Personnel Committee — Agenda Packet

Our intention is to have in-person meetings going forward. For the time being, we will hold the City Committee Meetings, Plan Commission, Council and most others at the Community Room at 933 Michigan Avenue. This in-person location will meet the legal requirement for our open meetings. We will have a virtual option available, but the technology for the hybrid style meeting may not be reliable all of the time. AGENDA PERSONNEL COMMITTEE Members • Alderperson Kneebone • Alderperson Olson • Alderperson Lang • Alderperson Birr • Alderperson Donahue Date and Time: September 14, 2026 6:35 PM (or immediately following previously scheduled meeting) Location: Community Room 933 Michigan Avenue, Stevens Point, WI OR Zoom Teleconferencing Meeting ID: 822 3933 8056 | Passcode: 801466 By Computer: Zoom Link By Phone: +1-312-626-6799 (US Chicago) Discussion and Possible Action on: 1. Roll Call. 2. Direct Primary Care (DPC) Presentation – Anovia Health 3. Direct Primary Care (DPC) Presentation – LINK Healthcare 4. Consideration of 2027 Health Plan Renewal Recommendations and Benefit Options 5. Adjournment. PLEASE TAKE NOTICE that any person who has special needs while attending these meetings or needs agenda materials for these meetings should contact the City Clerk as soon as possible to ensure that a reasonable accommodation can be made. The City Clerk can be reached by telephone at (715) 346-1569 or by mail at 1515 Strongs Avenue, Stevens Point, WI 54481. Copies of ordinances, resolutions, reports and minutes of the committee meetings are on file at the office of the City Clerk for inspection during normal business hours from 7:30 a.m. to 4:00p.m. PLEASE TAKE FURTHER NOTICE that a quorum of the Common Council may be in attendance at this meeting. Page 1 of 7 September 09, 2026 MEMORANDUM TO: Personnel Committee Members FROM: Sandy Frasch, HR Manager RE: Direct Primary Care (DPC) Presentation – Anovia Health Wendy Rosenthal, M3 Client Manager and the City’s insurance broker, would like to introduce the idea of Direct Primary Care (DPC) as a potential benefit for our employees. DPC can provide easier, more convenient access to primary care while potentially reducing overall healthcare costs. Anovia Health representatives will provide an overview of the DPC model, the potential benefits of DPC, and their respective programs. The representatives will also answer any questions the Personnel Committee may have. City Of Stevens Point 1515 Strongs Avenue Stevens Point, WI 54481-3594 Page 2 of 7 September 09, 2026 MEMORANDUM TO: Personnel Committee Members FROM: Sandy Frasch, HR Manager RE: Direct Primary Care (DPC) Presentation – LINK Healthcare Wendy Rosenthal, M3 Client Manager and the City’s insurance broker, would like to introduce the idea of Direct Primary Care (DPC) as a potential benefit for our employees. DPC can provide easier, more convenient access to primary care while potentially reducing overall healthcare costs. LINK Healthcare representatives will provide an overview of the DPC model, the potential benefits of DPC, and their respective programs. The representatives will also answer any questions the Personnel Committee may have. City Of Stevens Point 1515 Strongs Avenue Stevens Point, WI 54481-3594 Page 3 of 7 September 9, 2026 MEMORANDUM TO: Personnel Committee Members FROM: Sandy Frasch, HR Manager RE: Consideration of 2027 Health Plan Renewal Recommendations and Benefit Options The City’s self-insured health plan had a 95% loss ratio in 2025, with no premium increase for 2026. The 2026 year-to-date loss ratio has increased to 114%, meaning claims are exceeding premiums collected. As a result, plan changes are being considered for 2027 to help manage costs and minimize premium increases. The initial projected rate increase was 23%. Adoption of the recommended OptumRx Premium PLD formulary and Pass-Through pricing model is expected to reduce the increase. While the prescription changes affect approximately 2.2% of prescriptions, they are projected to generate approximately 30% in prescription savings and improve the plan’s funding forecast. Ethica recommends implementation effective January 1, 2027. Supporting documents are attached, including 2027 Pharmacy Renewal Recommendation, and OptumRx Reprice Summary. Wendy Rosenthal, M3 Client Manager and the City’s insurance broker, will be present to answer questions and review the renewal recommendations and benefit options. City Of Stevens Point 1515 Strongs Avenue Stevens Point, WI 54481-3594 Page 4 of 7 ethicapharmacyadvisors.com 1 City of Stevens Point 2027 Pharmacy Renewal Recommendation PREPARED BY ETHICA PHARMACY ADVISORS August 20, 2026 Executive Summary Following Ethica’s independent review of OptumRx’s 2027 M3 Coalition renewal proposal, we evaluated both contract pricing options and formulary alternatives to identify the most favorable financial and clinical strategy for the City of Stevens Point. Based on our analysis, Ethica recommends: • Move from Select Comprehensive Formulary to Premium PDL Formulary • Elect a Pass-Through Pricing Contract This combination provides the greatest overall value through lower net pharmacy costs, improved rebate opportunities, and minimal member disruption. Key Findings 1. Financial Impact Option Net Cost Savings vs Current Current Select Comprehensive $601,782 Baseline Premium PDL (Traditional) $407,901 $193,881 (32.2%) Premium PDL (Pass-Through) $420,099 $181,683 (30.2%) 2. Formulary Member Impact Minimal Disruption Expected • 97.8% of prescriptions experience no change • 15 members identified with affected medications • Approximately 2.2% of total prescriptions are impacted • The exclusions involve products with clinically appropriate formulary alternatives available through OptumRx. Page 5 of 7 ethicapharmacyadvisors.com 2 Final Recommendation Based on the projected financial results, limited member disruption, enhanced rebate value, and increased contract transparency, Ethica recommends that the City of Stevens Point adopt the OptumRx Premium PDL formulary and Pass-Through pricing model effective January 1, 2027. Refer to the OptumRx Reprice Summary and Formulary Disruption documents for the Plan Effective Date of January 1, 2027, for Applicable Rates, Terms, and Conditions. Ethica services are advisory only and under no circumstances should the information herein be relied upon or construed as legal advice. Clients are responsible for evaluating the accuracy, completeness and usefulness of any opinions, advice, services or information provided as well as for compliance with applicable Federal, State and local laws and regulations. Ethica disclaims all warranties and in no event shall be liable for any direct, indirect, special or consequential damages arising out of the information provided. Page 6 of 7 Biosimilar Strategy Formulary Current: Select Comprehensive Plan Design SUMMARY Traditional with Rebate Fee Credit Traditional Pass-Through Traditional Pass-Through Total Amount Paid $925,442.19 $921,598.94 $924,664.19 $921,598.94 $924,664.19 Administrative Fees $0.00 $0.00 $9,132.00 $0.00 $9,132.00 Ancillary Clinical Program Fees $0.00 $2,050.00 $2,050.00 $2,050.00 $2,050.00 Rebates Applied $263,180.00 $317,605.00 $300,865.00 $262,210.00 $241,150.00 Formulary Management Fee $0.00 $15,220.00 $15,220.00 $15,220.00 $15,220.00 Rebate Fee Credit Applied $60,480.00 $0.00 $0.00 $0.00 $0.00 Rebate Fee Credit Applied (Prepayment) $0.00 $64,800.00 $81,540.00 $60,480.00 $81,540.00 Market Change Adjustment $0.00 $118,122.49 $118,122.49 $118,122.49 $118,122.49 Total Costs $601,782.19 $407,901.46 $420,098.70 $467,616.46 $479,813.70 Average Cost per Claim $197.69 $134.00 $138.01 $153.62 $157.63 Total Savings $193,880.73 $181,683.49 $134,165.73 $121,968.49 Total Savings per Claim $63.69 $59.69 $44.08 $40.07 Savings%: 32.22% 30.19% 22.29% 20.27% Total Claims Count: Refer to Proposal for Applicable Rates, Terms, and Conditions Comprehensive 3,044 * Rebates Applied are calculated based on the greater of minimum rebate guarantees or projected collections.  This amount is then reduced by the Formulary Management Fee and Rebate Fee Credit (Prepayment). Premium PDL Select PDL Optum Rx Reprice Summary Customer Name: City of Stevens Point Plan Effective Date: 1/1/2027 Date Range: 6/1/2025 to 5/31/2026 Low WAC Page 7 of 7