Health Benefits Committee - Peralta Colleges · 3/10/2016 · ensure execution of key deliverables...

Health Benefits CommitteeMarch 10, 2016

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Agenda: March 10, 2016

9:00-9:05 Welcome and Introductions, Benefits Office

9:05-9:10 Open Enrollment

9:10-9:15 Enrollment and Trends

Medical Trending and Inflation

Census & Enrollment

Issues in Self-Funding

9:15-9:30 Year-to-date Spending

Review Benefits Spending

Review Revenues

9:30-10:00 Review of Service Resources (Manners and Mechanisms through Benefits Office & Demos)

Peralta Benefits Homepage, Jennifer

Peralta Enrolment Portal through Benefit Bridge, Ronnie

9:55-10:25 Review of Service Resources through Consultant, Alliant Insurance Service

Introduction

BenIQ

Affordable Care Act of 2010

10:25-10:30 Next Meeting Dates & Agenda items

3/10/2016Health Benefits Committee 2

Welcome & Introductions

Local 1021 Local 39 PFT Managers Confidentials Peralta

Retirees

Ava Lee-

Pang

Rick Putz Ed

Jaramillo

Sean Brooke Laura Leon-

Maurice

Debbie

Weintraub

Abigail

Brewer

Selwyn

Montgomery

Jennifer

Shanoski

Atheria

Smith

Tom Branca

William

Highsmith

Rick

Greenspan

Luther

Aaberge

Diana Lara


Constituents Representatives New Faces Around the District

Open Enrollment

Annual opportunity to enroll, change coverage

or plans

Active employees

Retired employees

COBRA participants

Surviving Spouses

Elections become effective July 1, 2016


Open Enrollment-Theme

Peralta Benefits Everyone,

…Wellness Begins With You!

3/10/2016

Health Benefits Committee

5

Open Enrollment-Qualifying Events

Plan and enrollment changes can occur outside of the open enrollment when

there is a qualifying event:

Marriage

Birth of a child

Loss of coverage under another group plan


Open Enrollment – Tentative Schedule &

Invited Participants

Open Enrollment Schedule

Benefits Fair Locations

Invited Participants

Kaiser

CoreSource

Anthem/Blue Cross

Caremark

Delta Dental

United Health Care

VSP

CIGNA

Costco

24 Hour Fitness

Employee Assistance Program

Pre-paid Legal Plan

Health Benefits Committee

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Time May 4 May 5

11-1 BCC

2-4 COA

9-11 Laney & The

District

12-2 Merritt

College

3/10/2016

Open Enrollment - Communications

Postcard:

Mid April - Save the Date: Benefits Mini – Fair Schedule

Annual Peralta Benefits Everyone-Open Enrollment Announcement -plan highlights & rates:

Typically end of April

Newsletter distribution, pending the outcome of union negotiation, possibility of 2 mailings

Emails:

Throughout the month of May

Mechanism to effect a change:

Actives: BenefitBridge

Retirees: Universal Benefits Enrollment Form (available on Peralta benefits homepage)

Claims Balance Statement:

Mailed from CoreSource to members of our self-funded plan:

Since grandfathered plans are subject to lifetime limits, it was requested that an annual statement be mailed to around open enrollment time so that affected participants can contemplate a plan change.

Health Benefits Committee 83/10/2016

Review Benefits Spending,

Fiscal Year 2015-2016


Projected Expenses 7/1/2015

thru YTD Expenses

2015-2016

30,948 2/29/2016 21,095

17,861 2/29/2016 13,396

8,582,885 2/29/2016 6,591,822

Kaiser North-retirees 2,732,999 2/29/2016 2,045,126

10,692,361 1/31/2006 3,668,116

7,824,429 1/31/2006 2,760,241

357,111 1/31/2016 246,219

894,570 2/29/2016 911,606

17,467 1/31/2016 12,987

Subtotal 31,150,631 16,270,608

28,745 2/29/2016 21,309

ASIG 882,760 1/31/2016 552,571

50,718 1/31/2016 33,643

Subtotal 962,223 607,523

1,832,172$

?

CoreSource Claims & RX & Vision-retirees

Incurred but not recorded

not incurred and not submitted

ASIG Administrative

CoreSource Administrative

MHN EAP

ING Stop/Loss (2)

DENTAL

Pacific Union / UHDM

MEDICAL

Kaiser-Washington (1)

Kaiser-ATL (1)

Kaiser North-actives

CoreSource Claims & RX & Vision-actives

Vendor Name

Enrollment Census, as of 2/29/16 (Medical)


Retirees Pre 2004 Retirees Post 2004 Retirees Post 2012 Grand Total

source: Bill Total Total

Contract 50% 100%

Subtotal

PFT 1021 39 Managers Confidentials

single 68 45 1 114 77 17 16 1 74 68 3

2-party 61 9 0 70 60 14 8 4 65 43 3

3+ 65 3 0 68 69 27 11 5 4 6 0

Total 194 57 1 252 206 58 35 10 561 143 117 260 821



Contract 50% 100%

Subtotal


single 30 4 34 6 1 8 0 114 46 4

2-party 14 0 14 5 5 4 1 117 77 1

3+ 9 0 9 2 5 3 0 6 15 1

Total 53 0 4 57 13 10 15 1 96 237 138 6 381 477



Self Funded Lite

Contract 50% 100%

Subtotal


single 20 0 1 21 17 2 5 1 0 0 2

2-party 31 0 0 31 18 2 10 3 0 1 6

3+ 41 0 0 41 23 4 4 2 0 0 0

Total 92 0 1 93 58 8 19 6 184 0 1 8 9 193

Actives

Kaiser

Actives

Self-Funded Traditional

Actives

Enrollment Census, as of 2/29/16 (Dental)




Delta Dental Plus Premier PPO Self-Funded In & Out of Network

Contract 50% 100%

Subtotal


single 109 46 155 91 17 24 2

2-party 106 9 115 76 20 22 9

3+ 109 3 112 93 36 12 5

Total 324 0 58 382 260 73 58 16 789 0 0 0 0 789



United HealthCare Dental

Contract 50% 100%

Subtotal


single 5 2 7 14 0 6 0

2-party 5 4 9 2 1 3 0

3+ 6 1 7 5 2 4 0

Total 16 0 7 23 21 3 13 0 60 0 0 0 0 60

Actives

Actives

Revenues as of December 2015


Estimated Revenues

Stop Loss/employee checks/cobra & survivor

payments(through January 2016)

$939,586.07

Employee Payroll-Pretax Contributions Medical (estimation based on contributions 7/1-12/31/15 x 2)

$671,190.00

Employee Payroll-Pre-tax Contributions Dental(estimation based on contributions 7/1-12/31/15 x 2)

$113,896.06

Medicare D Subsidies 13-14 subsidy received in 15-16 – usually run 1-2 years behind

$313,249.00

Significant Expenses:

Cash In-Lieu

Number of current

participants

Medical 44

Dental 27



Large Claims


Top 3 networks/cost per network

ALTA BATES SUMMIT MEDICAL CTR $1,062,498.59 (51.7% of claims paid)

UCSF MEDICAL CENTER $302,261.28 (14.7% of claims paid)

JOHN MUIR MEDICAL CENTER $190,705.79 (9.3% of claims paid)

TOTAL CLAIMS PAID (July 2015-Jan 2016) $3,621,688.58

Source: CoreSource Plan Performance Review Report


Medicare Kaiser Self-Funded

As of February 2016 15 25

14-15: Additional

premium/claims cost

$491,597

(Premium Expense)

$818,857

(Claims Paid)

13-14 additional claims cost

based on 2013-2014 claims

audit)

Approximately $1m

Medicare coordination is fluid:

• Can be interrupted if a retiree signs up for a private insurance

• Can only be primary during months of active coverage

Manner:

• Remind retirees to maintain enrollment

• Inform the District if there is a change in premium-IRS has a two-year look-back

period

• Medicare open enrollment and the District’s annual campaign ends 3/31/16; coverage

generally becomes effective 7 1 xx unless other overriding conditions apply as

approved by Medicare

• PRO representative to support outreach efforts, let me know by 3/15 – paid position 3/10/2016Health Benefits Committee 15


Provider Contracts

Blue Cross Network Statistics

How many providers are in California

Compare 1 year ago to today

Hospitals, specialists


January 2015 January 2016

Hospitals 399 399

Specialists 71,156 72,942

Source: Anthem Blue Cross

Significant Expenses: Provider Contracts

Anthem Blue Cross terminated their contract with Alameda Health as of January 1, 2016

Sample of notice below


Californa Medical and Dental Trends (3

year)


Trend Medical PPO CA Medical HMO Dental PPO

2014 9% 10% 5%

2015 9% 10% 4.5%

2016 9% 10% 3%

Source: Contracted actuaries who manage multiple pools in the state of ca

Review of Service Resources, Manners &

Mechanisms

PCCD Benefits Landing Page, Jennifer Seibert-Benefit Manager

Benefits Bridge, Ronnie Roberts-Benefits Office

BenIQ,

Introduction of Consultant-Alliant Insurance Services


Service Resources

PCCD Benefits Home Page


http://web.peralta.edu/benefits/

Benefits Landing Page-Important References


http://web.peralta.edu/benefits/

Service Resources

Benefits Bridge Portal and Demo, Ronnie Roberts

Weblink

Self-established user id, login and

auto-reset


Service Resources

Benefits Bridge Portal and Demo


Service Resources

Benefits Bridge Portal and Demo, Ronnie


Service Resources

Ben IQ demonstration

Affordable Care Act Update

1095 Reporting

Commuter Plan

Cadillac Tax Update


Alliant Introductions


Alliant Insurance Services, Inc. is the largest public entity broker/consultant in

California and brings to Peralta Community College District the experience gained

from working with many of California’s public entities. We have over 1,000 public

entity clients, including many cities, counties, special districts, community college

districts, and K-12 public schools, as either individual clients and/or as clients through

our relationship with Joint Powers Authorities.

Our Client base includes:

Over 300 Cities

55 of the 58 California Counties

Over 300 School Districts

12 Joint Powers Authorities

Over 200 Special Districts

Over 100 Hospitals

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Alliant Introductions


Tom Sher, Senior Vice President

Tom provides overall strategic planning and

direction of all Alliant Public Entity Benefit

Team resources in Northern CA. He

measures the effectiveness of Alliant’s

programs to ensure ongoing market

competitiveness, rate stability and

customer service.

Erin Thomas, Benefits Consultant

Erin provides implementation of benefit

plan strategy, bidding processes, special

projects and continual monitoring. Erin

will work to develop strategic plans and

ensure execution of key deliverables and

cost savings.

Reagan Peralta / Account Executive

Reagan is the main point of contact for the District and is

responsible for ensuring that the District’s expectations are

met. He assists with strategy planning and directs the service

team to ensure that goals and objectives are executed

effectively. He oversees benefit plan administration,

employee communications and vendor relationships.

Dianna Santos, Benefits Analyst

Dianna is responsible for providing

analytical and financial reporting. She is

also responsible for executing the work

plan on all areas related to the District’s

Benefit Program Marketing, including

but not limited to benefit plan options,

contract specifications, premiums and

competitiveness.

Scott McClave, Underwriting Consultant

As head underwriting consultant, Scott will

provide underwriting, forecasting and risk

analysis services for the District’s Benefit

Programs as well as evaluate alternative

funding options.

Daniel Chow, Account Associate

Daniel is responsible for day-to-day

service which includes: resolving routine

claim and billing issues, reviewing

contracts, coordinating and providing

support at open enrollment meetings,

ordering marketing materials and acting

as a liaison for vendor or third party

administration and service issues.

This is a title

Ben-IQ™

Welcome!


What Is Ben-IQ?

Mobile app for employees and

their dependents

Benefits information and messaging

Simple to navigate user interface

Comprehensive reporting analytics

Available for iPhone and Android


Ben-IQ Features

What can Ben-IQ do for employees and their families?

Ben-IQ gives employees 24/7 access to everything they need to know,

like:

3/10/2016Health Benefits Committee

BENEFIT INFO

Access to health plan highlights

FIND CONTACTS

Find nurse line and other important

ACCESS ID CARDS

Store and organize plan ID cards

WELLNESS TIPS

Wellness program information and tips

COST OF CARE

Find out how much care should cost

MESSAGES

Receive important messages

from your HR/benefits team

VIDEOS

Learn more about plan benefits

with access to online videos

FAQ

Access answers to frequently

asked benefits questions

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HR Messaging


Send messages to employees and dependents!

Open Enrollment info

Notices

Reminders

Plan tips

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Benefit Plan Information


24/7 access to health plan highlights

Available plans

High-level plan

information

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BEN-IQ Cost and Quality Information

Now it’s easy to make educated healthcare decisions


COST INFORMATION

for healthcare procedures

ROBUST SEARCH

by location or procedure

SIMPLE

and easy to use

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Important Numbers and FAQ


Employees can

find important

care information.

Less costly

options such as

Nurse line (if

available) are

served up first.

Got a question?

Find definitions for

common medical

terms and a

comprehensive

FAQ

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Plan ID Cards


Take a photo of your ID card

Choose which card to use

Email, edit, or delete the card

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Access To Benefits Videos


Upload benefits videos

for your employees

Employees can view the

Ben-IQ video, to learn

more about the app.

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Communication Resources

Education tools are available

Ben-IQ video

Sample email script

Poster

Flyer

Postcard

Table tents

Downloading instructions

HR administrator’s guide

Slides for OE presentations


Affordable Care Act Update Form 1095 is to be distributed by March 31, 2015

Distribution of Form 1095B by Kaiser

Distribution of Form 1095C by CoreSource

Some tax-payers may received more than one Form 1095

Commuter Benefits

IRS increased contributions to $255 per month effective January 1, 2016


Affordable Care Act Update Affordable Care Act Update

Cadillac tax moved to 2020


The thresholds in 2020 will be what they would be with indexation from 2018, had the tax not been delayed.

As such, the thresholds in 2020 will be higher than $10,200/$27,500.


Cadillac tax – What’s Included?



Cadillac tax – Who pays the excise tax?


Agenda Items for Next Meetings

Legislative Updates 2016

What happens when payments are received late from

COBRA participants and surviving spouses?

Medical trend analysis

Survey responses

Medicare campaign update


Next Meeting Dates

April 28, 2016

The Benefits Office is available to serve as a resource at your meetings.

Contact us at [email protected]


Health Benefits Committee - Peralta Colleges · 3/10/2016 · ensure execution of key deliverables...

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Transcript of Health Benefits Committee - Peralta Colleges · 3/10/2016 · ensure execution of key deliverables...