WOULD HAVE TO RAISE THE TAXES AND PHASE IT IN ARE WE WILL END UP WITH ANOTHER DEFICIT NEXT YEAR WHICH IS A BAD SPOT. IT IS A REALLY BAD

SPOT. >> AND THEN WE HIT THE TAX CAP

ANYWAY. >> SO, SORRY I WAS LATE. 'S WE KNOW EXACTLY WHAT THE FUND BALANCE IS?

>> WE DO, YES. >> THE FUND BALANCE FOR HEALTHCARE FUND? IT IS PROVIDED ON THE ATTACHMENT. I'M SORRY, I DID NOT SEE THE ATTACHMENTS BEFORE THEY WERE ATTACHED TO

THE AGENDA. >> THE FUND BALANCE FOR THE

COUNTY RIGHT NOW. >> FOR THE GENERAL FUND, I DID NOT COME PREPARED WITH THAT NUMBER AT THIS MOMENT. I CAN

GET IT FOR YOUR. >> HARD TO MAKE DECISIONS WITHOUT KNOWING WHAT WE ARE LOOKING AT.

>> I DID GET BALANCE FOR THE SELF-INSURANCE FUND AND IT IS

ATTACHED. >> 1.9 THE OTHER DAY? THAT HAS

PROBABLY CHANGED? >> I BELIEVE 1.968 WAS THE BUDGET SURPLUS. THAT'S WHAT WE DISCUSSED PREVIOUSLY.

>> YES, BUT IT WOULD NEED THE ADDITIONAL 3 MILLION NO MATTER

WHAT WE ARE ANTICIPATING. >> COMMISSIONERS AND JUDGE THE REASON WHY WE LOOKED AT 7.5% INCREASE WAS TO LESSEN THE BLOW

[01:40:04]

27.8%. >> YOU'RE SEEING 7.5% OVER

WHAT THEY ARE DOING NOW? >> CORRECT, YES.

>> WHAT WOULD BE THE TOTAL AMOUNT?

>> CAN YOU SHOW THEM THE SCENARIOS, FIVE AND SIX PROPOSALS FIVE AND SIX? THAT IS IN THE PACKET I HAVE BEFORE YOU IN THE RED ENVELOPE. IN THE LAST HANDOUT SHOWING PROPOSALS FIVE AND SIX. THERE ARE A COUPLE WAYS WE CAN APPROACH THIS. CONSIDER AIDING WHAT YOU ARE SAYING ESPECIALLY FOR LAW ENFORCEMENT WHO WORK REALLY HARD AND PUT THEIR LIVES AT RISK EVERY DAY. WE DID COME UP WITH A SALARY BANDED CONTRIBUTION SCENARIO WHICH WOULD MEAN YOUR PERCENT INCREASE FOR THOSE THAT MAKE 50,000 OR LESS AND WE HAVE THOSE NUMBERS BEFORE YOU, AS WELL. JOHN, DO YOU WANT TO

SPEAK MORE TO THAT? >> LET ME SAY. LAW ENFORCEMENT IS ALWAYS ON THE FRONT LINES AND WE HAVE ALWAYS TAKEN CARE OF LAW ENFORCEMENT. WE HAVE A RIGHT TO DO THAT, BUT SOMETIMES I GET TIRED OF HEARING ONLY CERTAIN GROUPS ARE DOING MORE THAN OTHER GROUPS AND A NO LAW ENFORCEMENT PUT THEIR LIVES ON THE LINE DOING THEIR JOB NOBODY ELSE WANTS TO DO BUT OUR EMPLOYEES TO A GOOD JOB TOO. IN PLACE KEEP THE COUNTY GOING, IF NOT FOR THE EMPLOYEES WE WOULDN'T BE GOING NOWHERE. WE WOULD NOT HAVE WHAT WE HAVE SO IT TAKES EVERYBODY TOGETHER TO MAKE IT WORK AND I DON'T WANT ALWAYS A WE WILL TAKE CARE OF THIS GROUP BECAUSE THEY ARE THE BEST OR THE MOST WHATEVER AND NOT THIS GROUP BECAUSE WHY? BECAUSE THEY ARE CLERKS OR I DON'T KNOW. TO ME THEY ARE ALL IMPORTANT. YOU KNOW , I DON'T WANT TO SAY 7% HERE, 4% OVER HERE. WHY?

>> ACROSS THE BOARD? >> ALREADY TAKING 7.5% AND ANOTHER THAT'S ALMOST 15%. I DON'T KNOW IF I WOULD GO 15%.

ANYWAY, WE NEED TO LOOK AT EVERYTHING ACROSS THE BOARD. I DON'T WANT TO START SPLITTING UP GROUPS. I THINK ALL EMPLOYEES ARE IMPORTANT, ALL EMPLOYEES MAKE THIS COUNTY RUN.

THEY SHOULD ALL BE CONSIDERED ESSENTIAL EMPLOYEES.

>> AGREED. >> I DID HAVE THE OPTION FOR THOSE MAKING LESS THAN 50,000 WHICH IS 70% OF OUR EMPLOYEES.

THAT IS ONE REASON WHY HAVE THE SALARY BANDED CONTRIBUTION EVEN 7.5% INCREASE IS NOT SIGNIFICANT , FOR EXAMPLE EMPLOYEE 39, BIWEEKLY THAT AMOUNTS TO AN INCREASE OF 42,003 CENTS LESS THAN THREE DOLLAR INCREASE FOR THAT GROUP.

AND FOR THE EMPLOYEE PLUS FAMILY WE ARE LOOKING AT $38 INCREASE PER MONTH PER PAY PERIOD. SO EVEN AT 7.5% NOT AN AGGRESSIVE NUMBER IT TAKES INTO CONSIDERATION CONTINUE WORKING WITH THE COUNTY WE DO HAVE A ROBUST PLAN AND I BELIEVE JOHN STATED PREVIOUSLY WE CONTRIBUTE 85% OF THE EMPLOYEE 15% IN TERMS OF WHAT WE PROVIDE FOR THE HEALTH PLAN. SOME SCENARIOS HAVE BEEN PRESENTED TO YOU SO YOU CAN DECIDE WHICH WAY TO GO FORWARD, IF YOU WANT TO DO ACROSS THE BOARD OR SALARY BANDED INCREASE OR IF YOU WANT TO DO NO INCREASE , WE PRESENT ALL OF THAT INFORMATION TO YOU SO YOU KNOW WHAT WE ARE LOOKING

AT. >> I WOULD LIKE TO KNOW HOW IT'S GOING TO AFFECT THOSE 30,035, NOT JUST 50 OR 60.

THOSE ARE BORDERLINE PRIORITY LEVEL BORDERLINE 30 OR 35 THEY WANT TO DO ANOTHER 7.5, HOW WILL IT AFFECT THEM?

[01:45:01]

>> I LISTEN TO WHAT THE EMPLOYEES SAY, EVEN NOW CURRENTLY WITH THE CURRENT RATES THAT WE OFFER IT IS STILL A STRAIN ON THEIR INCOME AND ANY INCREASE WOULD BE ADDITIONAL BURDEN THOSE THAT MAKE LESS THAN 30,000 A YEAR BY THE TIME THEY GET TAXES TAKEN OUT THEY MIGHT BE BRINGING HOME 12 OR 1500 A MONTH. THEY PAY THE RENT, CAR PAYMENT AND INSURANCE AND ANY CO-PAY THEY ARE BASICALLY LEFT WITH , THEY MIGHT BE IN A DEFICIT BY THE END OF THE MONTH WHEN IT COMES TO TRYING TO PAY THEIR BILLS. I DO LISTEN TO THE EMPLOYEES AND TAKE THAT INTO CONSIDERATION. ANY INCREASE IN CONSIDERATION OF EVERYTHING GOING UP. FOOD COST, HEALTH EXPENSE, GAS IS ALMOST 4 DOLLARS A GALLON. I UNDERSTAND THE BURDEN THAT IT

PLACES ON EMPLOYEES . >> LET'S JUST SAY HYPOTHETICALLY WE HAD THIS POOL OF MONEY AND WE WENT IN AND WE SAID WE WILL BUDGET THE 3.5 MILLION AREN'T WE IN THE SAME HOLE AGAIN NEXT YEAR? WILL HE EVER GET OUT? THAT'S MY QUESTION. LET'S SAY WE SAY SUCK IT UP WHEN YOU'RE, FUND 3.5 MILLION, WE WILL BE REASONABLE EMPLOYEES AND PAY WHATEVER CHUNK WE DECIDE TO PAY SINCE WE CAN'T GET A RECOMMENDATION FROM THE CONSULTANT. WHAT STOPS IT FROM HAPPENING AGAIN NEXT YEAR? NOTHING. I DON'T KNOW HOW WE GET OUT OF THIS HOLE. ALSO REMEMBER THE MOTION WE MADE ON ELIMINATING SOCIAL SERVICES WAS ALL THAT SAVING GOES TO RAISES FOR EMPLOYEES SO THAT NEEDS TO BE FACTORED IN. I DO WANT TO SEE THAT TOO, BUT FACTOR THAT IN BECAUSE THAT SHOULD COME INTO PLAY. AT THE END OF THE DAY WHAT'S THE LONG-TERM PLAN? WHAT IS THE LONG-TERM PLAN GETTING THIS HOLE OUT SO WE ARE NOT IN THIS FOREVER BECAUSE WE CAN KEEP PAYING $3.5 MILLION OFFICE IT'S DOWN. I DON'T KNOW WHAT TO DO. WE HAVE TO GET ANOTHER PLAN THAT WE PAY TO A THIRD-PARTY THAT WE HAVE NEVER BEEN ABLE TO DO IN THE PAST FOR SOME REASON. OR WE JUST HAVE TO KNOW WHERE TO PUT IT AS A BUDGET CHALLENGE EVERY YEAR.

>> I THINK THE ANSWER IS THAT WE NEED TO INVEST AND FUND A HEALTH PLAN TO AVOID FUTURE DEFICITS.

>> I GET IT, THAT'S A GREAT THEORY, BUT I NEED SOMETHING THAT SAYS IF WE DO THIS FOR THE NEXT FIVE YEARS OR THIS FOR THE NEXT THREE YEARS OR THIS FOR THE NEXT TWO YEARS WE CAN GET HERE BECAUSE THE FIVE-YEAR GLIDE SHOWS THE NUMBER GOING DOWN BUT I DON'T UNDERSTAND THE MATH ON HOW IT'S GOING DOWN. SO I GUESS I DON'T KNOW, BUT I NEED TO UNDERSTAND THAT MORE BECAUSE I DON'T KNOW HOW YOU ARE PROJECTING THAT GOES DOWN. WE ARE STILL IN THE HOLE.

>> YOU HAVE THE FORECAST THAT I ASKED YOU FOR JOHN ARE USED ON

THE CALL? >> I AM. IF YOU CAN SHOW THE GLIDE PATH AGAIN WHOEVER IS SHOWING THE SCREEN. I CAN WALK YOU THROUGH THE FIVE YEARS AND SHOW YOU WHERE, IF THE COUNTY CAN FIND REVENUE TO FUND A PLAN FOR 25, THEN THE INCREASES PROSPECTIVELY IN 26 AND 27 ARE MUCH MORE PALATABLE. THE PREMISE IS THAT THE COUNTY HAS NOT FUNDED SELF-INSURED PLAN APPROPRIATELY, LEAVING THE DEFICITS. IF YOU CAN BRING EVERYTHING UP TO BREAKEVEN, THEN WE KNOW AT LEAST THE PROJECTION, THE HEALTHCARE TREND IS ON AVERAGE 7.5% WE SHOW IN THE OUTLYING YEARS OF 26, 27 AND 28, IN A PERFECT WORLD NOTHING CHANGES. 7.5% INCREASE WILL FUND THE PLAN AND KEEP IT BREAKEVEN. WE DO KNOW THAT HOPEFULLY THE COUNTY WILL GO OUT NEXT YEAR AND THERE MAY BE SOME OPPORTUNITIES TO SHAVE OFF THE NECESSARY INCREASES THROUGH ADDITIONAL PLAN DESIGN OR CONTRIBUTION SCENARIOS, ET CETERA BUT REALLY THE ASK IS THE COUNTY TO GET THE PLAN TO WHERE IT IS SELF-SUSTAINING.

AND THEN YOU BEGIN TO MANAGE THE PLAN AND IT IS EASIER TO MANAGE 7.5% INCREASE VERSUS 24 OR 30. YOU CAN DO THAT IN A LOT OF WAYS, YOU HAVE MORE THINGS AT YOUR DISPOSAL. SO ESPECIALLY

[01:50:05]

SO THERE WILL NOT BE SIGNIFICANT DEFICITS EACH AND

EVERY YEAR. >> WHICH NUMBER JOHN OR TIM IS THE PROPOSAL ? I KNOW WE HAD THE OPTION TO SPREAD THIS OVER A PERIOD OF TIME. I KNOW IT WAS THREE YEARS WE TALKED ABOUT, WHICH PROPOSAL IS THAT WHEN AGAIN?

>> MORE TO THAT ? FINE-TUNING THE NUMBER THAT THE CORE NEEDS

TO PROVE FOR US TO BREAKEVEN. >> THAT WAS IN THE PREVIOUS PACKET , BUT IN ESSENCE PAY A LITTLE BIT OR PAY A LITTLE BIT MORE OVER A THREE-YEAR PERIOD. AS OF 2027, 9/30/ 27 THE COUNTY WOULD BREAKEVEN, STILL RUNNING A DEFICIT , BUT THE DEFICITS WOULD GET SMALLER AND SMALLER AS THE COUNTY PUT IN MORE MONEY. SO, NOT ALL FUNDING ALL AT ONCE. THAT IS AN OPTION. AT THE COUNTY SAYS WE CAN ONLY PUT IN THIS MUCH MORE, WE KNOW WE WILL RUN THE DEFICIT, IT'S GOING TO BE SMALLER AND WE ARE PREPARED TO PUT MORE IN THE FOLLOWING YEAR, THOSE ARE

OPTIONS, COMMISSIONER. >> THAT WOULD BE SOMETHING.

>> IN ORDER TO GET BACK TO BREAKEVEN.

>> THAT WOULD BE SOMETHING I WOULD BE MORE INCLINED TO START WITH AND SEE WHAT THE COURT SAYS, THAT WOULD BE MY MOTION.

WERE GOING TO EAT THIS WHOLE APPLE, BUT IN THREE BYTES OVER THE NEXT THREE YEARS TO ELIMINATE THIS DEFICIT. AND, I DON'T KNOW WHAT THE OFFICIAL AND WHICH WOULD BE, BUT DO HAVE A GOOD IDEA OF WHAT I'M SAYING?

>> THE 3.5 MILLION SPREAD OUT?

>> 2.5 AND SPREAD IT OUT OVER THREE YEARS, IT WOULD BE

COMPLETE BY THE THIRD YEAR. >> ACTUALLY, THEN THAT MEANS WE'RE STILL GOING TO HAVE THE END OF YEAR UNFUNDED BALANCE.

>> THAT'S EXACTLY WHAT MR. BASS SAID.

>> WE WILL HAVE THE END OF YEAR UNFUNDED BALANCE AND ALL OTHER ENTITIES, ASSUMING THEY ARE PARTICIPATING IN THE INSURANCE FUND, THEY'RE NOT GETTING A SHARE OF THAT EXPENSE.

>> MORE THAN LIKELY THEY ARE GOING TO BE GONE BASED ON WHAT IT SOUNDS LIKE FROM THIS COURT. THEY NEED TO BE GIVEN A HEADS UP , MORE THAN LIKELY THEY WILL NOT BE PART OF THE PLAN UNLESS THEY SHOW THEY CAN BE A SUBSTANTIAL OR FINANCIAL CONTRIBUTOR BECAUSE WE ARE PAYING THE LION SHARE OF THIS AND TAKING ALL THE LIABILITY. AND LITTLE OF THE BENEFIT. I'M NOT WORRIED ABOUT THAT, I'M WORRIED ABOUT THE NUMBER WE SEE TODAY THE 3.5 MILLION. IF YOU WANT TO SAY LET'S PUT IT ALL ON THE EMPLOYEES, I GUESS WE CAN, I WOULD LIKE CONFIRMATION OF THAT AND SPREAD THAT OVER THE NEXT THREE YEARS. WE ARE COMMITTED TO SAYING WE TAKE THAT AMOUNT ON, NOT SAYING WE KICK THE CAN DOWN THE ROAD, WE ARE TAKING ON THAT AMOUNT. I FEEL THIS IS THE MIDDLE GROUND. I HEAR ONE EXTREME AND I HEAR THE OTHER TRYING TO FEEL FOR THE EMPLOYEES AND THE BURDEN THIS PUTS ON THEM. I DON'T THINK THE EMPLOYEES WANT TO TAKE IT ALL ON, BUT WE ARE IN A SITUATION WHERE WE ARE STUCK.

MY SUGGESTION WOULD BE TO PUT A MOTION THAT WE PAY $3.5 MILLION SPREAD EQUALLY OVER THE NEXT THREE YEARS AND THAT'S MY

MOTION. >> HAVE TO TRANSFER AT THE END

OF THE YEAR. >> YOU PAY THE 3.5 MILLION WHETHER YOU PAY AS A PREMIUM FOR YOUR PAY AT THE TRANSFER.

EITHER WAY YOU ARE PAYING. >> IT WILL STILL ACCUMULATE AND THEN YOU ANOTHER DEFICIT NEXT YEAR ADDED ON TOP AND THEN ANOTHER ON TOP OF THAT SO I DON'T THINK THAT WORKS.

[01:55:05]

>> I ALWAYS UNDERSTOOD IT WOULD ONLY BE 3.5 THE WAY IT WAS

PRESENTED PREVIOUSLY. >> THAT DOESN'T MAKE SENSE FOR ME, MAYBE I'M NOT HEARING IT RIGHT.

>> THE 3.5 THEY ARE ASKING THIS YEAR SAYING WE NEED FOR NEXT YEAR'S BUDGET, IN ANTICIPATION WOULD THERE BE A FUN BALANCE MOVING FORWARD? OR A BREAKEVEN AT THE END OF NEXT YEAR AND THEN WE ONLY NEED 1.4 OR 1.5 NEXT YEAR. IT IS NOT DO US ANY GOOD, WE WILL PAY IT AT THE END OF THE YEAR WITH A FUND TRANSFER. YOU CAN HAVE A NEGATIVE BALANCE.

>> WE ARE PAYING, HOW MUCH AND WHEN IS THE ISSUE. I'M SAYING LET'S NOT PAY IT ALL RIGHT NOW.

>> YOU ARE NOT PAYING ANY NOW, YOU PAY THROUGH THE PREMIUMS THROUGHOUT THE YEAR. SO IT WOULD BE THROUGH THE

CONTRIBUTIONS. >> THAT IS PAYING IT, THIS IS PROJECTING FOR 25 , THAT THE EMPLOYEES WOULD PAY 2 MILLION AND WE WOULD PAY 14.3 MILLION. IS THAT WHAT I'M READING RIGHT BASED ON THE PROJECTION OF 25? ON THE FIVE-YEAR GLIDE. THIS PROJECTS NO INCREASE. I DON'T KNOW. I GUESS I WILL GO. I DON'T KNOW WHICH SCENARIO. AT THE END OF THE DAY IT IS HUGE.

>> THE EMPLOYEE WOULD PAY 2.1.

>> WHICH ONE ARE YOU ONE? >> I WAS ON SCENARIO ONE.

>> SCENARIO TWO I GUESS 7.5% INCREASE THE EMPLOYEES WOULD PAY 2.1 AND WE WOULD PAY 14.1 MILLION. SO, WHICH?

>> APPROXIMATELY THE 3 MILLION

>> THE EMPLOYEES ONLY PICKING UP APPROXIMATELY 200,000.

>> REQUIRED CONTRIBUTION THAT BALANCES IT. THE SCENARIO BALANCE MEANS WE WOULD GO UP SO THAT MEANS 2.116 , DIVIDED BY THE TOTAL. I DON'T KNOW HOW YOU FACTOR IN THE REBATES BECAUSE THE REBATES WE GET BACK REVENUE RIGHT? OKAY SO TOTAL REVENUE WE ARE PAYING ON THIS PROJECTION 14.177 MILLION DIVIDED BY 14,177,000÷17 720 , 000 , WE ARE PAYING UNDER THIS SCENARIO THE COUNTY PAYS 80% OF THE PREMIUMS AND THE EMPLOYEE PAYS 20. THAT IS, I WOULD, THIS IS WHERE I HOPE THE EMPLOYEES AT LEAST APPRECIATE BECAUSE I WOULD WELCOME YOU TO GO FIND A PLAN AROUND THE STATE THAT THE COUNTY IS PAYING 80%. I DON'T

PAY THAT KIND OF PREMIUM. >> IT SHOULD BE WRITTEN IN THE

BOTTOM. >> I'M JUST SAYING BECAUSE I AT LEAST WANT A PLACE TO ACKNOWLEDGE WE ARE PAYING 80% OF THE PREMIUMS, 80% UNDER THIS SCENARIO, WE OUGHT TO GET SOME

CREDIT SOMEWHERE. >> THAT WAS USED TWICE VERSUS THE RAYS. THAT WAS HIS THING . IT KEPT ON GOING. SO, WE TRIED TO GO TO TO THE PRIVATE WE SHOULD TRY TO GO HARDER TO GO TO PRIVATE BUT WE DIDN'T, WE STAYED. I AM ASKING IF , AGAIN I DON'T KNOW WHAT THE FUND BALANCES.

>> I HAVE THE FUN BALANCE. ALL I HAD TO DO WAS RUN THE REPORT, RIGHT NOW THE GENERAL FUND IS 39,061,483. NOW, KEEP IN ACCOUNT WE HAVE ALREADY COLLECTED THE MAJORITY OF PROPERTY TAXES FOR THE YEAR. SO THAT IS FOR THIS YEAR, FOR THE YEAR WE ARE IN, THE FISCAL YEAR ENDING 9/30/24. WE ARE AT 39,061,000. WE HAVE COLLECTED THE MAJORITY OF REVENUE AND EXPENSES ARE GOING TO CONTINUE. SO THAT FUND BALANCE IS GOING

TO DROP HARD. >> PROJECTED IS 25 MILLION.

[02:00:03]

RIGHT? >> WHAT'S THE GENERAL FUND

BALANCE? >> THE FUND BALANCE TODAY WHICH HE IS ASKING FOR IS 39,000,001 61,004 83. IN THE GENERAL FUND.

AGAIN, YOU WILL HAVE A LOT OF EXPENSES.

>> ANTICIPATED END OF YEAR. YOU HAVE TWO MORE MONTHS OF

EXPENSES AND NO MORE REVENUE. >> ANTICIPATED END OF THE YEAR FUN BALANCE IS WHAT YOU GAVE THE 25 AD NOT LONG AGO.

>> NOT 28? >> ESTIMATED END-OF-THE-YEAR FUND BALANCE WILL BE RUN 20 MILLION CONSERVATIVELY. 22. 20.

>> WE WERE AT 28. >> 25 LAST YEAR.

>> IT WENT BACK TO 28 AND 25. BETWEEN 20 AND 25 I DON'T KNOW WHAT HAPPENED. THE THING IS, I WAS THINKING IT WAS 25.

>> THE FUND BALANCE 9/ 30/23 WAS 25,782,000 $25,782,284.

REMEMBER, THIS YEAR , WE ADOPTED THE NO NEW REVENUE RATE. OUR REVENUE DID NOT GO UP, WE DID NOT COLLECT FROM SOME OF OUR PROPERTY TAX OWNERS AND TAXING ENTITIES. WE DID NOT COLLECT THE AMOUNT ASSESSED. THEY WERE DISPUTED AND SETTLED FOR A DRASTICALLY LOWER AMOUNT, THEREFORE THE REVENUE THAT WAS BUDGETED WAS NOT RECEIVED BECAUSE THEY SETTLED FOR MUCH

LOWER AMOUNT . >> WE GOT SOME.

>> YOU GOT SOME, BUT HALF , I UNDERSTAND HAVE IS BETTER THAN NOTHING, BUT WE WERE GETTING HALF BEFORE. THIS TIME, HAVE BECAME A LOT MORE MONEY THAN IT WAS IN PREVIOUS YEARS BECAUSE OF THE APPRAISED VALUE. SO THERE WAS A SIGNIFICANT CHUNK OF THE BUDGETED REVENUE THAT WE KNEW WE WOULD NOT COLLECT, YET COMMISSIONERS COURT TOOK ACTION TO ADOPT THE NO NEW REVENUE RATE. SO YES I AM ANTICIPATING THE FUND BALANCE IS GOING TO

TAKE A HUGE HIT THIS YEAR. >> GOING FROM 25 TO 20? ON TOP OF THAT EATING 3 MILLION FOR THIS THEN WE ARE DOWN TO 17.

>> IF YOU, YES. >> WE NEED TO KNOW WHAT WE ARE

VOTING ON. >> PAYING HALF, WHO KNOWS.

>> I KNOW WE HAVE A UNFUNDED HEALTH INSURANCE FUND BALANCE OF 2.5 MILLION THIS YEAR. EVEN IF I START OFF WITH THE 25 AND I ASSUMED WE BROKE EVEN THIS YEAR, 2.5 MILLION YOU WILL GET MAD AT ME IF I DON'T DISCLOSE I HAVE TO TRANSFER THAT OUT.

SO, TAKING THAT 2.5 OFF IS WHERE MY 23-22 CAME FROM AND

THAT'S THE MATH. >> I DON'T THINK WE CAN MAKE A DECISION TODAY. WE DON'T KNOW WHAT IT IS. WE DON'T HAVE GOOD ENOUGH NUMBERS FOR US TO DECIDE WHAT TO DO WITH RESERVES OR NOT. WE DON'T KNOW WHAT THE RESERVES WILL BE, WE HAVE TO MAKE A DECISION TODAY ON HOW MUCH INCREASE WE WILL PUT ON

THE EMPLOYEES PERCENTAGEWISE. >> AND THE OUTSIDE ENTITIES.

>> THAT FOR SURE, THAT'S DIFFERENT. THE WHOLE GRANDFATHER THING WE CAN WAIT. AT LEAST GET SOME DIRECTION ON THAT, BUT THEM AND I DON'T KNOW HOW WE DECIDE WHAT TO DO TODAY ON, OTHER THAN THE PERCENTAGE FOR THE EMPLOYEES BECAUSE WE HAVE TO GO TO OPEN ENROLLMENT. TO ME THAT'S THE DEBATE. I DON'T KNOW HOW WE DECIDE. WE DON'T KNOW THE RESERVES, WE DON'T HAVE THE NUMBERS.

>> AGAIN, I AM ANTICIPATING THE FUND BALANCE FOR THE GENERAL FUND TO BE APPROXIMATELY 22 MILLION.

>> YOU ARE ANTICIPATING BUT YOU DON'T KNOW.

>> WILL NEVER KNOW UNTIL THE BOOKS ARE CLOSED.

>> WE NEED TO BE CLOSE. >> 20 MILLION IS AN EXTREME THE CONSERVATIVE NUMBER BECAUSE I KNOW WE UNDERFUNDED HEALTH INSURANCE BY 2.5 MILLION. IT IS A KNOWN AMOUNT. SO I TAKE 25 MILLION, SUBTRACT 2.5, 22 IS A GOOD NUMBER AND THAT IS ASSUMING REVENUES CAME IN REALLY HIGH AND EXPENSES COME

IN LOW. >> SHE SAYS FUNDING THIS YEAR.

>> THE END OF 9/30. >> RIGHT NOW SHE KNOWS WE ARE

[02:05:06]

>> THAT'S THE REASON WHY SETTING THE PREMIUMS TO COVER THE CORRECT AMOUNT IS IMPORTANT BECAUSE IF YOU DON'T, THEN AGAIN WE WILL BE HERE NEXT YEAR SAYING HEY, WE NEED ANOTHER 3 MILLION. REMEMBER THE 3 MILLION WE DID NOT COVER IN PREMIUMS? WE NEED THAT NOW AND YOU HAVE TO TRY TO COME UP WITH 3

MILLION. >>

>> THE 22 MILLION , AGAIN A REALLY ROUGH ESTIMATE, THE 22 MILLION COVERS THE 2.5. FOR THIS YEAR.

>> THAT IS NOT TOUCH THE DEFICIT FOR NEXT YEAR.

>> DOES NOT TOUCH THE DEFICIT FOR NEXT YEAR, BUT NEXT YEAR PROPERTY TAX RATES HAVE NOT BEEN SET SO THERE COULD BE OFFSET. YOU COULD OFFSET BY HAVING PROPERTY TAX RATES HELPING TO FUND THE KNOWN DEFICITS. THAT IS THE ADVANTAGE OF HAVING THESE CONVERSATIONS AHEAD OF TIME INSTEAD OF AT THE

END OF THE YEAR. >> I THINK THE PROPOSALS IN THE BINDER THAT WE HAVE TO MAKE THE DECISION ON LIKE THE SALARY PROPOSAL BASED ON SALARIES AND THE LEVEL. THE DIFFERENT , THE PROPOSALS THEY HAVE IN THE BINDER EITHER THE COUNTY PICKING UP 100% OR THE DIFFERENT PERCENTAGES THAT THE EMPLOYEES WOULD TAKE ON , AND THEN THE OPTIONS TO LOOK AT THE EMPLOYEE SHARE BASED ON THEIR SALARIES. THEY HAVE DIFFERENT PERCENTAGES WE WOULD GO TO, THOSE ARE YOUR CHOICES. EITHER

100% COUNTY >> IS THAT LEGAL TO DO? CAN WE, LET'S SAY WE DECIDE TO DO AN AVERAGE OF 10% BUT WE DON'T WANT TO POP THE LOWER IS THAT DISCRIMINATORY OR ALLOWED TO SAY BECAUSE YOU MAKE A HIGHER SALARY YOU WILL PAY A HIGHER

PERCENTAGE? >> IN THE PROPOSALS PRESENTED 7.5% WAS MODEST, WE COULD MAKE THAT HIGHER OR LOWER.

>> CAN YOU MAKE IT DIFFERENT FOR DIFFERENT LEVELS OF PEOPLE WITH DIFFERENT SALARIES? 10% WILL HIT SOMEONE AT 30 HARDER THAN SOMEONE MAKING 60, BUT IS THAT LEGAL TO DO?

>> MANY DIFFERENT EMPLOYERS, INCLUDING GOVERNMENT ENTITIES AND CAN YOU SPEAK MORE TO THE LEGALITY OF THAT?

>> YOU CAN CLASSIFY PREMIUMS BY SALARY. IT IS DONE ALL THE

TIME. >> SO, THE PROPOSAL THAT I PRESENTED WAS FOR THOSE MAKING LESS THAN 50 TO HAVE A 0% INCREASE OR MODEST INCREASE OF 5% AND THOSE MAKING MORE WOULD ABSORB MORE OF THE COST, EVEN STILL WITH THOSE RECOMMENDATIONS IT IS A MODEST INCREASE. WE CAN DO FLAT ACROSS THE BOARD, WE CAN DO SALARY BAN OR WE CAN DO NOTHING.

>> SALARY BAN MAKES IT MORE PALATABLE. I DON'T KNOW WHAT TO DO. I DON'T KNOW HOW WE WILL PAY FOR IT EITHER.

>> EVEN THAT POLICE AND PERCENT OF EMPLOYEES MAKE LESS THAN 50,000 THAT'S WHY SALARY BANDED CONTRIBUTION WAS

PRESENTED. 7% OF SALARY . >> MORE CONTRIBUTIONS INDEED.

ONE OF THE PACKETS BEFORE YOU SHOWS THAT NUMBER.

>> WHERE ARE YOU AT? WHAT PAGE?

>> SHOULD WE START MAKING MOTIONS?

>> READY TO COME OUT OF WORKSHOP?

>> NOT MAKING A MOTION. >> IF WE ARE READY TO DO THAT.

>> THE WAY IT LOOKS ANYTHING UNDER 50 NO INCREASE

>> HE SAYS MODEST. >> MODEST I DON'T KNOW WHAT MODEST IS. ANYTHING ABOVE, ANYBODY MAKING ABOVE WILL PAY

[02:10:03]

TWICE AS MUCH? >> IF I CAN POINT OUT, WHAT IS ON THE SCREEN IS MORE THAN ONE SCENARIO. THIS IS JUST ONE OPTION COVERING TWO PAGES, UNDER 50,000 THEN YOU HAVE 50 TO 75. THE NEXT PAGE 75 TO 100 AND THEN OVER 100. THE SECOND SCENARIO, IF YOU SCROLL DOWN SOME MORE. 50,000, UNDER 50,000 , THERE ARE THREE SCENARIOS HERE.

>> 100 PER PAY PERIOD? >> THIS IS ANNUAL SALARY.

ANNUAL SALARY. >> SO IN PLAN THREE IS THAT

WHAT THIS IS? >> I'M SORRY, I'VE BEEN USING THE PAGE NUMBERS TO HELP ME KEEP TRACK. ONE AND TWO IS ONE SCENARIO. AND THEN THREE AND FOUR AND THEN YOU HAVE FIVE AND

SIX. THIS IS . >> CAN GO BACK AND SHOW TWO

AGAIN? >> THE MEDIUM INCREASE IS SCENARIO TWO. IN THE MIDDLE SCENARIO TWO.

>> 4.5% INCREASE UNDER 50,000 NOT 7.5 ONLY DOING 4.5, 7% 50,000 TO 75 AND 15 PEOPLE MAKING 75,000 UP TO 100 , 15%

OVER 100 AT 20%. >> AVERAGING 7.5%?

>> THAT WILL GET YOU TO THE 7.5% WITHOUT PUTTING THE BURDEN

ON LOWER PAYING EMPLOYEES. >> NO MATTER WHAT WE DO IT'S NOT ENOUGH SO YOU WILL DECIDE AND I WILL GO LONG. NO MATTER WHAT WE DO IT'S NOT GOING TO WORK. WE ARE SCREWED NO MATTER HOW WE DO THIS SO IT'S JUST A MATTER OF HOW.

>> IT IS NOT A PRETTY SCENARIO. SO, ARE WE READY TO COME OUT OF THE WORKSHOP? IT IS 11:17 AND WE ARE COMING OUT OF THE

[1. Discuss and consider authorizing and approving Nueces County’s Employee Self-Funded Group Health programs and ancillary services renewals for the plan or 2024-2025 as presented by the County’s Insurance Consultant, McGriff Insurance Services, LLC: Ancillary Benefits Renewal rates by product Third Party Administration (TPA) Self-Funded Group Health plan design and contributions]

ALL THE DISCUSSION. ANYONE ? >> WHAT DO YOU WANT TO DO?

>> ACCEPT A MOTION IF SOMEONE HAS ONE. WE ARE IN THE REGULAR

AGENDA WE CAN DO A MOTION. >> A SUGGESTION, THERE ARE THREE PARTS TO THIS AND THE FIRST SHOULD BE APPROVING

RENEWALS. >> JUST FOR THE EMPLOYEES?

>> NOT THAT PART, THE NEW RULES OF THE HEALTH PLANS FIRST.

>> THREE DIFFERENT VOTES FOR ALL THESE ON THE BOTTOM. OKAY

PERFECT. >> GOOD THAT MOTION INCLUDE DIRECTION TO GO OUT FOR RFP, THE ONLY WAY I WANT TO CONTINUE IS BECAUSE WE'RE GOING OUT FOR RFP AND I LIKE DIRECTION TO HAVE THAT YOU CAN START WORKING ON THAT WITH DIRECTION FROM US.

>> THAT'S A GOOD IDEA. >> START EARLY, START NOW.

>> MOTION ON THE BENEFIT RENEWAL RATES?

>> NOT ON THE RATES, THE RENEWAL OF THE PLAN.

>> IT SAYS RATES ON HERE. PLAN, YES, VERY GOOD.

>> MOTION WOULD BE TO RENEW THE PLAN BUT TO DIRECT PURCHASING AGENT TO IMMEDIATELY GO OUT FOR THE RFP TO LOOK AT A COMPLETE OVERHAUL OF THIS CURRENT PLAN FOR THE NEXT YEAR. THAT WOULD

BE MY MOTION. >> OUTSIDE THE COUNTY?

>> HOLD ON. THAT'S TRUE BECAUSE .

>> WHAT I TAKE FROM THIS IS YOUR GIVING DIRECTION TO START WORKING ON THE RFP. AS SOON AS I GET DEFINITIVE ITEMS AS TO

[02:15:02]

BEFORE WE GET DOWNSTREAM. >> ADD TO THE MOTION IN THE RFP DON'T INCLUDE OUTSIDE NON-COUNTY EMPLOYEES.

>> MY MOTION IS GOING TO BE TO ADD THEM WITH A CONTRACT

STATING THAT THEY PAY. >> THAT IS DIFFERENT THIS IS FOR NEXT YEAR'S PLAN. THE RFP FOR NEXT YEAR'S PLAN.

>> THIS IS JUST RENEWING THE PLAN.

>> I KNOW YOU WANT TO GET ME GOING.

>> THAT IS NOT HAVE TO DO IT TODAY.

>> I WILL HAVE, YOU HAVE COURT NEXT WEEK, I CAN HAVE A CLEAN AGENDA ITEM FOR THAT REQUEST. FOR THE RFP AND THE DIRECTION

YOU WANT ME TO TAKE. >> THAT WILL BE FOR THE NEXT YEAR NOT AFFECTING THIS YEAR. THERE IS NOT TIME.

>> MORE PROPER IF I CAN WRITE AN AGENDA ITEM.

>> WE CAN DO WHATEVER WE WANT.

>> WE ARE DIRECTING HIM BUT WE NEED TO RENEW THE PLAN NOW.

>> SO, HE HAS A MOTION FOR THAT . WE HAVE A MOTION AND A SECOND? ALL THOSE IN FAVOR SAY AYE. ANY OPPOSED SAME SIGN? THE MOTION PASSES. AND THEN THE NEXT MOTION WE NEED IS ON THE THIRD-PARTY ADMINISTRATION. THAT'S WHAT'S ON MY LIST.

WHAT IS THE MOTION WE NEED? >> THAT WHEN YOU MADE.

>> THAT WAS ALL-ENCOMPASSING. >> THE OTHER MOTION I WOULD LIKE TO MAKE IS ON OUR OUTSIDE ENTITIES THAT ARE ON THE PLAN TO RENEW THE AGREEMENT WITH THEM FOR THIS YEAR. MOVING FORWARD, IF THEY WANT TO CONTINUE THIS YEAR, THAT THEY NOT ONLY PAY THE EMPLOYER PORTION , EVEN INCLUDED THE EMPLOYER PORTION OF THE STOP LOSS, THEY PAY UP TO WHEN THE STOP LOSS KICKS IN FOR THEIR INDIVIDUAL RISK. WHETHER IT BE EMPLOYEE OR THE EMPLOYEE BENEFICIARIES OR OVER THE FAMILY MEMBERS ARE LISTED ON THE PLAN.

>> ALL CLAIMS UP TO THE STOP LOSS.

>> PHYSICALLY MOTION TO NOTIFY ALL THE NON-COUNTY EMPLOYEES AND THEIR ENTITIES THAT THEY HAVE TO PAY NOT ONLY PREMIUMS THEY ALREADY PAY, BUT THERE PORTION OF STOPLOSS PREMIUMS AS WELL AS ANYTHING UP TO THE STOPLOSS. YES.

>> THE NUMBER IS 475,000. >> DON'T GIVE SPECIFIC NUMBER BECAUSE THAT COULD CHANGE SOON. WHATEVER THE NUMBER IS, IT IS.

I DON'T WANT TO PUT A CAP ON IT. IF IT GOES UP OR SOMETHING HAPPENS WITH THE NEXT PRESENTATION, I WILL SECOND

THAT. >> WE HAVE A MOTION AND A SECOND, ANY OTHER DISCUSSION? DID YOU GET THAT ORDER DOWN

CORRECTLY? >> THIS WILL NO TO PUT THEM ON

NOTICE. THEY ARE IN OR OUT? >> THEY HAD A CHOICE, BUT IT IS THERE RISK, NOT THE COUNTY RISK.

>> SINCE INITIATING A FLURRY OF MEETINGS FROM OUR PARTNERS PROBABLY MOST OTHER THAN THE HOSPITAL DISTRICT THEY HAVE NO IDEA THIS IS COMING. I DON'T THINK THIS IS GOOD POLICY. I UNDERSTAND THE POINT AND I AGREE AND IT'S THE CIRCUMSTANCE AT THE TIME. A MONTH OR TWO AGO THIS WOULD HAVE BEEN MUCH EASIER FOR ME TO ACCEPT. THIS IS QUITE A QUICK TURNAROUND FOR GROUPS THAT HAVE THE BUDGETS IN BY SEPTEMBER 30

APPROVED AND EVERYTHING. >> I AGREE WITH THAT.

>> I DON'T KNOW WHY WE WAIT SO LONG. EVERY TIME IT COMES UP AT

THE END WE KNOW ABOUT THIS. >> IN LIGHT OF THE INFORMATION WE WERE GIVEN ABOUT THE COUNTY BUDGET I DON'T HAVE A CHOICE, THE COUNTY CANNOT AFFORD TO PICK UP THE TAB FOR ANY OTHER ENTITIES. I DO AGREE IT SHOULD HAVE MORE NOTICE.

>> THIS GIVES THEM PLENTY OF NOTICE TO GO BACK TO SEE IF THEY CAN DO THIS. I WOULD RATHER CUT THEM OFF. I THINK WE OUGHT TO CUT THEM OFF, IT IS COMPLETELY BAD POLICY WHAT WE HAVE BEEN DOING 25 YEARS AND TO TAKE RESPONSIBILITY BECAUSE I HAVE BEEN PART OF IT. I'M ONLY DOING THIS AS A COMPROMISE. I DON'T THINK SOME OF THEM, WILL EVEN BE ABLE TO AFFORD IT, IF

[02:20:02]

IT HAPPENS. >> YOU THINK THIS IS A GOOD

COMPROMISE? >> IT IS A COMPROMISE.

>> GOOD OR BAD FOR ANY OF US, THE COUNTY.

>> YOU FEEL IT IS A COMPROMISE AND I FEEL IT IS A COMPROMISE.

>> A MOTION AND A SECOND, IF THERE IS NO OTHER DISCUSSION ALL OF THOSE IN FAVOR SAY AYE ANY OPPOSED? SAME SIGN, THE MOTION PASSES. AND THEN THERE WAS A THIRD MOTION WE WERE

EXPECTING. >> FOR THE EMPLOYER PORTION OF THE RATES. EMPLOYEE AND EMPLOYER.

>> WE WILL HOLD ON HOW WE TALK ABOUT WHAT WE DO.

>> JUST THE EMPLOYEE RATES WE HAVE TO DO. I AM INCLINED TO GO WITH OPTION NUMBER TWO, THAT PUTS A LESSER BURDEN ON THE

LOWER PAID EMPLOYEES. >> CAN SOMEBODY PULL UP OPTION NUMBER TWO. AS IT SPREADS IT AROUND, I THINK IT WAS 4.5% ON THOSE MAKING UNDER 50,000 INSTEAD OF THE ORIGINAL .

>> IF I CAN CLARIFY , JUST TO CLARIFY YOU ARE CHANGING FROM A FLAT RATE TO A SALARY BAND STRUCTURE FOR THE RATES.

>> THAT WAS THE OPTIONS IN FRONT OF US, IS THERE SOMETHING

ELSE? >> IT IS COMPLETELY DIFFERENT FROM ANYTHING WE HAVE DONE HISTORICALLY. NE

A BAND BEFORE. >> WHAT DO MOST COUNTIES DO? WHAT IS THE CONSULTANT , WHAT DO MOST COUNTIES DO ON THIS?

>> MISSION A, IT'S GOING TO VARY. BASED ON COUNTY, I DON'T HAVE ANY SPECIFIC INFORMATION TO PROVIDE YOU, BUT IN GENERAL, CONTRIBUTIONS BY SALARY BAND IS NOT UNCOMMON IN GENERAL. I THINK IT MAKES POSSIBLY SENSE FOR THE COUNTY SINCE YOU HAVE SUCH A WIDE AND DIVERSE POPULATION, ESPECIALLY THOSE EARNING LESS THAN $50,000 THAT EQUATES TO A LITTLE OVER 70% OF THE WORKFORCE, IT MIGHT MAKE SENSE TO GO TO A SALARY BAND BASED ON THAT, BUT AGAIN IT IS PART OF THE CULTURE OF THE COUNTY, IF YOU WANT TO BEGIN TO STRATIFY CONTRIBUTIONS BASED ON

TOTAL COMPENSATION. >> KEEP IN MIND, IF WE VOTE ON A SALARY BAND CONTRIBUTIONS THIS YEAR, AND WE DECIDE NEXT YEAR TO UNDO IT WE MIGHT HAVE TO UNDO EVERYTHING WE DID

TODAY. >> IT CAN BE DONE?

>> I WILL ECHO TIM'S POINT, I REALLY THINK THE COUNTY NEEDS TO MAKE SURE, THIS IS THE APPROACH THAT THEY WANT TO TAKE MOVING FORWARD. IT IS PART OF THE CULTURE BUT THE COUNTY IS DEVISING IN WHICH HIGHER COMPENSATED EMPLOYEES WOULD PAY MORE TO THE COST OF THE PROGRAM. IT MAY BE CHALLENGING TO UNDO IT , AT SOME POINT AND TIME, BUT I WOULD SAY WHILE IT IS AN OPTION WORTH CONSIDERING, IT IS SOMETHING THE COUNTY SHOULD ENTER INTO WITH EYES WIDE OPEN.

>> BASICALLY WE DON'T HAVE THE OPTION, WE NEED TO DO 7.5% ACROSS THE BOARD ESPECIALLY FOR ONE YEAR IN LIGHT OF NOT ENOUGH INFORMATION IN FRONT OF US AND WHAT IT'S GOING TO DO IN THE FUTURE. WE REALLY HAVE ONE OPTION. OR ZERO AND THE COUNTY

PICKS UP 100%. >> CERTAINLY WE CAN DO MORE

THAN 7.5%. >> WE MIGHT AS WELL DO THE WHOLE THING AND IT'S NOT GOING TO CREATE ANYTHING.

>> IF YOU TRY TO INCREASE THE FUTURE RATES TO THE EMPLOYEES, YOU WILL NEVER BE ABLE TO GET ANYWAY. IF YOU DON'T START GIVING AT LEAST SOME SHARE. EVEN IF IT IS A SMALL SHARE, THEN YOU'RE GOING TO HIT THEM WITH A HUGE INCREASE AND THEN

YOU WILL HAVE THAT FALLOUT. >> WELL, DO I HAVE A MOTION?

>> FOR WHICH ONE? >> MOTION TO DO 7.5%.

>> 7.5 , TO THE EMPLOYEES AND A FLAT?

[02:25:02]

>> EVERYBODY GETS 7.5% FOR THIS YEAR IN LIGHT OF THE BUDGET. I DON'T THINK WE CAN'T NOT DO ANYTHING. THAT'S MY MOTION. I DON'T KNOW IF ANYBODY ELSE AGREES WITH IT.

>> I THINK IT SHOULD BE MORE BUT IN THE SPIRIT OF COMPROMISE

I WILL SECOND FOR DISCUSSION. >> I THINK IT WILL BE LESS.

>> RIGHT, THAT'S THE PROBLEM WE HAVE HOW DO WE PAY FOR IT? NOBODY WANTS TO DO IT, BUT HOW DO WE COME UP WITH ANY MONEY?

>> UNDERNEATH IT IS A THREE DOLLAR INCREASE ON THE PREMIUM.

>> I WOULD RATHER GIVE RAISES.

>> SO, THERE'S ANOTHER SCREEN THAT HAS BASICALLY.

>> WE KEEP FUNDING 3 MILLION A YEAR WITH NO RESERVES? THAT'S THE ALTERNATIVE. THAT'S THE HARD PART, WE ARE IN THE BUDGET CYCLE. IF YOU KNEW YOU WOULD RAISE TAXES TO OFFSET THEN IT WOULD BE EASIER. IF THERE IS A SIGNIFICANT TAX INCREASE THIS ALL, WE DON'T KNOW WHAT THAT'S GOING TO DO EITHER.

>> IF YOU DO 7.5% I BELIEVE THIS IS PER MONTH TO THE EMPLOYEE , IT IS, IF THEY ARE EMPLOYEE ONLY IT IS $2.93 .

INCREASED IF IT IS EMPLOYEE PLUS CHILDREN 2269, YES, THAT COLUMN FOR THE EPO THE NETWORK IF YOU LOOK RIGHT BELOW THAT, ON THE AETNA NETWORK THOSE ARE THE RATES SO THE EMPLOYEE WOULD BE ABLE TO LOOK AT THIS AND SEE WHICH COVERAGE THEY HAVE, WHETHER IT IS EPO NETWORK OR THE AETNA PLAN AND THEN YOU CAN LOOK OVER HERE AND THAT IS YOUR MONTHLY INCREASE.

>> AGAIN LET'S REMEMBER NO MATTER WHAT WE DO WE WILL HAVE

TO PAY 80 TO 93%. >> THAT IS NEXT TO IT, DEPENDING ON WHICH COVERAGE IS SELECTED, IT SHOWS YOU HOW MUCH THE COUNTY WOULD BE PICKING UP. THE INCREASE, YES.

>> UNLESS THERE IS ANOTHER MOTION, I HAVE A MOTION ON THE

FLOOR, FOR THE 7.5%. >> THAT IS ONE, THIS YEAR NOT

ANNUALLY. >> WE ARE HOPING TO DO SOMETHING TOTALLY DIFFERENT. OTHERWISE IF I DON'T HAVE A

SECOND. >> I THINK IT IS NOT HIGH ENOUGH BUT I SECOND FOR DISCUSSION. AS A COMPROMISE.

>> I AGREE WITH WHAT COMMISSIONER GONZALEZ MENTIONED, MAYBE THE MICROPHONE DID NOT PICK IT UP. THAT'S THE CONSTANT BATTLE THAT YOU HEAR. WE GOT A RAISE BUT PAYING THE DIFFERENCE IN THE HEALTHCARE, I GUESS YOU CAN TRY TO EVEN IT OUT. EASIER TO ACCEPT THAN NOT GETTING PAID ANY INCREASE IN

STOCK TO MAKE A DIFFERENCE. >> OKAY LET'S DO THE MATH.

>> IF YOU PAY MORE FOR INSURANCE.

>> HOLD ON, WE SET ASIDE LET'S TALK ABOUT THAT, WE SET ASIDE IF WE STICK WITH WHAT WE DID BY ELIMINATING SOCIAL SERVICES WHICH I BELIEVE IS 1.8 MILLION RANGE IF I'M NOT MISTAKEN.

>> IT WAS THE ADMINISTRATIVE, IF I REMEMBER CORRECTLY AND

AGAIN GOING BASED ON MEMORY. >> WE ELIMINATED THE ENTIRE SOCIAL SERVICE DEPARTMENT AND SAID ALL OF THE MONEY WOULD GO TOWARD EMPLOYEE RAISES THAT IS 1,000,008 AND WE ARE ASKING FOR 200,000 INCREASE. THEY ARE NOT GETTING ALL, IT IS TWO DOLLARS A MONTH IN SOME CASE AND THE RAISE WILL BE MORE THAN THAT IF

WE DON'T CHANGE IT. >> SOCIAL SERVICES BUDGET FOR THE ADMINISTRATION, THE OVERHEAD WAS THE 1.152 MILLION AND THEN YOU HAVE THE DIRECT BENEFITS THAT WE GIVE DIRECTLY TO THE PUBLIC. 451,000, WHEN YOU SAID SOMETHING ABOUT POTENTIALLY GIVING FUNDS TO ANOTHER AGENCY.

>> WE DO HAVE TO KEEP SOME OF THE BUDGET .

>> IF WE STICK TO WHAT WE DID, WHAT WE DO LATER IS

[02:30:03]

>> EVEN IF YOU SAY 1.1. >> EVEN IF YOU USE THE 1.1.

>> WE PASSED 1.5. I DON'T KNOW WHAT YOU ALL THE CHANGE. WE PASSED 1.5 COMING BACK AS RAISES TO THE EMPLOYEES, IF THAT CHANGES THAN IT CHANGES AND IF IT DOES NOT AS WE SIT TODAY IT IS 1.5 MILLION MINUS 200,000. NET GAINED TO THE EMPLOYEE OVERALL 1.3 MILLION.'S WERE NOT EATING UP THERE IN ANY WAY SHAPE OR FORM.

>> IT'S GOING BACK FOR DISCUSSION. IT HAS GONE BACK UP

AGAIN FOR DISCUSSION. >> AS WE SIT TODAY.

>> THE ITEM DID COME AND I THOUGHT THERE WAS A VOTE TO

RETAIN TWO. YOU DID NOT VOTE? >> WE TALKED ABOUT IT BUT DID

NOT VOTE. >> YOU MOVED THEM OVER.

>> OKAY, SO 1.4. TWO PEOPLE IT SHOULD BE LESS THAN 100,000,

1.4. >> IF YOU KEEP THREE MORE

PEOPLE IT IS STILL 1.1. >> NO MATTER WHAT THEIR MONEY FOR THE 200,000 YOUR PASSING ON. ZERO COST INTEREST. ZERO BASE INCREASE FOR THE EMPLOYEES WHEN YOU DO IT THAT WAY.

>> THAT IS CORRECT. >> THAT WILL OUTCOME UP IN BUDGET. FOR ALL EMPLOYEES THAT ARE LISTENING BY THE TIME WE GET THROUGH WITH THAT AND WE DID PROMISE THAT AS AN INCREASE SO IT WILL BE ZERO COST EVEN ADDING THIS. 7.5 AND REALLY WE CAN VOTE TODAY TO DO ZERO NEXT YEAR AND TRANSFER SINCE IT WILL BE THAT WAY IT DOES NOT MATTER WHICH WAY YOU CUT THE PIECE OF PIE IF YOU WANT TO SAY ZERO OR SEVEN WE WILL GIVE THEM THE INCREASE. SINCE WE PROMISED THAT IN THE BUDGET WE HAVE TO DO IT THIS WAY BECAUSE THEN IN TURN.

>> PROMISED WHAT? >> THE MONEY WE HAD IN SOCIAL SERVICES TO GO TO THE EMPLOYEE RAISES AS A BUDGET ITEM , WE NEED TO DO IT THIS WAY AND IN TURN THEY GET A COVERED IN THE BUDGET MEETING WHEN WE DO IT AGAIN.

>> WE DID NOT SAY THE AMOUNT, BUT THERE IS A SIGNIFICANT

AMOUNT TO COVER THE 7.5%. >> KEEP IN MIND THESE RATES

WOULD BE EFFECTIVE OCTOBER 1. >> SO, WE HAVE A MOTION AND A SECOND TO GO WAS 7.5% ACROSS THE BOARD FOR ALL EMPLOYEES.

>> AND THE EMPLOYER RATE YES. IS THERE ANY OTHER DISCUSSION? AND I WOULD ASK ALL THOSE IN FAVOR? AYE. ANY OPPOSED?

>> 7.5 WHICH WILL END UP BEING ZERO. )

>> CAN YOU PUT THAT IN WRITING?

>> WE ALREADY VOTED ON THE OTHER.

>> I THOUGHT IT WAS SEVEN, NOW 7.5?

>> IT WAS ALWAYS 7.5. >> 200 TOTAL FROM THE EMPLOYEES WITH MONEY SET ASIDE IN THE BUDGET TO GIVE TO THE

EMPLOYEES. >> APPROVED 5-0?

>> YES OKAY ARE THERE ANY OTHER DECISIONS WE NEED TO MAKE TODAY WITH ANY OTHER VOTES THAT WE ARE REQUIRED TO TAKE TODAY? I BELIEVE THAT IS IT, OUR PORTION WILL COME UP IN THE BUDGET MEETING, I ASSUME. WHETHER WE WANT TO DO THAT STAGGERED OR HOW MUCH WE TRANSFER TO FUND OUR HEALTH CARE.

>> YOU SAID THE EMPLOYER PORTION.

>> THE 27.8%? >> YES, THAT'S CORRECT.

>> OKAY. WE HAVE NOTHING TO GO INTO EXECUTIVE. I THINK WHEN

[02:35:06]

>> HOW IS THIS GOING TO BE RELAYED? SOMETIMES WE DO THIS,

HOW WILL BE RELAY THIS? >> WE NEED TO GET THE AGREEMENT FOR OUTSIDE ENTITIES QUICKLY AND SENT TO THEM.

>> WE WANT TO GIVE THEM NOTICE. MAYBE A LETTER FROM YOUR THE JUDGE TODAY THAT SAYS HERE IS THE MOTION, WE WILL GET THE AGREEMENTS LATER TO PUT THEM ON NOTICE SO THEY HAVE TIME?

>> WE CAN WORK WITH YOU TO GET THE WORDING. IT IS THE COURT

ACTIONS. >> HERE IS WHAT THE MOTION WAS PASSED IN COURT, WE ARE GIVING NOTICE AND WE WILL GET THE DOCUMENTS TO GO ALONG WITH THIS LATER.

>> IF YOU CHOOSE TO BE PART OF THIS, YES.

>> IT CAN BE AN EMAIL. SOMETHING SO WE KNOW IT'S GOING TO THE RIGHT PERSON. THIS IS WHAT THE COURT PASSED TODAY

EFFECTIVE OCTOBER 1. >> THESE AGREEMENTS HAVE TO BE SIGNED IF YOU WISH TO CONTINUE.

>> WE WILL WORK WITH THE COURT AND HR AS NECESSARY TO GET IT

OUT TODAY. >> THE EMPLOYER, THEY HAVE TO DO OPEN ENROLLMENT FOR THEIR EMPLOYEES AS WELL SO IT NEEDS

TO BE ASAP. >> SO WE WOULD HAVE TO DELAY OPEN ENROLLMENT FOR THOSE PEOPLE AND EXTEND AS TO WHETHER

OR NOT THEY WILL PARTICIPATE. >> WHETHER THE ENTITIES ALLOW THEM TO PARTICIPATE SO WE MAY HAVE TO GIVE THEM MORE TIME OR EXTENSION FOR THE OPEN ENROLLMENT IF THE EMPLOYEES HAVE NOT SIGNED THESE AGREEMENTS .

>> SO YOU SAY FOR THE EXTERNAL AGENCIES?

>> IF THEY OPT OUT THEY DON'T NEED TO GO TO OPEN ENROLLMENT.

IF THEY NEED TIME TO DESIGN WE DON'T WANT TO NOT LET THEM HAVE OPEN ENROLLMENT IF THEY CHOOSE TO STAY UNDER THE NEW

CONDITIONS. >> THEY CAN, IF THEY DON'T AGREE SIGNING UP DOES NOT HURT.

>> THEY CAN ONLY SELECT WHAT THEY WOULD ASSUMING THE ENTITY WILL STILL DISSIPATE IN OUR INSURANCE AND IF THE ENTITY CHOOSES TO NOT PARTICIPATE IN THEY WOULD AUTOMATICALLY RECEIVE , THEY WOULD RECEIVE DIFFERENT INFORMATION FROM THE

EMPLOYER. >> I WANT TO MAKE SURE YOU TAKE

THAT INTO CONSIDERATION. >> I WOULD RECOMMEND THAT

APPROACH. >> NOTIFICATION QUICKLY TODAY.

>> IS IT APPROPRIATE AT THIS POINT TO MAKE ANOTHER MOTION THAT SAYS WE AS A COURT ARE PUTTING A MORATORIUM ON ANYBODY

ELSE HEADING IN , BECAUSE . >> WE ARE NOT TAKING ANYBODY

ELSE IN. >> NOT TAKING?

>> THESE PEOPLE ARE GETTING THE OPPORTUNITY TO STAY IN SO NOW WE'RE GOING TO GET CALLS FROM OTHER PEOPLE, GRANTED IT SHOULD BE FOR ONE YEAR IF WE STAY ON COURSE, BUT WHAT IF OTHER ENTITIES CALL AND SAY HEY, WE WANT THAT DEAL.

>> WITH THE COST WITH THEM COVERING RISK AND RESPONSE ABILITY I DON'T THINK YOU HAVE A LOT OF PEOPLE JUMPING IN.

>> ONE YEAR ONLY. >> WHICH PART IS WHEN YOU'RE

ONLY? >> FOR THE AGENCIES THAT

JOINED. >> THIS WAS A STOP CAP COMPROMISE TO LET US STAY IN FOR A YEAR. THAT IS A GOOD POINT THAT MOTION CLEARLY ARTICULATED THIS IS FOR ONE YEAR AND THEN THEY GO THEIR OWN WAY. THAT WAS THE INTENT OF

EVERYBODY. >> THAT'S FOR THE HD ALSO? IS THAT FOR HOSPITAL DISTRICT ALSO?

>> FOR EVERYBODY. >> IT IS PART OF EVERYBODY FOR

NOW. >> I THINK THE MOU'S WOULD HAVE TO BE RENEWED ANNUALLY IF WE CHOOSE TO MOVE FORWARD.

LET'S DO THESE MOU'S OR AGREEMENTS AND I DON'T THINK MANY PEOPLE ARE GOING TO DO THAT , GIVEN THAT THEY WILL BE INCURRING ALL OF THE RISK AND THE COST OF THEIR EMPLOYEES AND

EMPLOYEE DEPENDENCE. >> AND THEN THAT OPPORTUNITY WILL BE EXTENDED TO NOT THE CREDIT UNION?

>> THE CREDIT UNION , SHE SAID EARLIER, BY LAW WE CANNOT OPEN

UP TO PEOPLE LIKE THAT. >> THE MOTION WAS TO DO THIS

[02:40:03]

WE LEAVE IT. >> AND THEN ADDRESS THE OTHERS

AFTER THIS. >> AS TO THE CREDIT UNION NOW.

>> OVER GOING TO ALLOW THE CREDIT UNION TO STAY ON? BY LAW WE WERE NEVER LEGALLY ALLOWED TO HAVE THEM ON.

>> I DON'T THINK WE CAN IF WE ARE NOT LEGALLY ALLOWED. I DON'T REMEMBER THAT ADVISORY.

>> SO WE NEED TO SEND THEM THE LEGAL OPINION THAT SAYS , WE DON'T NEED A MOTION TO SAY WE ARE EXCLUDING THEM IF WE SAY WE

CANNOT LEGALLY ALLOW THEM. >> WE WILL SEND MEDICATION, BUT WE'RE NOT GOING TO SHARE ATTORNEY AND CLANK MEDICATION AS THEY ARE AN OUTSIDE ENTITY, BUT WE WILL PUT THEM ON NOTICE.

>> THERE IS NO MOTION NECESSARY FOR THAT ONE SINCE WE ARE NOW FINDING OUT IT'S AGAINST THE LAW TO DO THAT SO WE DEFINITELY WANT TO DO WHAT WE ARE SUPPOSED TO BE DOING. OKAY, ANYTHING ELSE? IT IS, THERE WAS NO ADJOURNMENTS IN

* This transcript was compiled from uncorrected Closed Captioning.