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Redlands Unified Insurance Committee Health and Welfare Benefits Plan April 2012.

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Presentation on theme: "Redlands Unified Insurance Committee Health and Welfare Benefits Plan April 2012."— Presentation transcript:

1 Redlands Unified Insurance Committee Health and Welfare Benefits Plan April 2012

2 Insurance Committee Members Maria Clark Chuck Mendoza Deborah Severo Mike Kress Jolene Tripp Miguel Ruiz Celiza Hernandez Ed Sibby Sabine Robertson- Phillips Brad Mason Brian Guggisberg Felicia Robinson Kate Pearne Curtis Marcell Janet Jungnickel

3 Insurance Committee Timeline September-October Committee reviewed loss ratio reports of current providers, health care reform updates, IRC 125, and health fair. September-October Committee reviewed loss ratio reports of current providers, health care reform updates, IRC 125, and health fair. November-December Committee provided Keenan a list of providers for requests for proposals. January Committee listened to presentation from Rx and reviewed loss ratio reports. February Committee received results of proposals from selected carriers and provided direction to Keenan. March- 1 st Meeting Committee listened to presentations from selected providers. March- 2 nd Meeting Committee continued to listen to presentations from selected providers.

4 Insurance Committee Timeline March- 3 rd Meeting Committee participated in a prioritization activity and reviewed rates submitted from selected providers. Committee discussed rates and gave direction to Keenan to negotiate lower rates based on decrement adjustments. March- 3 rd Meeting Committee participated in a prioritization activity and reviewed rates submitted from selected providers. Committee discussed rates and gave direction to Keenan to negotiate lower rates based on decrement adjustments. April- 1 st Meeting Committee reviewed new rates and gave Keenan further direction to request different decrements within the presented plans. Committee also reviewed final rates of Rx and Mental Health plans. April- 1 st Meeting Committee reviewed new rates and gave Keenan further direction to request different decrements within the presented plans. Committee also reviewed final rates of Rx and Mental Health plans.

5 Insurance Committee Timeline April- 2nd Meeting Committee met to finalize recommendations for Benefits plan for the school year. April- 2nd Meeting Committee met to finalize recommendations for Benefits plan for the school year. FINAL PLAN PRESENTATIONS TO RUSD EMPLOYEES

6 Request for Proposals (RFP) Selected Carriers from RFP Process Aetna Kaiser Mental Health Network Express Scripts (Rx)

7 Plan Rates – Aetna Aetna Tier 1 Aetna Tier 2 Aetna PPO $20 Copay$30 Copay$20 Copay, 80/60 Medical$7,990.20$12,258.00$12, KPPC Pharmacy$1, Behavioral Health (MHN) $ Delta Dental$1, Medical Eye Services $ Prudential$ Total Health &Welfare Premium Cost $12, $16, $16, Maximum District Contribution $10, Employee Pay Annually $1, $5, $6, Employee Pay - 10thly $ $ $618.14

8 Aetna Tier 1 Information Providers included are Beaver Medical Group, Redlands Yucaipa Medical Group, Pinnacle Medical Group Epic Management still offering $20.00 co-pay for office visits and Urgent Care Aetna plan design comparable to current health plan through Anthem Blue Cross

9 Aetna Tier 2 Information Changes to Tier 2 are: –Redlands Yucaipa Medical Group and Pinnacle Medical Group are now in the Tier 1 network –Loma Linda University Medical Center is no longer in Tier 2. Those wishing to continue with Loma Linda will need to move to Aetna PPO –All other providers in Tier 2 remain the same

10 Plan Design - Aetna

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13 Aetna – Open Enrollment All Aetna Enrollees Must Participate in the Open Enrollment Process

14 Plan Rates- Kaiser Kaiser Permanente $30 Copay Medical$9, Kaiser PharmacyIncluded Behavioral Health (Kaiser)Included Delta Dental$1, Medical Eye Services$ Prudential$ Total Health &Welfare Premium Cost$11, Maximum District Contribution$10, Employee Pay Annually$ Employee Pay - 10thly$63.41

15 Plan Design- Kaiser

16 Kaiser – Plan Design

17 Kaiser – Open Enrollment If you are currently with Kaiser and are remaining with Kaiser, and you are not making any changes to your dependents, you do not have to participate in the Open Enrollment Process

18 Express Scripts (Rx) Information Cost Saving Changes to Rx are: –Co- pay $10/$25/$40 –Step Therapy –Select Home Delivery Changes to Rx saved each member approximately $13.00 per month

19 Mental Health Plan Information Mental Health Plan Changes are: –Carrier changing from Holman to Mental Health Network (MHN) –Similar Provider Network with Ability to include current provider –Enhancements with Employee Assistance Program (EAP) –No co-pay change –Holmans renewal rate was 100% increase Watch for more details shortly regarding Transition of Care for members who are receiving outpatient or inpatient mental health or substance abuse services on 7/1/2012.

20 Plan Design – Mental Health Network

21 Dental/Vision/Life Information

22 Rates for Part-time Employees FTECLASSIFIED BARGAINING UNIT CONTRACT PER MONTH (10 MONTHS) COST OF BENEFITS FOR THE SCHOOL YEAR MEDICALDENTALVISIONLIFE KAISER AETNA HMO TIER 1 (BEAVER ONLY) AETNA HMO TIER 2 (FULL NETWORK) AETNA PPO DELTA DENTAL MEDICAL EYE SERVS. PRUDENTIAL LIFE INS. 100% 6.25 OR MOREEMPLOYEE HRS PER DAY 20/80% 4 HRS BUTEMPLOYEE LESS THAN 6.25 HRS PER DAY 40/60% 2.25 HRS BUTEMPLOYEE LESS THAN 4.00 HRS PER DAY 60/40% EMPLOYEE , , LESS THAN 2.25 HRS PER DAY Rates effective 07/01/2012

23 Rates for Part-time Employees FTE CERTIFICATED BARGAINING UNIT, ADULT EDUCATION, RISE, AND HOME TEACHERS CONTRACT**HOURLYPER MONTH (10 MONTHS) COST OF BENEFITS FOR THE SCHOOL YEAR MEDICAL (MED+PHAR+ BH+CHIRO)DENTALVISIONLIFE KAISER AETNA HMO TIER 1 (BEAVER ONLY) AETNA HMO TIER 2 (FULL NETWORK) AETNA PPO DELTA DENTAL MEDICAL EYE SERVS. PRUDENTIAL LIFE INS. 100% EMPLOYEE % 36 HRS OR MORE/WEEK 25/75% EMPLOYEE % 27 TO 36 HRS/ WEEK 50/50% EMPLOYEE , , % 18 TO 27 HRS/ WEEK 75/25% EMPLOYEE , , % 12.5 TO 18 HRS/ WEEK **ADULT ED, R.I.S.E., and HOME TEACHERS ONLY Rates effective 7/1/2012

24 Information Meeting Timeline April 17, 10:00 a.m.General Information Meeting April 17, 5:00 p.m.General Information Meeting April 18, 3:00 p.m.General Information Meeting April 19, 4:30 p.m.General Information Meeting April 26, 2:00 p.m.Retiree Information Meeting RETIREES ONLY April 25-27, 2012RTA/RESPA/RAPA Voting All information meetings will be held in the Board Room May 14, 2012Open Enrollment Begins May 25, 2012Open Enrollment Closes July 1, 2012New Benefit Cards received by staff Computer Lab open daily 8:00 a.m. – 5:00 p.m. during the Open Enrollment Period.


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