Welfare Trust Health Plan Current Status

• 1. HCC selects plan.
• a. HCC members are generally union leaders that have lots on their plates. Although medical benefits are very important to all members, it is one of many things many HCC members do. Since HCC members are not medical industry professionals, they rely on the City's health care professionals for information and advisement.
• b. The City's medical plan changes are determined by a group called the Health Care Coalition (HCC). The HCC consists of one representative from each union that participates in the City's standard medical plans plus city representatives. Each year the HCC gets together to look over the previous years medical cost, the projected costs for the upcoming year, and discuss any changes to the plan. These changes may come from a HCC member's desired coverage change or from a change due to medical cost considerations. The HCC weighs desired changes with cost impacts to the plans. If a HCC member would like a plan change, they need to convince the other HCC members to support the change, and then the HCC negotiates the change with the City. The HCC members all have equal voting rights and decisions are democratic.
• c. The other HCC members are less similar to Local 27 than the majority are to each other and as such have different medical benefit desires or desired benefit structure. If the majority of the HCC wants a specific disease coverage benefit like diabetes because many of their members are susceptible to that disease then the plan is likely to add that benefit as opposed to back or joint injury coverage fire fighters would benefit from.
• 2. The Plan Open Enrollment Guide is available on Local 27's website.
• 3. Costs are based on an average city employees' usage. So, if Local 27 members use less medical services than other city employees, the savings are spread out among the 12,000 city employees. The same happens when Local 27 members use more medical services than other city employees. Historically, Local 27 may have used less medical services than other city employees, but there are years (including 2005) Local 27 members have used more medical services.
• 4. Any savings Local 27 realizes are put into a big pot with all 12,000 City employees' savings and costs. If in the end there are savings, the savings are spread among all 12,000 employees. If Local 27 had savings but the City as a whole had losses, then the losses are spread among all 12,000 employees including Local 27 members.
• 5. Any losses Local 27 experiences are put into a big pot with all 12,000 City employees' savings and costs. If in the end there are losses, the losses are spread among all 12,000 employees. If Local 27 had losses but the City as a whole had savings, then the savings are spread among all 12,000 employees including Local 27 members.
• 6. There is no current Occupational Health program. But even if an occupational health program was agreed to and implemented today, the City's medical plans would not coordinate any programs or benefits unless our HCC representative could convince the other HCC members to make the change for only our benefit, and then the HCC would negotiate the change with the City.
• 7. Members can choose to stay with the City's plan and pay the full premium (monthly retiree rates LEOFF I or II: for employee - under age 65 $649.33, for spouse - under age 65 $583.31 1st child under age 21 or 23 & FT student $183.06, all additional children (not each child) under 21 or 23 & FT student $137.95), sign up for Fire Fighter Family Medical ($415 monthly for retired member or spouse under age 65 and $100 monthly for each child), choose a commercial medical policy, or choose to not to buy medical insurance.
• 8. If a member would like to make plan changes, they only have access to and know only one HCC member. Members elect Local 27's President directly, but the President may appoint a representative to the HCC and members elect the President on a wide variety of issues and qualifications.
• 9. If a member gets a larger medical bill than expected, the member may be dissatisfied with the Union's past negotiations on medical benefits but also blames the current medical bill on the medical carrier for claim problems.
• 10. Plan savings is the difference between the cost of the City's plan and a Welfare Trust plan. Since no Welfare Trust plan exists today, there is no current plan savings.
• 11. Any cost increase in excess of 7% is shared with the City. The City pays 85% of any costs over the 7% and members pay 15% of the costs over the 7%.
• 12. The entire appeal process is with the carrier.
• 13. The City controls members' medical information. Medical information stays with the City's carriers with the exception of members who participate in Fire Fighters Family Medical (FFFM). FFFM has access to members' medical information in order to process claims and administer benefits. Since the City is providing the plans and although access is regulated by HIPA, the City has limited access to members' medical information. If members or the Union requests medical information, they need to request the information from the City and may be denied access. (This was a hurdle that Local 27 had to go through for our actuary report and is a significant reason for the delay in the Welfare Trust Self-Funded Vote.)
• 14. N/A
• 15. There is great inertia to overcome for benefit changes either positive or negative, and as a result, Local 27 defers its medical benefits negotiations to the HCC. Local 27 negotiates medical benefit changes with the City but has not been successful in obtaining a benefit change at a feasible cost. The City has a strong interest in providing the same benefits to all of its employees, has successfully negotiated other groups to accept changes that make the other groups' plans more like the City's HCC plans (SPOG), and have significantly increased groups' medical premiums for groups that maintain different medical benefits (Local 2898).

• 16. $'s for medical benefits are not pensionable nor taxed. $'s for medical benefits could be pensionable, but then it would be considered taxable income and would lower members' benefits or members would need to supplement the medical benefits $'s out of their take home pay.
• 17. Reserve fund is being held L27 Trust Plan reserve. If plan is approved, $ is used to fund the plan's required reserve. If plan fails, fund is distributed to members in some form of benefit.