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Corporate Services
Report
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Report To: -RL HHUDORHUPHD30DLDHHORSPH&RPPLHH
Date of Meeting: January 7, 2019
Report Number: COD -001-19 Resolution: JC -069-19
File Number: By-law Number:
Report Subject: Health Benefit Program Renewal & ASO Consideration
Recommendations:
That Report COD -001-19 be received;
2. That the presentation by DJ Nascimento from Mosey & Mosey Benefit Plan Consultants
outlining the Health Benefit Program renewal and ASO consideration, be received with
thanks;
3. That the recommendation by Mosey & Mosey to remain under the Insured Funded
Arrangement (also referred to as non -refunded accounted arrangement) with Sun Life
be approved as outlined in the presentation and executive summary;
4. That the Director of Corporate Services be authorized to sign the appointment letter with
Mosey & Mosey to renew the Benefit Program with Sun Life through the Local Authority
Services (LAS) under either option of Insured Funded or ASO, as decided by Council;
and
5. That DJ Nascimento of Mosey & Mosey be advised of Council decision.
Municipality of Clarington
Report COD -01-1 9
Report Overview
Council approval is requested for the February 1, 2019 renewal of the Health Benefit
Program, remaining with Sun Life on an Insured Funded Arrangement, with placement
through Local Authorities Service (LAS).
1. Background
Page 2
1.1 In renewing the Health Benefit Program in place for February 1, 2019 the General
Government Committee approved report COD -019-17 ASO Review for Provision of
Employee Group Benefits, and at the November 20, 2017 Council meeting Resolution
#GG -458-17 was approved as follows:
That Report COD -19-17 be received;
That the Health and Dental Benefits Program for the first renewal term, February 1,
2018 to February 1, 2019, be approved to remain as is with Sun Life Financial to take
advantage of the 15% renewal cap;
That the ASO option for provision of Health and Dental benefits be reviewed in advance
of the next renewal period of February 1, 2019 to February 1, 2020, with consulting
assistance as needed at an estimated cost of $20,000 to be funded from the ASO
Reserve fund; and
That registered interested parties be advised of Council's decision regarding the award
by the Corporate Services Department in consultation with Finance.
2. Process Undertaken to Assess the 2019 Renewal Options
2.1 In February 2017 the program manager at the Local Authority Services (LAS), an arm of
the Association of Municipalities of Ontario (AMO), sent a letter (Attachment #1) to the
CAO to advise that LAS has partnered with Mosey & Mosey Benefit Consultants to
provide municipalities access to an aggregated group of benefits plan. Mosey & Mosey
contracted with Sun Life to underwrite the program for their consortium of approximately
30 municipalities with over $7 million premium dollars, which provides bargaining power
to the participating municipalities.
2.2 The Municipality met with Mosey & Mosey to explore whether they could obtain a
reduction in the current rates in place for 2018. Mosey & Mosey approached Sun Life,
but were advised that there was no immediate advantage available on the existing plan
due to the rate guarantees in place.
2.3 Morneau Shepell was engaged by the Municipality to provide an analysis of the funding
arrangements comparing the existing Fully Funded program to the Administrative
Services Only ASO option. Their review assessed the ability of the Municipality to enter
into an ASO arrangement based on claims experience over the recent two (2) years, in
Municipality of Clarington
Resort COD -01-1 9
Page 3
accordance with the resolution and funds provided. The Director of Finance/Treasurer
has provided an overview of that undertaking in the financial section of this report.
2.4 The Municipality also independently requested a quote directly from Sun Life to see if
there would be an advantage by utilizing the services of Mosey & Mosey. The
independent quote resulted in an overall increase in premiums of approximately 14.3%,
(from 2018 rates) which is referred to as the stand-alone option in the Mosey & Mosey
Executive Summary (Attachment #2). The LAS program through Mosey & Mosey
provides a definite savings for the Municipality.
2.5 Mosey & Mosey was engaged to conduct a review of claims experience for the recent two
years and to obtain a quote. Their written presentation outlined the result of their review
and provided the recommendation to continue with the Fully Funded program, which they
refer to as non -refund accounted arrangement to maximize the containment of premium
cost at 9.8%.
2.6 The intention is to continue assessing the ASO option with the recommended new
renewal date of November 1, 2019, under LAS, which also lends better to appropriate
budgeting.
3. Financial Assessment
3.1 The Director of Finance provides the following overview of the Morneau Shepell
assessment:
x The Municipality of Clarington engaged Morneau Shepell to provide information
regarding:
o the advantages and disadvantages of Refund Accounting and Administrative
Services Only (ASO);
o a study of claims fluctuation from month-to-month to understand the risk
exposure with ASO;
o a mock financial accounting of two (2) benefit years to determine the "claims
fluctuation reserve" required if the Municipality were to switch; and
o a lag study to recommend a level for "incurred by not reported reserve".
x The Morneau Shepell report supported the independent assessment of Mosey &
Mosey that over the past two years an ASO funding program would have resulted in
a deficit to the Municipality. It should be noted that both reports concluded that the
difference is within $15,000 over the two year period; however in one year the deficit
is approximately $144,000 while the following year is a $132,000 surplus.
x From a financial planning and budgetary perspective the difference between the two
funding models is the amount of fluctuation in any given period. With ASO, the
fluctuations from period to period are borne by the Municipality. The current funding
model requires known amounts to be paid for the year which may be adjusted
annually at renewal.
Municiprington
Report C 9
ion study showed that over the two year period:
Page 4
Dental $40,000 $60,000 $50,000
Health $58,000 $115,000 $90,000
Total $100,000 $170,000 $141,000
x The Municipality has established a reserve fund for ASO which currently has a
balance over $500,000. Based on the past two years, this reserve fund would
provide sufficient funding to mitigate the fluctuation in claims.
x Based on an estimate of 5% of non -pooled paid claims for the "incurred by not
reported reserve" of $86,000 the existing reserve fund would be sufficient to meet
those needs as well.
x The Morneau Sheppell report did not recommend either an ASO or fully funded
model. It is recognized that over time the costs will even out in a fully funded model
because the benefit provider will increase premiums or reduce premiums based on
actual claims however the timeline for recognition of decreases could be longer.
The main difference between the funding models is the risk of volatility in the claims
and the level of risk the Municipality is willing to absorb.
4. Summary
4.1 If Council were to decide to change to ASO option the Municipality is in a position to
mitigate periodic fluctuations and can smooth funding levels over time. However it should
be noted that the ASO method does present a more volatile expense model than the fully
funded model with the risk ultimately transferred to the Municipality under the ASO
option.
4.2 Remaining with a fully funded option with the unexpected low increase at 9.8% for an
additional ten month period to November 2019 allows further assessment of the impact of
the OHIP download to the employer for dependents under 25 years of age, will allow
additional claims experience review, and mitigates risk for the Municipality.
4.3 It is anticipated that a move to ASO may be in the best interest in the near future, when
the combined review periods result in a comfortable surplus and all rate guarantees have
been exhausted.
Municipality of Clarington
Resort COD -01-1 9
5. Concurrence
Page 5
This report has been co-authored by the Director of Finance/Treasurer who concurs with
the recommendations.
6. Conclusion
It is respectfully recommended that Council authorize the renewal for February 1, 2019
on the existing fully funded program through LAS with a November 1, 2019 renewal going
forward and that the ASO funding option continue to be reviewed and considered in
future.
7. Strategic Plan Application
Not applicable.
Submitted by:
Made Marano, H.B. Sc., C.M.O.,
Director of Corporate Services
:57 7Z��
Trevor Pinn, B.Com, CPA, CA
Director of Finance / Treasurer
Reviewed by:
Andrew C. Allison, B. Comm, LL.B
CAO
Staff Contact: Kerri McMullen, Compensation & Benefits Supervisor, ext. 2206 or
kmcmullen@clarington.net
There are no interested parties to be notified of Council's decision.
Attachment 1 — LAS Letter to Chief Administrative Officer
Attachment 1 — Municipality of Clarington — Executive Summary — December 2018
Andrew Allison
CAO
Municipality of Clarington
40 Temperance Street
Bowmariville, ON L1C 3A6
Dear Mr. Allison,
As you may be aware, the cost of providing a group benefits plan to your staff continues to grow.
Fortunately, there is a Municipal Group Benefits Program to offer relief from rising premiums.
since 2009 LAS has partnered with Mosey & Mosey Benefits Consultants to provide more than 30 Ontario
municipalities access to an aggregated group benefits plan. As one of the most recognizable names in
benefits consulting, Mosey & Mosey brings over 40 years of group benefits consulting experience to the
municipal` or r.IVor mg withyour municipa i ye can develop a enefits philosopher a con rots - "-
costs and minimizes the internal resources required to. manage your benefits program.
Because each municipality is diverse in its needs and capacities, we allow you to design your own benefits
plan. We offer tangible and measurable savings through aggregated purchasing that includes lower
rates, lower administrative costs, and preferred expense levels: Historicallynew'enrolments have seen
an average savings of 12.45% over, pre-existing benefit costs at the'time of quotation.
In addition to saving money, you can also expect prompt assistance, professional advice, and ongoing
communications to meet your municipality's unique needs. LAS is committed to offering a program that
provides support to Ontario municipalities through a proven delivery model.
For more information on this program, or to begin the quotation process, please contact DJ Nascimento
at dnascimento@mosev.on.ca or 1.800.268.8383 ext. 276.
Sincerely,
Eleonore Schneider
LAS Program Manager
AM•
200 University Ave. Suite 801 www.las.on.ca Tel 416. 971.9856 Toll Free in Ontario
Toronto, ON, M5H 3C6 las@las.on.ca Fax 416. 971.6191 877.426.6527
Attachment # to Report COD -001
EXECUTIVE SUMMARY
TO: MUNICIPALITY OF CLARINGTON
FROM: MOSEY & MOSEY
SUBJECT: EMPLOYEE GROUP BENEFIT PLAN REVIEW
DATE: DECEMBER 12, 2018
The Municipality of Clarington recently granted Mosey & Mosey authority to:
• 5 HT HV1/W--I RLP D\NZ-IIU; P 46 --1 LLH-UiD HARW ir-O ❑E FLSDWRI ACU -J VRE VLFP SULW- J U9 -S
benefits program, to undertake a review and act on your behalf to negotiate the February
2019 renewal;
• Obtain a Local Authority Services (LAS) quote from Sun Life; and
• Review an Administrative Services Only (ASO) option for the Health and Dental benefits.
Renewal Negotiations for February 1, 2019
We note that the current group benefits arrangement with Sun Life is:
• All benefits are currently insured non -refund accounted, and were transferred to Sun Life
effective October 1, 2016.
• As a result of that marketing and subsequent transfer, the rate guarantees provided by Sun
Life are:
0 40 months on Life (i.e., Employee, Dependent & Optional) L guaranteed to February 1,
2020;
0 28 months on Long Term Disability (LTD) guaranteed to February 1, 2019; and
0 16 months on Health and Dental, with a global rating cap.
At the February 1, 2018 renewal for the Health and Dental benefits, the implemented increases
were +21% and +20% respectively, resulting in an overall premium increase (for all benefits
combined) RI LII❑❑❑ [DI ❑❑Ft LLHVDSS(FD\b'R LR W-11DWJ fDS❑
$ INJLFMH❑LQJ C6 ❑❑C/1 LLHV_SURSR\/HGAA0G-alone renewal for February 1, 2019, we negotiated with
the insurer on the basis that the Municipality of Clarington will be included within the (LAS) Group
Benefits Program. We felt this arrangement would provide the lowest possible costs at this
renewal, as well as future renewals.
Rating Within the Local Authority Services (LAS) Group Benefits Program
Summarized on the next page are the proposed renewal adjustments from Sun Life, in comparison
to the renewal adjustments negotiated by Mosey & Mosey, as part of LAS. We note that these
rates are only guaranteed until the next LAS renewal, which is November 1, 2019. Being a
participant within the LAS plan under the current arrangement (fully insured), these rates continue
to maximize overall savings now and will almost certainly soften subsequent renewal rate
adjustments.
Attachment #1 to Report COD -001-19
Benefit
Current Cost
Sun Life Proposed
Stand Alone Renewal
Effective February
Cost
1, 2019
Mosey& Mosey Revised
Cost Within the LAS
Effective February
Negotiated
Consortium
1, 2019
Monthly
Monthly
Monthly
Volume
Premium
Premium
Adjustment
Premium
Adjustment
Life Insurance
79,168,000
$ 17,143.75
$ 17,143.75
0.0%
$ 17,143.75
0.0%
Dependent Life Insurance
325
2,389.12
2,389.12
0.0%
2,389.12
0.0%
Long Term Disability
1,566,925
41,734.64
59,262.28
42.0%
55,136.15
32.1%
Extended Health Care
Single
46
6,775.19
7,588.18
12.0%
7,287.44
7.6%
Couple
122
37,002.20
41,442.21
12.0%
39,799.91
7.6%
Family
218
85,483.27
95,741.43
12.0%
91,947.05
7.6%
Dental
Single
44
2,845.71
2,988.10
5.0%
2,920.56
2.6%
Couple
122
15,861.14
16,654.03
5.0%
16,279.52
2.6%
Family
218
44,024.62
46,226.32
5.0%
45,185.44
2.6%
TOTAL MONTHLY PREMIUM
$ 253,259.64
$ 289,435.42
$ 278,088.94
TOTAL ANNUAL COST -ALL
BENEFITS
$ 3,039,115.68
$ 3,473,225.04
$ 3,337,067.28
Variance To Current Cost
$ 434,109.36
14.3%
$ 297,951.60
9.8%
Note: Impact of Stand Alone vs. LAS Consortium: $434,109.36 - $297,951.60 = $136,157.76 premium savings
Mosey & Mosey Recommendations
Since the lowest available renewal cost can only be obtained through the LAS Program, we
recommend appointing Mosey & Mosey as your agent of record (a signed letter of appointment
would be required to appoint Mosey & Mosey as your Benefit Consultant), so that we can proceed
with placing the Municipality of Clarington within this consortium. In addition, there will be no
additional cost to the Municipality of Clarington and we will confirm the negotiated renewal rates
(as part of the LAS consortium) to Sun Life, effective February 1, 2019. We recommend retaining
the insured non -refund accounted arrangement at this time; but will revisit the ASO funding
arrangement in the future.
Mosey & Mosey was established in 1971 and has a solid understanding of the public sector,
representing over 200 municipalities across Ontario.
The Local Authority Services (LAS) Group Benefits Program is underwritten through a multi-
employer consortium plan; with more than 30 participants and over $7 million in annual premiums,
the Consortium Program was developed by LAS and Mosey & Mosey to allow individual
municipalities to achieve benefit costs through the increased purchasing power of the overall
group.
• The Account would be managed as follows:
o DJ Nascimento ❑Account Executive
o Patricia Lane ❑ Service Advisor
o Jesse Schafheitlin []Technical Analyst
Attachment #1 to Report COD -001-19
• Since the Municipality of Clarington is currently insured with Sun Life, joining the LAS
Program with the current funding arrangement would not require any change in carrier and
would be seamless to the employees. Moving to an ASO arrangement would require a new
policy number and new drugs cards for employees.
• The only deviation is with regards to the pooling, which differs slightly from the current
arrangement.
Extended Health Care Pooling
7EHT ❑dFLSD C&®lQ❑JVUI\/LF❑lJlH MR;M-J-DJDIL,JF-PHEVWIRJall out -of -country claims to be
pooled from the first dollar as well as all in -Canada EHC claims in excess of $15,000 per insured
i n d i v i d u a l S _ -+DJI_I.7--NHCSF4R@G1FG P VAM-L H RUHDIIHIHEFOGIG1l9;P �H S®I_ L\VCHCSHLU _FH
7 EHI/ $ 6 ❑S®❑VCSFTZQ:LJ EDUangement is almost identical, except that the in -Canada claims in
HEFHWR EEI❑❑TI❑❑1DLHEHLFQCHG_IIU;P ANH_S0LIVLHLSHIJJlHLFH17 EHERE Abf-country claims are also
pooled from the first dollar. With a higher pooling limit would result in lower stop loss charges as
the Municipality would be taking on an additional $5,000 of risk for those individuals who has
Extended Health Care claims in excess of $15,000.
Administrative Services Only (ASO) Quote for Health and Dental
Underwriting the Health and Dental benefits on an ASO basis is a funding arrangement that larger
groups explore, because they have the financial stability to be able to take on the additional risk (of
being fully liable for claims costs), while also lowering their administrative costs.
Please keep in mind that the Life, Dependent Life and Long Term Disability will remain as is as
there is not an ASO option for these benefits.
°/EM-G❑L6 III/ LLHVC$ 6 2 ESLRSRVDO EH(L IV_DLILM _IERI EER❑ VNIO ❑ADM RI _& QU_J W- V
plan would have performed over the past two years, if the funding arrangement had been ASO;
Municipality of Clarington
Health and Dental Consolidated Analysis
Retrospective Two (2) Year ASO Analysis
i2017/2018 All Years Combined
Paid Premium/Deposits $1,663,154 $2,114,615 1 $3,777,76
Paid Claims 1,538,828 1,746,838 I_ 3,285,666
Pooling Credit (101,889) (110,792) I_ (212,681)
$1,436,939 $1,636,046 $3,072,985
212,630
121,134
$1,770,703
($107,549)
246,179
137,919
$2,020,144
$94,471
* Charge for Out-of-Country/$15,000 Stop Loss threshold is based on 24.50%.
458,809
259,053
$3,790,847
($13,078)
** General Administration, Claims Handling, Profit Charge, Premium Taxes, Consulting Fees
(8.43% of total expenses).
Attachment #1 to Report COD -001-19
Mosey & Mosey Recommendations
• ASO would result in modest savings from expenses, however, The Municipality would assume
the risk of any increase in claims; since the two year combined ASO result would have been a
deficit, Mosey & Mosey recommends retaining the insured non -refund accounted funding
arrangement at this time and revisit the ASO funding arrangement at a later date.
Consideration of Appropriate Funding/Underwriting Arrangement
Risk:
The primary difference between Non -Refund Accounted and ASO funding arrangements is the
degree of risk and the level of liability assumed; the primary factor is your own tolerance for risk
and the level of liability that you wish to assume under the plan.
The emergence of high cost drugs to treat catastrophic health conditions has threatened the
stability of employee group benefit programs; these drugs have the potential to significantly
improve their health while at the same time jeopardize the sustainability of your employee benefit
program.
Other factors to consider:
Aging workforce and increased chronic disease (e.g. diabetes, heart disease, asthma etc.).
Pending changes to OHIP+; dependents less than 25 years of age will now go to private plan first
for their prescription drugs (expected date of March 2019 and expected increase of 2%-10%).
Each client must carefully consider the potential advantages and disadvantages when deciding
upon the most appropriate underwriting method. No one factor will be more important to this
C-1-FLAR VVD-1WW l-F(t-IIAV CJD/N ID FHF_
Conclusion:
Mosey & Mosey will support the final decision made by the Municipality of Clarington as we have
no vested interest moving forward with a Non -Refund Accounted or ASO funding arrangement.