City of Holyoke Health Benefit Trust Committee Meeting March 10, 2025

City of Holyoke Health Benefit Trust Meeting

March 10, 2025

City Hall, Old Tax Collector’s Office

In attendance: 

PEC Representatives: Joe O’Connor- Retirees, Chris Butler-Fire Dept, Chris Adams- UFCW

City Representatives: Sean Mangano- HPS CFO, Dazhana Argueta-Personnel Specialist

Others: Quentin Donohue – Chair, Steve Corbin – Dowd, Kelly Curran – HR Director, Rebecca Sutter – Dowd, Rory Casey – Treasurer, Heidi Fountain- BCBS and Dan Shanahan- BCBS

The meeting began at 5:05 PM

Quentin Donohue requested a moment of silence for Tanya Wdowiak, in respectful acknowledgment of her mother’s passing.

Agenda:

Receive Minutes from February 24 meeting

• Recommendation to accept minutes by Quentin Donohue. 
• MOTION:Trustee Butler made a motion to accept meeting minutes and Joe Seconded. Motion carried unanimously.

BCBS Weight Management Program Savings Analysis and Other Declined Pharmacy Programs

-Dan Shanahan, Pharmacy Sales Account Executive and Heidi Fountain, Senior Account Executive

• Heidi introduced a weight loss program and introduced Dan Shanahan.
• Dan- explained GLP medication and the difference between them being prescribed for weight loss and for diabetics. BCBS wants to put up guardrails on medication. Members are required to enroll in a program in order to receive this medication. If they continue lifestyle changes taught in the program, weight will stay off. Access to health optimizer app which helps make healthy eating choices along with a bluetooth weight scale. Cost for city $148 dollars per engaged member per month. Not including medication. Estimated $116,044 per year.
• Steve asked if the major savings are regarding those that opt out of the program. Dan responded, yes. 
• Rory disagreed with the fact that employees want to take the pill to lose weight quickly. Employees have jumped through hoops and now adding the additional responsibilities such as adding weight may be discouraging. 
• Dan- the only requirement is to add weigh in app. Rory- which will cost us $116k. Heidi-There are two types of classes for this prescription. This is only for employees that are not taking medication for diabetes. This is a tool to help members not be on this medication for a long period of time costing your health plan money. 
• Chris Adams- spending $321k on medication currently? No, this is savings for adding the program. Chris Butler- savings come from Rx savings? A better way to look at it is the Avoidance savings $214,806K.
• Have to have a certain level of BMI of 27 or 30 in addition to 6 months of weight loss or lifestyle change. Dr has to sign to attest but no proof is needed. 
• Steve- prediabetes and obesity is a common diagnosis and if it shows on your claims, it is included in this estimate. 
• Sean- if we opt into the program and offer to those eligible and they don’t enroll-the drug is not covered. Dan-Yes, they will get a bill. Sean-It’s approved but will go from $45 to hundreds. 
• Rory-What happens if the community does not opt in. Dan- they would be covered. 
• CVS piloted this program for 2 years and the data comes from them. 
• Steve-what percent of members opt out. Dan- I can go back to CVS and get that information. 
• Sean- for plans that are fully insured are you offering a plan deduction. Dan-no, everything with fully insured takes long. Sean recommended that union groups speak to their members instead of this small group making this decision. 
• Chris Butler-what does outreach look like?  Dan- outreaches happen 30 days prior and schedule meetings for intake and explain the program and get idea of members goals and see what their involvement with the program would be. Quentin- is this CVS exclusive? Dan- yes but it can get filled anywhere. The program itself is exclusively through CVS. 
• Joe- is the scale wifi. Dan- Yes, it’s bluetooth and connected to the app.
• Chris Adams- can’t see that there will be that big of savings (avoidance). I lost over 100 lbs and then another 20 on Ozempic. My numbers went down but only one medication went down. 
• Quentin- how much are we spending on this now? Dan/Heidi- we can get the numbers
• Sean- if we participate in this program can the progress be tracked? Dan- yes, there are monthly reports. 
• Quentin asked Steve if we need to act on this now? Heidi- Need a decision by the end of March but can always be picked up next year. 
• Joe- the 70 so-called people can stop anytime and go back and forth? Heidi- they would have to meet requirements. Dan-Also dependent on time that has passed. Continuation authorization can be denied if the member is not meeting the milestones. 
• Heidi- Dan, do we have an idea from CVS on what the accelerator is? Dan-there is just across the board increases. There is just a natural increase. 
• Quentin- best we take this under advisement.
• Dan continued to review other programs
  • Rewarding ways to help members- no cost to the city. Members get savings on copays. Once identified as taking one of the medications, the member is reached out to see if they want to enroll then discounting their copays. No penalty if a member does not enroll. Member notified monthly
  • Transform Diabetes Care- Extra support program for members with type 1 and 2 diabetes. 81c per subscriber per month. Members can reach out with any questions. Good when they cannot get a hold of their doctor. 
  • Drug Savings Review- Provider focus program. Clinical team that when new Rx is submitted, the clinical team looks at medication and members history to ensure their is no drugs interactions and makes recommendation for savings .52c per subscriber per month 
  • Pharmacy advisor- support for members to ensure they are aware of side effects of medication and to answer questions regarding medication .27c per subscriber per month
• $19k annually for Transform Diabetes and Drug Savings Review 
• Dan- Avg 2:1 ROI with these programs
• Sen recommended we take this into consideration and get recommendations.

Broker Review

• No update to reporting as this is a supplemental meeting not a monthly meeting. 
• Renewal Projections- shows 20% increase Stop Loss
• Steve reviewed different renewal rates
• Sean asked what the rate increase was this year which was 10%. Likes numbers but hard to tell if 9.5 or 12 percent is better without knowing where we are now. Steve- assume that at the end of year we are at 0 to be conservative. $1.2 million in trust after paying January receipts. 
• Quentin- asked Rory where we were at with Cash share. Rory said we will have it soon. Quentin asked if it included anything from last year. Rory- no. Won’t be in account until everything is settled. Sean asked what recommendation should be for what is in account Steve apox. 
• Avg monthly claims $920k and $420k for Rx in one month. Sean- so between 4 and 5 million. 
• Sean- leaning toward 9.5% with what is going around recently. 
• Heidi insite- rates are going between 9.5 to 19% average. 
• Rory- for next 3 years, could you ask the Mayor to contribute X dollars to build trust but keep rates down for employees.
• Sean asked Steve if he thinks there is a significant difference between the 9.5 and 12 percent? Steve- no
• Sean said we should make a decision on rate and also decide on cost savings. 

Set Insurance working rates

• Quentin- want to keep a single digit increase. Split the difference between 7.5 and 9.5 to 9%

MOTION: Chris Adams made a motion to set the rate at 9%. Chris Butler seconded. Joe liked Rory’s thoughts. Chris Adams- rescinded his motion.

• Sean- does not want to make a decision based on what Rory said because City Council could say “Why would taxpayers front money to pay for employee insurance that don’t all live in the City”

MOTION Chiris Adams made a motion to set rates at 9%. Chris Butler second. Quentin-All those in favor of setting a working of 9%? Motion carried unanimously. 

• Sean- can we get total rates based on others like GIC and other municipalities. Are we high or low?
• Quentin- glad we are voting on something less than double digits taking into consideration employee money but that we are investing in the future

• Joe-asked why has the PPO enrollment increased. Steve believes the enrollment is actually lower than it was with HNE. Steve checked and numbers were higher
• Steve- You can increase PPO rate which will deter them from enrolling in the PPO

MOTION: Joe O’Connor made a motion to adjourn.  Qunetin asked Joe to rescind his motion which he did

MOTION: Chris Butler made a motion to add 2 of the programs. Chris Butler rescinded his motion

 Quentin made a recommendation to adjourn. 

MOTION: Joe O’Connor made a motion to adjourn. Chris Butler second. Motion carried unanimously.

The meeting adjourned at 7:04 PM

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