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Board of County Commissioners Meeting Minutes - Final June 18, 2019 In response to comments directed to staff, Administrator Brown detailed a suggested two (2) year phase-in of the employee contribution amount, which was followed by discussion among the Board. He continued with the reasoning behind the reserve account policy, the difficulty with increasing the employer contribution, and provided clarification to retirees on the plan. The Chairman called for a recess at 3:18 p.m., and reconvened the meeting at 3:33 p.m., with all members present. Following the recess, individuals provided comments and concerns regarding alternative medications for medical necessities, employee premium increases, salaries, and retention. Julie Buck, Utility Services employee Emilie Enzmann, Sheriffs Department, Corrections employee John O'Connor, President, International Association of Firefighters Local 2201 Detective Bob Sunkel, Sheriffs Department employee Deputy Jessica Ogonoski, Sheriffs Department employee Detective Chris Lester, Sheriffs Department employee Detective Joseph Karman, Sheriffs Department employee Ms. Amin responded to concerns regarding alternative medications and the appeals/approval process. Director Boyll confirmed that prior to the October 1, 2019 effective date, Rx Benefits would be sending letters to impacted members so that they could formulate alternatives with their doctors. She also stated that a "grace fill" emergency benefit would be in place. In response to an inquiry from Commissioner O'Bryan, Ms. Amin explained that the prescription approval/preauthorization process typically would need to be updated annually with select medications requiring quarterly approvals, and that subsequent approvals would be a simpler, more streamlined process. Administrator Brown offered support for Formulary Optimization, and explained that programs such as this were added to keep future costs and premiums under control. He also provided clarification to questions regarding stop -loss coverage, exploring the option of a different provider, and self -funding. He made it clear that 100% of the employee/employer contributions and all rebates received go back into the plan. Constitutional Officer Jeffrey R. Smith, Clerk of the Circuit Court and Comptroller, commended staff and the Board on their management of the healthcare crisis. He stated his opinion that the two (2) year phase-in of premium increases would be most helpful to his employees. Indian River County Florida Page 17