1. California Independent Schools Benefit Trust UPDATES AND INFORMATION
March 2018
California Independent Schools Benefit Trust UPDATES AND INFORMATION

2. Agenda Welcome and Introductions CISBT Goals and Structure Next Steps
Who is Bolton? What is their role in the Trust?
Trust update and “reason for being”
ACA updates
Anthem medical option
Lines of Coverage Options
Carrier and Vendor Options
Plan Designs and Rates
Carrier Requirements
Workterra online enrollment & administration
Next Steps

3. About Bolton
In business for over 85 years, Bolton & Company is one of California’s largest privately owned insurance and employee benefits consulting firms
Worked with the task committee and the trustees to create the CISBT program
Proud to have more than 100 Independent Schools as clients
Committed to the long term success and health of the Trust
Offices in Pasadena, Santa Clara and Anaheim

4. Ronald Wanglin, CIC, CSRM
Bolton Team
Ronald Wanglin, CIC, CSRM
Chairman of the Board
EMPLOYEE BENEFITS
Tom Polenzani Director of Employee Benefits
Jamie Gershon, CSRM, AAI Senior Vice President Northern California
Jacqueline Roth Executive Vice President Southern California
Lorelei Suarez Vice President Education Northern California
Nicholle Trugman Senior Client Executive
Brent Graham Client Executive
Kristy Ureta Senior Client Manager
ADDITIONAL SUPPORT
Michelle Cammayo, GBA, RHU Compliance Specialist
Nat Knox Client Manager
Scott Tamura Assistant Vice President Technical Consulting Unit
Kimberly Marrone Associate Client Manager

5. Goals and Objectives
A sustainable statewide trust, accessible to all Cal-ISBOA member schools
Leverage large-scale volume into:
Administrative efficiencies
Premium savings (reduce trends)
Multiple lines of coverage
Additional services: Voluntary Plans, Wellness, Work Perks, Compliance and more

6. Update Eight schools enrolled, 460 members
70 plus schools requested initial quotes
75 percent of member schools renew in October – January 1st
Goal of 16 schools enrolled by January 1, 2019
Since the Trust existence, beating industry renewal trends for medical insurance
Product
Q Increase
CISBT 
HMO
9.9%
 6.5%
PPO
17.5%
 10%
HDHP/HSA
Total Combined
14.7%
 7.1%

7. This is your Trust Requested by member schools
Three years in the making
CISBT will have a Board of Directors comprised of member schools.
The success of this trust is up to you: you are the decision makers and you will shape the future direction of the trust, make plan decisions and other decide on other benefits.
Stakeholder meeting each July to review and improve the trust.
For the Trust to survive and become a viable option, schools must commit to the Trust as a long term solution.

8. Long-term strategy Built to be sustainable
Attractive so that schools join
Choice - multiple plan offerings
Enhanced contracts and benefits
In compliance with ACA regulations
Combined risk (need a good mix of good and bad risk)
Increase membership year after year
Wellness and disease management (near future)
Must be viewed as a long term solution, not a year to year rate chasing option
Bend the trend

9. Trust Structure
Established under a Multiple Employer Welfare Arrangement (MEWA)
Trust plan year begins January 1st. Renewal will always be January 1st of each year.
Designed to give small employers access to health coverage on terms similar to those available to large employers
This allows us to combine all the schools (small and large) to leverage our combined size and offer large group plans
We are creating our own pool of like-demographics based on our industry that will run better than the insurance carriers’ existing pools which combine industry groups based on size

10. ACA Changes in 2018 Small group was redefined in 2016
Employers with 50 to 100 employees:
Must move to small group at renewal
Only small group-specific plans are available
Metallic plans with reduced benefit options
Member level rating, every member rated based on age
No more composite rates
Narrow networks are often the only way to reduce cost
Individual Mandate repealed starting January

11. Medical Insurance Rating Structure:
The way the rating structure was established is on a 4-tier basis:
Employee only
Employee + Spouse
Employee + Child(ren)
Employee + Family
In addition, each school’s demographics and risk will be reviewed by underwriting in order to determine which rating band your school will be assigned. The trust has Seven rating bands (rating band number 1 represents lowest risk, number 7 is maximum risk)
Since CISBT is structured as a large group program, pediatric dental and vision are not embedded in the medical plans offered.
However, dental and vision are benefits offered within the trust and your school is free to choose to offer these benefits to your faculty and staff. You can offer them a la carte, or on a packaged basis.

12. Medical Insurance
“What information is needed in order to determine what rating band Anthem would apply to our school?”
The following information is required in order for Anthem to provide a medical quote for your school:
Complete census information, including date of hire, number of hours worked, date of birth, home zip code, dependent tiers of coverage
Current and renewal information (if available): summary of current plans, rates, contributions, any claims and/ or large claims information
Names of the medical insurance carriers your school has had in place for the past 5 years
A broker authorization letter, if you are not currently a Bolton employee benefits client.

13. Trust Structure Medical: Anthem Blue Cross Ancillary
Dental: Anthem HMO & PPO
Vision: Anthem
Group Life/AD&D: Guardian
Voluntary Life/AD&D: Guardian
Disability: Guardian
Employee Assistance Program (EAP)

14. Trust Structure
“Do we have to purchase all of the lines of coverage offered in the trust?”
No, you have the following purchasing options available:
Just medical
Medical and ancillary products
Medical, dental and vision only
Medical, life and disability only
In addition, the Workterra COBRA administration services and FSA Administration services are optional
Please keep in mind: while participation in all of the lines of coverage offered is not required, one of the advantages of electing all of the coverages and services available in the CISBT is billing consolidation
In addition, you will be able to have Workterra customize your online program offering to include your current school program options outside the trust. There is a $0.50 PEPM (per employee per month) charge to cover the amount of system work required to provide this customization 

15. Medical Insurance “What about Kaiser?”
You will be able to continue to offer your Kaiser policy outside of the trust and include the Anthem products from the trust as part of your program
Under this offering, please note the following:
Anthem requires that at least 50 percent of the total participants enroll in their plans which there may be some flexibility of +/- 10%.
You will need to switch brokers for both the Kaiser plan as well as the trust plans, if your school is currently not a Bolton employee benefits client – this will allow you the opportunity to review potential changes to the existing Kaiser policy
Depending on when your current Kaiser policy renews, you may have two separate open enrollment periods
Depending on your group size, Kaiser may agree to change your renewal date; as a result, there may be a rate change for this existing policy
Bolton can help you explore these options and help your school with any compliance requirements associated with this change (i.e. short plan year 5500 filing, etc.)

16. Ancillary Lines of Coverage
4 Group Life/AD&D Plans
1 DHMO Plans
2 DPPO Plans
1 LTD Plan
3 Vision Plans
Additional Voluntary Life/AD&D Plan
The CISBT program offers several ancillary products.

17. Additional Services Member advocacy HR consulting services
Workterra
Designated Bolton customer service line
HR consulting services
Employee handbook
HR-focused webinars and seminars
ThinkHR
Absence management support*
Compliance consulting services
Updates
Webinars and seminars
Summary plan descriptions (SPDs) and 5500s
*optional – additional fees apply

18. Administrative Efficiencies
One online enrollment system - Workterra
Helps guide the member through the trust options
Can be customized to each school’s needs
Branded with school’s logo
Own Program
Special Announcements
Feeds data to insurance carriers
Feeds data to your payroll company* (depending on payroll firm, there may be fees involved)
COBRA administration services*
FSA administration services*
*optional – additional fees apply

19. 5/6/2016
Trust Fees
You can join CISBT on the first of any month during the plan year
The program will renew for all school participants on January 1st of each year, no matter when your school joined

20. Trust Fees There will be trust fees associated with the CISBT program
In order for the trust to make these benefits available, expenses have been incurred and collectively we pay for these services
The trust does not charge fees to make a profit and none of the trustees are paid for their work. Like you, they are all employed at an Independent School, which is a member of Cal-ISBOA and they volunteer their time
There are two types of technology fees:
The first is a $1,500 enrollment fee per school, which covers all the technology implementation costs
The second monthly fee is $6.50 per employee, per month. This fee may decrease in the future as the trust grows in number of enrolled employees

21. Trust Termination Rules
“If we participate in the CISBT program and a year or two into it we decide to leave it, what do we have to do? Also, if we decide to come back to the CISBT program are there any restrictions?”
As long as you complete one full year of coverage with the trust, if your school decides to leave the CISBT program, you may do so
You will need to provide Cal-ISBOA with a 60-day written notice
You will not be able to come back into the program for two years
Upon your return, you may be required to complete an underwriting questionnaire in order to request underwriting approval

22. Next Steps Interested in looking further into the trust?
Look for census template, broker authorization sample letter, and other information on the Cal-ISBOA website
Submit the required information to Bolton – business cards are being passed out now

23. Online System Requirements
For each participating school:
School information: address, list of contacts and type of access requirement
Workterra agreements:
Remote Access Secure Site
Business Associate Agreement
Carrier Letters advising them that Workterra will be implemented
Customized to each school’s needs:
School’s logo
Certain Lines of Coverage offered, outside of the trust offerings
Special Announcements

24. Online System Requirements
For each participating school
Feeds data to ancillary insurance carriers
Will need carrier information for those outside the trust offerings
Feeds data to payroll company
Will need payroll vendor and contact information
COBRA administration services
Will need detailed report on current COBRA participants and anyone in their election period (name, address, plans participating in, dependents covered, etc.)
FSA administration services
Will need detailed report on current FSA participants (election amount by FSA account, what has been used so far, etc.)

25. Absence Management Requirements
For each participating school that would like a quote on implementing this service
School information (address, main contact)
Current paid time off policy
Accrual definitions
Absence types
Period term
Eligibility
Carry over rules
Administrative rules
Current disability policy, if outside of the trust
Contract

26. Trust Requirements For each participating school
Must have a Cal-ISBOA membership (or in the process of obtaining a membership)
School information (address, main contact, etc.)
Membership agreement
Banking information and school contact
Authorization to automatically draw from their bank account

27. No HSA School Funding Required!
Medical Insurance
The CISBT program offers 9 medical plans.
HMO Plans
Premier HMO
Classic HMO
Value HMO day
Value HMO %
PPO Plans
Classic PPO
Classic PPO
Classic PPO
HSA HDHP PPO Plans
Lumenos LHSA497
Lumenos LHSA499
No HSA School Funding Required!
Traditional
HMO Network

28. Medical Insurance HMO Medical Plan Options - Benefits
Benefit Attribute
Premier
Classic
Value day
Value %
PCP Office Visit
Specialist Office Visit
$10 copay
$20 copay
$30 copay
$40 copay
Preventive Care
No Charge
Lab and X-Ray Advanced Imaging
$100 per test
20% coinsurance
Out-of Pocket Max – Ind.
Out-of Pocket Max – Fam.
$1,500
$3,000
$2,000
$4,000
$6,000
$3,500
$7,000
In-Patient Hospitalization Out-Patient Surgery
$250/admission
$125/admit
$500/day max 3 days
$250/admit
Emergency Room Urgent Care
$100 copay
$150 copay
$200 copay
Prescriptions
Tier 1 Tier 2 Tier 3
Tier 4
20% coinsurance (max. $250/fill)

29. Medical Insurance PPO Medical Plan Options - Benefits
Benefit Attribute
Classic PPO
Classic PPO
Classic PPO
PPO
Non-PPO
Deductible – Ind. Deductible – Fam.
$250
$750
$500
$1,500
$4,500
$1,000
$3,000
$2,000
$6,000
PCP Office Visit
Specialist Office Visit
$20 copay1
30%
$30 copay1
40%
Preventive Care
No Charge1
Lab and X-Ray Advanced Imaging
10%
30% ($800 max bene)
20%
40% ($800 max bene)
Out-of Pocket – Ind.
Out-of Pocket – Fam.
$2,500
$5,000
$6,500
$13,000
$4,000
$8,000
$12,000
$24,000
$10,000
$20,000
In-Patient Hospitalization Out-Patient Surgery
30% (limit $1,000/day)
30% (limit $350/admit)
40% (limit $1,000/day)
40% (limit $350/admit)
Emergency Room
Urgent Care
$150 copay + 10%
$150 copay + 10%
$150 copay + 20%
$150 copay + 20%
Prescriptions
Tier 1 Tier 2 Tier 3
Tier 4
$10 copay
$20 copay
$40 copay
20%(max. $250/fill)
$10 copay + 50%
$20 copay + 50%
$40 copay + 50%
20%(max. $250/fill) + 50%
20% (max. $250/fill) + 50%
1Deductible Waived

30. Medical Deductible Applies
Medical Insurance
HSA HDHP Medical Plan Options - Benefits
Benefit Attribute
Lumenos LHSA497
Lumenos LHSA708H
PPO
Non-PPO
Deductible – Ind. Deductible – Fam.
$1,500
$3,000
$4,500
$9,000
$2,500
$5,000
PCP Office Visit
Specialist Office Visit
10%
30%
20%
40%
Preventive Care
No Charge1
Lab and X-Ray Advanced Imaging
30% ($800 max bene)
40% ($800 max bene)
Out-of Pocket – Ind.
Out-of Pocket – Fam.
$6,000
$18,000
In-Patient Hospitalization Out-Patient Surgery
30% (limit $1,000/day)
30% (limit $350/admit)
40% (limit $1,000/day)
40% (limit $350/admit)
Emergency Room
Urgent Care
Prescriptions
Tier 1
Tier 2 Tier 3
Tier 4
Medical Deductible Applies
1a: $5 copay
1b: $15 copay %
$40 copay %
$60 copay %
30%(max. $250/fill) %
1b: $15 copay %
$40 copay %
$60 copay %
30%(max. $250/fill) %
1Deductible Waived

31. Dental Insurance Dental HMO Plan Option - Benefits Benefit Attribute
DHMO Opt. 1
Deductible
None
Annual Benefit Maximum
Unlimited
1110 – Prophylaxis
No Charge
2140 – Amalgam, Primary, one surface
3310 – Root Canal - Anterior
$90 copay
4210 – Gingivectomy per Quadrant
$95 copay
6751 – Crown-porcelain fused to metal
$175 copay
Orthodontic Services
Child Adult
$1,695 copay
$1,895 copay

32. Dental Insurance Dental PPO Plan Options - Benefits Benefit Attribute
DPPO Opt. 1
DPPO Opt. 2
PPO
Non-PPO
Deductible – Ind.
Deductible – Fam.
$50
$150
None
Annual Benefit Maximum (per person)
$1,500 (rollover applies)
$3,000
(rollover applies)
Preventive Services (cleaning, x-rays)
No Charge
Basic Services (fillings; periodontics; extractions; endodontics)
20%
10%
Major Services (bridges, dentures, implants, crowns)
50%
40%
Orthodontic Services (adult & child)
Orthodontic Lifetime Maximum
$1,500
$2,000
Out-of-Network Reimbursements
N/A
Fee Schedule
UCR – 90th %

33. Vision Insurance Vision Options - Benefits Benefit Attribute
Anthem Opt. 1
Anthem Opt. 2
PPO
Non-PPO
Frequency
Exam
Lenses
Frames
Once every 12 months
Once every 12 months Once every 24 months
Once every 12 months Once every 12 months
Eye Exam
$10 copay
Up to $49
Single
Bifocal
Trifocal
$25 copay
Up to $35
Up to $74
Contact Lenses
$130 allowance
Up to $92
Up to $50

34. Group Life/AD&D Insurance
Group Life and AD&D Plan Options Benefits and Rates
Benefit Attribute
Plan Opt. 1
Plan Opt. 2
Plan Opt. 3
Plan Opt. 4
Life and AD&D Amount
$25,000
$50,000
$75,000
1 x annual salary to $300,000
Guaranteed Issue Limit
$300,000
Reduction Schedule
To 65% at age 65, to 40% at age 70, to 25% at age 75, to 15% at age 80
Exclusions
Suicide, war, riots, felony and substance abuse
Waiver of Premium
Included
Accelerated Benefit
Conversion
Rates
Life Rate (per $1,000)
AD&D Rate (per $1,000)
$0.140
$0.020
$0.130
$0.120

35. Voluntary Life/AD&D Insurance
Voluntary Life and AD&D Plan Options – Benefits
Benefit Attribute
Plan Opt. 1
Life and AD&D Amount
Employee
Spouse
Child
$10,000 increments to $500,000 (OE increase $50,000, not to exceed GI)
$5,000 increments to $250,000 (not to exceed 50% of employee amount)
$1,000 increments to $10,000 (not to exceed 10% of employee amount)
$500 infants (birth to 14 days)
Guaranteed Issue Limit
$150,000 under age 65; $50,000 age 65-69; $10,000 for age 70+
$20,000 under age 65; $10,000 age 65-69
$10,000 or $500
Reduction Schedule
To 65% at age 65, to 40% at age 70, to 25% at age 75, to 15% at age 80
Exclusions
Suicide, war, riots, felony and substance abuse
Waiver of Premium
Included
Accelerated Benefit
Conversion

36. Voluntary Life/AD&D Insurance
Voluntary Life and AD&D Plan Options – Rates
Rate Age Bracket
Life Rate per $1,000
Under 20
$0.044
20-24
25-29
30-34
$0.049
35-39
$0.071
40-44
$0.123
45-49
$0.191
50-54
$0.289
55-59
$0.462
60-64
$0.773
65-69
$1.252
70-74
$2.458
75+
Employee and Spouse
AD&D Rate per $1,000
$0.030
Child
Life Rate per $1,000
$0.156
Child
AD&D Rate per $1,000
$0.030
Employee coverage must be elected before purchasing life/AD&D coverage for your spouse or child.

37. Group LTD Insurance
Long Term Disability Plan Option Benefits and Rates
Benefit Attribute
Plan Opt. 1
Monthly Benefit Amount
66.23%
Earnings Definition
Gross monthly income before taxes, including any pre-tax contributions to a deferred compensation plan, excluding commissions, bonuses, overtime pay or other extra compensation
Monthly Benefit Maximum
$7,000
Elimination Period
90-Day
Definition of Disability
Unable to perform the material duties of your own occupation during the own occupation period. After two years, you must be unable to perform the material duties of “any occupation” for which you are reasonably fit by education, training, and experience.
Benefit Duration
To SSNRA
Pre-Existing Limitations
3/12
LTD Rate (per $100 of covered payroll)
$0.190