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2014-15 Health Insurance Plan Design Welcome !. 2014-15 Health Insurance Plan Design Introductions Janice Wavra, The Insurance Center Jay Clark, District.

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Presentation on theme: "2014-15 Health Insurance Plan Design Welcome !. 2014-15 Health Insurance Plan Design Introductions Janice Wavra, The Insurance Center Jay Clark, District."— Presentation transcript:

1 2014-15 Health Insurance Plan Design Welcome !

2 2014-15 Health Insurance Plan Design Introductions Janice Wavra, The Insurance Center Jay Clark, District Office Ben Miller, District Office

3 2014-15 Health Insurance Plan Design Agenda

4 2014-15 Health Insurance Plan Design Question and Input Forms

5 2014-15 Health Insurance Plan Design

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7 Why is the district accepting health insurance proposal options? Affordability

8 Affordability of Health Insurance Unless we are ready to make changes to the health Insurance plan Fewer and fewer employees will be able to afford The District will have fewer and fewer dollars to meet student and staff needs The evidence

9 Affordability of Health Insurance Claims Ratio All other variables being equal Ignoring Medical inflation Ignoring employee census Ignoring ACA impact Ignoring all other variables Claims ratio history determines the premium rate for future benefit cycles

10 Affordability of Health Insurance Claims Ratio Claims ratio Cost paid by the plan for health care Divided by the amount of premium dollars paid into the health plan Industry Standard is a Ratio of 85% For every $1.00 in premium $.85 pays for health care

11 Affordability of Health Insurance Claims Ratio Claims ratio surplus or deficit Ratios below 85% represent a surplus Surplus is justification for a reduction in premium rates Ratios above 85% represent a deficit Deficit is justification for an increase in premium rates

12 Affordability of Health Insurance Claims Ratio School District of Holmen (preliminary info) Claims January – December 2013 Medical Claims$5,139,162 Rx Claims$955,568 Total Claims$6,094,730 Premiums January – December 2013 167 single @ $9,624/yr.$1,607,208 193 family @ $21,804/yr.$4,208,172 Total Premiums$5,815,380

13 Affordability of Health Insurance Claims Ratio Claims January – December 2013 Total Claims $6,094,730 Premiums January – December 2013 Total Premiums $5,815,380 Claims Ratio105%

14 Affordability of Health Insurance Claims Ratio Premium increase necessary to achieve industry standard of 85% Total Claims$6,094,730 Necessary Premiums for 85% ratio÷ 85% $7,170,270

15 Affordability of Health Insurance Claims Ratio Premium increase necessary to achieve industry standard of 85% Necessary Premiums $7,170,270 Actual Premiums$5,815,380 Necessary Premium Increase$1,354,890 Necessary % Premium Increase23%

16 Affordability of Health Insurance ACA Beyond Our Claims Ratio ACA is influencing the market Industry response is protect from worst scenario Rate increase 50%-60% Preliminary information in the La Crosse School District is 25% increase

17 Affordability of Health Insurance District Budget School District of Holmen 2014-15 budget Allows for 10% increase in health insurance premiums For the Districts portion of premium (generally 80%) $5,815,380 total premiums 80% $4,652,304 +10% $465,230

18 Affordability of Health Insurance District Budget 2014-15 Budget Allowance +10% or $465,230 At +25% increase budget impact of $1,163,076 Budget gap of -$697,846

19 Affordability of Health Insurance Employees Budget Current Family total annual premium $21,804 Employees share, no less than 20% or $4,360.80 A 10% increase results in $436 less in take home pay in 2014-15 A 25% increase would reduce take home pay by $1,090 With wage increase at less than 2% is this affordable?

20 Affordability of Health Insurance The evidence Unless we are ready to make changes to the health Insurance plan Fewer and fewer employees will be able to afford The District will have fewer and fewer dollars to meet student and staff needs

21 Affordability of Health Insurance Questions on why we need to consider changes to the health insurance plan??

22 2014-15 Plan Design Options

23 2014-15 Plan Design Options Objectives Obtain pricing options early Provide adequate time to make the best decision Input from staff and school board

24 2014-15 Plan Design Options Objectives Obtain pricing options early Provide adequate time to make the best decision Input from staff and school board

25 2014-15 Plan Design Options Review and Input School Board Review and Input: 3/24/14, 4/14/14, 5/12/14, 5/26/14 Staff Review and Input: 3/26/14, 4/1/14, 4/1/14 Modify as Necessary

26 2014-15 Plan Design Options Development of Options Identify & Examine Driving Factors List, Evaluate & Select Potential Options Determine Implementation Year Incorporate Into 3-Year Direction

27 2014-15 Plan Design Options Identify Driving Factors ACA Utilization and Claims Wellness Based Affordability of Premiums / MOOP Accessibility to provider of choice Competitive Market

28 2014-15 Plan Design Options Development of Options Identify & Examine Driving Factors List, Evaluate & Select Potential Options Based on actual data Determine Implementation Year Incorporate Into 3-Year Direction

29 2014-15 Health Insurance Plan Design Options

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34 2014-15 Health Insurance High Claim Area Options

35 2014-15 Health Insurance Wellness & Education

36 2014-15 Health Insurance Status Quo Option

37 2014-15 Health Insurance Plan Design V. Determine Potential Strategy Implementation Year VI. Strategies Incorporated Into 3 Year Direction

38 2014-15 Health Insurance Plan Design VII. How to get more information * District Website * E-mail

39 2014-15 Health Insurance Questions and Input?? * Ask now, or * Fill out input form, or * E-mail: milben@holmen.k12.wi.us clajay@holmen.k12.wi.us


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