2020 Medical Plan Projections September 10, 2019

Fixed Costs and Rebates Administration fees for medical and pharmacy will continue at current levels for three years. Fees for HRA, HSA, and FSA account administration will continue at current levels for three years. Premium for Aggregate stop loss will continue at current level Estimated Pharmacy rebates of approximately $985,000 during 2020

Claims Projections Used claims incurred 5/1/18 – 4/30/19 and paid through 5/31/19 There were two claims above $450,000 individual stop loss level during 2018 and none year-to-date in 2019 Claims were projected forward assuming 6% annual trend for medical and 8% for pharmacy Based on market averages, PreferredOne/Navitus actuarial estimates and County experience

Recommended Rate Action: Advantage 9.9% HSA 6.0% Select 7.0%

2019 Premium Benchmarks Charts show weighted average premiums for all plans offered by each county

Historical Premiums Comparison to old HealthPartners insured rates Self Insured 2011 Total Premiums were not exceeded until 2019 Purple line shows hypothetical insured premiums with 4% increases each year from ’12 onward Significant savings resulting from self-insuring in ’13 – premium reductions plus accumulated reserves

Paid Parental Leave September 10, 2019

Paid Parental Leave Paid Parental Leave is paid time for parents to bond with a child following: the birth of a child placement of a child in employee’s home for adoption placement of a child in the employee’s home in cases of surrogacy when the employee is the intended parent

Prevalence of Paid Parental Leave Hennepin County 3 weeks Ramsey County 3 weeks City of Minneapolis 3 weeks City of St. Paul 4 weeks for mother; 2 weeks for other parent State of MN 6 weeks

Estimated Cost of Offering PPL Estimated cost of implementation On average 100 employees per year take maternity/paternity leaves Average wage of County employees $34.28/hr. 2 weeks x $34.28 x 100 employees = $274,240 3 weeks x $34.28 x 100 employees = $411,360 6 weeks x $34.28 x 100 employees = $822,720 12 weeks x $34.28 x 100 employees = $1.6 mil