JOINT LABOR-MANAGEMENT BENEFITS COMMITTEE

www.keepingLAwell.com

Joint Labor-Management Benefits Committee (JLMBC) COMMITTEE REPORT 19-45 JLMBC MEMBERS:

Employee Organizations David Sanders, Chairperson Paul Bechely Chris Hannan Steve Koffroth Michael Davies Management Wendy G. Macy, Vice-Chairperson Lita Payne Rich Llewellyn Tony Royster Matthew Rudnick

Date: December 5, 2019 To: JLMBC From: Staff

Subject: Projects & Activities Report RECOMMENDATION That the JLMBC receive and file the projects and activities report regarding informational items, project updates, staffing summary, and completed projects/meeting calendar for November 2019. DISCUSSION Following are updates for the LAwell Civilian Benefits Program (LAwell Program) for November 2019: A. Informational Items

• Anthem Blue Cross (Anthem) Vivity Guest Membership – Anthem informed the City of a recent enhancement to its Vivity Health Maintenance Organization (HMO) product. Through Anthem’s Guest Membership program, Vivity HMO members (including dependents) now have access to routine, non-emergency care while traveling or residing in California outside of Vivity’s Los Angeles County/Orange County service area effective September 1, 2019. Guest Membership was previously only available to Vivity HMO members traveling or residing outside the state of California. Prior to this enhancement, Vivity HMO members within California but outside the plan service area could only access out-of-area emergency coverage. To utilize the program, members must apply for a Guest Membership and meet one of the following qualifications:

1. Long-term traveler Guest Membership: available for qualified Vivity HMO members and their covered spouse or dependent(s) who will be away from home for 90 or more days in a row. This is usually for long-term work assignments or for a member who lives in two states.

2. Families apart Guest Membership: is available to qualified Vivity HMO members’ covered dependent(s) who do not live in Vivity’s service area for 90 or more days in a

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row. This membership is typically used for divorced or separated families living outside of the plan’s service area.

3. Student Membership: is available to qualified Vivity members’ dependent(s) up to the age of 26 who are out of Vivity’s service area for 90 or more days in a row for school.

The Guest Membership program is a national program administered by the Blue Cross Blue Shield Association. Guest Membership benefits generally have a uniform member cost share structure across the country, with variances by state due to state-level regulatory requirements. A high-level comparison identifying variances between the City’s Vivity HMO plan and the Anthem Guest Membership program is provided below:

Benefit City of Los Angeles Vivity HMO –

Member Cost Share

Anthem Guest Membership –

Member Cost Share Inpatient Hospital No charge 10% coinsurance Outpatient $15 per office visit/

No copayment for facility $15 per office visit/ 10% coinsurance for facility

Emergency $100 copayment per visit $150 deductible/ 10% coinsurance

Mental Health Inpatient Hospital

No charge 10% coinsurance

Mental Health Outpatient

$15 per office visit/ No copayment for facility

$15 copayment/ 10% coinsurance

Information about the Guest Membership program available to Vivity HMO members is included in Attachment B. Anthem indicates it is currently working on an email communication template and can also publish information on this program on the City’s Anthem microsite to provide members information regarding this program.

B. Project Updates

• 2020 Open Enrollment Update – During the month of November, staff completed the following activities related to this year’s Open Enrollment period:

- Distributed and mailed over 25,000 confirmation statements to all LAwell eligible

members - Distributed targeted reminder communications to about 900 members who are required

to submit supporting documents (e.g., birth and/or marriage certificates) for newly added dependents or cash-in-lieu affidavits

- Announced an extension to the Open Enrollment correction window to December 10 by direct mail, Citywide email, and online updates to the www.keepingLAwell.com and Personnel Department websites

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Following the close of these November activities, staff will work with Morneau to review and validate Open Enrollment elections and prepare accurate data transmissions to both the LAwell Program’s benefit service providers and the City’s payroll system.

• 2019 Employee and Family Assistance Program (EFAP) Lunchtime Seminars – As previously

reported to the Committee in the November Projects & Activities Report, staff worked with LAwell Program EFAP service provider, Optum to develop an ongoing lunchtime seminar series for members for calendar year 2019. The goal of this series is to both educate and engage members with the services provided through the EFAP. One seminar per month was held until the start of Open Enrollment in October, with a final seminar on Work Life Services held in November 2019. Each seminar was held as a combined seminar/webinar event. The topic seminar, date, location, and attendance are provided in the table below:

Seminar Date Held Location Attendance

On-site Web Total

Managing Your Finances June 27 Public Works 10 10 20 How to Better Manage Stress July 25 City Hall East 8 14 22 Making the Most of Your Working Day August 29 City Hall 2 21 23 Positive Parenting Sept 26 City Hall 12 16 28 Work Life Services Nov 21 City Hall East 11 14 25

Staff is working with Optum to determine the lunchtime seminar topics and schedule to be offered in calendar year 2020. Additionally, staff will work with Optum to research different methods of advertising the seminar/webinar schedule to increase member awareness and utilization of the services offered through the EFAP.

• Affordable Care Act (ACA) Tax and Annual Reporting Update – Staff is currently working with

Ernst & Young on annual Employer Shared Responsibility (ESR) and Minimum Essential Coverage (MEC) reporting for determining ACA eligible employees for the 2019 stability period. Staff is also currently working with Ernst & Young to review and establish requirements and procedures for transferring data files, mapping, and reporting in preparation for the ACA tax filing for the 2019 tax year. The ACA tax reporting deadline is January 31, 2020.

C. Staffing Summary During the month of November, several vacancies within the Employee Benefits Division (EBD) were filled:

• Chuong Tran has accepted the position of Senior Management Analyst I effective November 10, 2019. Mr. Tran previously worked as a Senior Management Analyst I at the Harbor Department.

• Theodore Vasquez has accepted the position of Personnel Analyst within the Benefits section of EBD effective November 10, 2019. Mr. Vasquez previously served as the Wellness Program Assistant supporting the LIVEwell Wellness Program.

• Robyann Jumaoas has accepted the position of Management Assistant effective November 12, 2019. This is Ms. Jumaoas’s first appointment to the City.

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• Eric Lan has accepted the position of Management Assistant effective November 25, 2019. This is Mr. Lan’s first appointment to the City.

Staff is currently working to fill the remaining vacant Wellness Program Assistant position. Following is a summary of staff positions supporting the LAwell Program:

Position Authority Staff Member Function Est. % Allocated to LAwell Program

Personnel Chief Personnel Analyst Steven Montagna Division Chief 60% Senior Management Analyst II Jenny M. Yau Governance-Wellness-Contracts/Procurements 75% Senior Personnel Analyst II Paul Makowski Section Manager 100% Senior Management Analyst I Chuong Tran TPA Administration/ACA/Member Services 100% Senior Personnel Analyst I Theodore Vasquez Communications/Payroll/Contracts 100% Senior Personnel Analyst I Leo Reyes Wellness Program Coordinator 100% Personnel Analyst Robyann Jumaoas COBRA/Employee & Family Assistance Program 100% Personnel Analyst Helen Georgeson Participant Services/BPP/JLMBC 100% Personnel Analyst Vacant Wellness Program Assistant 100% Management Analyst Eric Lan Contractor Efficiency and Procurements 100% Management Analyst Susan Valencoure FSA Administrator/Life Insurance Claims 100% Benefits Specialist Brianna Collins Member Services Rep: A-F 100% Benefits Specialist Khia Moore Member Services Rep: G-I / K-M 100% Benefits Specialist Ariana Alvarez Member Services Rep: N-V 100% Benefits Specialist Maria Lopez Member Services Rep: J, W, Z, Sworn 100% City Attorney Assistant City Attorney Curtis Kidder Board Counsel 25%

D. Completed Projects/Meeting Calendar Staff maintains a log of completed projects as well as a calendar of upcoming Board meetings and proposed topics (Attachment A). Submitted by: _____________________________________ Paul Makowski, Senior Personnel Analyst II Reviewed by: _____________________________________ Jenny M. Yau, Senior Management Analyst II Approved by: _____________________________________ Steven Montagna, Chief Personnel Analyst

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COMPLETED PROJECTS & UPCOMING MEETINGS CALENDAR

COMPLETED PROJECTS: NOVEMBER 2019 # STATUS PROJECT

1 Completed JLMBC Report: Benefits Plan Administration and Communications Consulting Request for Proposal

2 Completed JLMBC Report: Employee Benefits Trust Fund Staffing Reimbursements – First Quarter Fiscal Year 2019-20

3 Completed JLMBC Report: LIVEwell Program Update – September to October 2019 4 Completed JLMBC Report: Projects & Activities Report for November 2019 5 Completed JLMBC Appeals November 2019 – 2 cases processed 6 Completed Catastrophic Illness November 2019 – 2 cases processed

7 Completed Employee and Family Assistance Program (EFAP) Lunchtime Seminar: Work Life Services

8 Completed

2020 Open Enrollment Activities: - Open Enrollment confirmation statements emailed and mailed- Open Enrollment targeted reminder notifications regarding submission of

supporting documentation mailed- Open Enrollment correction window extended

JLMBC UPCOMING MEETINGS CALENDAR MEETING DATE AGENDA ITEM PRESENTATION (VENDOR)

January 2020 – No meeting

6-Feb-20

Benefits Service Provider Presentation WageWorks (Tax-Advantaged Spending Accounts)

Quarterly LAwell Program Data and Metrics Review Keenan & Associates

Health-Dental-Vision Procurements Development

FY 2019-20 Strategic Initiatives Update

LIVEwell Program Update

Monthly Projects & Activities Report

5-Mar-20

Benefits Service Provider Presentation Kaiser (Health Insurance)

Health-Dental-Vision Procurements Development

LIVEwell Program Update

Monthly Projects & Activities Report

ATTACHMENT A

114202CAMENVIV 3/19

As a Vivity member, you have access to health care benefits across the country when you’re away from home. Through Anthem’s Away From

Home Guest Membership program, Vivity members can be a “guest” of a health care provider who participates in the program when they’re away from their home service area for 90 days or more in a row. That even

includes covered family members who have long-term stays outside the Vivity plan service area.

Here are the states that are part of the program:*

Arizona Hawaii Michigan North Carolina

Arkansas Illinois Minnesota Ohio

California (outside Vivity service area)

Indiana Missouri Oklahoma

Colorado Kentucky Nevada Pennsylvania

Connecticut Louisiana New Hampshire Texas

Delaware Maine New Jersey Virginia

Florida Maryland New Mexico Washington, D.C.

Georgia Massachusetts New York Wisconsin

Ready to get started?

Call Anthem’s Away From Home Guest Membership program at 1-800-827-6422. They’ll help you:

• Check to see if the requested Guest Membership region is covered. • Apply and get a Guest Membership application. • Submit your application and answer any questions you have along the way.

* These states may have regions that are not covered, which means applicants can still be denied coverage if the region in the guest state does not have Away From Home Guest Membership providers.

Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

Away From Home Guest Membership: health care

coverage that goes with you

ATTACHMENT B

114203CAMENVIV 3/19

To learn more about Away From Home Guest Membership benefits, call 1-800-827-6422.

Away From Home Guest membership: health care coverage that goes with you

As a Vivity member, you have access to health care benefits across the country when you’re away from home. Through Anthem’s Away From Home Guest Membership program, Vivity members can be a “guest” of a health care provider who participates in the program when they’re away from their home service area for 90 or more days in a row. The program also includes covered family members who have long-term stays outside the Vivity plan service area.

How does Guest Membership work?

Guest members will still be covered by their Vivity doctor when they’re at home, and the premium will still be paid through Vivity. When they’re away from home, the program helps make sure members get the care they need from doctors who have a contract with their plan.

The Guest Membership program is available in the following states: Arizona, Arkansas, California (outside Vivity service area), Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Texas, Virginia, Washington D.C. and Wisconsin.1

There are three types of Guest Membership, based on whether a member is eligible and how long they’ll be out of the home service area:

• Long-term Traveler Guest Membership is availablefor qualified Vivity members and their covered spouse ordependent(s) who will be away from home for at least90 days or more. This is usually for long-term workassignments or for a retiree who lives in two states.

• Families Apart Guest Membership is available to qualifiedVivity members’ covered spouse or dependent(s) whodon’t live in Vivity’s service area for 90 or more days ina row. The member can’t get this type of GuestMembership. It’s typically used when the spouse ordependent(s) in divorced or separated families livesoutside of the member’s plan service area.

• Student Guest Membership is available to qualified Vivitymembers’ dependent(s) who are out of Vivity’s servicearea for 90 or more days in a row for school. Whilemany colleges have a place on campus where studentscan get care, those places usually don’t accept healthinsurance, so families can end up having to pay a lot forthat care. That’s where the value of Guest Membershipcomes in, because it allows students to get care from adoctor in the program at a lower out-of-pocket cost.

ATTACHMENT B

1 Some states may include regions that are not covered by the Away From Home Guest Membership program. In these cases, applicants can be denied coverage. 2 Your copay under your Vivity plan applies.

Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

How are prescriptions filled through Guest Membership?

Prescription benefits are provided by the Vivity home plan; they’re not handled as a Guest Membership benefit. Members on Guest Membership need to use their Vivity member ID cards when they get a prescription filled.

How do you enroll in the program?

Signing up is as easy as 1, 2, 3:

1. Call the Away From Home Guest Membershipprogram at 1-800-827-6422 to see if youqualify and if the program is available in therequested region.1

2. The Guest Membership team will help youcomplete an application and help you choosea provider, if needed.

3. Once you’re approved, you’ll get a GuestMembership ID and information about yourbenefits. Guest Membership copays for servicesmay be different than the copays required byyour Vivity plan.

How long does it take to set up Guest Membership?

You’ll get a notice from us within 20 days from the date we get your application. Coverage for urgent care or emergency room visits is available during that time through your Vivity home plan, if needed. Coverage is based on the same limits and out-of-pocket amounts that are part of your Vivity plan.

Can Guest Membership be extended or renewed?

Yes, as long as members and their covered spouse or dependent(s) continue to qualify for the program. A renewal letter and application will be mailed 6 weeks in advance of the termination date. To renew Guest Membership, submit a renewal application at least 30 days before your membership expires.

Don’t forget that as a Vivity member, you always have access to LiveHealth Online and 24/7 NurseLine. With LiveHealth Online, you can have video visits with a doctor or mental health professional anytime, anywhere.2 With 24/7 NurseLine, registered nurses are available to answer your health-related questions. Just use your Vivity membership card to access these services.

ATTACHMENT B