1. Presentation to the Special Administrative Board
2017 Benefits Renewal
Presentation to the Special Administrative Board
Edmond T. Heatley, Ed.D., Chief Human Resources Officer & USI Insurance Services LLC
June 26, 2016

2. 2017 Benefits Renewal Renewal Process Summary
2017 District Costs for Benefits
2017 Benefit Renewal Overview
Renewal Recommendations of Joint Benefit Committee (JBC)
Next Steps

3. Renewal Process Summary
SLPS Procurement and USI managed the RFP Process.
36 markets were notified of the Request for Proposal (RFP).
10 markets provided no response to the RFP.
15 markets declined to provide a quote.
1 market was disqualified due to late receipt of their quote.
10 markets provided quotes.
Copies were provided to SLPS Procurement, HR/Benefits and USI
USI provided summary findings from which finalists were selected.
The Joint Benefit Committee participated in the selection process.

4. 2017 District Cost for Benefits
Based on previous strategy, the 2017 RFP process and negotiations heavily focused on providing our Employees a with competitive benefit package at the best cost to the District.
Below is an overview of the District’s Calendar Year Annual cost for ACTIVE employees compared to the proposed scenario. This includes premiums paid for Medical, Wellness, Rx, Dental, Vision, Life, STD, LTD, and EAP.
2016 Current District Responsibility
2017 Renewal “As Is” Scenario* District Responsibility
2017 Renewal Option Scenario** District Responsibility
District Premium
$30,178,898
$31,616,549
$28,960,056
$ Increase
N/A
+$1,437,651
-$1,218,841
% Increase
+4.8%
-4.0%
*Scenario: Renew All current carriers.
**Scenario: Move Medical, EAP and Wellness to United Healthcare (UHC). Renew all other current carriers.

5. 2017 Benefit Renewal Overview
Coverage
Carrier
2017 Proposed Renewal
Rate Guarantee(s)
Comments
MEDICAL – Fully Insured
CURRENT: Aetna (formerly Coventry) – incumbent
+5.0%
No rate guarantee
Current wellness program would continue. Estimated annual cost to the District of $970,345 (for ACTIVES ONLY).
OPTION: United Healthcare (UHC)
-7.3%
2nd year rate cap of +9%; 3rd year rate cap of +12%
Minimal provider disruption. Includes wellness fund and coordinator. Estimated annual savings to the District of $1,685,923 (for ACTIVES ONLY).
RX – Self Funded
Express Scripts - incumbent
Est. +6.6%
Participates as a member in Business Healthcare Coalition (BHC)
No fee/administration increase. Increase is estimated claims based on current claim and payment data. Estimated annual cost to the District of $600,167 (not including rebates).
DENTAL
Delta Dental of Missouri - incumbent
+0.0% or +2.5%
+ 0.0% for 1 year rate guarantee. +2.5% increase for 2 year rate guarantee.
Includes Healthy Smiles program.
2.5% increase is an estimated annual cost to the District of $28,000 (with employee contributions).
BASIC LIFE & ADD & VOLUNTARY LIFE
CIGNA - incumbent
+18.2% for Life
3 year rate guarantee
No plan changes. Increase due to claim utilization. Estimated annual cost to the District of $52,000 for Life. Increase in rates for Voluntary Life due to claim utilization.
SHORT TERM DISABILITY (STD)
+7.4%
No plan changes. Increase due to claim utilization. Estimated annual cost to the District of $53,000.
LONG TERM DISABILITY (LTD)
-10.0%
No plan changes. Estimated annual decrease in cost to the District of $56,000.
VISION
VBA - incumbent
+26.5%
No plan changes. Estimated annual cost to the District of $4,300 (accounting for employee contributions).
NOTE: Estimated annual premium increase to the District on the Life, STD and LTD = $49,000 for an overall increase of 3.1%.

6. Renewal Recommendations of the Joint Benefits Committee (JBC)
The Committee is comprised of representatives from Local 420 Active and Retiree groups; Local 148; Local 44; the PSRSSTL Retirement office, Finance and Human Resources. The Committee met on July 20, 2016.
Recommendations
Medical – Move the coverage to United Healthcare (UHC). There is a -7.3% decrease in the rates for There is a rate cap of 9% for the January 1, 2018 renewal and 12% rate cap for the January 1, 2019 renewal. The Affordable Care Act fees are included.
Pharmacy - Renew with Express Scripts. There is an estimated increase of +6.6% due to an escalation in Specialty Utilization and Costs and overall rise in prescription utilization.
Dental – Renew with Delta Dental of Missouri with the +2.5% increase for 2 years with a 3rd year rate cap based on the loss ratio. An option is a 1 year renewal with a +0.0% increase. These options were negotiated down from the initial 5.5% increase.
Vision – Renew with Vision Benefits of America (VBA). VBA, in error, quoted lower rates for the Buy-up plan in 2014 and honored them for 3 years. There were no competitive markets. The rates are guaranteed for 3 years.

7. Renewal Recommendations of the Joint Benefits Committee (JBC) continued
The Committee is comprised of representatives from Local 420 Active and Retiree groups; Local 148; Local 44; the PSRSSTL Retirement office, Finance and Human Resources. The Committee met on July 20, 2016.
Recommendations
Life, AD&D, Voluntary Life – Renew with Cigna for 3 years. The District has had high claim utilization. There were no competitive markets.
STD - Renew with Cigna for 3 years. The District has had high claim utilization. There were no competitive markets.
LTD – Renew with Cigna for 3 years. The District has a rate decrease due to market competition and moderate claim utilization.

8. District Responsibility Renewal Scenario
Move Medical to UHC, renewal all other Lines. Continue integrated Rx OOP max with UHC/ESI.
TOTAL Estimated Annual Premium
Employee Responsibility
District Responsibility
Coverage
Carrier
Current
Proposed
% Change
Medical
UHC
$22,042,323
$20,401,700
-7.4%
$2,635,436
$2,680,736
1.7%
$19,406,887
$17,720,964
-8.7%
Pharmacy
Express Scripts
$10,086,256
$10,750,863
6.6%
$976,639
$1,041,020
$9,109,616
$9,709,843
Rx Rebates
-$1,093,118
-$1,278,535
-17.0% $0
0.0%
Wellness
Included above
Dental
Delta of MO
$1,605,817
$488,289
$1,117,528
Vision
VBA
$109,656
$138,734
26.5%
$46,686
$71,421
53.0%
$62,971
$67,313
6.9%
Basic Life and AD&D
CIGNA
$284,140
$335,802
18.2%
Voluntary EE & Dep Life
$215,256
$327,896
52.3%
Short Term Disability
$723,055
$776,286
7.4%
Long Term Disability
$566,406
$509,911
-10.0%
EAP
$1,413
$945
-33.1%
Total Premium
$34,541,204
$33,569,419
$4,362,306
$4,609,362
$30,178,898
$28,960,056
Total Savings/Cost
-$971,785
$247,056
-$1,218,841
Percent of Change
-2.8%
5.7%
-4.0%
NOTE: The Dental coverage is shown with the 0.0% increase for a 1 year renewal. The 2.5% increase for 2 years would be an increase in premium to the District of approximately $27,786 (accounting for employee contributions).

9. District Responsibility Per Employee Per Month 2010 through 2017 Proposed
For All Coverages
District Responsibility Per Employee Per Month 2010 through 2017 Proposed - All Coverages
2010
2011
2012
2013
2014
2015
2016
2017 Proposed*
District Responsibility
$28,509,576
$27,822,986
$27,249,754
$28,260,446
$27,583,817
$30,799,608
$31,927,961
$28,960,056
Active Employee Headcount
3,751
3,639
3,227
3,393
3,602
3,618
3,641
3,555
Per Employee Per Month (pepm)
$633.38
$637.15
$703.69
$694.09
$638.16
$709.41
$730.75
$678.86
% Change From Prior Year
0.6%
10.4%
-1.4%
-8.1%
11.2%
3.0%
-7.1%
*Move Medical to UHC, renewal current carriers all other Lines

10. Next Steps
SAB Consideration of Recommendations

11. Questions?