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School Employees Health Care Board Stephanie Hearn, BHP Executive Director Richard Packert, BHP Trustee Stephanie Hearn, BHP Executive Director Richard.

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Presentation on theme: "School Employees Health Care Board Stephanie Hearn, BHP Executive Director Richard Packert, BHP Trustee Stephanie Hearn, BHP Executive Director Richard."— Presentation transcript:

1 School Employees Health Care Board Stephanie Hearn, BHP Executive Director Richard Packert, BHP Trustee Stephanie Hearn, BHP Executive Director Richard Packert, BHP Trustee January 5, 2010

2 AGENDA I. I. Butler Health Plan II. II. Best Practice Standards III. III. Questions

3 Butler Health Plan STRUCTURE

4  Butler Health Plan is a self-funded health trust.  The objective of the consortium remains the same after two decades of service:  To provide competitive medical and dental benefits at affordable prices. Butler Health Plan

5 Butler Health Plan Key Stats  Represent 15 school districts  7,500 school employees  20,000 covered lives  Annual budget $70 million

6 Butler Health Plan Members Butler County Educational Service Center Butler County Board of MR/DD Butler Technology & Career Development Schools Edgewood City Schools Fairfield City Schools Great Oaks Institute of Technology Hamilton City Schools Lakota Local Schools Madison Local Schools Middletown City Schools Monroe Local Schools New Miami Local Schools Ross Local Schools Sycamore Community Schools Talawanda School District

7 Butler Health Plan Structure  Butler Health Plan (BHP) was formed in 1985 and is governed by a seven member fiduciary Board of Trustees.  Board of Trustees:  Dan Hare - Chairman, Superintendent, Butler County Educational Service Center  Craig Jones – Treasurer, Lakota Local Schools  Jan Kesselring - VP Operations, Butler Tech  Nancy Lane - Treasurer, Fairfield City Schools  Marsha Mueggenberg – Classified Trustee, Ross Local Schools  Richard Packert – Certificated Trustee, Middletown City Schools  Robin White - President/CEO Great Oaks

8   Each district has three representatives:   One Administrative   One Certificated   One Classified   45 Member Committee reviews information and suggests plan changes for medical and dental. (3 common plan designs) Butler Health Plan Structure Benefit Information Committee

9 Butler Health Plan Plan Designs Classic PlanChoice PlanBasic Plan PPO No deductible Annual out-of-pocket maximum for Rx PPO $350 annual deductible Flat copays for Rx PPO HDHP Lower premium with higher out-of-pocket costs

10 Butler Health Plan MARKET ANALYSIS

11 S.E.R.B. / O.E.A. Health Care Survey Summary Findings 2009

12 Butler Health Plan (BHP) January 1, 2009 Median Premium Rate Comparison - SERB / OEA Data Medical and Rx

13 Overall Conclusion All the BHP plans are LOWER in premium rates and competitive in coverages.

14 BestPracticeStandards

15 Standard Butler Health Plan 1) Health plans must offer wellness programs, including HRAs, biometric testing, health coaching. 1) Exceeds standard – Offer on site HRAs, biometric testing, and access to nurse health coach. Included in premium “Free to all BHP members” Offer on-site screenings at 120 buildings 34 lab panel (venous puncture) with an extensive Personal Health report and follow up with Nurse Coach Cont. Butler Health Plan SEHCB Best Practice Standards

16 Easy to Understand Easy to Measure Nationally Accepted Standards Consistent and Fair Modifiable & Controllable Focuses on Five Risk Categories that account for 70% of Health Costs: Smoking LDL Cholesterol Triglycerides Glucose Blood Pressure

17 Participants Tested with Abnormal Conditions Men Over 40: PSA (Prostate Cancer) 8 Thyroid Disease29 Total participants who may need medication but are not currently taking medication for diabetes, high blood pressure, or high cholesterol 144

18 Incentives School Promotion Only Employee Meetings

19 Cont. Standard Butler Health Plan 2) Health plans shall include a disease management program covering: asthma diabetes COPD obesity 2) Exceeds standard – Offer disease management program covering: asthma diabetes COPD obesity Butler Health Plan SEHCB Best Practice Standards

20 Cont. Standard Butler Health Plan 2) Additional disease management programs include: Acute bronchitis Congestive heart failure ADHD Cancer Depression Epilepsy Hepatitis C HIV/Aids Hyperlipidemia Hypertension Low back pain Migraines Multiple sclerosis Osteoporosis Rheumatory arthritis Butler Health Plan SEHCB Best Practice Standards

21 StandardButler Health Plan 3) Health plans must include access to providers that offer care for complex medical conditions.. 3) Meets standard – Many tertiary providers in network. 3 Networks  HealthSpan  MultiPlan  Emerald Health Cont. Butler Health Plan SEHCB Best Practice Standards

22 StandardButler Health Plan 4) Health plans shall undertake periodic dependent eligibility audits. 4) Meets standard – Audits conducted every three years. 100% sample size for every school district. Butler Health Plan SEHCB Best Practice Standards

23 Butler Health Plan 25 Year Success Story All members have input Focus on wellness Financial Management

24 Butler Health Plan Financial Management A. A. Minimal overhead (6 cents on the dollar) – –Direct contracts with all vendors (Separate contracts with networks, claims payer, stop loss, etc.) B. B. Assertive claim management − −Custom provider discount arrangements − −Independent vendor audits − −Member education (HealtheReports) C. C.“All for one – one for all” operating philosophy (Common plan designs; Common rates)

25 Questions


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