1. PAISBOA Health Benefits Trust
Annual Healthcare Renewal Meeting
August 2nd, 2017

2. Agenda PAISBOA State of the Union & Updates Aetna Overview
Martha Scache, Board Chair, PAISBOA HBT
Bob Mueller, Executive Director, PAIBSOA HBT
Aetna Overview
Tim Neary, Senior Account Executive, Aetna
CVS, Dental, Vision & Health Risk Committee Review
John Manion, Armstrong, Doyle & Carroll, Inc.
Renewal Review
Online Open Enrollment Review
Martha will introduce Trustees and welcome everyone

3. PAISBOA HBT Trustees Martha Scache Carol Lerner Joan Barone
Abington Friends School
Carol Lerner
The Philadelphia School
Joan Barone
Waldron Mercy Academy
Heather Gelting
The Hill School
Michele Todd
The Haverford School
Cindy Nichols
Episcopal Academy
Christine Schaefer
University of the Arts
Alan Joffe
Perelman Jewish Day School
Tom Taft
Germantown Academy
Kristin Heasley
La Salle University
Michael James
University of the Sciences
Don Cates
Salus University
Martha will introduce Trustees and welcome everyone

4. Aetna Review
Effective 11/1/2017, you will have access to Aetna’s network and programs
Aetna Select (HMO replacement) Managed Choice (POS Replacement) & Choice POS II network (PPO replacement)
Best in Class Member tools and resources
We’re here to answer your questions
Tim will re-review the move to Aetna minutes

5. Aetna Review Established in 1853 1.4m members in Pennsylvania
23.2m members nationwide
Local Member Services in Allentown, PA
Extensive network both locally and nationally
28,000 providers locally
65 Hospitals in Southeastern PA alone
97.9% match to providers utilized by HBT members
1.9m providers nationally
National Hospital network
Tim will re-review the move to Aetna minutes

6. Aetna Review
The Aetna plans were built to match the existing IBC plans as closely as possible.
The names of the plans have changed, but the coverage levels should be almost identical.
Not everyone may know about the plans being built to match existing. This would be a good reinforcement

7. Aetna Review PC HD1-HC1 PC HD3-HC1 PC 20/30/70 DPOS C3F3O2 KPOS 15S
HMO Cust. 515
HMO C3F3
HMO C4F5
HBT HD 1500/3000
HBT HD 2500/5000
HBT Choice 20/30
HBT Choice 20/40
HBT Mgd. Choice 15/25
HBT Select 25/35
HBT Select 20/40
HBT Select 30/50
Not everyone may know about the plans being built to match existing. This would be a good reinforcement

8. Aetna Review HMO C3F3 HBT Aetna Select 20/40 Network Local National
Deductible No
Referrals
Yes
PCP Copay
$20
Specialist Copay
$40
Inpatient Hospital Copay
$150 per day, 5 day max
X-Ray
Complex Radiology (MRI)
$80
PT, OT, Speech
$40, 30 visits per year
Spinal Manipulation
$40, 20 visits per year
Durable Medical Equipment
50%
This would just be an example slide of the match

9. Aetna Concierge Differentiated Superior service Results driven
Offers a consultative approach
Guides members to the right connection at the right time
Make the most of a teachable moment
Knows third-party vendor offerings and educates on basic information (warm transfers)
Clinical alerts available
Teaches how to use Aetna tools
First impression treatment
Aetna Navigator-based web chat – outbound text messaging
Targeted outreach for members that may contact us multiple times
Wellness education
Assists members with appointment scheduling
Higher member engagement
Inter-program referrals data available
Higher utilization on member tools available
Tim: Review the Concierge component

10. Your personalized health information is available to you 24/7
Aetna Navigator
Secure, easy-to-use member website lets you:
Review your claims
Find a doctor
Look up health information
Get an ID card
Research costs of care
Tim: Review the online tools
Your personalized health information is available to you 24/7
TIP
It’s easy to print your ID card from your secure member website.

11. Aetna Mobile Find a doctor or urgent care center Research claims
Get an ID card
Tim: Review the Mobile app and the ID card available on the phone

12. Aetna ID Card All members will have 2 cards, Medical and Rx
Family ID card that shows up to five family members
ID cards available on Aetna Navigator®
Tim: Review Family ID card aspect

13. Aetna PAISBOA Site
Aetna built a Provider Web site specific for PAISBOA HBT members:
Tim: Review PAISBOA HBT Micro site

14. Aetna PAISBOA Site Members will need to locate their PCP ID #’s
Tim: review Provider search, then flip to John Manion to talk about Rx etc.

15. Rx Coverage The Rx coverage with CVS will remain in place
Nationally, Rx Trend is increasing at a faster pace than medical
This is mainly attributable to the inflation in Specialty Medications
John: review Rx staying with CVS

16. Specialty Rx
Specialty Medications represent less than 1.1% of all scripts for PAISBOA HBT
But they constitute over 43% of our Rx Gross Cost
John: remind all that Specialty Rx is driving inflation

17. Specialty Rx
John: remind all that Specialty Rx is driving inflation

18. Specialty Rx
The Specialty Trend is not expected to end, but we can put provisions on the plan to control costs
John: remind all that Specialty Rx is driving inflation
CVS Caremark 

19. Mandatory Mail
A Mandatory Mail order program will begin in November for anyone taking long term Maintenance Meds
3 month supply for 2 copays from either Mail or CVS direct
2 grace fills will be allowed (Nov/Dec), but then via CVS
John: review Mandatory mail program

20. Mandatory Mail
Affected members will be notified via mailing and will be given the option to procure their maintenance meds via mail or at a CVS site.
John: review Mandatory mail Process

21. Delta Dental
PAISBOA HBT will continue to offer Delta Dental Basic and Enhanced plans to members.
The renewal for 2017 is 0.0%
Rates and plans are in Renewal packets.
John: review Delta Dental

22. Vision - EyeMed
PAISBOA HBT will be offering $100 biannual Vision plan to all members as part of their benefits.
The vendor is EyeMed and info about the plan will be in the Open Enrollment materials.
John: review EyeMed Vision program

23. Doctors on Demand
PAISBOA HBT members have access to telemedicine site allowing for efficient access to medical care.
More info will be provided directly to members.
John: review Doc on Demand program

24. Naturally Slim
PAISBOA HBT members have access to Metabolic Syndrome Reversal program
More info will be provided directly to members
John: review Naturally Slim program and results

25. Aetna Wellness
Aetna is offering on-site biometric screenings for all participants of the plans, effective 11/1
We would like to take full advantage of this opportunity
Talk to HBT/ADC about scheduling
John: possibly review Aetna Wellness programs – On Site screenings, $50 for Health Risk Assessments and Wellness Programming

26. Aetna Wellness
Aetna is offering PAISBOA HBT members $50 for completing the online Health Risk Assessment on Aetna Navigator, effective 11/1
A information campaign will inform members of this program in the Fall
John: possibly review Aetna Wellness programs – On Site screenings, $50 for Health Risk Assessments and Wellness Programming

27. Renewal Review
Bob: Renewal Review

28. Member Communications
All members will be getting receiving an Open Enrollment benefits review book
This guide will review the medical, Rx, Vision and ancillary benefits
It will also review the online Open Enrollment
John: Member Open Enrollment books for all 8200 members

29. Online Open Enrollment
All Schools will be required to have their employees go online to make benefit elections
This process is efficient and paperless and will allow schools to meet the Open Enrollment deadlines
John: review Mandatory online open enrollment process steps

30. Online Open Enrollment
Employee will be provided a link that will take you to the Benefitsolver Login page.
John: review Mandatory online open enrollment process steps
Click on the Register Link to begin the process.

31. Online Open Enrollment
You will then need to create a user name and password and will receive a confirmation when this step is complete.
John: review Mandatory online open enrollment process steps

32. Online Open Enrollment
John: review Mandatory online open enrollment process steps
You are now on the Open Enrollment Election Portal. Click “START HERE” to elect benefits for the coming plan year.

33. Online Open Enrollment
Make Benefit Elections
John: review Mandatory online open enrollment process steps

34. Online Open Enrollment
Review and Approve
John: review Mandatory online open enrollment process steps

35. Action Items
All Schools will need to elect its plan designs by August 25th
Employee benefits elections will be due by September 29th
Open Enrollment meetings must be requested asap!
John: review key dates

36. Thank you!