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1 2014-15 Medical and Insurance Benefit Renewal Recommendations Governing Board Meeting March 25, 2014 Tahlya Visintainer and Christie Davis.

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Presentation on theme: "1 2014-15 Medical and Insurance Benefit Renewal Recommendations Governing Board Meeting March 25, 2014 Tahlya Visintainer and Christie Davis."— Presentation transcript:

1 1 2014-15 Medical and Insurance Benefit Renewal Recommendations Governing Board Meeting March 25, 2014 Tahlya Visintainer and Christie Davis

2 Insurance Renewal process – Annually look at claims for prior 12 months with actuaries and make assumptions for the following year’s claims – Other considerations: legislation, regulation and market PUSD’s Employee Benefit Trust Board – Established to oversee the trust fund and make recommendations to the Governing Board on management of the trust – Currently 6 Trustees: Chairman and Board Member Matthew Bullock* Trustees: Dr. Denton Santarelli*; Ms. Julia Smock; Ms. Lisa Morris; Mr. Will Briggs; Mr. Donald May (*members required by Trust Agreement) – Over the course of 2-3 meetings, the Trustees evaluate information and recommendations from administration in order to reach their own recommendation to this Board 2 Benefit Renewal Process and Players

3 MEDICAL BENEFITS & PREMIUMS 3

4 Budget for 2014-15: $22 million or approximately $7500 per employee – Contributing factors: fewer high cost claimants and removal of retirees from our claims Same budget as 2013-14 resulting in no increase to employee premiums – Increase in costs of ACA fees and additional staff must be provided benefits – No decrease in HSA Contributions $1250 for CDHP 2500 $375 for CDHP 1250 $250 available for PREP (Wellness) – Plan Changes to the Traditional Plan: – Increased out of pocket maximum to capture the co-pays and deductible due to ACA – Increase co-pay for urgent care – Changed chiropractic to co-insurance to align with other therapies (Physical, Occupational, Speech) 4 Renewal Overview

5 Traditional PPOMonthly26 Pays22 PaysCDHP 1250 CDHP 2500 Employee$86.80$40.06$47.35 $0.00 Employee + Children$498.49$230.07$271.90 $260.96$120.44$142.34 $157.69$72.78$86.01 Employee + Spouse$601.42$277.57$328.05 $326.20$150.55$177.93 $197.11$90.97$107.51 Family$1,064.58$491.34$580.68 $619.79$286.06$338.07 $374.50$172.85$204.27 Dual Family$498.49$230.07$271.90 $260.96$120.44$142.34 $157.69$72.78$86.01 5 Medical Premiums for 2014-15

6 PHARMACY 6

7 Moving to one provider of prescription coverage - Optum RX – Change for the Traditional Plan members from Express Scripts – Change for the CDHP Plan members is an expanded drug list 7 Pharmacy

8 DENTAL 8

9 Change the existing Delta Dental Plan to a Standard Delta Plan that includes: – Check-up Plus Plan added- Preventative and Diagnostic covered at 100% – Sealants now covered 100% up to age 19 – Annual maximum benefit $1,000 (reduced from $1500) Impacts approximately 4% of the staff who are on Delta Dental 9 Delta Dental

10 Monthly26 Pays22 Pays Employee$15.00$6.92$8.18 Employee + Children$61.69$28.47$33.65 Employee + Spouse$51.94$23.97$28.33 Family$76.04$35.10$41.48 Dual Family$61.69$28.47$33.65 TDA Dental Employee$0.00 Employee + Children$11.55$5.33$6.30 Employee + Spouse$9.28$4.28$5.06 Family$13.60$6.28$7.42 Dual Family$11.55$5.33$6.30 10 Dental Premiums for 2014-15

11 VOLUNTARY 11

12 Vision- VSP – Rates increased slightly due to ACA fees – Additional coverage added: Diabetes Testing Frame allowance increased for brand name frames AFLAC – Moving to Group Plan – More plans, guaranteed issue Critical Illness (Includes Cancer and Wellness) Hospitalization (Includes ICU) Accident Advantage 12 Other Voluntary Benefits


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