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Insurance Committee Meeting Minutes 9/21/16
Posted by Kyndall Jirasek on 10/17/2016
Meeting Date: September 21, 2016
Meeting Location: Administration Meeting Room
Recorded By: Kristin Baum
20 of the 32 Campus/Departments were represented at the meeting.
1. Compass – Catherine Donaldson is no longer our Health Pro. Catherine’s emails are being re-routed to our new Health Pro, Laurens Doelman. Please communicate this change to your staff. (flyer attached – please put up in work/break room).
2. Airrosti Update - We will no longer be waiving the co-pay to go to Airrosti beginning January 1, 2017. Please communicate this important update to your staff.
3. Davis Vision - Davis Vision provides an added benefit if employees buy their glasses from a Visionworks provider. The frame allowance is $200 instead of $150 for all other providers. (benefit summary attached)
4. Delta Dental Renewal - We changed to Delta Dental on January 1, 2014 with a two-year rate guarantee. In 2016 we received an initial 40% rate increase due to utilization running at 118%. What this means is that Delta Dental is not collecting enough premium to cover the cost of the claims. January through July 2015 they collected roughly $608,000 in premium but paid out over $717,000 in claims. What is driving the high utilization are employees utilizing a non-network dentist instead of going to a Delta Dental provider where we receive the best discounts. We were able to make some plan changes and received a 9.9% increase in 2016. We still have not improved as much as we need to and received a 13.62% increase for 2017.
We did discuss making some plan changes which would have given a 9.9% increase on the high plan and no increase on the low plan for 2017. Committee members polled their campuses and with a vote of 13 to 9 it was voted to keep the plans as they are for 2017 with the 13.62% increase. 10 campuses did not respond. Keep encouraging employees to utilize an in-network dentist.
5. Employee Assistance Program (EAP) – The first 9 months of the Employee Assistance Program (EAP) have been slow. From January through May 31, 2016 a total of 49 employees have received assistance. Please remind employees that this program is available with many services to help with work and life issues (flyer attached – please put up in work/break room).
6. Medical Plan Changes for 2017
There are several changes being made to the medical plan effective January 1 (refer to medical plan option attachment)
1. The District monthly contribution is increasing from $375 to $400
2. Employees with single coverage on the iNGAGED plan will not see a rate increase
3. iNGAGED and Non-Engaged participants will be eligible to enroll in any of the plan options. There are new rules that now limit the way we can structure the Non-Engaged plan. We currently have 3 iNGAGED plans and one Non-Engaged plan (low option). With this change we can no longer alter the benefits, only the rates. We will continue to have 3 plans (low, mid and high) and six sets of rates (3 iNGAGED and 3 Non-Engaged).
4. Premiums are increasing for most employees covering dependents.
5. The deductible and out of pocket maximums have increased across all 3 plans for both in network and out of network.
6. The emergency room facility co-pay increased from $150 to $300. The physician fee remained the same with deductible and co-insurance.
7. The fourth quarter deductible carryover has been eliminated.
8. The total out of pocket maximums (medical and prescription) increased.
7. Pharmacy Update – we currently have a 3 tier pharmacy structure and will be moving to a 4 tier. Generic drugs will be in the 1st tier, brand in the 2nd, formulary in the 3rd and specialty in the 4th. Members whose drugs fall into the 4th tier will pay a 10% co-pay up to a $2500 maximum. We have gone out to bid for new pharmacy benefit manager. More information on the pharmacy program will be communicate once a decision has been made.
8. Open Enrollment – An email will be send the Principals announcing the upcoming open enrollment to provide to all staff. It will include the schedule along with the instructions for completing the health assessment and scheduling the biometric screening.
We will hold 5 question and answer sessions. Four will be here at Admin and one at Support Services. These sessions are for employees who want to talk about specific situations, or have personal questions they want answered prior to making their decision on enrollment day. If employees can’t make it to one of these sessions, they can call or email the benefits department at any time.
All employees will receive an Open Enrollment flyer. The flyer will include all of the information we have discussed regarding the changes for 2017. Extra flyers will be sent to be placed in your work room/break room and it will also be available on the PfISD website on the benefits page available for download.
Important items to remember and communicate to your staff regarding the iNGAGED plans:
1. Employees and Spouses enrolling in the iNGAGED plan must complete the Health Assessment
2. The Health Assessment site will open on September 27
3. If the spouse is not in the HA site email the benefits department at benefits@pfisd.net with their full name and date of birth – we can update immediately
4. We are resetting all of the passwords so employees are not expected to remember from last year. Employee will login with social and date of birth as password and then will be prompted to change it at that point.
5. The directions to completing the HA is included in the flyer and I will provide it in the email to the Principals and Supervisors.
6. Employees need to schedule their bio-metric screening appointment.
7. Employees without appointments will only be seen as time permits.
8. The last day to enroll will be Saturday, November 12th. Employees should make appointments for their bio-metric screening on this day as well. They can show up without an appointment but again appointment will be honored first.
When enrolling:
1. There will be a gatekeeper at the door of the enrollment location. This gatekeeper will verify that you and your spouse (if enrolling) have completed the requirements.
2. If you are enrolling in the iNGAGED plan and you have not met all of the requirements you will not be able to meet with the enrollment rep
3. The gatekeeper is going to give you a confirmation page to provide to the enroller –
- you (and your spouse) have met the requirements
- you are electing the Non-Engaged plan
- you are waiving medical coverage
9. Next Meetings
Wednesday, February 15, 2017 – 4:30 – 6:00 p.m.
Review results from the previous year (enrollment, premiums received, claims paid, reserve amounts, etc.), begin discussion for possible changes for the next plan year
Wednesday, April 19, 2017 – 4:30 – 6:00 p.m.
Discuss potential changes to coverage and employer/employee premium contributions
Wednesday, May 24, 2017 – 4:30 – 6:00 p.m.
Discuss all renewal-related items and reach consensus on committee’s recommendations
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