2015 WAHUThe Well, the Wise and the

Worried

City of MilwaukeeSeptember 17, 2015

2

7,000+ employees including Police, Fire, Public Works, Library, Health Department and other administrative support departments

Approximately 100 work locations scattered throughout the City

Many employees work out in the “field” during workday Employees work a variety of hours and shifts depending

upon the department City provides Health Insurance coverage to both active

employees and retirees (22,000 membership) Healthcare costs had been increasing around 8-9%

each year◦ Expenditures approximately $139M in 2011

City of Milwaukee Overview

3

2009◦ Negotiated labor contracts that included Wellness Program

because employees and labor groups wanted to control health care costs

◦ Joint Labor-Management Committee (9 individuals from Labor and 3 from Management) forms and meets regularly to design Wellness Program

2010◦ Wellness and Promotion Labor Management Committee

develops 3-step wellness program, completes RFP process, and selects Workforce Health to be partner for the Wellness Your Choice Milwaukee program

◦ City Wellness Program begins Includes tobacco cessation classes for those who use tobacco,

and a variety of worksite programs and activities led by Workforce Health

City Wellness Timeline

4

2010◦ All employees and spouses offered 3-Step Wellness Health Appraisal process

including lab work, on-line questionnaire and coaching session◦ Over 80% participation has remained constant since program inception◦ Members choosing not to participate pay monthly health assessment fee

2012◦ Implement benefit design changes to health plan including 12% employee

premium payment, deductibles, co-insurance and out of pocket maximum◦ Switch from insured HMO to self-funded EPO◦ Continue to partner with UHC and with Workforce Health (WFH) on health and

wellness initiatives 2013

◦ Continue Wellness program and added onsite Wellness Center so WFH coaches and program leaders have a City worksite

◦ WFH also provides services outside of City Hall complex 2014

◦ Expand 3-Step wellness initiative and add Healthy Rewards Program Outcomes based program to keep people engaged year round in wellness

activities and programs Employees earn points through biometrics and activities to qualify for Health

Reimbursement Account (HRA) award

City Wellness Timeline, Cont.

5

2015◦ Grow the Healthy Rewards program by adding additional point

opportunities and increasing participation award◦ Add onsite Workplace Clinic for employees and spouses◦ Make health care benefit design changes including

Link co-insurance to UHC premium providers Increase deductibles slightly but offset with increased HRA award for

Healthy Rewards Change 3 Tier drug co-pay to 20% co-insurance

2016◦ No Benefit Design Changes Anticipated◦ Healthcare premiums for active employees are flat for the fifth

year in a row. Reasons include Benefit design changes that encourage more thoughtful and

appropriate utilization Switch to self-funding Wellness program and Workplace Clinic

City Wellness Timeline, Cont.

6

City of Milwaukee 3-Step Wellness Participation

94

58

90

50

90

79

90

57

87

72

77

82

78

65

78

29

74

46

75

26

0

1,0002,000

3,000

4,000

5,0006,000

7,000

8,000

9,00010,000

Total Eligible Completed All Steps

20102011201220132014

Number of Participants

83% 87% 85% 82% 86%

7

Healthcare Expenditure Trend

20072008

20092010

20112012

20132014

2015 Projec

ted

2016 Projec

ted

2017 Projec

ted

2018 Projec

ted$0

$25,000,000

$50,000,000

$75,000,000

$100,000,000

$125,000,000

$150,000,000

$175,000,000

$200,000,000

$225,000,000

$250,000,000

Trend w/out HC Changes

Trend w/out 2nd HC changes

Trend w/HC Changes

8

9

10

11

12