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2014-15 Medical and Insurance B enefit Renewal Recommendations

2014-15 Medical and Insurance B enefit Renewal Recommendations. Governing Board Meeting March 25, 2014. Tahlya Visintainer and Christie Davis. Benefit Renewal Process and Players. Insurance Renewal process

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2014-15 Medical and Insurance B enefit Renewal Recommendations

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

  2. Benefit Renewal Process and Players • 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

  3. Medical Benefits & Premiums

  4. Renewal Overview • 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)

  5. Medical Premiums for 2014-15

  6. pharmacy

  7. Pharmacy • 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

  8. Dental

  9. Delta Dental • 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

  10. Dental Premiums for 2014-15

  11. voluntary

  12. Other Voluntary Benefits • 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

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