Benefit Choices in a Changing Environment Pat Haines SVP, Benefits.

Benefit Choices in a Changing Environment

Pat HainesSVP, Benefits

• 2013: A Year of Difficult Choices• The World in Which We Live: The Context for

Making Choices• The Choices Facing Each of Us

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Topical Overview

• Retirement Plan• Modify Apportionment Policy

• Disability Plan• Increase Benefit

• Medical Plan• Increase Dues• Change Pharmacy Benefit Management (PBM) partner• Increase Rx Copay for Generic Drugs• Design Health Accountability Program

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2013: A Year of Difficult Choices

• Retirement Plan• Rationale

• Maintain plan solvency• Provide generational equity• Protect benefits against inflation

• Impact• 1% apportionment = $57.7 mil

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Choices: Rationale and Impact

• Disability Plan• Rationale

• Protect benefits against inflation• Impact

• The increase in liability = $714,000

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• Medical Plan• Rationale

• Provide some limited flexibility• Provide quality coverage• Continue support of Community Nature• Ensure financial solvency

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• Medical Plan• Impact (2014)

• Cost Savings• New pharmacy benefit partner = $2.9 mil• Dues action (21% → 23%) = $13.6 mil• Rx copay change ($8 → $10) = $400,000

• Call to Health = improved member health

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• Declining enrollment• Aging population• Healthcare Reform• Inherent volatility

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Medical Plan: Other Factors Affecting Costs

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Medical Plan Before and After: Forecasts

2013 ForecastAs of: June 2013 February 2014

Total Revenue $174,538 $174,200

Total Expenses(claims & admin) $180,759 $184,079

Net Income ($6,222) ($9,878)

Fund Balance(reserve)

$58,258(32.2%)

$52,111(28.3%)

$ in 1000s

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Total Revenue $167,689 $182,492


Net Income ($15,251) ($3,938)


$40,929(22.4%)

$46,058(24.7%)

$ in 1000s


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Total Revenue $166,321 $190,872


Net Income ($22,920) ($2,438)


$16,916(8.9%)

$42,493(22.0%)

$ in 1000s

• Exchanges: Public and Private• Partner Coverage: no subsidy; surcharge; none• High Deductible Health Plans• High Performing, More Restricted Networks• Health Accountability and Responsibility: more

carrots and sticks• Reference-Based Pricing

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Choices by Other Large Employer Plans

• Online store or marketplace• Public (government) or Private (industry)• Single or multi-carrier• Health only or other coverage options• Decision support

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Exchanges: Expanded Choices for Individuals and Employers

• Members in transition• Seminary students• Early retirees• Part-time church workers (< 20 hours)• Non-mandated emerging ministries

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Public Exchanges: Who Might Benefit

• 2015 Dues Model• Mid councils: Terms of Call• Employing organizations:

Share or not; pre-tax or post-tax• Members: enroll or not

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Choices That YOU Have

• Be a responsible consumer• Understand your benefits• Seek care at the right time and at the right

place• Look for value (cost and quality)

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• Answer the Call to Health• Preventive care• Telephonic coaching• Health assessment• Know your numbers• Vision exam• Tobacco cessation• CREDO

• myactivehealth.com/pcusa

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Benefit Choices in a Changing Environment Pat Haines SVP, Benefits.

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