►
From YouTube: Clearwater Benefits Committee Meeting - June 2, 2021
Description
Clearwater Benefits Committee Meeting - June 2, 2021
A
Good
morning,
everyone
it's
nine
o'clock
on
wednesday
june.
The
second-
and
this
is
our
second
benefits
committee
for
2021..
Everyone
should
have
an
agenda
we're
going
to
talk
about
some
new
coaching
programs.
The
claims
experience
review,
we're
going
to
talk
about
renewal
projections,
2021
rate
discussion
and
we're
going
to
discuss
when
we'll
have
our
final
meeting,
which
will
probably
be
some
time
in
july,
and
then
we'll
have
some
time
for
questions.
So
I'm
going
to
hand
it
over
to
sean
fleming
from
the
gearing
group
to
initiate
the
meeting.
A
B
B
Can
they
hear
karen
some
okay?
She
said
it's
good
now
she
thought
it
was
muted,
so
they
can
hear
us
now
well.
Good
morning,
everybody
started
off
gave
you
an
agenda
with
claims
experience
in
front
of
you,
but
we
actually
wanted
to
talk
about
something
that
there's
no
handout
for
first
and
I'll
kind
of
leave
this
off
and
jennifer
jill
tony
whoever
wants
to
jump
in
with
anything
there
on
the
coaching
program.
B
As
you
all
know,
we
have
the
clinic.
We
have
a
health
coach
in
the
clinic
and
that
health
coach,
just
so
everybody
knows,
is
the
health
coach
and
the
wellness
coordinator
are
ultimately
funded
out
of
the
premiums
that
are
being
paid
to
cigna
to
administer
the
program.
Part
of
that
administrative
fee
is
to
make
that
those
employees
their
employees,
which
everybody
in
the
clinic
obviously
is
ultimately
a
cigna
employee,
but
as
an
example,
the
doctor
in
the
clinic,
that's
part
of
the
city's
bill
where
they
pay
for
staff
for
that.
B
B
If
you
all
remember
with
the
health
coach
in
in
2000
19
19.,
well,
what
happened?
Was
we
had
an
on-site
kind
of
claims
as
a
helper?
If
you
want
to
call
that
for
certain
healthy
employees
with
finding
a
doctor,
things
like
that,
and
we
had
noticed
at
the
time
that
people
where
they
you
know
used
to
maybe
have
50
60
70
people
asking
that
person
for
help
a
week.
You
know
went
down
like
five
six
seven
a
week,
so
it
was
kind
of
a
waste
of
money.
B
So
we
we
rolled
out
the
coaching
position
and
we've
been
monitoring
the
effectiveness
of
that
coaching
position
since
it
it
put
in
it,
started
off
okay,
lower
than
kind
of
in
line
with
where
we
expected,
but
we
thought
that
it
would
grow
more
people
would
engage
with
that
coach
and
it's
grown
a
little
bit
but
prior
to
covet
it
really
hadn't
grown
at
the
rate
that
we
expected
and
since
covet
you
know,
a
lot
of
things
have
changed
right.
People
are
interacting
with
different
mediums.
B
For
the
resources
that
are
being
allocated
to
it
and
I'll
I'll
add
live
a
little
bit
here,
I
obviously
haven't
been
able
to
do
the
coaching,
because
I'm
not
a
city
clearwater
employee,
but
I
do
know
that
the
coach
is
extremely
well
liked
for
the
people
that
work
with
them
extremely
well
respected.
B
So
this
has
nothing
to
do
with
any
of
that.
But
one
thing
that
we've
been
looking
at
is:
is
there
a
better
way
to
allocate
those
resources
and
one
option
that
has
come
up
that
we
wanted
to
talk
with
the
committee
about
and
get
any
feedback
or
thoughts?
Is
we
have
a
nurse
practitioner,
a
nurse
practitioner,
one
of
the
two
that
has
sort
of
been
per
diem,
so
they're
getting
paid
just
now?
B
If
we
were
to
eliminate
that
coach
position,
sigma
medical
would
ultimately
be
able
to
fund
that
other
provider
in
the
clinic,
so
the
city
gets
more
access
to
care
kind
of
at
no
additional
cost,
probably
actually
a
little
bit
of
a
savings,
nothing
that
is
gonna.
You
know
make
a
30
different
because
there's
a
difference,
but
I
think
the
biggest
difference
is
you
get
more
access
to
care
with
a
provider,
and
I
just
blanked
on
the
name.
Is
that
yolanda
yolanda?
B
I'm
sorry,
I
want
to
say
yolanda-
is
the
individual,
that's
kind
of
filling
that
position,
so
what
we
want
to
talk
about
with
the
committee?
If
anybody
wants
to
add
anything
to
that
is,
we
are
looking
at
possibly
eliminating
that
coach
position
and
to
be
able
to
use
that
to
have
more
access
to
care
time,
especially.
D
Yeah
it's
about
30
hours,
but
with
the
potential
of
it
being
more.
When,
like
the
doctors
go
on
vacation,
you
know
that's
what
we
use
it
for
now.
It's
because
the
you
know
so
dr
terencinko
and
molly
right
now.
Both
work
for
tens
and
so
yolanda
fills
in.
D
A
D
Many
hours
for
us,
so
it
does
provide
more
access,
but
so
no
to
answer
your
question
not
on
a
full-time
basis.
And
yes,
the
health
coach
is
full-time
and
that's
why
he
said
it's
not
a
dollar.
D
A
little
bit
of
a
savings
not
that
much
savings
because
yolanda,
I
don't
remember,
she's
a
pa
or
a
nurse
practitioner
either,
but
that
rate
is
much
higher
than
what
the
health
coaches
rate
is.
So
you
know
so.
D
Savings
because
her
rate
is
higher
anyways
because
of
the
different
transition
sure,
but
you
know
so
just
a
payback
of
what
what
sean
said.
The
people
that
used
nyla
love
her
I've,
never
gotten.
D
It's
just
that
it's
not
utilized
and
she's
tried.
You
know,
we've
tried
in
terms
of
different
marketing
things
and
whatnot.
It
just
doesn't
seem
to
be
something
that
our
employees
are
as
a
as
a
whole
are
interested
in
and
as
in
the
fire
department
aspect,.
C
D
D
On
having
a
full-time
position
that
is
not
being
utilized,
although,
like
I
said
making
an
impact,
I
don't
want
to
take
it
away.
You
know
from
the
impact
that
she
has
made
with
some
people.
D
So
that's
why
we're
proposing
this
and
also
wanted
to
kind
of
similarly
or
at
the
same
time,
just
remind
that
we
do
have
this
food
smart
program
that
has
a
dietitian
built
into
it.
So
I've
done
both.
I
have
worked
with
nyla
because
I
like
to
know
what
we're
offering
to
our
employees.
D
It's
an
app
it's
a
multi-source
thing,
it's
an
app
that
has
all
kinds
of
recipes
and
we'll
just
kind
of
help.
You
build
a
food
plan
and
has
it'll,
do
your
grocery
shopping
and
everything
for
you
as
well,
but
in
addition
to
that
they
have
a
dietitian.
That
is
at
no
charge.
It's
virtual,
but
it's
I
mean
it's
kind
of
like
a
telehealth
type
of
a
thing,
and
you
know
for
me:
I
didn't
it
wasn't
a
decline
by
not
having
the
person
physically
there.
D
I
think,
through
code
we've,
all
gotten
used
to
doing
so
many
things
remotely
that
the
service
will
still
be
provided
to
our
employees
and
that's
what
I
think
I
want
people
to
understand.
Not
in
person,
though
now
you
do
have
the
option
for
the
health
insurance
to
go
to
a
dietitian
in
person,
so
that
still
exists
as
well,
but
through
the
foodsmart
app
there's
no
cost
to
the
employees
and
then,
additionally,
we're
also
thinking
about.
B
Yes,
so
there's
another
program
called
amada
that
we're
looking
to
roll
out
we'll
bring
some.
You
know,
maybe
even
probably
a
videos,
probably
better.
They
have
some
stuff,
but
iman
is
a
program
they're
an
independent
company
from
cigna,
but
sigma
has
done
a
lot
with
them.
As
of
some
of
the
other
carriers,
we
have
the
united
healthcare
clients
with
a
lot
of
blue
cross
clients
with
obama
and
the
clients
they
started
off
as
a
diabetes
prevention
program.
So
essentially
the
criteria
to
engage
in
the
omada
program
was.
B
B
We're
trying
to
get
after
anyway
and
and
the
way
omada
works,
what's
kind
of
interesting
is
when
you
engage
into
a.
B
Send
you
a
digital
scale
that
actually
has
a
cellular
signal
in
it,
and
it
goes
to
your
health
coach
at
omada
that
you're
engaged
with,
and
you
know
you
use
that
scale
weigh
in
there's
different
things.
There's
there's
if
you're
pre-diabetic,
you
know
a
diabetic
nowadays
on
the
planet
is
probably
15
to
20
grand
a
year.
So
if
we
can
keep
somebody
from
getting
into
that
state,
you
know
it's.
It's
obviously
a
worthwhile
venture
diabetes
is
probably
you
know
if
you,
if
you
count
cancer
aside,
you
know
cancer
is
largely
uncontrollable.
B
Cancer
is
more
about.
Can
we
detect
it
early
enough
to
reduce
the
cost?
You
know
diabetes.
We
know
we
have
a
lot
of
people
in
that
pre-diabetic
state
voluntary
program.
All
that
data
is
sent
to
the
health
coach.
You
can
engage
with
them
on
the
app
you
know
via
video
calls
texts,
they'll
actually
do
nutrition
as
well.
That's
a
big
part
of
it.
You
can
log
your
food.
B
Is
there
a
cost
employee
from
them?
No
no
cost
to
the
employees
and
what's
kind
of
cool
about
the
program
is
you
know
we
get?
We
got
bombard
in
our
office
with
people
trying
to
sell
us
programs
right,
oh
five
dollars
per
employee
per
month.
Then
we'll
do
this
program
for
you
and
what
happens?
Is
you
pay
all
this
money
and
then
seven
people
do
it
and
you
just
wasted
a
bunch
of
money.
So
the
way
a
model
works
is
there's
a
one-time
charge
that
hits
as
a
preventative
claim.
B
B
B
No,
it
actually
is,
I
would
say,
more
of
a
dietitian
and
an
overall
kind
of
management
they're
using
the
weight
loss
as
kind
of
the
benchmark.
You
know,
because
you're
not
going
to
go
every
two
weeks
and
get
your
blood
sugar
tested
for
them
to
say.
Oh,
you
know
we
lowered
sean's
blood
sugar
2,
so
the
weight
loss
is
kind
of
the
metric
they're
using.
But
it's
more
about
improving
that
overall
kind
of
metabolic
health,
because
that's
ultimately
what
puts
somebody
in
that
pre-diabetic
there's.
C
B
B
So
if
you're
already
diabetic
that
we
program
wasn't
really
designed
for
you,
that's
a
whole
nother
monitoring,
all
those
things
they
actually
in
the
meantime-
and
I
think
cigna
is
working
on
terms
on
how
you
can
add
these
programs
as
well
they've,
created
a
type
2
diabetic
program
that
would
potentially
be
an
option
down
the
road.
That's
meant
to
target
the
people
that
are
already
there
and
part
of
that
program
when
they
roll
it
out
is
going
to
be
like
it
would
include
your
monitoring
equipment.
C
So
that
coach
has
seen
all
that
data
and
then,
in
correlation
with
that,
we
still
have
the
dietitian
that
can
go
through
that
that
we
have
in
the
city
that
can
go
ahead
towards
the
people
that
aren't
type
2
diabetes
or
yeah,
one
diabetes
and
their
food.
So
yeah.
It
sounds
like
a
good
program.
Yeah,
especially
there's
no
cost.
D
Working
with
it,
but
the
way
that
it
sounds
you
know
it
sounds
like
a
win
again.
D
Acknowledge
in
terms
of
shifting,
because
you
know
the
services
that
people
you
know
in
terms
of,
if
we
decide
to
not
have
the
health
coach
anymore,
that's
why
we're
trying
to
have
these
replacement
programs
so
that
the
you
know,
employees
understand
that
it's
I
mean
in
all
honesty,
the
weight
and
obesity
is
one
of
our
highest
cost
stars
because
it
leads
to
everything
else.
So
it's
not
a
matter
of
saying
that
that's
not
important.
It's
just
not
utilized
so.
C
Complaint
I've
heard
about
the
healthcare
clinic
is
access,
so
this
will
be
an
increase
in
access.
By
doing
that,
which
would
be
a
positive
yeah.
I
think
we
as
far
as
iff
portion
of
it
would
be
very
pro
to
having
an
additional
clinician,
pa
or.
B
Yeah,
my
understanding
is
yolanda,
gets
very
positive
feedback
from
everyone
and
and
candidly
the
clinic
in
some
regards.
You
know,
we've
been
dealing
with
this
for
a
couple
years,
because
that
person's
in
that
kind
of
per
vm
status
they've
been
afraid
that
one
day
she's
going
to
get
another
job
or
walk
for
that
and
this
kind.
C
Of
helps,
you
know
lock
in
that
we
do
have
a
provider
that
people
like-
and
this
is
coming
out
of,
the
our
80
000
a
month,
ish
that
that
we're
paying
sigma
management-
or
this
is
coming
out
of
our.
B
B
B
B
B
Easy
decision
something
a
lot
you
know.
Unfortunately,
when
you
look
at
the
numbers,
it's
you
know,
sometimes
probably
averaging
three
people
a
day.
You
know
it's
just
you
can't
have
a
full-time
person,
three
people,
you
know
they
need
to
be
seen,
probably
eight
or
nine
or
ten
a
day
to
really
kind
of
justify
that
position.
I
think
a
lot
has
changed.
B
C
D
C
D
Wellness
emails-
and
I
know
they
come
out
every
week
and
there's
a
lot
of
stuff
in
there,
but
you
know
we
are
actually
having
one
of
the
wellness
wednesdays,
we're
you
know
having
food
smart
people
there
to
like
talk
about
it.
You
know-
and
things
like
that,
so
we
are
certainly
trying
to
promote
the
program
actually.
D
D
Okay,
any
other
questions
from
any
of
our
remote
people
that
have
in
regards
to
this
item.
Gina
just
mentioned
that
this
is
being
recorded.
This
meeting
so
yeah
in
regards
of
posting
it
to
confidence,
we'll
maybe
wait
on
posting.
D
B
So
in
july,
when
we
set
a
date
for
that,
we'll
bring
back
some
of
the
amada
stuff,
I
think
you
guys
will
like
it.
It's
not
necessarily
for
everybody,
and
it's
not
not
meant
to
be,
but
just
meant
to
get
more
options
so
and
and
I'll
just
say,
on
that.
We're
also
going
to
look
at
kind
of
with
some
of
those
programs
if
there's
any
way
to
integrate
them.
B
All
right,
you
guys
ready
to
hop
into
claims
experience.
Oh
yeah,
yes
yeah,
so
everybody
has
in
front
of
them
like
claims.
I
think
everybody's
been
here
before
and
just
I
guess
the
people
online
probably
can't
see
it.
I
was
just
trying
to
think
if
there's
anything,
but
I
don't
know
if
there
is
so
okay
we'll.
B
We'll
send
this
out
to
you
electronically
right
after
so
everybody
takes,
wants
to
take
a
look.
You
guys
are
kind
of
pros
with
this,
but
we'll
just
run
through.
If
we
want
to
look,
maybe
we'll
go
to
the
gold
so
so
far
through
the
first
four
months
of
the
year,
we
have
about
6.8
million
in
funding.
In
our
first
column,
that's
gone
into
the
plan
of
that
320
000
goes
to
cigna
to
administer
the
program,
and
then
in
the
next
column
we
have
about
512
000,
and
that
goes
for
reinsurance.
B
So
anybody
that
goes
in
the
middle
of
that
250
and
300.
So
basically,
300
000
in
claims
is
covered
by
the
reinsurance,
so
512
000
for
that
coverage
and
we'll
take
a
look
at
some
of
the
statistics
on
that
here
today.
There
are
a
couple
large
claims
that
are
driving
things
so
then,
going
on
taking
a
look
at
our
claims,
we've
had
4.6
million
in
claims
for
the
year
1.5
million
in
pharmacy,
so
total
claims
have
been
about
6.2
million.
B
B
So
the
plan
is
running
a
little
bit
higher
and
we'll
talk
about
what's
driving
that
in
a
second.
But
if
you
take
a
look,
then
we
had
pharmacy
rebates
that
came
in
at
just
shy
of
1.1
million.
B
C
B
Plans,
they
obviously
run
a
little
bit
hotter
in
the
beginning
of
the
year,
because
remember
everybody
on
reinsurance
starts
at
zero.
So
you
have
a
couple
of
catastrophic
claims:
the
city's
picking
up
that
first
300
thousand
once
that
individual
hits
three
hundred
thousand.
You
know
for
the
rest
of
the
year.
The
reinsurance,
in
this
case.
B
If
you
flip
the
page
real
quick,
pre-coded
flash
here,
you'll
almost
see
in
the
first
three
months
and
then
copenhagen
kind
of
in
april
claims.
It
was
very
similar
last
year
and
if
we
even
went
back
a
couple
of
more
years,
you
would
see
that
that's
kind
of
the
same
case
for
the
city.
The
first
couple
of
months
january
always
seems
to
be
low
because
it's
largely
into
separate
claims
and
then
it
all
catches
up
coming
in
from
there.
So
overall
plan
running
pretty
consistently.
B
So
there's
a
little
bit
there,
where
it's
a
little
bit
on
the
artificial
and
low
side
by
the
time
we
have
another
month
of
claims,
we'll
probably
see
that
irregularity
gone
we'll
be
looking
at
that.
I
know
we
talked
a
little
bit
in
the
last
meeting
about
how
insurance
companies
and
actuaries
are
trying
to
account
for
part
a
kind
of
what
didn't
happen
and
then
part
b
is.
Is
there
an
impact
of
things
that
were
delayed?
B
B
So
we'll
talk
about
that
when
we
look
at
the
projections
overall,
if
what's
a
little
abnormal
for
the
city
and
we'll
talk
about
why
in
a
second
is,
if
you
look
in
the
box
that
says
medical
and
pharmacy
claims
per
employee
per
month,
you
see
medical
is
up
11.3,
which
that's
a
little
bit
higher
than
most
of
our
groups
are
trending
right
now,
but
what's
interesting
is
a
lot
of
our
groups.
Pharmacy
is
up
20
to
25.
B
You
guys
are
only
at
5.7.
So
that's
actually
a
positive
there,
we'll
take
a
look
if
you
want
to
flip
back,
though
understand
kind
of
what's
driving.
If
you
want
to
flip
back
two
pages.
B
B
So
that,
obviously
the
city
pays
the
first
300
000,
but
that
kind
of
abnormality
and
that
spike
is
what's
driving
that
so
as
the
year
goes
on
and
we
have
more
mature
data,
the
impact
of
that
shrinks
in
the
big
picture
right.
But
when
you
only
have
a
couple
of
months
and
then
all
kinds
of
hits
it
hits
in
that
one
month
it
makes
the
numbers
look
a
little
bit
worse,
but
ultimately
that's
what
the
insurance
is
for.
B
You
guys
any
questions
on
that.
I
know
this
group
is
pretty
much
pros
with
this,
so
I
don't
wanna,
there's
no
reason
to
really
drag
it
out
and
do
a
bunch
of
stuff
behind
that
we
have
last
year
is
is
the
second
page
we
have
the
high
cost
claims
and
then
to
that
point,
if
you
want
to
look
at
the
fourth
page,
we
did
a
little
look
at
january
to
april
year
to
year.
B
And
if
you
go
to
the
as
so
the
first
line
down
is
the
total
gross
claim
so
you'll
see.
Last
year
you
were
5.6
million.
That's
a
little
bit
immature
because
7.1
this
year
last
year
you
had
six
claims
over
100
000
at
that
time
period.
This
year
you
have
eight
but
look
at
the
difference
in
the
amount
of
those
catastrophic
claims
861
last
year,
verse
1.9
this
year,
so
that
extra
you
know,
jump
that
we've
seen.
That
is
really
those
couple
of
claims.
A
A
B
B
B
C
300
000
minus
employee
number
ones,
cost
number
one
cost:
minus
300
000
equals
the
stop
losses
and
on
it
just
looks
like
on
that
next
page
that
total
stop-loss
recovery
that
would
be
closer
to
two
minutes.
Yeah
I'll
double-check
that
and
I
know,
cam's
listen.
B
So
I'll
have
it,
but
that's
the
same
thing
for
the
total
high
claims
cost
of
a
million,
unless
that's
a
a
cumulative
number
in
april,
but
it
sure
doesn't
look
like
it
on
the
previous
page
yeah.
Let
me
cam,
why
don't
you
text
me
that,
because
I
know
can't
put
the
report
together,
I
don't
know
how
he
did
the
calculations
but
I'll
I'll
circle
back
and
use
that
answer
in
a
second.
B
We're
doing
that
rolling,
so
these
aren't
monthly
totals
these
are
cumulative
totals
through
february
cumulative
total
through
march
and
cumulative
through
correct,
yes,
so
so
kind
of
that
one
sense.
So
what
we're
showing
here
now
now,
I
understand:
that's
why
I
was
getting
more
confused.
I
think
camp's
texting
so
so
claimant,
one
as
an
example
in
february,
so
we
on
this
report
when
they
hit
a
hundred
thousand.
We
put
them
on
this
report,
so
claimant,
one
in
january
hadn't
had
a
hundred
thousand
claims,
so
they
didn't
hit
the
report.
B
B
B
Medical
things
that
they
would
be
doing,
no,
it's
everything,
so
it's
ultimately
everything
we
can't
separate
it
out,
but
that's
the
way
the
stop
loss
pays
right.
The
stop
loss
doesn't
matter.
If
you
have
a
knee
and
a
shoulder.
Those
aren't
separate
like.
C
C
In
the
previous
year
we
had
2.2
million
in
reserve
yeah
the
surplus
from
last
year
was
2.2
million.
I
would
say
maybe.
B
B
B
There's
a
lot
more
fights
going
on
right
now,
so
I'm
gonna,
I'm
gonna,
walk
through
this
a
little
bit
on
the
brisker
side.
But
so
you
guys
stop
me
with
any
questions
because
there's
just
a
couple
points
I
really
want
to
talk
about
with
it.
I
know
you've
all
looked
at
the
bottom
line
already
so
so.
B
Overall,
the
projections
come
out
to
a
5.3
increase,
but
I
do
want
to
walk
through
it
just
kind
of
quickly,
so
you
guys
understand
a
couple
things
and
even
talk
about
an
initial
projection
we
shared
with
hr
two
months
ago.
I
want
to
talk
about
some
of
the
differences
because
it
goes
it
just
so
everybody
has
a
comfortable
understanding
is
what's
going
on
in
it.
So
on
the
top
line
and
let's
look
at
the
total
column
we
broke
out
medical
and
pharmacy.
B
Explain
why,
in
a
second
so
total
gross
paid
claims
over
the
time
period
of
may
2020
to
april,
2021
was
19
million.
The
first
thing
we
do
out
of
that
is
in
that
time
period
we
back
out
any
catastrophic
claims,
so
any
claims
that
are
over
that
300
000.
B
So
the
signal
reporting
through
the
time
period
when
we
got
it,
I
think
there
was
a
little
bit
of
extra
claims
that
came
in
on
that
one
claim,
but
it
was
991
000
because
obviously
they're
a
little
bit
over
a
million
this
year
with
those
large
claims,
sometimes
the
way
they
come
in
the
data
moves.
So
we
did
this
projection
before
we
had
gotten
some
of
that.
So
there's
a
little
bit
of
a
variance
there.
So,
oh
well,
actually,
no
they're,
not
I'm
looking
at
the
wrong
one.
B
I
can't
read
the
first
line:
is
we
take
out
capitation,
which
are
the
fixed
costs?
So
decapitation
is
going
to
be
certain
lab
work.
Imaging
mental
health
is
capitated
with
cigna,
so
we
pull
out
991
000
and
then
we
pull
out
any
individuals
that
have
reinsurance
that
would
apply
to
reinsurance.
So
we
have
one
claim
kind
of
in
that
250
to
350
range
over
the
prior
12
months
and
we
had
three
that
actually
exceeded
350.
B
B
That
net
says
15.7
million
in
claims,
so
the
next
line
is
the
one
I
really
wanted
to
talk
about
so
maturation
factory.
So
this
is
where
everybody
is
fluffing
their
projection
for
copenhagen,
and
what
they're
trying
to
look
at
are
those
things
we
talked
about
earlier.
B
How
much
should
have
been
in
the
clinic
claims?
It
wasn't
because
people
didn't
go
to
the
doctor
and
then
is
there
an
impact.
B
You
know:
is
there
an
impact
of
people
delaying
that
care?
What
does
that
mean?
So
when
we
looked
at
this
projection
two
months
ago,
when
we
had
april
and
may
which
were
really
low,
there
was
about
five
percent
in
here
that
we
have
had
in
company
all
right.
If
you
take
a
look
now,
because
we
still
have
that
month
of
april,
we
think
more
has
come
back.
B
A
B
B
And
if
you
want
to
go
down
a
couple
lines,
we
didn't
make
any
plan
changes.
So
then,
what
we
do
where
you
see
that
1.2
million
number
is
we
put
back
in
that?
First,
the
city's
responsibility
on
those
catastrophic
questions,
those
don't
get
trended
for
medical
inflation
and
then
we
have
back
in
the
capitation
so
that
that's
not
trending
as
well,
because
that's
not
going
up
13
per
year,
that's
marginally!
Going
up!
If
at
all,
we
subtract
out
the
pharmacy
rebates,
then
going
down,
we
add
the
administration,
the
reinsurance,
for
quarry
fees.
B
B
There's
one
that
cures
spinal
atrophy
in
children
there's
another
one
that
cures
the
progressive
blindness
they
cost
anywhere
between
1.1
and
1.4
million,
but
they
in
most
everyone
they
cure.
These
things,
which
is
amazing,
it
means
final
atrocity,
is
something
a
baby,
but
obviously
that
could
be
a
1.1
million
dollar
expense
to
the
plan
with
your
reinsurance.
B
So
what
cigna
started
is
something
called
a
mark
which
is
basically
you
pay
99
cents
per
member
per
month
and
if
you
ever
have
one
of
those
claims
it's
just
covered
by
that,
so
it's
almost
the
second
form
or
re-insurance
to
cover
those
gene
therapies,
the
one
that
will
be
interesting
that
was
delayed
last
year
during
coped
is
there's
one
coming
out.
That's
supposed
to
cure.
B
And
hemophilia,
if
anyone
knows
it
can
easily
be
six
to
seven
hundred
thousand
a
year
in
medications
alone.
Before
anything
happens,
we
have
a
group
where
there's
there's
an
individual
six
hundred
thousand
a
year,
but
you
know
if
they
so
much
as
cut
their
leg,
it
can
easily
be
a
two-month
hospital
stay
to
control
the
bleeding.
So
if
this
comes
out
in
curiosity,
hemophilia
it'd
be
amazing,
but
you
know
it
could.
C
B
B
They
haven't
said
that
yet,
but
I
think
you'll
see
that
that's
going
to
be
your
choice,
if
you
don't
buy,
they
are
just
it's
going
to
be
excluded
from
random
sharks
which
could
blow
the
plan
up.
Pretty
quick.
You
know
the
problem
with
like
like
a
hemophilia
or
some
of
these
is
it
tends
to
be
genetic?
B
C
B
So
so
that's
going
to
be
members,
so
that's
going
to
be
everyone
involved:
okay,
not
just
employees,
okay
yeah,
so
they
do
that
one
on
a
member
basis.
So,
overall
the
projection
comes
out
to
5.3.
We
do
want
to
look
at
may
claims
before
our
last
commitment
to
see
if
it
makes
any
drastic
change.
I
don't
expect
we'll
be
higher
than
the
5.3,
because
we've
really
accounted
for
everything.
B
So
you
know
if
there's
some
major
shift
and
claims
drop
a
lot.
You
know
we
might
be
in
a
position
where
we
could
look
at
a
lower
scenario,
but
for
the
point
of
discussion
today
we
wanted
to
put
this
in
front
of
you
guys,
so
you
knew
kind
of
what
we're
looking
at
what
we're
expecting
and
you
know
kind
of
go
from
there.
Obviously,
last
year
we
had
a
zero
the
year
before,
I
think,
was
around
five.
B
If
I
remember
right
so,
if
you
kind
of
think
about
it
in
a
two
year
sense,
you
know
it's
almost
kind
of
like
two
and
a
half
two
and
a
half
and
in
some
regards,
if
you
find
that
out
over
the
two
years,
just
still
compared
to
the
market
around
you
and
what
people
are
saying
even
at
the
five
is
really
really
positive.
Historically,.
C
B
They
remember
the
first
early
on
in
that
time
period
we
had
those
hepatitis
c
drugs
which
were
ultimately
cures
for
hepatitis
c
for
most
of
the
population
that
came
out
the
city
had
about
20.
You
know
people
that
added
two.
A
B
And
I
think
that
year
you
know
it
was
like
a
six
to
a
seven
percent
increase,
but
since
that
year
the
increases
have
been,
I
think,
that's
the
highest
one,
that
we've
had
really
since
going
self-funded.
B
So
we've
actually
done
a
lot.
There
yeah,
I
think
everything
you've
done
with
clinic
everything
you've
done
with
wellness,
you're
you're,
starting
to
see
it.
It
doesn't
change
quite
but
you're,
seeing
a
lot
of
the
the
benefits
of
that
over
the
long
term,
and
that's
why
you
know
with
the
team
we're
looking
at
what's
next
on
them
on
this
site,
because
we
want
to
make
sure
that
we're
keeping
it
fresh
and
we're
keeping
people
engaged.
B
So,
on
the
the
subsequent
page
is
just
the
so
you
guys
have
it
have
an
idea
tuck
it
with
your
membership.
C
B
B
You
know,
plus
just
you
know.
I
think
what
jay
made
me
knows
better
than
me,
but
I
think
what
also
has
changed
a
little
bit
last
year
when
the
pandemic
had,
I
think,
everybody
kind
of
the
unknown
on
what
financials
would
look
like.
I
think
everybody
was
in
panic
mode
last
year
come
april
may-
and
I
don't
know
I
mean
now.
A
B
C
B
C
B
I'm
sure
there's
some
industries
still
that
are
struggling
and
small
businesses.
I
failed
along
the
way,
but
for
your
guys,
revenue
sources.
Yeah
everybody
was
worried
last
year
about
state
revenue
sharing
and
all
that,
no,
it's
it's
all
it's
already
and
it's
definitely,
I
think,
we're
in
a
better
position.
B
So
that's
definitely
good
and
you
know
one
thing
it's.
It
is
interesting.
We
have
some
groups
that
have
said
you
know.
Stephen
to
your
point.
I
mean
fire.
You
know
anybody
might
not
like
this,
but
you
know
we.
We
do
have
some
groups
that
have
started
to
say.
Should
we
with
ourselves
set
a
floor
regardless
of
what
the
projection
comes
out?
C
B
A
two
and
a
half
percent,
even
if
it
comes
out
at
zero,
you
know
and
they've
been
playing
with
that
idea-
nobody's
necessarily
put
that
into
any
sort
of
policy.
Yet,
but
some
groups
have
said
hey:
should
we
do
2.5
every
year
in
case
we
have
a
couple
years
where
it
comes
out
at
zero
and
then
it's
10
in
the
third
year
that
would
soften
that
impact
to
the
employees.
B
You
know,
so
that's
something,
maybe
in
the
future,
that
that
is
one
of
the
challenges,
because
if
you
subsidize
employees
in
good
years,
you're
going
to
have
the
the
rate
shock
the
following
year,
when
it
has
to
go
back
and
and
potentially
catch
up,
plus
so
having
something
more
moderate.
C
Throughout
so
that
you're
not
having
the
peaks
and
valleys
so
bouncing
up
and
down
with
based
on
a
good
year
or
a
bad
year,
it
doesn't
make
some
sense
so
for
the
reserve.
I
know,
there's
a
specific
amount
that
we
have
to
keep
them
reserved
and
we
have
that
specific
number
like
last
year,
we
have
2.2
is
a
moving
target.
It's
ultimately
the
way
the
state
says
it
is
it's
60
days
worth
of
claims.
B
And
then
there's
also
there's
there's
kind
of
not
a
hidden
component,
but
when
they
do
the
financials,
the
actuary
also
does
estimate
for
what
they
call
incur,
but
not
reported
so
they're
guessing
how
many
claims
are
out
there
where
sean
went
to
the
doctor
yesterday,
but
that
doctor
is
not
going
to
submit
him
for
two
weeks
right,
so
they
make
an
estimate
on
this
incur
but
not
reported
number
which
we
actually
give
jay
and
his
team
every
year,
because
you
guys
have
to
book
that
as
a
liability
in
the
financials.
B
So
there's
that
number
and
then
there's
60
days
so
two
months
worth
of
claims
similar
to
an
escrow
account
yeah
some
ways.
So
so
the
the
state
minimum
that
what
they
look
for
is
you
know
ballpark.
You
could
take
that's
6.2
million
divided
by
four
and
multiply
that
times.
You
know
two
and
that
would
be
the
ballpark
of
where
they
would
do
it.
I
mean
you
would
generally.
B
B
Cost
so,
ultimately,
when
we
look
at
the
projection,
we
don't
build
anything
to
build
reserves
up
right.
We
don't
add
any
fluff
to
those
reserves
up,
but
we
don't
build
any
drawdown
on
reserves
as
well.
So
we
try
and
look
at
it
solely
on
that.
Here's.
What
it's
doing
you
know
some
groups
will
say
you
know
they'll
account
for
a
certain
say:
oh
you
know
we
feel
we
have
too
much
in
reserves
and
they'll
account
for
that
that
you
can.
C
Get
in
trouble
pretty
quick
kind
of
doing
that.
What
obviously
we're
trying
to
balance
is
making
sure,
because
employees
do
contribute
a
portion
that
we're
not
over
charging
right.
You.
C
I
said
we'd
like
to
know
kind
of
how
much
we
have
total
reserve
on
these
accounts.
I
mean
if
we
have
five
million
six
million
reserves
over
this
cumulative
amount,
that
should
help
us
offset
some
of
these
costs.
If
our
projection
is
68,
projections
say
three
and
a
half
million
that
should
be
able
to
help
reduce
some
of
these
costs
from
employees.
If
we
have
that
much
reserve.
So
I'd
like
to
a
far
extent,
but
I'd
like
to
know
how
much
we
have
in
our
service
in
our
medical.
So
where.
B
B
C
First
and
foremost,
first
question
did
corbett
and
you
may
have
winnowed.
This
did
coleman
have
any
effect
on
my.
B
Friends,
so
yeah
kind
of
what
we
talked
about
was,
if
you
look
at
you
know
page
two
of
the
claims
and
you
look
at
last
year
in
april
and
may
in
those
months
you've.
Obviously
claims
were
in
those
months
because
people
weren't
going
down
right.
So
if
you
look
and
you
see-
even
if
you
just
go
to
the
far
total,
where
you
see
the
615
and
the
597
claims
for
employee
per
month,
claims
were
lower
during
those
months,
because
a
lot
of
things
were
shut
down
right
and
then
so.
B
D
On
my
ipad
yeah,
we
did
have
that
because.
C
D
B
Here's
what
we
saw
in
pharmacy
overall
overall
in
pharmacy,
the
impact
was
negligible
in
the
sense
that
most
people
still
filled
their
prescriptions.
What
what
everyone
will
tell
you
probably
did
happen.
A
little
bit
is,
you
know,
think
about
you
know
I
felt
a
little
sick.
Maybe
I
had
a
sinus
infection
and
normally
I
would
have
gotten
an
antibiotic
for
that,
but
maybe
I
just
said:
I'm
gonna
grind
it
out,
because
I
don't
want
to
go
to
an
urgent
care
where
a
bunch
of
people
might
be
getting
tested
for
covet.
B
You
know
things
like
that.
So
there's
probably
a
little
bit
of
a
drop
because
of
people
didn't
go,
get
some
of
that
care.
Maybe
the
doctor
would
have
prescribed
them
something,
but
overall,
for
the
most
part,
people
filled
their
prescriptions
throughout
the
pandemic.
You
may
remember
it's
hard
to
believe
this
was
so
long
ago.
There
was
a
little
bit
of
a
fear
at
first
about
a
drug
shortage
like
whether
or
not
so
everybody
cigna
and
all
the
companies
were
removed
like
some
of
the
limits,
so
you
could
go
film
quick.
B
So
what
we
did
see
is
like
april
may
june,
we
saw
more
fills
than
normal,
but
then
obviously
because
you
had
gotten
a
three
month
supply
or
a
six
month
supply
or
whatever.
Now
you
didn't
fill
that
for
the
next
six
months,
so
it
all
kind
of
washed
out
in
that
time
period.
But
that
was
a
little
bit
what
we
saw
in
that
regard.
So,
overall,
I
would
say
no
it
really
didn't
affect
pharmacy.
B
I
found
that
page,
so
you
guys
had
561
000
in
overall
spend
last
calendar
year
because
of
code,
so
an
extra
half
a
million,
but
that
half
a
million
was
probably
negated
by
all
the
people
that
didn't
go,
get
care
but
ultimately
yeah,
there's
probably
about
half
a
million
in
there
a
little
bit
extra
because
of
coven,
and
you
had
just
give
you
an
idea.
You
had
11
hospital
admissions
because
of
coven
for
79
total
days
in
the
hospital.
B
D
C
C
B
Up
so
hold
on,
let
me
expand
on
that.
You
had
301
md
live
or
amwell,
which
is
the
sigma
one.
You
had
737
people
actually
see
their
own
providers
through
some
sort
of
telemedicine
and
that
I
don't
have
a
number
of
the
year
before,
but
oh
actually,
yes,
I
do.
That
was
compared
to
nine
the
year
before
yeah,
so
huge
100
yeah
nine
the
year
before.
So
you
actually.
B
C
Years
are
we
seeing
any
trend
in
that
this
year?
So
far,
are
we
seeing
a
decrease
or
increase?
I
haven't
looked
at
that
yet
this
year.
B
But
I
I
think
what's
changed
because
of
it
is,
and
it
happened
to
me
right
my
doctor.
Let
me
do
virtual
business
and
one
of
my
wife's
doctors
let
her
do
virtual
just
to
fill
a
script.
B
You
know
and-
and
you
know
so
candidly-
it's
kind
of
a
racket.
Then
you
got
to
go
for
another
question
just
to
fill
a
script
anyway,
yeah,
but
I'm
not
a
doctor,
but
you
know
think
about
it,
safe
for
two
hours
of
driving,
probably
45,
minutes
of
sitting
in
the
waiting
room
and
then
to
have
five
minutes
with
the
doctor.
So
hopefully,
doctors
now
are
embracing,
saying:
hey,
wait,
a
minute,
I'm
still
getting
paid
and
you
know
they'll
start.
C
To
see
I'm
wondering
about
that,
one
where
an
employee
may
have
normally
used
if
it's
just
something
simple
the
telehealth,
but
they
call
the
doctor's
office.
Oh
the
doctor
can
see
you
on
a
teleconference
call
in
two
hours,
so
now
they
end
up
paying
their
20
hour
or
just
just
40
over
here,
as
opposed
to
vacuum
free
over
here,
but.
B
You
know
what
it's
definitely,
if
it's
something
more
than
like
a
sinus
infection
or
something
I'd
rather
me.
Personally,
I
think
it's
better
than
they
call
their
own
doctor.
That's
because
he
gets
logged
in
the
emr
they're
able
to
see
those
trends
so
yeah,
I'm
just
curious
how
that
was
trending
in
there
yeah.
I
I
think
that's
going
to
continue
on
the
telehealth,
because
a
lot
of
places,
including
the
doctors,
seem
to
be
going
more
towards
the
meetings
you
also
had.
B
C
Probably
something
that's
like
I
know
just
based
on
some
of
the
patients
that
I
had.
Some
of
them
have
expressed
that
they
would
rather
go
to
an
urgent
care
than
an
er
because
of
the
increased
chance
of
covid
and
emergency
rooms.
D
Expanding
services
of
the
clinic,
so
we
you
know
that
was
before
covid
that
we
were
talking
about
that
and
right.
The
only
thing
that
we
really
expanded
is
in
terms
of
doing
pre-employment
physicals
at
the
clinic
for
administrative
positions.
We
started
doing
that
to
just
also
introduce
employees
you
know
to
the
clinic,
but
in
terms
of
expanding
services,
that's
not
something
that
has
been
done
yet,
like.
I
said
a
lot
of
that
guy
kind
of
derailed,
because.
D
Continue
to
talk
about
things
are
so
different
now
because
of
covid.
D
Been
reaching
out
to
the
clinic
in
terms
of
just
you
know
not
a
barrier
but
a
challenge
in
terms
of
getting
a
provider
that
will
commit
to
coming
in.
You
know,
I
mean
on
a
you,
know,
weekly
basis,
whatever.
Without
that
kind,
you
know
without
that
kind
of
guarantee,
and
so
how
do
we
build
that
into
the
you
know
in
terms
of
what
they're
paying
and
whatnot?
So
not
that
it's
not
something
that
we're
not
continuing
to
look
at,
but
also.
C
D
Know
that
some
of
the
things
that
tony's
been
exploring
is
that
dr
terencinko
is
certified
as
the
right
word
to
use
and
that,
but
in
several
different
disciplines,
and
so
just
trying
to
expand
on
making
sure
that
employees
understand
what
all
she
is
capable
of
doing
outside
just
being
a
general
practitioner
so
trying
to
take
advantage
more
of
that.
But
I
mean
you
missed
it.
D
We're
talking
about
adding
programs
not
necessarily
to
the
clinic,
but
just
you
know
overall
again
the
shift
in
terms
of
how
employees
are
not
just
employees
but
how
people
are
kind
of
seeing.
B
D
D
D
Came
out
of
code
is
a
lot
of
our
employees
got
to
go
to
the
clinic
because
they,
you
know
it
was
a
convenient
service
that
we
offered
for
them,
and
the
clinic
was
a
good
partner
through
that.
For
us.
D
At
the
clinic
that
we're
hoping
will
turn
into
patients
because
again
the
more
claims
that
we
can
send
to
the
clinic
the
better
off
for
the
plan.
So,
whereas
we've
had
a
pause
on
adding
new
services,
we've
really
tried
hard
to
increase
both
marketing
and
just
ways
to
entice
employees
to
get
them
to
go
to
the
clinic.
To
take
advantage
of
the
service
that
we
have
so
there's
plenty
of
capacity
there
and
we're
going
to
increase
capacity
by
potentially
adding
another
provider
out
there
same
services.
D
B
And
what
what's?
What
I
would
say
is
always
interesting
when
it's
you
know
kind
of
family
practice
kind
of
all
right.
But
now,
if
you
start
talking
about,
let's
say
you
want
to
bring
a
cardiologist
in
two
days
a
week.
One
there's
sometimes
equipment
needs
that
can
get
pretty
expensive,
but
you
know
you'll
have
a
certain
percentage
of
people
that
are
already
working
with
a
cardiologist
right.
They
know
they
have
someone
and
they're
not
going
to
leave
their
doctor
right.
B
Even
if
it's
for
you
like
nope,
that
doctor's
kept
me
alive,
I'm
not
reading
them
right
and
you
get
into
more
of
these.
It's
kind
of
like
dentists,
right,
like
people,
people
it
amazes
me,
people
go
see
all
kinds
of
different.
You
know.
General
practitioners
don't
mess
with
their
dentist
and
network
out
a
network
like
they're,
going
to
their
dentist
right
and
I
think
a
lot
of
the
specialties
where
the
challenge
comes
is
you've
got
a
smaller
percentage
of
the
population
that
you
can
target
and
they're.
B
Just
people
are
tied
to
their
doctor
or
maybe
they're
going
to
be
more
skeptical,
like
you
know,
a
specialist
they're
expecting
them
to
be
in
the
fancy
building
and
like
right.
It's
you
know
so
there's
different
expectations
with
some
of
those.
So
that's
the
challenge
we
always
kind
of
battle
with
bringing
someone
someone
in
that
went
back
a
number
of
years
ago,
when.
C
We
we
went
to
the
lower
lower
cost
insurance,
lower
cost,
cigna
the
affordable
care
act
cigna,
and
we
have
all
those
issues
with.
D
Cigna
is
doing
some
promotions
to
get
people
to
the
clinic
and
again
we
put
all
that
stuff
in
our
weekly
wellness
email.
D
Yeah,
we
have
a
claims
call
every
other
week
so
that
you
know
we,
you
know,
have
content
communication
in
terms
of
with
gearing
group
and
cigna
to
have
a
conversation
with
regular
science
issues.
So
that
seems
to.
C
C
A
So
any
and
anything
you
know
we
don't
wait
for
those
bi-weekly
goals
either
I
mean
clearly
if
something
comes
up.
It's
immediately
addressed
so
yeah
you've
been
really
good
at
giving
those
things
and
a
lot
of
the
challenges.
B
Now
that
we
run
into
is
something
on
the
doctors.
It's
not
normally
like
a
cigna
problem.
It's
normally
somebody
needs
to
pick
up
the
phone
and
and
call
the
doctor
and
say:
hey
you
built
this
wrong
or
you
didn't
know.
I've
asked
you.
So
that's
what
that's!
What
like
my
team
kind
of
does
with
what
josie
is
normally
they're,
calling
the
doctor
and
stuff
so
that
you
know
having
a
signal
rail.
They
can
really
only
fix
the
issue
if
it's
on
the
signal,
so
that
was
part
of
why
we
said
wait.
B
So
in
july
we
will
we'll
have
the
dental
renewals
and
we'll
look
at
updated
claims.
We'll
also
talk
a
little
bit
about
motivate
me
and
any
potential
adjustments
or
truths
we
want
to
make
to
that
and
we'll
try
and
bring
some
information
on
the
armada
program,
since
that
will
probably
be
something
that
will
be
wrong.
C
D
B
And
I
know
cigna
so
amanda
developed
those
after
kind
of
the
initial
program,
so
I
know
they're.
I
think
they're
working
on
a
way
to
integrate
that
into
you
know.
Can
they
add
that
into
claims
the
one
problem
with
it?
Not
a
problem,
but
the
diabetes
prevention
program
is
easy
because
it's
preventative
so
the
toronto
clients
make
it
free
to
the
employees
when
you
start
getting
into
like
the
type
2
program
now.
A
B
Into
a
situation
of
it's
not
really
a
preventative
program,
it's
more
of
a
care
program,
so
there's
different
rules
that
come
into
play
with
what
you
can
do.
So
that's
definitely
something
that
that
develops.
They
also
bought
a
company.
I
think
I
told
jennifer
about
this
one
day,
but
they
bought
a
company
called
fizzera
and
fazera
is
a
virtual
physical
therapy
company.
B
So
I
think
at
some
point
down
the
road
you
may
see
that
sort
of
integrating
I
actually
tried
it.
I
had
kind
of
like
a
hamstring
strain
and
tried
this
virtual
program,
and
it
was
really
unbelievable.
Do
it
at
home
on
your
schedule,
talk
with
a
coach,
they
build
a
program,
send
you
any
of
the
equipment
you
need
and
they
build
like
all
your
you
know,
but
it's
gone
through
rehab.
They
build
all
the
exercises
into
the
app
every
week.
So
you
just
pull
up
the
app.
B
B
D
So
yeah
motivate
me
with
the
with
the
exercise
and
the
dietitian.
Those
are
the
two
big
and
the
weight
loss
as
well.
Those
three
are
the
big
things.
D
All
right
any
other
questions
or
comments
or
anything
else
we
need
to
discuss.
So
the
next
meeting
will
be
a
big
meeting.
We
will
need
a
forum
so
that
we
can
make
some
decisions,
so
hopefully
we
can
give
that
we'll
probably
do
it
the
same
way
that
we'll
have
options
like
this,
so
that's
slightly
more
convenient
to
be
able
to
have
so
all
right.
No
other
questions.
We
will
end
the
meeting.
Thank
you
all
very
much
good
to
see
everybody.