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KERR COUNTY COMMISSIONERS COURT
Special Session
Wednesday, November 5, 2008
1:00 p.m.
Commissioners' Courtroom
Kerr County Courthouse
Kerrville, Texas
PRESENT: PAT TINLEY, Kerr County Judge
H.A."BUSTER" BALDWIN, Commissioner Pct. 1
WILLIAM "BILL" WILLIAMS, Commissioner Pct. 2
JONATHAN LETZ, Commissioner Pct. 3
BRUCE OEHLER, Commissioner Pct. 4
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2
I N D E X
November 5, 2008
1.1 Consider/discuss, take appropriate action
regarding proposals received for Kerr .County
Employee Benefits for 2009
1.2 Consider/discuss, take appropriate action to
receive recommendations from Courthouse Windows
Committee and to award bid for courthouse windows
and doors replacement and/or renovation
--- Adjourned
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On Wednesday, November 5, 2008, at 1:00 p.m., a special
meeting of the Kerr County Commissioners Court was held in
the Commissioners' Courtroom, Kerr County Courthouse,
Kerrville, Texas, and the following proceedings were had in
open court:
P R O C E E D I N G S
JUDGE TINLEY: Okay. Let's come to order, if we
might, for this special Commissioners Court meeting posted
and .scheduled for this date and time, Wednesday, November the
5th, 2008, at 1 p.m. It's a bit past that time at this
point. Because the agenda lists a visitor's input, I'm going
to ask if there's any member of the public that wishes to be
heard on any matter that is not a listed agenda item. Any
member of the public that wishes to be heard on any matter
not a listed agenda item?
COMMISSIONER BALDWIN: Want to talk about Tivy
coaches or anything? Now would be a good time.
JUDGE TINLEY: I see no one coming forward to speak
on any matter that's not a listed agenda item. We'll move
on. Any Commissioners' comments? Commissioner Baldwin?
COMMISSIONER BALDWIN: Judge, I do not.
COMMISSIONER WILLIAMS: Nothing.
JUDGE TINLEY: Commissioner Williams? Letz?
COMMISSIONER LETZ: Not today.
MR. OEHLER: No.
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JUDGE TINLEY: Okay. Let's go to the first item on
the agenda here. Consider, discuss, and take appropriate
action regarding proposal received for the Kerr County
employee health benefits for 2009. Ms. Hyde and company.
MS. HYDE: Come on, pop.
MR. OEHLER: Pop. You got your phone turned off?
MR. LOONEY: Yes, sir, it's on vibrate. But I've
got it in my front pocket, so if I jump --
COMMISSIONER BALDWIN: If you start smiling.
MR. LOONEY: If I start smiling, you'll know.
JUDGE TINLEY: No Looney tunes today?
MR. LOONEY: Not today.
MS. HYDE: Y'all got the letter from Gary from last
week at the front of your books.
(Low-voice discussion off the record.)
MR. LOONEY: It wasn't last week; it's today.
MS. HYDE: Oh, I lied. He didn't send it to you.
He just put it in the front. There's a couple of
spreadsheets, when we get to them, that are a little bit
confusing, so hopefully you can just bear with us on that.
If you go to the first section -- do you want to read the
letter or let them just read it?
MR. LOONEY: That's fine. I can go through it and
tell them. You can just introduce me, that's okay.
MS. HYDE: This is Gary, and I'm going to let him
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MR. LOONEY: Popovich in disguise.
MS. HYDE: That's right.
MR. LOONEY: Thank you, Ms. Hyde. Judge Tinley and
Commissioners, I'm Gary Looney. I appreciate you very much
taking the special session today and providing this time. I
would have been here a couple weeks ago except for some
family issues, and I appreciate you taking that into
consideration with a special program today -- or special
meeting today. Let me kind of hit the highlights real quick,
letter itself. But essentially, we went out to the market,
to the stop loss insurance. We got a -- a lot of information
into the market and very little information back out of the
market, because the stop loss market and the carriers today
simply said you guys are in such good shape where you are
today, we're really not competitive with your stop loss
quotes. So, we've got two or three quotes that were -- one
actually that was submitted late. The other two are not even
in the -- close to the market, so they weren't even worth
including on the spreadsheet.
So, we have our renewals from Monumental Life.
Monumental Life has offered us two options. One is the
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option where we are currently, and if you'll look under Tab
1, it's the big spreadsheet which unfolds, got all the small
numbers on it and all that. Based on our experience under
the last two years under the plan, the -- the request for the
increase in the premium rate is justified based on our
previous experience. If you'll look at the far left column,
that is the current status, the current rates, and then the
offerings for Option 1 and Option 2. Option 1 and Option 2,
the only difference is that we currently have a stop loss --
percent in excess of that. Option 1 is renewal as-is, with
the $50,000 stop loss. Option 2 is increasing that to
$60,000. $60,000 means that any individual employee or
dependent that exceeds $60,000 in any given plan year, that
the .insurance company will pay losses in excess of that up to
the full amount of the policy itself, which is, in our case,
$2 million. So, they have expenses potentially up to one
million, nine hundred, and either fifty or sixty thousand
dollars.
COMMISSIONER LETZ: Question. Where does it show
COMMISSIONER BALDWIN: I don't see 60.
COMMISSIONER LETZ: I don't see 60 either. I see,
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MS. HYDE: On all three of them, Gary, it says 50.
COMMISSIONER LETZ: I just wanted to make sure I
was looking at the right spot.
MR. LOONEY: Let me put my glasses on here,
Commissioner. .The one on the far right is 60. You need
to --
COMMISSIONER BALDWIN: Oh, that's a 60?
MR. LOONEY: That's 60.
COMMISSIONER BALDWIN: See, he's from San Antonio.
MR. LOONEY: That's 60. You might -- you can
correct that on the --
COMMISSIONER WILLIAMS: It's supposed to be 60?
MR. LOONEY: It is supposed to be 60.
COMMISSIONER LETZ: But it says 50.
MR. LOONEY: It says 50.
JUDGE TINLEY: So, it's 50, 50, 60, then.
MR. LOONEY: It's 50, 50, 60.
JUDGE TINLEY: Okay.
COMMISSIONER BALDWIN: Obama numbers.
COMMISSIONER WILLIAMS: Yeah.
MR. LOONEY: My dripping down economics, I guess,
or whatever. So that is -- and that's the difference between
the two, actually. That's the primary difference between the
two. What that means is we accept an additional $10,000 on
any one given risk. The premium differential for that is
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approximately a little over $30,000. Premium differential is
savings in premium, which means that we would have to have
three employees and/or dependents exceed that $50,000 number
before we would endanger the savings that we made. So, from
a risk-reward standpoint, the fixed dollar savings versus the
potential exposure at this point makes sense for us to make
that change.
COMMISSIONER LETZ: How many claims have we had
over 60,000?
MR. LOONEY: Over 60, or over 50?
JUDGE TINLEY: Fifty.
COMMISSIONER LETZ: Over 50.
MR. LOONEY: Over 50,000? We've had three claims
this last year over 50,000.
COMMISSIONER LETZ: And pretty much, if they go
over 50, they'll probably go over 60, wouldn't they?
MR. LOONEY: It varies, but right now we've got
three that are over -- over the -- over the $60,000 mark.
So --
JUDGE TINLEY: Are those claims waning?
MR. LOONEY: Some of the -- one of the claims is
pretty much off the books now. It was early in the year, and
it's pretty much off the books. One of them -- or two of
them are ongoing, but one of them -- one of them has to do
~~ with treatments that were very expensive in the beginning,
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and now are more into the maintenance medication type
circumstance. The insuring company has asked us to give
additional information on that one patient that's got that
ongoing for -- they potentially have talked about the
possibility of adding a laser to that one person, but we
won't know that until we get the managed care reports.
There's some visitations taking place next week that are --
the individual is going through some additional care and
treatment next week.
COMMISSIONER LETZ: Explain "laser."
MR. LOONEY: Laser means that the $60,000 amount
COMMISSIONER LETZ: Just, like, 80,000 or some
MR. LOONEY: 80,000, 90,000, possibly. We've had
lasers in the past, and this last year was the first year in
a long time we haven't had anybody lasered. But our -- we've
got a -- we're up to the point -- I got a call this morning
on the way here that said that the major case management
nurse had gotten a call that the patient that we were
concerned with will have an evaluation done next week, and
that'll give us an indication of what the status is. From
everything that we know at this point, it's just the
continuation examination that everything is fine. There's no
-- it's a standard follow-up session that they're going
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through; it's not something that was especially -- especially
aggregate factors, where -- where it says employee only,
that's the premium that the County is paying?
MR. LOONEY: No, sir. Aggregate factor is an
estimation that the actuaries give us that says that, based
on your open population, your previous experience, we expect
on a monthly basis on average for your employees to incur
that amount of medical expense.
COMMISSIONER LETZ: Okay.
MR. LOONEY: And then they factor that in for each
individual category of insured, and that's what they estimate
the maximum claim liability is. That's how they limit the
maximum claim liability. The actual premiums that we pay for
', the services and for the -- that expense to cover those
expenses are listed under the monthly fixed cost category.
Those are the actual -- that actual hard dollar cost that we
deal with.
COMMISSIONER WILLIAMS: What is the attachment
MR. LOONEY: Attachment -- that's what the attach
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-- the attachment points are that factor. That's the
attachment points, is the calculation of the amount of money
.based on the population. That's -- you take the aggregate
factors times the overall exposure, and that gives you the
actual attachment points on a monthly basis. So, the
experience that we've given them through the RFP process and
through their own experience for the past three years. So,
basically, the recommendation at this point on the stop loss
carrier is to move to the $60,000 ISL process, "ISL" meaning
individual stop loss. And that the FARA contract for claims
administration is a three-year contract. This is the
beginning of their second year, and none of their expenses or
charges changed.
JUDGE TINLEY: No increase in the admin costs?
MR. LOONEY: No, no changes in any admin fees or
any of the administration costs. If you'll turn over to Tab
2 real quick, I'll show you basically where we are as far as
this first 10 months of the year. This is -- this is the --
from left to right, the medical and prescription drug
charges. Those are charges, gross bill charges. Then we go
through the self-funded claims that were paid in relationship
to those charges, and eligible claims are claims that are
potentially -- either individuals are not eligible for
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benefit in some manner, or there's a coordination of benefits
with another carrier, or it's not covered under the plan
design as such. That gives us the net claim. The net claim
that's paid is after the specific claim has been calculated
so that that reimbursement is calculated into that process.
So, through the end of 10 months, our total medical
charges have been paid at about $1,140,000. Based on simple
-- simple projection for the next two months, that takes us
to about 1,400,000 -- between a million four and a million
five, which is well within the budget numbers that we
projected last year for your expense in your plan. The
population is listed there as far as the number of covered
insured, so it gives you where the population is as far as
the enrollment is concerned. One of the things that I wanted
you to pay close attention to is the number on your
prescription drugs. $360,000 in prescription drugs. Based
on the total, that's about 28 percent of your total plan
cost.
JUDGE TINLEY: Relative to most well-managed plans,
where is that percentage?
MR. LOONEY: We -- we like to see it in the 12 to
15 percent range.
COMMISSIONER LETZ: So we're still high.
JUDGE TINLEY: So it's about double.
MR. LOONEY: So you're about double of where the
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normal -- where we normally like to see a plan.
COMMISSIONER LETZ: We were at that level last
year, as I recall. Doing worse --
MR. LOONEY: We were a little lower last year.
We've gone up just a few percentage points.
COMMISSIONER LETZ: Well, not worse, but --
MR. LOONEY: Yeah. So, we're taking a lot of meds.
COMMISSIONER LETZ: Have to choose your words
carefully when you talk about this stuff.
MR. OEHLER: Yeah.
MR. LOONEY: So, that is something that I'll --
I'll address in just a second. Just to give you some
indication of what we may or may not --
COMMISSIONER LETZ: Gary, before you get to that,
didn't we do some changes to get -- to try to correct that
last year? To -- like, we basically -- I mean, the
copayment --
MR. LOONEY: Copayments were changed.
COMMISSIONER LETZ: -- on the name brands, so to
speak.
MR. LOONEY: We changed the copayments. We
adjusted some of the formularies.
COMMISSIONER LETZ: And that didn't help?
MS. HYDE: Well, it helped, but the problem is, our
employees are getting older. And when we were talking during
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budget, I told you that we're going to bring up some of these
numbers. The 50-year-olds --
COMMISSIONER LETZ: Experience. They're
MS. HYDE: Experience. Our maturity level is -- is
increasing. And when you start hitting the maturity level of
50, we have a lot of mature people, and it tends to start
showing maturity in many different ways, and this is it.
Which is why we're going to talk about retirees and stuff.
MR. LOONEY: We have -- we have 14 retirees on the
employees over the age of 63. So, we have a pretty healthy
population -- percentage of the population that's getting
into that. As I -- as I say in my notes, with all due
respect to those of us who are older --
COMMISSIONER LETZ: But in the over 65, doesn't
Medicare become primary for those people?
MR. LOONEY: Only if they're retired. Only if they
are in retired status, and that's one of the things that
we'll -- that I'll go over with you. But the -- the next two
pages under Tab 2 show you the -- the fact that, based on our
budget information, that I have projected that you needed an
increase in your budget of 8 percent. That budget increase
actually worked out to be 5.8 percent, so the factor that we
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use for funding in the budget to fund the budget -- to fund
change the premium contribution for active employees. We do
want to consider and look very hard at the concept of
make on behalf of the plan. And I have given you some
examples. I'll skip ahead to that in a few minutes.
But you have two charts in here. One is showing
the employee rate at 240, 129, 359, and that's the
contribution by the retiree at being $180 a month. It's
currently $135 a month. So, the $180 a month, and then the
next page shows a contribution level at $135 a month. It
shows the difference in collections based on those -- the
retired employees. The final entry into that one tab is our
HRA account. And it shows that through the end of 11 -- 10
months, that our HRA account has had contributions of
$143,000 made to employees, and we're at 50 percent of what
the liability is, and we're well under the amount that we had
projected to spend in the HRA for this year. So, for budget
purposes, we're well within range as far as that. Real
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quickly, if you'll go to Tab 3 --
MS. HYDE: Just one note for the HRA account.. We
talked about it during the budget, but I don't think -- I
think the Judge brought it to my attention it was never voted
on, and this would need to be voted on as well. The HRA
somehow modified three or four years ago from the original
intent, which means that it was supposed to be $600 for the
employee. If it was an employee plus spouse, it was supposed
to be another $600, and if it was employee, spouse, and
children, it was supposed to be another $600, for a maximum
of $1,800. That was the original intent. It was never put
out that way.
JUDGE TINLEY: So, somehow, it got plugged in
where --
MS. HYDE: Originally.
JUDGE TINLEY: -- employee and spouse, you got the
1,800.
MS. HYDE: You got the full 1,800.
JUDGE TINLEY: So we need to correct that today --
MS. HYDE: The last four years.
JUDGE TINLEY: -- as part of our adoption.
MS. HYDE: We have been paying additional moneys,
and so I request that we change it back to what the original
intent was and what the contracts read, and -- and stop the
bleed.
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JUDGE TINLEY: The contract does read 600, 600,
600?
MR. LOONEY: That's correct.
JUDGE TINLEY: If we approve the contract as part
of the order, why, we've covered; is that correct?
MR. LOONEY: That's the old contract.
MS. HYDE: This is the new contract.
JUDGE TINLEY: Well, does the new contract --
MS. HYDE: It was not clarified in the old
contract; it was just in there that it was up to our
discretion. And in y'all's order, where y'all talked about
it end everything, it was six, six, and six, but somehow it
got ',modified to six and 1,800.
JUDGE TINLEY: The new contract --
MS. HYDE: So, for single, the new contract is six,
six,' and six.
COMMISSIONER BALDWIN: Don't give up. Hang in
there.
JUDGE TINLEY: Okay. I finally got it, didn't I?
COMMISSIONER BALDWIN: I didn't hear it; I was
~ tallying .
JUDGE TINLEY: She said the new contract says six,
six, six. It's specified in the contract.
COMMISSIONER BALDWIN: So, if we adopt the new
contract, it's in there.
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JUDGE TINLEY: Bingo.
COMMISSIONER BALDWIN: Dang, I love this country.
JUDGE TINLEY: What a concept.
COMMISSIONER BALDWIN: I love it.
MR. LOONEY: On the -- on Tab 3, there's a complete
description of the medications for all classes of employees.
It Shows that the -- on here that the -- the cost analysis of
thelprescription drug plan, you can see where our retail is
versus our preferred and non-preferred medication. One of
the things that we were trying to do, Commissioner Letz, is
to shift people into generic medications. Our generic
percentage actually is pretty high. We're in the 60 percent
range, and so that's -- that's actually pretty high.
However, the -- the balance of the claims coming through the
branded medications, we're getting some pretty heavy hits in
that area. This is a complete claims summary that gives you
all 'those statistics you want to know about, who's -- other
than telling you who. specifically is taking the medication,
tells you as a group where the medications are -- are being
utilized, and there is a list of the types of medications.
Now, the last two pages are the pages I want you to
look at, if you will. You know, what it has to do with is
changing the copayment process. We currently have copayments
of x,10, $20, and $35. $10 for generic, $20 for branded
medications, and then $35 for those that are not on the
1 V
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1 ~ formulary that are non-preferred branded medications. What
2 we did is we went through and we did an analysis on -- said,
3 okay, we're going to change that. We're going to leave
4 generic at $10, but we're going to move to $25 versus $20,
5 and', to $40 versus $35. What impact would that have on the
6 claims that have been paid through this time? And the impact
7 over a 10-month period will be approximately $9,000. $9,000
8 based on moving it up to that level.
9 ', JUDGE TINLEY: You're talking about $9,000 in
10 additional copay?
11 ' MR. LOONEY: $9,000 in savings that were generated
12 that will be shifted to employees for this process of paying
13	for those	-- those drugs.	
14	'	JUDGE TINLEY: Okay.	
15	',	MR. LOONEY: It's a	cost shift back to the
16	employees	simply by copayments	being increased. Same thing
17	witY~ Page	2, except we changed	it to $10, $30, and $45. Then
18	in 'Chat ca	se, it saves approximately 20,000 over the last ten
19	months, or	a total of 24,000 -	- 22,000, 24,000 over an annual
20 ~ basis.
21 COMMISSIONER LETZ: The --
22 ' MR. LOONEY: To be able to significantly impact the
23 medication process by changing the copays in that manner,
24 it's really not impacting the overall cost of our medical
25 plan significantly to go back in and -- while these may seem
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like-small .pinpricks, you know, as far as the overall plan is
designed, for those individuals that are on medications, that
are taking medications on a regular basis, it can build up,
because you're taking five, six, or -- $5 a month or $10 a
month additional, and you're talking about another $60, $120,
whatever, out of their expense -- out of their pocket on an
annual basis. So, changing that -- I'm not a proponent of
charging that -- that process on the plan, because I don't
thick we get enough dollar savings generated out of those
types of changes.
JUDGE TINLEY: Question. I'm sure you've seen a
lot',of employee plans, groups this size. What is the norm on
thole various classes of prescriptions?
MR. LOONEY: What we're seeing.
JUDGE TINLEY: And what do you see trending there?
MR. LOONEY: What we're seeing now is a trend
toward actually removing any type of copayments for generic
medications, actually going to a zero copay on generic
medications. Either that, or really moving into some of the
other -- some of the organizations out there. You can join
clubs or whatever else and get generic medications for $4 or
$5 or whatever, so that's under the copay limit now
currently, anyway. So, some of those medications are
available. Moving toward zero copays on the medication is
supposed to generate more of that transition from the branded
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.cations to the generic.
JUDGE TINLEY: What do the statistics show on that?
MR. LOONEY: It -- it varies from where you were
previously. You had a $10 copayment previously, but you're
not -- you're close to the 60 percent range right now for
using generics. We try -- what we try to do is move a client
from the -- in the 40 and 50 percent range up into the 60 and
65 percent range to get them into that generic utilization,
plug the mail-order utilization, because that does save us
money in those areas. So --
MS. HYDE: We were at 35 to 40 last year.
COMMISSIONER LETZ: So we've moved a lot.
', MS. HYDE: We have moved a lot. I mean, we have
pushed the scrips.
MR. LOONEY: So, we've made some changes. But I
think we need to look at some other methodology, either go
back in and do a tighter analysis of our formulary so that we
can identify those medications that are high-cost
medications, that do have generic equivalents, and then
additional costs, possibly, on those that are high frequency
utilization medications. Number one is Nexium. That's the
number one pill that -- that has generic options, and has
other therapeutic branded medications that are less expensive
also. So, changing plan design in that manner, the impact is
on just those individuals, obviously, that are using those
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medications, whereas changing the copays impacts every
individual that takes medication, and obviously we've got a
lot'of people taking medications.
COMMISSIONER LETZ: Are -- is the breakdown of the
categories pretty, oh, normal, I guess you'd say? I mean, I
guess --
', MR. LOONEY: As far as the formulary is concerned?
COMMISSIONER LETZ: No, just the category, the
types of drugs or medications that our people are taking. Is
it in the breakdown?
MR. LOONEY: It's relatively common. What we see
is --
MS. HYDE: We've got a lot that our top -- our
top-dollar spenders are in the mature range, and sometimes
more expensive is not best.
COMMISSIONER LETZ: Well, I guess I'm looking more
-- Z'm looking at just the category, the class totals. And
the -- I think the number one number of scrips written were
', antidepressants. That surprises me, but I don't deal with
this. I mean, it seems that we have an awful lot of people
on antidepressants.
MR. LOONEY: You're the boss, not the employee.
(Laughter.)
COMMISSIONER LETZ: My question is --
COMMISSIONER WILLIAMS: There's the answer.
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COMMISSIONER LETZ: My question, though, is, is
MR. LOONEY: Very much so.
MS. HYDE: Yes.
MR. LOONEY: Whereas, you know, also --
COMMISSIONER LETZ: I also saw some antimalarials.
I'm'trying to figure out where we have a mosquito problem.
Anycaay, I thought maybe they're military. I don't know where
it was I saw antimalarial.
MR. LOONEY: You have -- some of the medications
that you have, you know, again, identify an aging population,
such as arthritic medications. That doesn't necessarily --
you know, arthritis occurs at all ages, but Humira is a
high-cost medication, and it's used for -- we looked it up
today; it's used for treatment of arthritis and other types
of ~.nflammatory circumstances. The other one we run into
that's fairly high-cost is Imitrex. Imitrex is used for
headaches, for -- and those are either injectable or pills.
So, ',there's a possibility of adding a fourth category of
prescription, so we keep the copayments similar for the
branded that we have now. Call it -- we'd call it specialty
meds. We'll put it into a specialty med. Instead of having
it as a copayment, now we have it as coinsurance, so that we
move to either a 25 percent process or -- or a 30 percent or
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a 5b percent process. If we're going to have that specialty
medication, then it is in a coinsurance process.
We always temper that with medical requirement
information, so that if there's absolutely no other
medication that can be used for the care and treatment of
that process, that -- and if there's no other way to acquire
that medication, because we have, through our PBM currently,
a specialty medication -- a specialty med delivery system,
which means they can go through the scrip care organization
and ',get those specialty meds at a discount base. If they're
through the retail operation, we don't get the discount. So,
we try to go through that specialty medication base. That
medication process, particularly your specialty medications,
is a very, very sensitive area. People who need special
medications, you do not want to create any burden or any
profess for them not to be able to get the medication,
because that'll keep them from having additional costs in the
playa under the medical plan. So, we have to be very careful
about the categorization of those specialty medications.
JUDGE TINLEY: So, you bring nothing to us in the
way of proposal in that respect? Is that what I'm hearing?
MR. LOONEY: There -- not at this point. And
there's a couple -- there's a couple reasons for that. One
is, we're going through a situation where we're having
Medicare completely reevaluate their delivery of their
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prescriptions -- their prescription programs. And a lot of
the', special meds are tied to what Medicare evaluations are,
so we have to -- if we do something in advance of Medicare
changing their perspective on the Medicare prescription meds
and,the way they're pricing them, then we could shoot
ourselves in the foot by trying to create something in
advance. That was supposed to have been done prior to
election. So, you know, the staging and timing of that -- I
won't know what the timing of that will be, probably, until
the first week in December, as to when that's going to take
place. So, later in the plan year, it may very well come
back and say, this is something we need to change. That is
not'a requirement that you maintain that delivery of that
formulary on an annual basis. You can change it one time a
yeah during the plan year as long as you give employees 60
days notice of the change, so you can change that formulary
once during the plan year. So, that may occur first quarter
of next year, once we see what that -- what those numbers
actually are. That's the reason we don't have that in front
of you at this point.
Under tab -- on the next tab, one of the things
that we looked at, too, was we talked about the age 65 and
older individual. These are the actual claims for active
employees and retired employees that are over the age of 65.
We split out claims by age category in that situation. We've
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got'10 months of claims; again, that's about 60,000 -- 59,000
tot$1 in paid claims. We know that the split between active
employee and retired employee is approximately 50/50. We
have 14, I believe, retirees, and 15 active employees, so
this is fairly representative of the entire group. Projected
annually, that's -- again, that's about -- that's, what,
60,000, 10 months; we're looking at maybe 72,000 annually.
Right now, the prescription drug program is one of the
primary reasons that retired county employees are on the
plan, because they fall under the same formulary that all
active employees do, so there is no restriction on
prescription drugs that retirees have under the program, and
the majority of them are not -- I take that back. I have no
idea of knowing, but many of them may not be on Medicare Part
D, which is the Medicare prescription drug process. One of
the things that we've done, and we've seen with other plans
as far as retirees are concerned, we've created a
coordination of benefits. Hi, Sheriff.
SHERIFF HIERHOLZER: Hello.
MR. LOONEY: You're not armed, are you?
SHERIFF HIERHOLZER: Yes, I am.
MR. LOONEY: Uh-oh, you are.
SHERIFF HIERHOLZER: I made sure of that.
MR. LOONEY: Are you nearing retirement?
SHERIFF HIERHOLZER: Not yet. Y'all won't let me.
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MR. LOONEY: I'm safe right now. The thing that
we've seen other clients do, and as we -- we require -- or we
don't require an individual retiree to be on Part A and Part
B of Medicare. We do, however, calculate benefits as if they
were, so we coordinate with Medicare Part A and B, regardless
of whether the retiree has signed up for those benefits or
not. We have no -- we have no way of monitoring whether or
note in addition to Part A and B, the individual retiree has
a supplement insurance policy, 'cause those benefits are
typically paid on an indemnity basis, and we don't know
whether they're paid or not. So, they may have the county
plan as a coordination of benefits, Part A and B, and also a
supplement of some sort; they may have it available. We
don't know that for a fact. But what we're seeing by other
employers, we're seeing other employers take Medicare Part D,
adding that into the plan, you know, with the assumption that
that employee -- retiree is on Medicare Part D, so that the
claims that are paid then are assumed to be a coordination of
claims against Medicare Part D, as opposed to having the
standard. Medicare Part D -- there's a lot of
misunderstanding about Medicare Part D.
So, if you'll turn over to Tab 6 real quick, on Tab
6 there is a listing of all of the Medicare Part D providers
in the state of Texas. It also has a brief description of
all ',the plans that are available, including the pricing and
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the cost of all those plans.- Medicare Part D is an
independent applied-for policy. It's a policy that an
individual applies for from an independent provider. As you
can see, the independent providers are Aetna, Blue Cross/Blue
Shield, We1lPoint, a lot of the major insuring companies.
So, an individual who makes application for Part D then makes
application through one of these insuring companies, and then
whatever their policy is, is what the individual receives
benefits for under Medicare Part D. I did -- I have no idea
-- I'm not -- I don't sell Medicare Part D as an agent. We
try'to help individuals understand Part D. But the best
thing I could do at this point is to give you this summary of
benefits based on Aetna's program, which is the most popular
here in this area, because Aetna is tied in with H.E.B. from
a supplier process, and so H.E.B. Market had Aetna through
all !their stores, so they became probably the largest
provider in this area.
So, the last part of this is an explanation of the
Medicare Part D and the three different plans that Aetna
provides. Basically, what they provide is a copayment
function. Aetna -- Aetna pays for zero copayments on
preferred generics, $10 copayment on non-preferred generics,
$35 copayment on branded, $74 copayment on the non-preferred
branded, and then 33 percent coinsurance on medications that
are specialty meds. They have a 33 percent coinsurance
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factor. So, the cost of that plan, that Part D Medicare
plain, for individuals in 2009 is $50.50 a month, I believe.
It's listed on there. It's under -- it's $53.10 for that,
for that plan. If we change the plan document that says that
we will coordinate with Parts A, B, and D, then the claim
administrator will automatically assume that the individual
has,what we give them as a standard Part D medication
', program, which would be in this point. What I'm saying is we
use Aetna's enhanced plan as the model for them to pay claims
against. The -- go back one tab now to Tab 5. You'll see a
lisping of dates of birth. Some of you may recognize these
dates, and they are all pretty much individual. But the --
the 'dates that you see here, the highlighted dates are
retirees.
COMMISSIONER LETZ: Tab 5?
MR. LOONEY: Tab 5.
JUDGE TINLEY: Retirees.
', MR.	LOONEY:	The highlighted dates are	the
retirees. The	other -	- the others that are from	1941 and up,
those are the individuals that work for the county currently
that are over the age of 65. Now we come to the complicated
page. The next page is the complicated page. What I tried
-- what I want to try to do is to give you an indication or a
feeling about Medicare in relationship to the county plan,
both for retirees and for active employees.
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JUDGE TINLEY: That are. Medicare eligible?
MR. LOONEY: Medicare eligible.
JUDGE TINLEY: Okay.
MR. LOONEY: Active employees. I got -- Monday, I
got in the mail -- I got a letter in the mail from United
Health Care. United Health Care is -- they're the sponsor
for'. the Medicare Medigap programs for A.A.R.P. Just barely
qualify, but I get A.A.R.P. This letter essentially says to
the individual, as a member of A.A.R.P., it says, you need to
look at joining Medicare as an option to selecting your
employer's coverage. This is the first time that we've ever
seen a letter of this type go out to the general public.
This has to be approved by -- before it can be mailed, it has
to be approved by CMS or has to be approved by Medicare. The
system --
i COMMISSIONER WILLIAMS: Approved by who?
~'I MR. LOONEY: CMS. It has to be approved by them.
~,
', So, ,you know, timely -- I get this Monday, and it's talking
about, you know, Mr. Employee -- not employer, but
Mr. Employee, you need to take a -- consider this, what the
option might be. So, we take a look, and if you're a
retiree, Part B of Medicare currently has this under --
you'll see on the chart the monthly premium for Part A is
zero. That's part of your Social Security; that's already
covered. You have to apply for Part B. Part B premium is
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$96.40 for the 2009 year. You can get a lower premium than
that if you can show that your income basis is lower, but
this is the standard premium for Part B. Part D, I estimated
it as $55; we see that the Aetna premium is 53.10, so that's
pretty close. Apart -- supplement to Medicare, you know,
they have the alphabet soup for supplements to Medicare.
They go from A to L. Part -- a Supplement G -- Supplement G,
let me explain real quickly what Supplement G does.
Supplement G pays the deductibles for the Part B -- I'm
sorry, it does not pay the deductible for Part B. It pays
the deductible for Part A, increases the hospital rooms up to
365 ', days, it takes care of that hospitalization number up to
a full year. It does not pay the deductible under Part B,
which is currently $136. $136.
A physician can charge up to 15 percent more for
carQ and treatment than actually he will be paid by Medicare,
so ~ physician that normally charges $100 has the ability to
charge $115 under Medicare if he wishes to do so. That
becomes a balance billed to the employee. Part G, the
Supplement G pays 80 percent of that additional amount. So,
these will be a 20 percent coinsurance payment for the
15 percent increase over and above what the physician can
charge. That supplement, plus a Part D supplement, plus Part
B, the total cost of that would be approximately $316 for an
individual per month, if they have those parts together.
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Then, at this point, if they do not take the supplements, if
they just simply selected the county's plan, they would have
a $135 payment to make. They would not have to have Part D
or a supplement, because the County's plan takes care of
those two benefits. The county obligation, on the other
hand, is we fund for retirees, less what their contribution
is. So, our total funding is $620, and we've got a $135
payment by the retiree. Then we've got a net of $485 per
month that we actually budget for a retiree. Are y'all with
me so far?
COMMISSIONER BALDWIN: Yep.
JUDGE TINLEY: I can find those numbers.
MR. LOONEY: You see the --
JUDGE TINLEY: Understanding them may not be
totally --
MR. LOONEY: Okay, you see them.
JUDGE TINLEY: -- in line, but...
MR. LOONEY: Well, let's take -- now, that's the
retiree circumstance. That's the retiree person.
COMMISSIONER LETZ: Before -- how many of our
retirees are under 65? That are getting -- that are in
there?
MR. LOONEY: That I don't know.
MS. HYDE: One.
MR. LOONEY: One?
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MS. HYDE: We're showing 14, because we have a
brand-new one, and that'll be the only one that's under 65.
COMMISSIONER LETZ: So, we're paying $485 a month
for employees that are on Medicare -- for retirees that are
on Medicare?
MR. LOONEY: Correct, on that payment for funding.
MS. HYDE: That's right. $6,011 per employee as of
this time, on the 14.
COMMISSIONER LETZ: And that is just a secondary
insurance for them.
COMMISSIONER BALDWIN: Pretty nice benefit.
JUDGE TINLEY: I think you got the problem spotted,
Jon.
MS. HYDE: Plus your $600 HRA.
COMMISSIONER LETZ: 600.
MR. LOONEY: For retired employees, though, we
i
don't give them --
COMMISSIONER LETZ: We don't give them the HRA?
MS. HYDE: Yes, we do.
COMMISSIONER LETZ: Not -- no, only the active
ones, it says here. It says on this little chart that we
only give 600 if it's a --
MS. HYDE: HRA's go to your 65-year-olds, and then
they went to retirees. And we stopped it this year.
MR. LOONEY: Oh.
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MS. HYDE:' We did not go there.
JUDGE TINLEY: Okay.
MR. LOONEY: That was not supposed to happen.
COMMISSIONER LETZ: Do you have a breakdown of, I
guess, the claims that we've paid for these retirees that are
on Medicare?
MR. LOONEY: I can get that information.
COMMISSIONER LETZ: It's my understanding that
Medicare is pretty --
MR. LOONEY: Medicare pays virtually 100 percent.
COMMISSIONER LETZ: Right, so it's -- I don't know
~ why we're --
MR. LOONEY: It's the prescription drug --
MS. HYDE: Prescriptions.
COMMISSIONER LETZ: Just the drugs, okay.
MR. LOONEY: We're spending --
MS. HYDE: Prescriptions.
MR. LOONEY: -- a lot of money in the prescription
drug program.
COMMISSIONER LETZ: Okay.
MR. LOONEY: So, an active employee who's over the
I, age of 65 is eligible to participate with Medicare. And that
is just -- you know, for purposes of discussion, if you've
', got an active employee, we fund at, again, $620 a month. The
~I~ plan that's provided is an HRA plan that has a $600 annual
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$1,000 deductible, so you have a net deductible allocation
during that year of $400. Then you have a maximum
out-of-pocket in case of critical illness of $2,000. So,
once an individual employee exceeds that $2,000 number, less
the $600 HRA then the benefits are covered at 100 percent for
the balance of the year, with a couple of exceptions. The
exceptions are that copayments don't go away. Copayments
don't -- are not debited against -- or credited against your
max out-of-pocket, so if you continue to see the physician,
copayments to see physicians are $30 per visit to the
physician. And you still have the copayments that you make
for medications on a monthly basis, which, again, depending
on the category depends on what you -- what you pay for in
that area. So, as a county employee, you potentially have
$2,000 out-of-pocket max, less the HRA, $1,400, and then that
continuation of copayments. They go on if you're in a
critical illness.
JUDGE TINLEY: Under the current setup, if an
individual is Medicare-enrolled -- eligible and enrolled,
Medicare becomes secondary to our plan, does it not?
MR. LOONEY: Medicare, I don't think, becomes
secondary. I don't think -- maybe -- that's a good question.
I'm not really sure.
COMMISSIONER WILLIAMS: No, it doesn't.
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MS. HYDE: On our active employees, Medicare is
secondary.
COMMISSIONER WILLIAMS: Secondary.
MR. LOONEY: It's secondary.
JUDGE TINLEY: Yeah.
MS. HYDE: It is secondary right now.
MR. LOONEY: So --
MR. OEHLER: Medicare is secondary.
MS. HYDE: Medicare is secondary on active --
COMMISSIONER WILLIAMS: For active employees. For
retired employees, --
JUDGE TINLEY: Not retirees.
COMMISSIONER WILLIAMS: -- it's primary.
MS. HYDE: Not retirees. Retirees, we become
secondary.
MR. LOONEY: So, we haven't excluded that. We --
in other cases, we've excluded that payment for Medicare.
Participated in the plan.
JUDGE TINLEY: Can the plan be written whereby --
legally, whereby those that are Medicare-eligible as active
employees, that the coverage we provide is secondary
coverage?
MR. LOONEY: No. No, the -- the option for an
employee to be covered under Medicare as an active employee
is strictly a voluntary action by the employee. The employer
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cannot write documentation that creates a situation where
plan, they audit the employers on a regular basis, and they
will go back and charge that employer for any expenses that
they paid that were in excess of their employer's plan.
Okay. They actually do -- we get audits from the Medicare
people all the time, where they've said, no, we overpaid your
employee. Since we overpaid your employee, you're
responsible for reimbursing us as the employer. Not the
employee, the employer. It's an employer --
MS. HYDE: Judge, if you'll think back, we've
gotten some of those letters.
JUDGE TINLEY: Oh, yeah. Oh, yeah.
MS. HYDE: And so that's not -- that's not unusual.
MR. LOONEY: If an active employee, though,
voluntarily chooses to become covered under Medicare, you
know, what is -- what is, then, his responsibility or
liability? We still have the HRA program, because they're an
active employee. So, as an active employee, the individual
still has the HRA. If they're under Part B of the Medicare,
then their premium allocation is $96.40 per month. If they
take a Part B circumstance, then their deductible -- and they
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Medicare, there are no copays. Under Medicare, once you're
in the Medicare system, there's not any copayments. You may.
have that 15 percent excess that the doctor charges, but the
plan G, again, pays 80 percent of that, so your potential
maximum out-of-pocket as an employee potentially centers
around, again, the prescription drug program.
The statistics from the Medicare people tell us
doughnut hole, where they move out of copays to where they're
making full payment, and then they move back into major
medical coverage by Part D. That hole that sits out there is
about $4,000. If you take into consideration all the
expenses that the individual has to incur before they drop
into that category under Part D that pays for their expenses
in excess of that. So, the exposure for an employee, again,
is back to that prescription drug program. So, somebody that
is an active employee who would want to make a change and
come in to Eva and say, you know, Medicare is going to be a
better long-term circumstance for me. I'm going to be under
Medicare; it's going to continue even after I retire or after
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I leave or whatever. I'll stay on that plan. I've got my
supplements in place. I've got, then -- I do or do not have
', Part D, which, again, is that $50-a-month number. And I've
got my HRA from the County; it helps reimburse me for
expenses that I have under that plan. If those individuals
choose to do that, then that removes them from the
self-funded claim liability and shifts it to Medicare.
COMMISSIONER OEHLER: But it has to be their
choice.
MR. LOONEY: Has to be their choice. You cannot
physically twist an arm, or -- or not -- you know --
MS. HYDE: I can't even talk to them. I can
explain to them.
MR. LOONEY: You can explain.
MS. HYDE: I can give them information, but I
cannot -- I cannot --
JUDGE TINLEY: Recommend. Suggest.
MS. HYDE: No. Modify, discuss, huh-uh.
MR. LOONEY: No, that's -- but, you know, that
temperament is changing. Because now --
MS. HYDE: Last night.
MR. LOONEY: Yeah, it changed a great deal last
night. But the temperament is changing, because this letter
was approved by Medicare to go out, to encourage employees to
reconsider the fact that their employee -- employer coverage,
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which has greater out-of-pockets, has greater coinsurance
factors, has more exposure, that Medicare is a better -- the
best place for them to be.
JUDGE TINLEY: Well, you are making a
recommendation relative to our retirees, are you not?
MR. LOONEY: To the retirees.
JUDGE TINLEY: Premium-wise?
MR. LOONEY: I made a recommendation to increase
the premiums up to -- again, two benefits that they get are
the coordination, which satisfies all of the outstanding
deductibles, and the prescription drug program. A standard G
program is $165. Part D, which covers prescriptions, is 50.
That's $215. So, at $180, there's still a benefit for being
under the county plan.
JUDGE TINLEY: And that's a $45-a-month increase
from where we are at this point.
MR. LOONEY: Right.
JUDGE TINLEY: We increased it slightly last year,
I believe, from 110 to 135?
MS. HYDE: And I needed Kevlar.
JUDGE TINLEY: Pardon?
MS. HYDE: And I needed Kevlar.
II JUDGE TINLEY: It wasn't that bad, was it?
MS. HYDE: Yeah.
JUDGE TINLEY: Here, again, I didn't need to take
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the pill. You did, right?
COMMISSIONER WILLIAMS: You're the boss.
MS. HYDE: It will be at 5.0. this year, so, you
know, I'll be safe. Maybe.
MR. LOONEY: As far as a recommendation to the
active employees, you know, my recommendation would be to
provide an educational seminar to inform them of the option,
and if they wish to participate, then that will be their
option.
JUDGE TINLEY: Should this be done prior to
enrollment?
MR. LOONEY: Yes, it should. It should be done
prior to enrollment, and some of the ability for them to move
will be determined by what dates and time they change, and
whether they're eligible for Part B or not at the time. If
they're eligible for Part B. So, it may not be just a simple
mass change at the anniversary date. They may opt out at a
later date when they become eligible for Part B, if they're
not eligible for Part B currently, either for the fact that
they have enrolled or there's a waiting period for that
purpose. Typically, if you -- if you move from your employer
to Part B, there is no waiting period because of the loss of
coverage from your employer, so you have a certificate of
continuation and authority to move onto the other plan.
MR. OEHLER: Basically, by upping that premium, or
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their contribution, makes Medicare look a little more --
JUDGE TINLEY: Well, it makes it more in line with
i
'', what their actual costs would be if they were to go that
route, but still not to that level. Still a bargain --
MS. HYDE: Absolutely.
JUDGE TINLEY: -- to remain here. Absolute
~ bargain.
MS. HYDE: Absolute bargain.
JUDGE TINLEY: Just for the scrip coverage. And --
and it's paying for that, plus the coordination of benefits,
which is a major plus. As we get older -- and I'll speak for
myself -- it's a real hassle to mess with that stuff, because
it's a paper tiger, and there's rules out the gazoo. And so
it's really good to have those folks that do that stuff, that
know what they're doing, take care of it for you.
COMMISSIONER WILLIAMS: Second that.
JUDGE TINLEY: Yeah.
MR. LOONEY: So, primarily, my -- my, you know,
basic recommendation is that we increase our individual stop
loss from $50,000 to $60,000. The renewal that we received
from Mutual of Omaha for our group term life insurance, it
was bid also. There's nobody -- the closest bid to their bid
was about a 30 percent increase over current rates, so it
didn't make any sense to make a change in that coverage.
That's in force. .That total annual premium is still less
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than $15,000 a year, so it's not a great impact on the
overall cost of the plan. Recommendation, again, is to leave
the employee contribution for active employees at the current
level, but to change the retirees' contribution level and
II increase that by $45 on a monthly basis from $135 to $180,
and to offer an educational seminar to those employees that
are over 65 who wish to attend that seminar, to consider the
', possibility of -- of some other Medicare process as opposed
to the county plan.
JUDGE TINLEY: And to do an HRA contract with the
specific --
MR. LOONEY: HRA.
~ JUDGE TINLEY: -- 600, 1,200, 1,800.
MR. LOONEY: Six, six, and six.
MS. HYDE: And retirees do not get the HRA part.
MR. LOONEY: Right. I think we -- we've already
changed that, but we can do that documentation, make sure
it's documented also.
COMMISSIONER BALDWIN: How long have they been
getting that?
MS. HYDE: As long as I've been here.
COMMISSIONER BALDWIN: How long have they been
getting that?
MS. HYDE: Since y'all started the HRA card.
JUDGE TINLEY: Could you give me a number, Judge?
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Would you get a number out of her?
MS. HYDE: I don't know .when you guys started your
~ HRA.
MR. LOONEY: Four years ago.
AUDIENCE: With Mutual of Omaha.
MR. LOONEY: Four years ago.
MS. HYDE: You were still with E.B.A. -- E.P.A.?
MR. LOONEY: That was right after that.
MS. HYDE: Right when they left, and they picked up
I Mutual.
AUDIENCE: Mutual of Omaha.
COMMISSIONER WILLIAMS: Either three or four years.
COMMISSIONER LETZ: Four.
JUDGE TINLEY: Four.
COMMISSIONER LETZ: Last year we went back with the
-- started -- HRA started rolling off this year.
MR. LOONEY: The excess of the --
COMMISSIONER LETZ: Right. I mean, you accumulate
it up to three years, and then it started rolling off.
MR. LOONEY: It didn't roll off; it just stays
flat.
COMMISSIONER LETZ: It stopped increasing.
MR. LOONEY: Yeah. That's my story, and I'm
sticking to it.
JUDGE TINLEY: You heard the recommendations of Mr.
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Looney, our consultant. Do I hear a motion with regard to
the 2009 employee health benefits plan?
COMMISSIONER WILLIAMS: Move we approve the
recommendations as presented by Mr. Looney.
COMMISSIONER BALDWIN: Can we outline them in
the -- in the motion, please?
JUDGE TINLEY: Okay.
COMMISSIONER BALDWIN: I know you're saying his
recommendations, but just for fun -- you do it. You give us
the language one more time.
COMMISSIONER WILLIAMS: I'll withdraw the motion
till we hear the recommendations spelled out.
MR. LOONEY: Okay.
COMMISSIONER BALDWIN: Please. I'm sorry about
I this .
MR. LOONEY: That's all right. We'll increase the
individual stop loss level from $50,000 per annum to $60,000
per annum. Want to increase the contribution by the retired
employee from $135 a month, to increase it by $45 a month to
$180 a month. We want to leave the employees' current
contributions at their current level, the active employees at
their current level. Want to make certain that our contract
with -- our HRA contract reads 600 plus 600 plus 600, to a
maximum of $1,800 per family; $600 for a spouse, $600 for --
to a maximum of $1,800.
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COMMISSIONER LETZs And the HRA is only applicable
to active employees.
MR. LOONEY: HRA~is only active employees.
COMMISSIONER WILLIAMS: Prior to making a motion,
let me ask a question.
(Low-voice discussion off the record.)
COMMISSIONER WILLIAMS: I'm sorry?
MS. HYDE: You might want to discuss that last one,
'cause they have been doing it -- we've been doing it, so we
have a precedent. Do we want to continue it or not? I mean,
that's pretty big.
COMMISSIONER BALDWIN: I think he's saying no.
MR. LOONEY: I thought we stopped it.
MR. OEHLER: Especially when you increase them $45
a month, and then you take 600 away from them.
COMMISSIONER BALDWIN: Yeah.
COMMISSIONER OEHLER: You know, how hard do you
want to get beat up?
COMMISSIONER WILLIAMS: That's a $1,000 hickey,
isn't it?
JUDGE TINLEY: Let me come back to another couple
of items that maybe need to be included as part of the
recommendation going into the motion. That we maintain our
employee life and accident coverage with Mutual of Omaha.
MR. LOONEY: Maintain employee life and accident
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coverage with Mutual of Omaha, and also the recommendation to
have the employee seminar based on Medicare.
JUDGE TINLEY: And we approve the stop loss as
shown by Option C with Monumental Life, which includes the
$60,000 individual stop loss limit.
COMMISSIONER WILLIAMS: Up from 50 to 60.
MR. LOONEY: Right.
JUDGE TINLEY: Is that it?
MR. LOONEY: I think so.
COMMISSIONER WILLIAMS: Now, the question is, all
of which requires a funding level increase of 5.9 percent.
We budgeted 8, is what I've been told, so that all of this
falls within the budgetary constraints that we've placed --
MR. LOONEY: The number that -- the hard number
that I use is $620 per employee per month, and that's for
active employee positions, whether they're filled or not.
COMMISSIONER WILLIAMS: Okay. I move approval of
the Kerr County medical benefit plan for year 2009, as per
the recommendations of Mr. Gary Looney.
COMMISSIONER BALDWIN: I second.
JUDGE TINLEY: Motion made and seconded. Question
or discussion on the motion?
COMMISSIONER BALDWIN: I have a question about the
retirees -- us providing any kind of program for retirees.
How long have we been doing that?
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MR. .LOONEY: For -- forever. It was here when I
got here. It was in all the plan documents that I reviewed
prior to that. I assume it's been a tradition within the
county for a number of years.
COMMISSIONER WILLIAMS: Forever.
COMMISSIONER LETZ: I think it's -- I'm in favor of
that. I think that's, you know, a good -- a good benefit for
our retirees.
COMMISSIONER BALDWIN: Sure.
COMMISSIONER LETZ: But I also think we need to try
to, you know, encourage them into Medicare as much as
possible.
COMMISSIONER OEHLER: What happens if there's a
funding shortfall in our budget for this? Tying that to what
Commissioner Williams just did, that the 5 point whatever
percent that we budgeted --
COMMISSIONER WILLIAMS: Eight.
MR. OEHLER: Supposedly eight. What if that amount
doesn't cover it?
MR. LOONEY: That's set at the maximum funding
limitation for the --
COMMISSIONER WILLIAMS: Well, I don't know how to
answer that, except that, you know, we've always operated
that way.
COMMISSIONER OEHLER: I understand.
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COMMISSIONER WILLIAMS: We had an estimate of cost
based on an early evaluation, not final evaluation, as to
what we could anticipate. We budgeted accordingly. In most
instances, I think Mr. Looney's recommendations and the plans
that's come back were at or under. And I don't recall that
we've ever had a budgetary shortfall on the -- on the macro
picture.
COMMISSIONER OEHLER: I hope not.
.JUDGE TINLEY: What --
COMMISSIONER WILLIAMS: I do too, but --
JUDGE TINLEY: I believe the numbers last year,
what we've budgeted and what we -- what was not utilized was,
ballpark, 400?
MS. HARGIS: 400,000.
JUDGE TINLEY: Yeah. A lot of discussion in that.
MR. OEHLER: Okay. I just want to make sure we're
not shooting ourselves in the foot here.
JUDGE TINLEY: Not getting outside the -- outside
the ditches. I appreciate that.
COMMISSIONER LETZ: It's possible.
COMMISSIONER OEHLER: There may be some things that
pop up that may not be expected.
COMMISSIONER WILLIAMS: Before we --
MR. LOONEY: Fortunately, we have that insured.
'~, Those are the types of things we do have insured.
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MR. OEHLER: Okay.
COMMISSIONER WILLIAMS: I don't -- where are we
with the six, six and six?
COMMISSIONER LETZ: That -- that's --
MR. LOONEY: For retirees?
COMMISSIONER LETZ: I agree with that. It's the
retirees that's questionable, I think.
COMMISSIONER WILLIAMS: That's what I'm talking
about, for retirees.
COMMISSIONER LETZ: Because it -- on the 600 for
the HRA for the retirees, only the retiree is eligible,
correct?
MS. HYDE: Yes.
COMMISSIONER LETZ: Not their --
MS. HYDE: No spouses, no nothing. Just the
retirees.
COMMISSIONER LETZ: Max at 600 for the retirees.
COMMISSIONER WILLIAMS: So, the motion that I made
doesn't affect the current situation with the retirees.
MS. HYDE: Well, the one you did make said cut it.
JUDGE TINLEY: Yeah.
MS. HYDE: So, I'm hoping you meant don't cut it.
COMMISSIONER WILLIAMS: That's what I'm trying to
clarify.
MS. HYDE: It's just $600.
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COMMISSIONER WILLIAMS: Leave it as it is, is the
sense of my motion.
JUDGE TINLEY: You want to leave the HRA
coverage -- HRA benefit in place for retirees?
COMMISSIONER WILLIAMS: Yes, sir. That will be
included in my motion.
COMMISSIONER OEHLER: That's a wise choice, being
that you upped it $45 a month.
COMMISSIONER BALDWIN: That means you enjoy living
in Kerrville.
MR. OEHLER: Means you enjoy living.
COMMISSIONER WILLIAMS: I heard your words of
caution.
COMMISSIONER LETZ: What that means is that the --
currently, if my calculations are correct, they pay 135, but
we give them 600, so they're only paying -- four and a half
months they're getting free. We're cutting that to three
months free.
MS. HYDE: Right.
COMMISSIONER LETZ: We'll be going up.
COMMISSIONER WILLIAMS: That's about the size of
it.
COMMISSIONER LETZ: They pay one and a half months
~ more .
COMMISSIONER BALDWIN: My question -- my question
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earlier about how long have we been participating in -- with
the retirees, it really goes to this -- the IRA --
COMMISSIONER LETZ: HRA.
COMMISSIONER BALDWIN: HRA. IRA is the
professional rodeo association. But --
COMMISSIONER WILLIAMS: Also a rebel group in
Ireland, but that's okay.
COMMISSIONER BALDWIN: That's right. Well, I
wasn't thinking of that one. After last night, are you
kidding me? My question was really directed to that. How
long have we been contributing to that program for them? And
the answer is just a short four years. And, to me -- to me,
that is a major, major thing that the taxpayers are doing for
our retirees. That is a big deal. If I were a retiree, I
would -- I think I would -- I would think what a nice thing
these people are doing for me. I really don't have a lot of
reason to complain. There's been a slight increase of $45,
but the overall picture, they're really giving me a good
benefit.
COMMISSIONER WILLIAMS: That's a good point.
COMMISSIONER BALDWIN: It's a good program. So, I
guess bottom line is, I really don't want to hear it.
COMMISSIONER OEHLER: We'll see what happens.
We'll see what happens.
COMMISSIONER BALDWIN: I'm sending them to y'all.
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I'm not going to listen.
COMMISSIONER OEHLER: You know, there might be
several individuals that may come see you and I and everybody
else on this Court.
COMMISSIONER BALDWIN: I know of a couple, but I
suddenly don't speak English any more, so they're going to
You .
I, MR. LOONEY: The budget number that I provided
included funding the HRA for the retirees.
COMMISSIONER BALDWIN: Okay. I second whatever
happened here.
COMMISSIONER WILLIAMS: Whatever I said?
JUDGE TINLEY: I just wanted to clarify your --
that your second was to the motion that included the HRA for
the retirees.
COMMISSIONER BALDWIN: Yes, sir.
JUDGE TINLEY: All right. Any further question or
discussion on the motion? All in favor of the motion,
signify by raising your right hand.
(The motion carried by unanimous vote.)
JUDGE TINLEY: All opposed, same sign.
(No response.)
JUDGE TINLEY: The motion carries.
COMMISSIONER WILLIAMS: Gary, thank you. You
helped make some sense out of all of this for us.
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MR. LOONEY: Thank you, sir.
JUDGE TINLEY: Again, thank you for your help,
Mr. Looney.
COMMISSIONER BALDWIN: Don't encourage him. Good
gosh.
(Low-voice discussion off the record.)
JUDGE TINLEY: Do we need -- do we need a separate
motion to continue in force the supplementals that we have?
MS. HYDE: I would not think so, but I asked
earlier and y'all backed me with a rock saying that if it was
in the contract, you don't have to, so I'm unsure.
JUDGE TINLEY: That's a voluntary plan, but -- but
it is administered through you, so --
MS. HYDE: Right.
COMMISSIONER LETZ: Wouldn't hurt to do a motion.
JUDGE TINLEY: That's what I'm thinking.
COMMISSIONER LETZ: I'll make a motion that we keep
the supplemental plan offered to the employees the same as
last year.
MR. OEHLER: Second.
JUDGE TINLEY: Motion made and seconded as
indicated. Question or discussion on the motion? All in
favor of the motion, signify by raising your right hand.
(The motion carried by unanimous vote.)
JUDGE TINLEY: All opposed, same sign.
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(No response.)
JUDGE TINLEY: The motion carries. Why don't we
take a few minutes recess here?
(Recess taken from 2:20 p.m. to 2:39 p.m.)
JUDGE TINLEY: Okay, let's come back to order, if
we might. We'll be back in session. We were in recess for a
short period of time. One more item on the 1 o'clock meeting
agenda, to consider, discuss, take appropriate action to
receive recommendations from the courthouse windows committee
and to award bid for courthouse windows and doors,
replacements and/or renovation. We've got some legal issues
relating more to the advertisement and solicitation for bids
than we do the bids themselves, and the County Attorney has
recommended that -- that the Court reject all bids and that
we rebid in the proper manner. The improper manner was --
that responsibility lies with me, and I'll take
responsibility for that, but it needs to be rebid.
COMMISSIONER BALDWIN: I move that we do so.
COMMISSIONER LETZ: I'll second, with a question.
JUDGE TINLEY: Motion made and seconded to reject
all bids and -- and rebid the project.
COMMISSIONER LETZ: My question is, I know that the
-- we lacked specificity in some things like insurance and
bonding and all that, but the -- what we're going to put in
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there is following the state law, which we would have to
follow anyway, so why do we have to put it in there?
MR. EMERSON: Because the statutes, under 262,
specifically says you shall include the following five or six
items --
COMMISSIONER LETZ: Oh, okay.
MR. EMERSON: -- in your notice.
COMMISSIONER OEHLER: It says you shall.
COMMISSIONER LETZ: Answers that one.
COMMISSIONER BALDWIN: See how easy Jon is to get
along with?
COMMISSIONER WILLIAMS: When you explain things to
I him.
COMMISSIONER BALDWIN: When you explain things to
him.
JUDGE TINLEY: Any other attention to be given to
my shortcomings? All in favor of the motion, signify by
raising --
COMMISSIONER BALDWIN: Wait a minute. Whoa, whoa,
whoa, whoa. Here's an opportunity, guys.
COMMISSIONER WILLIAMS: Maybe we should ask him
what the other shortcomings are.
COMMISSIONER BALDWIN: And you're bald-headed. I'm
ready to vote.
JUDGE TINLEY: All in favor of the motion, signify
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by raising your right hand.
(The motion carried by unanimous vote.)
JUDGE TINLEY: All opposed, same sign.
(No response.)
JUDGE TINLEY: The motion carried. Anything else
on the 1 o'clock meeting agenda? Hearing nothing, we will
adjourn that meeting.
(Commissioners Court adjourned at 2:43 p.m.)
STATE OF TEXAS I
COUNTY OF KERB I
The above and foregoing is a true and complete
transcription of my stenotype notes taken in my capacity as
County Clerk of the Commissioners Court of Kerr County,
Texas, at the time and place heretofore set forth.
DATED at Kerrville, Texas, this 7th day of November,
I 2008 .
JANNETT PIEPER, Kerr County Clerk
BY:
Kathy B nik, Deputy County Clerk
Certified Shorthand Reporter
11-05-08
ORDER N0.31081
PROPOSALS FOR KERR COUNTY EMPLOYEE BENEFITS FOR 2009
Came to be heard this the 5th day of November, 2008, with a motion made by
Commissioner Williams, seconded by Commissioner Baldwin, the Court unanimously
approved by a vote of 4-0-0 to:
Approve the Kerr County Medical Benefit Plan for 2009 as recommended by Mr. Looney
as follows:
1. Increase the individual stop loss level from $50,000 per annum to $60,000 per
annum, as shown by Option C with Monumental Life
2. Increase the contribution by the retired employee from $135 a month to $180 per
month
3. Leave the active employees' contributions at their current level
4. Set the HRA levels at $600 per employee, $600 per employee plus spouse and
$600 per employee plus .spouse plus children, for a total of $1,800 per family (for an
employee with spouse and child coverage), and $600 for retirees, with no HRA levels for
retirees' spouses or children
5. Maintain the employee life and accident coverage with Mutual of Omaha
6. Recommend to active employees to attend an educational seminar to inform them
of the options of switching to Medicare as their primary insurance
ORDER NO. 31082
PROPOSALS FOR KERR COUNTY EMPLOYEE BENEFITS FOR 2009
Came to be heard this the 5th day of November, 2008, with a motion made by
Commissioner Letz, seconded by Commissioner Oehler, the Court. unanimously
approved by a vote of 4-0-0 to:
Keep the supplemental plans offered to the employees the same as last year.
ORDER N0.31083
AWARD BID FOR COURTHOUSE WINDOWS AND DOORS REPLACEMENT
AND/OR RENOVATION
Came to be heard this the 5th day of November, 2008, with a motion made by
Commissioner Baldwin, seconded by Commissioner Letz, the Court unanimously
approved by a vote of 4-0-0 to:
Reject all bids received and re-bid the project for replacement and/or renovation of the
Courthouse Windows and Doors.