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From YouTube: City of Clearwater Benefits Committee Meeting
Description
Video of city of Clearwater Benefits Committee Meeting, held over Zoom.
A
Okay
good
morning
it
is
friday
april
23rd
and
it's
approximately
907.
My
name
is
jill
paul,
I'm
the
benefits
committee
kind
of
leader
here
and
I'd
like
to
welcome
ryan
mcmullen
to
the
benefits
committee.
I
think
this
is
his
first
first
meeting
and
tony
rozier.
Our
new
hr
assistant
director
she's,
been
with
our
team
since
january,
and
we're
very
happy
to
have
her.
A
2020
was
a
challenging
year,
but
we
did
send
out
the
survey
to
all
employees
and
to
retirees
that
participate
in
medical,
dental
and
or
vision
insurance.
We
asked
seven
questions,
four
of
which
the
employee
or
retiree
was
selected.
They
had
to
select
a
rating
between
strongly
agreed
to
strongly
disagree,
and
there
were
three
open
ended
questions
that
would
require
a
response.
A
We
received
219
responses
via
the
survey
site
and
mail
mail-in
responses.
This
equates
to
somewhere
between
about
12
percent
of
the
benefit
eligible
population
of
employees
and
retirees.
We
responded
when
responding
to
the
question
asking.
If
the
employees
were
satisfied
with
our
health
plan,
we
had
75.8
percent
either
agreed
or
strongly
agreed
when
responding
to
the
question
asking.
If
employees
and
retirees
had
the
opportunity
to
ask
questions,
get
information
and
make
changes
during
open,
enrollment,
78.8
percent
either
agreed
or
strongly
agreed.
A
The
third
question
we
asked
is
if
the
benefits
highlight
book
contained
all
the
information
needed
to
make
informed
insurance
decisions
and
selections
and
67.5
either
agreed
or
strongly
agreed.
The
fourth
question
asked
if
the
employees
or
retirees
knew
who
to
reach
out
to
if
they
didn't
understand
their
benefits
and
82.6,
either
agreed
or
strongly
agreed.
A
A
Since
2020
was
the
first
year
promote
our
motivate
me
program,
we
wanted
to
address
participation
in
the
program
and,
if
the
utilization
of
the
program
and
the,
if
the
employees
had
noticed
any
improvement
in
their
physical
or
mental
health
by
utilizing
motivate
me
in
the
clinic,
we
received
positive
feedback
from
employees
that
use
the
clinic.
Regarding
motivate
me,
one
employee
stated
that
the
motivate
me
program
forced
them
to
get
the
physical
and
other
screenings
which
uncovered
underlying
health
issues
that
are
now
being
treated.
A
B
Great
well,
thank
you
jill
good
morning.
Everybody
thanks
for
quote-unquote
getting
together
virtually
this
morning.
I
certainly
didn't
think
you
know
13
months
ago.
We'd
still
be
doing
this
when
we
kind
of
started
it,
but
here
we
are
definitely
miss
seeing
everyone
and
and
having
some
of
those
face-to-face
meetings,
but
joe
really
gave
a
a
great
overview
of
kind
of
the
stuff
we
wanted
to
cover
today
and
obviously
you
know
covid
and
how
that
affects
the
medical
plan
and
the
health
insurance.
B
I
think
is
probably
a
question
on
everybody's
mind,
so
we
are
going
to
dive
into
that.
Just
a
little
bit.
Look
at
some
of
the
specific
experience
for
the
city.
You
know
looking
back
on
last
year,
but
also
kind
of
talk
about
some
of
the
things
where,
where
people
are
looking
at
what
the
impacts
are
in
the
future
in
the
next
year
and
the
upcoming
year.
So
that's
what
we're
going
to
kind
of
hit
on
today
before
we
get
started,
and
I
I
put
some
stuff
up
on
the
screen.
B
D
B
C
B
B
All
right,
sorry
about
that,
so
let's
try
this
again
what
I'd
like
to
do
if
anybody
printed
this
out,
I'm
gonna
start
with
page
two,
which
is
all
of
last
plan
year
and
then
we'll
go.
Look
at
the
first
couple
months
of
the
current
plan
year
that
we're
in
so
one
thing
for
those
of
you
that
have
been
on
the
committee
for
a
while.
We
did
make
a
little
change
to
the
claim
reporting.
The
top
half
is
really
what
you're
used
to
seeing
on
the
bottom
half.
B
What
we
tried
to
do
was
create
a
kind
of
one
page,
stop
to
really
give
you
a
lot
of
the
key
pieces
of
information
on
the
plan.
Instead
of
looking
through
a
bunch
of
reports,
we
want
to
put
it
all
in
one
place,
so
it
was
there
for
easy
reference.
So
I
know
we
have
a
couple
people
that
are
new,
so
I
will
go
kind
of
look
at
these
columns
one
by
one,
so
everybody
understands
what
they
mean
just
if
anybody's
new,
so
so
starting
off
the
city
self-insures
its
medical
plan.
B
What
that
means
is
that
the
city
pays
an
administrative
fee
to
a
carrier,
a
third
party
administrator
which
is
cigna,
and
then
the
city
pays
for
claims
as
they
occur.
So
by
claim
we
mean,
if
you
go
to
the
hospital,
the
doctor,
the
pharmacy
there's
a
cost
for
that
service
after
the
employee
pays.
Any
cost
share
that
they're
responsible
for
the
plan
pays
the
rest,
the
plan
being
the
city
in
this
case.
B
So
what
we
do
each
year
is
we
look
at
how
much
funding
we
think
the
city
needs
for
the
plan,
so
taking
a
look
and
saying
based
on
expenses
based
on
medical
inflation,
fancy
word
they
use
in
the
insurance
industry.
I
have
no
idea.
Why
is
trend
instead
of
just
saying
medical
inflation,
but
that's
looking
at
what
is?
How
is
the
cost
of
care
increasing
on
a
year-over-year
basis?
B
B
So
you'll
see
over
here,
just
total
enrollment
you'll
see
that
it
goes
up
and
down
a
little
bit.
So
that's
why
our
funding
changes
a
little
bit
up
and
down
now
the
opposite.
Just
for
a
little
insurance,
101
of
being
self-insured
is
fully
insured,
which
the
city
was
for
many
years
and
fully
insured.
The
insurance
company
gives
you
a
premium,
and
then
it's
kind
of
winner
take
all.
If
claims
are
more
than
the
premium,
they
lose
money.
If
claims
are
less,
they
make
money
so
with
self-insured.
The
city
really
takes
over
that
role.
B
B
Just
to
give
you
an
idea,
because
what
is
paid
to
cigna
to
administer
your
plan
on
an
annual
basis
last
year
was
about
960
thousand
dollars.
Out
of
that,
almost
21
million,
so
it's
always
good
to
put
that
in
perspective
and
keep
that
in
mind.
As
we
look
at
the
next
column,
we
have
stop
loss
or
reinsurance.
B
B
So
what
that
means
is
the
city
of
clearwater
pays
the
first
three
hundred
thousand
dollars
on
that
claim
and
anything
after
that
is
paid
by
the
reinsurance
company.
Now
cigna
offers
us
reinsurance
on
our
current
plan,
but
you're
not
necessarily
tied
to
cigna.
You
can
use
a
third
party
if
they
give
a
a
better
rate
as
we're
looking
at
that
and
you'll
see.
B
I
think
it's
always
important
that
coverage
actually
costs
more
than
even
the
administration
of
the
plan
and
that's
because
the
risks
that
are
out
there
with
some
of
new
drugs
treatments
cancer
treatment.
It's
very
easy
to
have
a
three
four
five
hundred
thousand
dollar
claim
that
could
hit
the
city's
plan.
So
that's
why
that
premium
costs
what
it
costs
so
that
cost
about
1.4
million
for
last
year,
medical
claims.
B
B
So
we
add
those
up
anything
up
to
the
stop
loss
level
and
we
had
17.2
million
in
total
claims
last
year.
So
when
we
add
those
claims
to
the
fixed
costs,
our
total
plan
costs
us
19.6
million
dollars
last
year,
so
we
came
in
under
budget,
which
is
great.
It's
great.
Obviously,
because
we
don't
like
to
go
over
budget,
you
know
it
doesn't
make
finance
people
or
anyone
happy,
but
the
other
reason
that's
really
important
is
as
we
project
forward
for
future
years.
B
B
Minus
total
plan
cost
here,
and
we
have
these
totals
here
so
you'll
see
any
month
in
red.
We
had
a
negative
in
the
plan
and
then
any
month
that's
black.
We
had
a
positive
month,
so
we
had
surplus
in
those
months
now
I'm
going
to
talk
about
as
we
talk
about
covid
a
little
bit
more,
but
I
do
want
you
to
just
look
here
at
april
and
may
in
total
claims.
B
So
if
you
take
a
look,
most
claims
that
are
paid
in
a
month
generally
incurred
a
month
or
two
before
so
april
and
may
was
really
when
everything
was
shut
down
for
copen.
We
still
had
people
going
to
the
hospital.
There
were
still
essential
services,
but
a
lot
of
our
elective
surgeries,
a
lot
of
testing
those
didn't
happen
during
that
time
period.
So
we
got
a
little
bit
of
an
artificial
boost
in
april
and
may
of
last
year,
where
we
have
pretty
substantial
surpluses
for
those
months,
so
that
definitely
helped
things.
B
That's
a
brand
name
drug,
there's
a
high
probability
that
it
has
a
pharmacy
rebate,
and
that
is
basically
a
refund
from
the
manufacturer
to
the
insurance
company
for
allowing
that
drug
to
be
on
their
formulary
drug
pricing.
Transparency
is
a
hot
topic
in
washington
right
now.
This
is
part
of
why
so
the
way
it
might
work
is,
let's
say,
there's
a
drug.
That's
a
thousand
dollars
a
month
that
manufacturer,
even
though
they
charge
a
thousand,
might
give
the
insurance
company
200
back
every
time
it's
filled,
so
the
real
cost
is
only
800..
B
The
reason
that's
also
been
a
hot
topic
is
there's
been
some
talk
about.
Should
the
consumer
get
some
benefit
of
that
right?
Should
the
consumer
get
that
money,
maybe
up
front,
you
know
at
the
pharmacy.
So
that's
one
of
the
topics
in
washington.
The
challenge
with
that
sometimes
is.
If
you
look
at
the
city
of
clearwater's
plan
as
an
example,
you
still
have
relatively
low
pharmacy
copays,
so
the
city
is
paying
the
bulk
of
the
cost.
B
Of
that
drone,
now,
if
you
flipped,
you
know
jill
mentioned
a
high
deductible
plan
well
on
a
high
deductible
plan.
We
have
on
a
guarant
group.
If
you
have
a
drug
that
costs
1500
a
month.
That's
what
you
have
to
pay
on
a
high
deductible
plan
is
that
fifteen
hundred
dollars,
so
that's
really
where
some
of
that
discussion
has
come
in
is:
should
the
consumer
get
the
benefit
of
that
story
for
another
day?
B
B
They
came
back
now.
These
are
actually
for
the
year
before
they
get
paid
in
march,
so
we
get
them
the
subsequent
year,
but
we're
kind
of
counting
them
based
on
the
year
they
come
in,
and
the
thing
that
I
think
is
interesting
about
this
to
my
earlier
comment
about
the
insurance
companies
making
money.
If
you
take
a
look
at
the
900
000
and
pharmacy
rebates,
it's
almost
like
they
administered
your
plan
for
free,
so
so
keep
that
in
mind
as
people
talk
about
the
high
cost
of
insurance.
B
B
So
the
last
thing
we
look
at
here
is
claims
per
employee
per
month.
So
we
divide
out
what
we
do
here
is
we
divide
out
the
claims
each
month
divided
by
the
number
of
employees
on
the
plan
that
way,
if
you
lose
or
add
employees,
we
know
how
that
trend
is
running
so
857
dollars
was
our
claims
per
employee
per
month.
B
That
was
kind
of
the
long
part
now
we'll
go
to
the
quicker
part.
So
just
on
this
dashboard,
what
we
have
is
is
over
here
on
the
left.
We
have
a
look
at
what
is
that
cost
to
funding
as
a
percentage
so
89
last
year,
so
89
of
what
we
budgeted
is
what
our
cost
came
in
at
this
gives
you
a
little
idea
of
a
breakout
of
costs
over
the
years
split
up
by
those
factors
and
then
added
together.
B
B
B
So
you
had
a
little
bit
of
an
increase
last
year
with
the
pharmacy
and
if
you
can't
dissect
the
little
graphs,
here's
a
better
summary
so
year
over
year
we
had
a
1.4
decrease
in
medical
claims.
We
had
a
24.8
increase
in
pharmacy
costs.
Sorry
not
claims,
but
claims
cost
a
couple
things
going
into
that.
There's
a
lot
of
higher
cost
drugs
coming
out
in
the
market
that
are
driving
that
up
a
number
of
them
around
cancer,
a
number
around
diabetes.
B
We
had
a
little
bit
last
year
it
it
seems
like
a
long
time
ago.
It
might
be
hard
to
remember,
but
we
also
remember
we
had
this
fear
of.
Was
there
going
to
be
a
drug
shortage
because
of
the
pandemic?
So
we
also
had
some
fill
limits
removed.
So
people
rushed
out
and
got
a
lot
of
drugs
filled
up,
so
they
had
them
in
the
medicine
cabinet.
So
we
had
a
little
bit
of
a
spike
from
some
of
that.
B
So
it's
not
that
the
health
of
the
population
has
changed.
It's
that
they're
moving
more
people
into
using
these
higher
cost
biologic
drugs.
So
that's
driving
costs
up
a
little
bit
as
well
down
here
on
the
left.
We
just
have
a
graph
of
these
numbers
and
what
I
think
is
really
great
about
this.
Is
you
see
the
april
and
may
drop?
B
B
B
So
now,
let's
take
a
look
at
first
three
months
of
the
current
plan
here.
So
first
thing
is
you
had
a
good
january,
as
seems
to
always
be
the
case
for
the
city
of
clearwater
february
and
march,
were
a
little
bit
higher.
So
we
did
have
deficits
in
those
months
and
I
think
if
you
go
back
and
look,
the
exact
same
thing
happened
last
year,
february
and
march,
so
the
city
because
of
its
size,
it's
very
a
lot
of
the
claims
are
very
predictable.
B
B
So
overall
we
had.
We
got
the
pharmacy
rebates
for
the
2020
plan
year,
almost
about
175
000
increase
in
those
pharmacy
rebates.
So
pretty
good.
There
now
remember
that's
for
the
whole
year.
So
it's
skewing
these
numbers
a
little
bit
because
we're
not
going
to
get
any
more
pharmacy
rebates
for
the
rest
of
the
year,
but
over
so
overall.
The
plan,
though,
has
a
slight
surplus
year-to-date.
B
What
we
did
down
here,
because
those
pharmacy
rebates
would
really
skew
it
is
in
calculating
this
percentage.
We
we
prorated
them.
So
we
took
this
number
divided
by
12
and
we've
added
three
months
in
and
we'll
change
that
each
month,
so
it
gives
you
a
real,
accurate
snapshot,
but
overall,
our
medical
trend,
we're
up
about
5.8
percent
on
medical
and
4.4
percent
on
pharmacy,
but
remember
pharmacy
had
jumped
a
lot
last
year,
so
we're
at
a
higher
point
and
then
going
in
here
you'll
see
those
claims
per
employee
per
month.
B
B
Yes,
so
great
question
steve,
I
do
have
some
slides
with
that,
so
I'll
get
to
that
in
one
second.
So
steve
makes
up
a
ring.
Great
point,
though,
which
we'll
talk
about,
so
we
did
have
some
reduced
costs
because
people
weren't
getting
care
because
of
covet,
but
on
the
flip
side
we
had
some
increased
costs,
because
people
had
coveted
that
we
never
had
in
years
before
so
we're
going
to
look
at
both
of
those
items
and
and
what
I
want
to
use
to
segue
into
that.
B
Maybe
is
to
take
a
look
at
these
two
months
of
april
and
may
where,
where
we
dropped
off
so
much
last
year,
so
what
the
industry
and
I'll
just
be
candid,
I
mean
they're
they're
struggling
with
in
a
lot
of
ways
is
a
lot
of
entities
went
down
like
this
in
florida,
the
more
rural
the
entity
is,
we've
looked
the
less.
They
dropped
right.
The
less
doctor's
office
closed.
B
B
B
Because
you
know
I
was
at
an
entity
the
other
day,
and
this
this
had
happened
with
someone
with
a
mammogram.
They
were
supposed
to
have
their
mammogram
last
march
facility
shut
down.
They
just
didn't.
Go
back
in
they
went
this
march,
and
now
they
have,
they
found
a
stage
3
cancer
that
they
probably
would
have
found
stage
1
last
year,
so
that
obviously
costs
more
there's
concerns
with
that.
But,
more
importantly,
you
know
that
person's
prognosis
is
a
lot
worse
as
a
result
of
that
so
they're.
B
Looking
at
all
those
things
saying,
has
everybody
gone
back
and
got
those
services
they
missed?
Have
95
percent
of
them
or
is
it
50
and
then
they're?
Also
looking
and
saying?
Well,
some
of
those
diagnoses
diagnoses
that
didn't
happen.
How
much
are
they
going
to
cost
if
we
catch
them
a
year
down
the
road?
So
that's
what
everybody's
looking
at
and
struggling
with
and
I'll
add
one
more
thing.
B
We
have
some
groups
that
renew
in
like
march
or
april
and
like
on
the
fully
insured
basis,
the
insurance
companies
have
added
six
to
eight
percent
to
their
rates.
To
account.
For
that
now
the
good
thing
for
the
city
of
clearwater
is
we
tend
to
bring
numbers
back
to
you
guys
in
june
generally,
so
by
then
these
months
will
be
out
of
our
projection.
B
B
Some
entities
don't
have
the
benefit
of
that
you
know
and
they
had
to
renew
and
and
they're
they're
a
little
bit
potentially
going
to
pay
the
price,
because
underwriters
and
actuaries
are
going
to
guess
on
the
high
side
right
they're
going
to
pad
it
in
their
favor.
They
want
to
be
they'd
rather
have
more
money
than
less
left
at
the
end
of
the
year.
B
Let
me
do
this,
I'm
going
to
jump
around
and
then
I'll
go
back
and
look
at
the
overall,
since
the
question
has
come
up,
let's,
let's
just
keep
rolling
with
covid
and
then
we'll
we'll
turn
things
around.
So
we
just
did
our
annual
review
with
cigna,
where
they
look
at
the
plan
on
a
lot
of
different
details
and
metrics
and
what
they
did
is
they
put
together
a
report
on
covid
and
specifically
the
impact
on
the
city's
plan.
B
So
just
to
give
you
guys
some
snapshots
and
some
of
the
things
they
looked
at
so
last
year
and
obviously
this
really
started
march
right.
We
had
779
individuals
tested
through
the
medical
plan,
so
I
want
to
give
that
that
one
caveat
in
that
you
know
early
on,
especially
there
were
like
some
pop-up
testing
sites
that
were
maybe
run
by
the
county
or
the
state
health
department.
B
B
The
average
age
of
those
diagnosed
was
40.,
and
this
is
just
a
good
place
to
kind
of
mention.
So
when
you,
when
you
look
at
covid,
and
you
look
at
some
of
the
way,
it
impacts
people's
health,
the
older
you
get
obviously
the
more
at
risk.
You
are
of
severe
complications,
not
that
somebody,
young
can't
have
it
so
that
average
age
of
40.
B
We
know
that
it's
probably
skewed
in
some
regards,
because
we
know
there's
some
younger
people
that
were
probably
asymptomatic
with
covid.
There
may
be
some
older
people
that
were,
and
we
know
that
there
are
some
younger
people
that
maybe
didn't
even
get
tested,
even
though
they
they
thought
they
had
it
because
it
impacted
them
in
a
very
minimal
way,
so
that
that
could
be
skewed
a
little
bit
high
65
male
35
female,
which
is
interesting
on
the
split
and
51
had
chronic
conditions.
B
So
why
is
that
important?
You
know,
there's
definitely
ties
if
you
have
something
like
diabetes.
You
know
if
you're,
overweight,
hypertension,
some
of
those
things
heart
conditions,
it
can
potentially
impact
you
more.
So
you
had
11
individuals
hospitalized
for
covid
for
a
total
of
79
days,
so
the
average
length
of
stay
was
seven
days
for
somebody
with
coven,
which
is
interesting
pretty
long.
So
that's
it's
not
worthy,
and
you
had
15
days
where,
where
at
least
one
of
those
people
was
in
the
icu,
so
what?
B
B
Yeah
so
or
jennifer
or
tony
might
have
to
jump
in
here,
but
they're,
you
know
so
the
reimbursements,
my
understanding
is
they're
flowing
down
kind
of
through
the
counties.
So
we
have
a
lot
of
groups
where
we
provided
reporting
to
the
group
to
provide
to
the
county,
and
I
think
I
think
jay's
on.
I
can't
see
the
full
last
vote,
so
some
of
that
I
know,
can
get
submitted
potentially
for
reimbursement.
B
I
don't
know
if
anybody's
been
reimbursed
for
testing
expenses
yet,
but
we
have
been
providing
some
of
that
data
and
the
hope
that
maybe
there'll
be
some
money,
although
I
will
say
it's
largely
on
the
testing
area
and
that
when
you
look
at
this,
this
is
the
bulkier
cost.
Probably
is
still
that
hospital
admissions.
G
Yeah,
hey
sean
I'll
jump
in
here,
real
quick,
so
we
have
been
submitting
it.
I
don't
think
we've
gotten
anything
back
yet,
but
a
majority
of
the
stuff
that
is
eligible
for
reimbursement
is
the
preventative
stuff.
So,
like
the
ppe
and
that
kind
of
a
thing
and
the
testing
like
sean
is
saying,
I
don't
think
the
hospital
will
be
eligible
for
reimbursement.
H
B
B
Okay,
great
so
a
couple
other
things
so
what
they
also
looked
at
is
you
know
that
shutdown?
What
did
it
affect
right?
So
pcp
visits
we're
down
about
five
percent
which,
by
the
way
this
is
a
lot
lower
than
most
of
our
other
groups.
Specialist
visits
down
only
one
percent
admissions
to
the
hospital
down
about
17
emergency
room
down
11.
B
So
I
think
one
good
thing
with
emergency
room
is:
if
you
thought
you
were
going
to
emergency
room
where
a
bunch
of
people
at
covid,
you
really
questioned
whether
or
not
you
should
go
to
the
emergency
room,
so
I
think
that
drove
some
overall,
better
utilization,
urgent
care.
So
a
lot
of
those
people
went
to
the
urgent
care
instead,
so
that
was
up.
42
outpatient
surgeries
actually
went
up
a
little
bit
because
more
of
those
services
moved
outpatient
and
then
virtual
care,
which
we'll
talk
about
a
553
jump
in
virtual
medicine,
virtual
care.
B
B
B
So
what
that
means
is
those
carriers
that
were
loading,
eight
percent
to
the
rates
as
an
example,
we
don't
need
to
take
that
kind
of
measure,
so
that
overall
is
good
news.
So,
as
we
take
a
look
at
that,
so
I'm
not
going
to
spend
a
lot
of
time
on
this
side,
but
this
just
looks
at
coveted
risk
factors.
B
B
If
you
go
to
a
private
facility,
a
cvs,
a
walgreens,
a
doctor's
office,
any
of
those
places
that
are
administering
it,
they
can
submit
a
charge
to
the
insurance
company,
there's
no
charge
to
the
employee
for
administering
that
vaccine
and
maintaining
it
generally.
What
we've
seen
is
about
19
that
they're
getting
reimbursed
in
that
regard,
so
just
wanted
to
share
that
to
kind
of
wrap
that
up
before
we
move
on
to
the
other
items.
Does
anybody
have
any
questions
on
that
steve?
I
see
your
hand,
I
think.
F
B
F
B
No
now,
what
I
will
say
is
there's
a
number
of
sites
that
are
being
federally
funded,
so
they
won't
ask
for
your
insurance,
okay,
so
those
so
so
the
answer
so
kind
of
you
know
if
the
question
is,
are
we?
Are
we
paying
for
vaccines
to
be
administered?
Sometimes
is
ultimately
the
answer.
It
depends
on
where
they
go.
F
B
So
taking
a
look
here,
I'm
not
going
to
hit
on
all
these
things.
This
is
from
the
cigna
annual
report.
Just
looks
at
some
of
the
trends.
They
look
at
numbers
on
a
little
bit
different
basis.
They
look
on
the
incurred
dates,
so
the
data
incurred
we
use
the
paid
date
because
the
incurred
date
could
stuff
can
come
in
after
the
fact,
but
just
a
couple
hits
the
highlights
here
to
hit
on
top
three
diagnostic
categories
is
circulatory
or
heart.
B
Musculoskeletal
and
neoplasms
is
cancers
so
to
the
question
mike
had
earlier
kind
of
what's
driving
the
increases
or
what's
driving
the
trend,
so
you
had
a
seven
percent
reduction
in
catastrophic
claims,
so
the
those
high
cost
claims
over
fifty
thousand,
you
had
a
seven
percent
reduction.
That's
one
of
the
big
drivers,
all
the
other
claims.
We
were
down
about
2.6
on
the
incurred
basis.
So
again
those
numbers
aren't
going
to
match
up
100
and
then
look
at
this
specialty
pharmacy.
So
those
high
cost
drugs
42
overall
increase.
B
So
pharmacy
is
a
big
part
of
the
driver.
Just
remember,
though,
the
spend
isn't
one-to-one
pharmacy
is
a
much
lower
spend
than
medical
proportionally.
You
could
see
that
on
those
claims
or
reports
and
over
here
just
a
couple
things:
generic
dispensing
rate
88
so
88
of
our
drugs
are
being
dispensed,
are
generics
and
here's,
our
top
three
drug
classes,
anti-inflammatory
disease,
modifiers,
that's
going
to
be
those
biologics
I
talked
about.
B
B
B
C
B
So
potentially-
and
I
think
the
a
good
example
would
be
the
you
know-
the
comment
that
jill
made
from
the
survey
where
somebody
said
they
went
in
because
of
motivate
me
and
they
found
something,
so
I
think
that's
definitely
a
potential.
But
overall,
as
far
as
these
specialty
drivers,
I
would
say
those
those
individuals
that
probably
didn't
come
from
a
routine
screening.
That's
probably
something
that's
been
ongoing
for
a
while.
I
think
the
one
area
that
I
would
say.
B
So,
if
you
look
at
things,
you
would
generally
find
like
hyper.
You
know:
high
cholesterol.
Those
drugs
are
relatively
low
costs
of
all
the
things
that
you
would
look
at
with
that.
You
know
if
somebody
found
a
cancer
from
that.
Definitely
that
could
drive
it.
You
know
the
other
thing
would
be.
If
you
had
somebody
that
didn't
know
they
were
diabetic
and
maybe
they
got
on
one
of
those,
but
still
generally,
I
think
there
would
be
a
buildup
because,
generally
you
wouldn't
start
somebody
on
the
high-cost
drug.
B
They
generally
start
them
on
a
generic
and
make
their
way
through
and
say
none
of
these
are
working.
So
I
think
that
could
potentially
happen,
but
it
could
take
a
little
bit
of
time
now.
The
flip
side
of
that,
though,
is
gonna,
be.
Does
that
help
us
avoid
a
hundred
thousand
dollar
hospitalization,
because
somebody
didn't
know
you
know,
and
then
they
end
up
in
the
hospital
you
know
and
they're
told
their
blood
sugars
are
so
so
off
that
that
happens.
So
that's
part
of
the
way
you
would
want
to
look
at.
B
So
this
is
just
some
pharmacy
insight.
You
know
some
more
information
on
some
of
the
spend.
Here's.
What
I
think
is
really
to
the
question,
even
that
gina
just
brought
up,
which
I
think
is,
is
really
something
good
to
look
at
and
take
a
look
at.
So
what
an
insurance
company
looks
at
is
what
they
call
a
compliance
rate
and
using
my
real
simple
example
of
hypertension.
B
You
know
if
I'm
diagnosed
as
hypertensive
and
the
doctor
prescribes
me
a
blood
pressure
medicine
so
that
gets
tracked.
If
I
fill
that
script
every
month
or
every
three
months
with
my
supply,
they
can't
tell
obviously,
if
I'm
actually
taking
it
but
they're
assuming
I
am,
they
look
at
what
they
call
compliance
rate.
So
do
I
take
the
medicine
that
I've
basically
been
told
I
should
take
and
over
on
the
right,
you
have
the
cigna
norms
and
over
on
the
left.
B
Now
we
have
the
city
of
clearwater
and
you
guys
are
now
way
above
the
norms
in
that.
So
one
thing
we
started
doing
to
look
at
this.
It
does
affect
this
a
little
bit
is
we
started
submitting
the
data
through
the
clinic
into
the
medical
plan,
but
what
I
think
is
so
you
know
noteworthy
and
important
here
is
across
the
cigna
book
of
business.
Only
72
percent
of
diabetics
are
filling
their
meds.
B
B
B
It's
only
md
live
going
forward.
You
had
301
visits,
but
look
at
this
so
this
if
we
look
the
year
before
so
signal
providers.
So
what
this
means
and
like
my
provider,
did
it
is,
you
know,
sean
had
a
visit
with
his
own
doctor
over
telemedicine.
Instead
of
in
person,
737
visits
and
behavioral
health
virtual
visits
985,
we
saw
a
big
increase
in
behavioral
health
with
the
with
the
pandemic.
B
B
B
B
B
All
right
so
last
thing
and
kind
of
to
the
questions.
You
know
we
made
a
big
emphasis
on
motivate
me
and
looking
at
you
know,
preventative
care
looking
at
trying
to
get
ahead
identify
conditions.
Looking
at
some
of
these
things
make
sure
people
get
their
well
visits,
make
sure
they
get
their
testing
and
the
first
thing
I'll
say
is:
if
we
look
overall,
everybody
was
way
down
last
year
collectively
because
of
covid,
a
lot
of
things
were
down
in
the
city
of
clearwater,
so
we
did
include.
B
We
did
include
clinic
data,
so
we
started
reporting
that
data
because
of
motivate
me
so
there's
a
little
bit
of
a
boost
because
of
that
which
I'll
hit
on
with
these
slides,
but
it's
really
important
to
compare
to
the
norm,
because
the
norm
is
cigna
public
sector
book
of
business
in
the
state
of
florida.
So
this
is
your
peers
and
counterparts
that
have
cigna
so
looking.
Overall
preventative
care
is
a
total
preventive
percentage
of
spend
1.4.
B
B
These
really
aren't
going
to
be
driven
much
by
the
clinic
because
we're
not
doing
those
you
know
child
exams.
In
there
the
city
jumped
up
5
78
on
pediatric
screening
rates,
you're
above
the
norm
of
cigna
of
by
11,
which
is
great
for
adult
overall
well
visit
rates.
42
percent
the
signo
norm
is
32,
so
we've
got
a
10
over
the
cigna
norm,
20
jump
year
over
year,
but
part
of
that
is
because
the
clinic
wasn't
in
the
prior
year.
B
B
B
That's
38
of
the
overall
incentives
available
for
an
average
of
a
hundred
and
forty
two
dollars
earned
per
individual
on
the
incentive.
So
of
that
kind
of
breakout
you
had
800
that
earned
eligible
incentives.
You
had
1300
that
did
not
average
age
of
those
doing
it.
48.8
43.3
of
the
individuals
that
didn't
so.
What
that
tells
us
is
that
our
younger
employees
aren't
jumping
as
much
to
to
get
involved
with
motivate
me
and
do
that
so
overall,
I
think
fantastic
results.
B
B
76
did
did
health.
Coaching
798
did
that
screening,
which
is
obviously
your
gatekeeper,
and
then
you
had
two
that
earned
the
maternity,
so
the
cigna
motivate
me
maternity
program
is
part
of
everybody's
plan.
So
that's
something
that
sort
of
operates
in
its
own
silo,
but
that's
just
kind
of
a
real
high
level
overview
motivate
me-
and
I
think
you
know
overall,
very
good
results
for
year,
one
in
general.
We
can
always
do
better
and
we
always
want
to
do
better.
B
I
think,
given
the
fact
that
you
had
this
during
a
pandemic,
don't
discount
that
I
think
the
results
you
know
are,
probably
you
know.
I
think
you
had
some
people-
probably
that
would
have
done
it-
that
maybe
lost
sight
of
it
a
little
bit
during
the
pandemic,
with
everything
else
going
on.
So
I
think,
potentially
you
see
those
those
numbers
go
up
a
little
bit
more
this
year.
Now
that
we're-
hopefully
a
little
bit
more
back
to
normal.
B
F
Steve
so
I
think
there
might
be
a
slight
difference
in
the
actual
numbers
compared
to
what
we're
seeing
on
here,
based
on
police
and
fire,
because
we
are
do
our
comprehensive
annual
medical
screenings
each
year.
I
know
I
don't
know
if
joe
has
the
numbers
as
to
what
percentage
of
police
and
fire
go,
do
motivate
me
and
the
wellness
business
is
composed
as
compared
to
other
people
in
the
city.
F
But
I
know
there's
a
lot
of
people
in
the
fire
department,
at
least
that
don't
really
look
at
that
for
the
extra
hundred
some
odd
dollars,
because
it's
considered
a
second
less
less
comprehensive
medical
screen
than
we
currently
get.
So
what
we
may,
you
may
actually
have
there's
a
lot
more
people
that
are
doing
based
on
police
and
fire
doing
comprehensive
wellness
visits.
But
it's
not
reflected
in
here.
G
See
yeah,
you
know
steve
when
I
was.
I
had
some
conversations
with
the
union
about
this
as
well,
and
one
of
the
things
that
I
think
would
be
helpful
so
that
we
could
get
some
additional
participation
from
you
know
both
police
and
fire
is
and-
and
I
think
it
would
be
beneficial
to
them
as
well
as
if
they
actually
brought
that
report
to
their
doctor,
and
you
know
so,
it's
they
don't
have
to
repeat
anything
that
was
done.
G
They
just
have
an
actual
face-to-face
meeting
with
the
doctor
where
the
doctor
goes
over
those
results
and
that
I'm
sure
well,
I
don't
want
to
say
I'm
sure,
but
I
think
that
that
could
count
as
their
annual
physical,
which
would
then
be
a
trigger.
You
know
for
that
gatekeeper
meeting
and
then
qualify
at
them
for
it.
So
I
you
know,
I
think
it's
an
education
piece
that
I
want
to
work
on
with
police
and
fire
so
that
they
do
that.
G
I
do
know
that
I've
been
successful
with
that
in
other
cities,
where
that's
that
did
count
as
an
annual
physical
by
bringing
that.
So
again
we
don't
want
you
guys
to
repeat
that
stuff,
but
it
is
again
beneficial
to
have
that
conversation
with
your
physician,
because
you
know
it's
not
a
doctor.
That's
reviewing
that
stuff.
That's
at
you
know
life
scan,
so
it's
just
an
extra
layer
of
protection
for
you
all
and
then
making
sure
that
you,
you
know,
are
having
that
without
having
to
repeat
it.
G
So,
yes,
an
extra
step,
but
not
an
overly
invasive
one,
then
I
think
we
could
get
some
additional
utilization.
So
thank
you
for
bringing
that
up,
because
it's
one
of
the
things
I
wanted
to
talk
to
sean-
and
you
know
robin
our
clinic
director
about
to
see
if
that's
something
that
we
could
kind
of
incorporate
and
push
you
know,
so
that
would
be
guys
to
participate
more.
F
G
Sean
you
want
to
jump
in,
but
you're
allowed
to
it's
all
about
coding,
because
a
lot
of
the
stuff
that's
done
is
not
done
through
our
clinic
at
all
whatsoever
majority
of
the
stuff.
Isn't
we
prefer
you
obviously
to
go
to
the
clinic
because
there's
a
lot.
The
plan
has
a
significant
savings.
If
you
do
that,
but
there's
not
a
requirement.
G
B
Yeah-
and
I
think
you
know
what
I'm
thinking
jennifer
is-
maybe
you
know
for
well.
Let
me
answer
that
question
yes
steve,
so
if,
if,
if
somebody
has
a
preventative
exam
at
their
their
doctor,
that's
to
trigger
the
code
which
will
ultimately
get
them
the
credit
for
that.
So
what
I'm
thinking
out
loud,
you
know
I
can
talk
with
with
jill
tony
and
jennifer
after
is
maybe
what
would
help
would?
Maybe
we
should
do
like
a
one-page
flyer
for
police
and
fire.
That
kind
of
explains.
B
You
know
that
since
you
had
this
life
scan,
here's
what
you
need
to
do
and
you
can
still
get
the
motivate
me
credit
and
then
you
we
can
definitely
have
that
conversation
with
the
clinic
just
to
make
sure
they
understand
the
expectation
there.
But
I
think
would
that
help
steve
like
a
flyer
that
you
know
even
we
can
print
them
off.
You
guys
can
put
them
up
in
the
the
station
or
whatever
just
to
to
make
sure
people
know
that's
available.
F
That
that
would
that
would
probably
help,
but
even
beyond
that
to
let
all
the
city
employees
know
that
they
don't
have
to
go
through
the
city's
clinic
to
do
their
initial
gatekeeper
evaluation
as
long
as
it's
a
preventative
done
through
their
regular
doctor.
That's
again,
we
all
we
are
on
the
impression
that
they
had
to
go
specifically
through
the
city's
clinic
to
get
that
gatekeeper
evaluation
and
then
some
some
information
on
how
it
needs
to
be
coded
to
to
trigger
this.
B
Yeah
and
the
so
the
one
thing
I'll
tell
you
steve
why?
Why?
Obviously
you
know,
of
course,
the
clinic's
a
a
benefit
for
the
city
financially
and
all
that
is,
if
you
go
to
an
individual
doctor
and
there's
liability
reasons,
and
all
this
right,
you
can't
dictate
to
the
doctor
how
they
code
that
visit
where
the
clinic
you
know,
even
if
they
find
something
else
right.
B
A
regular
doctor
is
going
to
mark
that
other
code
down
because
they
need
to
document
that
they
did
it
and
they
want
to
get
paid
for
it
and
they
probably
get
paid
more
than
a
preventive.
So
so
as
much
as
we
like
it,
nobody
can
go
into
the
doctor
and
say:
yes,
I
have
this,
but
you
know
it
will
trigger.
So
let
me
let
us
work
with
the
team
and
we'll
see
what
we
can
come
up
with.
I
think
you
know
even
a
a
flyer
to
share
with
you
guys
to
reinforce
that.
B
E
I
just
wanted
to
add
one
thing
for
the
gatekeeper
steve
employees
can
go
on
my
cigna
to
get
the
form
that's
needed
to
be
filled
out
by
the
doctor
and
the
employee
health
center.
When
you
go
to
the
employee
health
center,
they
already
have
that
form
printed
out,
but
any
employee
on
our
plan
can
print
out
that
form
and
bring
it
to
any
doctor
and
that's
a
gatekeeper.
G
Yeah,
your
communication
of
that
steve,
you
know,
that's
the
beauty
of
these
committees-
is
that
you
know
they
get
to
hear
it.
You
know
from
you
guys
and
that
you
know
we're
dispelling
these
rumors
and
you
know,
because
we
want
the
employees
to
use
this
this
program.
You
know,
that's
why
it's
there.
It's
not
meant
to
be
a
carrot
that
they
can
never
touch.
So
you
know
hope.
G
I
appreciate
the
conversation
very
much
and
hope
that
you
will
bring
that
back
because
there's
still
time,
you
know
what
I
mean
like
we,
we
still
got
you
know
through
october,
so
go
you
know,
I
mean
like
get
this
stuff
done
and
you
guys
you
know,
collect
that
money
because,
as
you
can
see
with
our
claim
stuff,
the
prevention
is
key
and
you
know
that's
the
whole
reason
we
do.
The
motivate
me
is
to
make
sure
that
we're
catching
things
or
doing
our
best
to
catch
things
early
and
that
our
employees
are
healthy.
G
B
Yeah-
and
I
think
you
know
on
that-
steve
though
I
think
we
also
want
to
promote
people
that
the
the
private
seamless
easiest
way
to
do,
that
is
definitely
through
the
clinic
because
it
just
they're,
they're,
they're
gonna,
we'll
brief
them
on
the
the
screenings
that
you
guys
do
and
make
sure
they're
aware.
But
you
know
I
think
what
can
happen
is
that
I've
seen
with
people
with
the
life
scans
before
is
they
go
and
bring
it
to
a
regular
doctor
and
they
still
order
a
bunch
of
the
other
tests
again.
B
So
then,
your
you're,
causing
yourself
a
burden
you're
causing
the
you
know,
you're,
causing
extra
costs
to
the
city
because
now
they're
paying
for
the
life
scan
and
on
the
medical
plan.
So
we
can
take
a
look
at
that
and
I'll
we'll
look
at
some
ideas
for
some
flyers
and
some
good
ways
to
word
that,
and
maybe
you
guys
can
spread
around.
D
B
All
right,
so
the
only
other
thing
we
really
had-
and
I
pulled
the
document
down-
is
just
to
give
you
guys
an
idea
of
timing.
You
know,
generally,
we've
been
back
with
the
committee
in
june
to
talk
about
funding
renewal
increases
potentially
over
all
the
plans
running
well,
so
we'll
be
back.
You
know,
late
may
early
june,
try
to
look
at
updated
numbers
and
to
start
talking
about
renewal.