The primary focus of the meeting was the detailed presentation by Anthony from Nova Connection, highlighting the limitations of the current fully insured health benefits model, similar to the state health benefit plan. Anthony pointed out the lack of transparency and limited control over health plan expenditures as significant drawbacks, which contribute to substantial yearly cost increases. He explained that the current setup offers minimal insight into claims data, making it challenging for municipalities to effectively manage health care costs. In contrast, Nova Connection’s fully unbundled model would allow for the customization of each component of the health plan, including partnering with Aetna as the third-party administrator (TPA), providing direct access to a health network.

Anthony emphasized the importance of transparency, stating, “With the lack of flexibility and the lack of visibility, it’s almost impossible to truly control your spend over time.” He advocated for a partially self-funded approach, which would grant municipalities access to critical data needed to make informed decisions about their health plans. The comparison of Nova Connection’s performance against industry averages revealed that while the industry typically experiences annual increases of 7 to 10%, Nova Connection’s clients see much lower increases, averaging around 2.2%, with many clients experiencing an initial reduction in costs.

The presentation also delved into the pharmacy benefit management (PBM) aspect of the proposal. Anthony critiqued existing PBMs for creating conflicts of interest by profiting from rebates that ideally should be passed on to clients. He explained that Nova Connection’s approach would involve a transparent PBM, allowing for a broader formulary and access to a wider range of medications, including generics, which could improve patient outcomes. An interactive discussion ensued, with council members seeking clarification on various aspects of the proposal, including the term “proprietary generics” and the customization of health programs.

Financial specifics of the new proposal were outlined, projecting a potential 20% reduction in costs with a maximum liability under the self-funded program set at $4.5 million, compared to the current $5.66 million. This reduction was attributed to the shift away from the inefficient state plan, with the proposal promising savings through direct rebate aggregation and independent clinical reviews focused on medical needs rather than just cost savings. The inclusion of stop-loss insurance was highlighted as a significant risk management measure, protecting the township from catastrophic expenses by covering claims exceeding a $100,000 threshold.

Feedback from township employees regarding the proposed healthcare plan was reportedly positive, with concerns primarily centered around the network of doctors. Assurances were provided that even if a doctor is not within the Aetna network, coverage would still be available at a different cost-sharing rate. The representative confirmed that due diligence had been conducted on the call center associated with the healthcare plan, noting high satisfaction levels among clients nationally.

In addition to the health benefits discussion, the Roxbury Town Council touched on several community matters. Updates were provided on improvements in water quality at a local lake, attributed to various applications, including alum. These efforts have reduced harmful algal blooms, although increased aquatic weed growth was observed. Discussions about potential federal funding for dredging to remove phosphorus from the lake were also noted, amidst concerns about low water levels affecting boaters.

The council addressed road safety, emphasizing the state law requiring a four-foot clearance for vehicles passing pedestrians and cyclists. This measure was highlighted as crucial for ensuring safety, particularly with increased road usage in favorable weather conditions. The need for greater awareness and enforcement was discussed.

Other community updates included recognition of the township’s environmental efforts, progress on a local park project, and an introduction of proposed ordinance 13-25 to amend land use application and review fees. The meeting concluded with a brief public portion, where no attendees raised issues or comments, followed by an executive session to discuss litigation and tax appeals, with no further actions expected upon their return.