2020 2020-2021 2021 MEDICAL PLAN RECOMMENDATIONS April 13, 2020 - - PowerPoint PPT Presentation

2020 2020-2021 2021 MEDICAL PLAN RECOMMENDATIONS

April 13, 2020

2019 2019-2020 PLAN YEAR REVIEW

SEPTE TEMBER 1, , 2019 - AUGUST 31, , 2020

• Plan changes implemented 2019-2020
• Increased district contribution to $350/month
• Increased premiums to all plans except High Deductible (Employee Only)
• Plan data as of February 2020
• High-Deductible Plan claims are 1.8 times > than the same reporting period during the 2018-

2019 plan year

• High-Deductible Plan expenditures are 5% < revenue
• Core Plan expenditures are 235% > than revenue
• Basic Plan expenditures are 36% > than revenue
• Prescription costs are $198,871 higher than the same time period during the 2018-2019 plan

year

• Stop Loss Claimants
• Four claimants with claims exceeding $250,000
• Eight claimants with claims exceeding $100,000

PROPOSED PREMIUMS: HIG IGH DEDUCTIBLE PLAN

PHA Incentive $25.00 – Employee Only & Employee plus Children $50.00 – Employee plus Spouse & Employee plus Family

HDP Number of Employees on each coverage level 2020-2021 Proposed Premium District Contribution PHA Incentive 2020-2021 Monthly Premium with District Contribution & PHA 2020-2021 Monthly Increase Employee 649 $ 485.00 $ (350.00) $ (25.00) $ 110.00 $ 35.00 Employee + Spouse 36 $ 1,086.00 $ (350.00) $ (50.00) $ 686.00 $ 142.00 Employee + Child(ren) 204 $ 979.00 $ (350.00) $ (25.00) $ 604.00 $ 128.00 Employee + Family 130 $ 1,389.00 $ (350.00) $ (50.00) $ 989.00 $ 181.00 Total 1,019 (69%)

PROPOSED PREMIUMS: BASIC PLAN

PHA Incentive $25.00 – Employee Only & Employee plus Children $50.00 – Employee plus Spouse & Employee plus Family

Basic Plan with PHA Number of Employees on each coverage level 2020-2021 Proposed Premium District Contribution PHA Incentive 2020-2021 Monthly Premium with District Contribution & PHA 2020-2021 Monthly Increase Employee 274 $ 715.00 $ (350.00) $ (25.00) $ 340.00 $ 93.00 Employee + Spouse 18 $ 1,401.00 $ (350.00) $ (50.00) $ 1,001.00 $ 183.00 Employee + Child(ren) 74 $ 1,231.00 $ (350.00) $ (25.00) $ 856.00 $ 161.00 Employee + Family 54 $ 1,763.00 $ (350.00) $ (50.00) $ 1,363.00 $ 230.00 Total 420 (28%)

PROPOSED PREMIUMS: CORE PLAN

PHA Incentive $25.00 – Employee Only & Employee plus Children $50.00 – Employee plus Spouse & Employee plus Family

Core Plan with PHA Number of Employees on each coverage level 2020-2021 Proposed Premium District Contribution PHA Incentive 2020-2021 Monthly Premium with District Contribution & PHA 2020-2021 Monthly Increase Employee 31 $ 1,051.00 $ (350.00) $ (25.00) $ 676.00 $ 137.00 Employee + Spouse $ 2,210.00 $ (350.00) $ (50.00) $ 1,810.00 $ 288.00 Employee + Child(ren) 4 $ 1,841.00 $ (350.00) $ (25.00) $ 1,466.00 $ 240.00 Employee + Family 3 $ 2,622.00 $ (350.00) $ (50.00) $ 2,222.00 $ 342.00 Total 38 (3%)

2020 2020-2021 PROPOSED PLAN CHANGES

• Increase the deductible and out-of-pocket maximum on all three medical plans
• High Deductible Plan
• Increase deductibles from $2,500 individual/$5,000 family to $3,500 individual/$7,000 family
• Increase maximum out-of-pocket from $7,000 individual/$14,000 family to $8,000

individual/$16,000 family

• Basic Plan
• Increase deductibles from $1,100 individual/$2,200 family to $2,000 individual/$4,000 family
• Increase maximum out-of-pocket from $7,000 individual/$14,000 family to $8,000

individual/$16,000 family

• Core Plan
• Increase deductibles from $750 individual/$1,500 family to $1,250 individual/$2,500 family
• Increase maximum out-of-pocket from $7,000 individual/$14,000 family to $8,000

individual/$16,000 family

2020 2020-2021 PROPOSED PLAN CHANGES

• Increase the Specialty drug for all medical plans from $250

co-payment per prescription to 30% of the negotiated cost up to a maximum $1,500 per prescription

• Change pharmacy providers from Maxor to PCA RX
• Change dental provider from Ameritas to Cigna resulting in

a larger provider network and a 11.5% reduction in premium costs

• Change supplemental accident provider from Allstate to

American Fidelity

SURROUNDING DISTRICT CONTRIBUTIONS

School District 2018-2019 District Contribution Northwest ISD $350.00 Decatur ISD $396.00 Lewisville ISD $326.00 to $393.00 Mesquite ISD $266.00 to $297.00 Irving ISD $351.00 Allen $340.00 Frisco ISD $325.00 Garland ISD $325.00 Coppell ISD $325.00 McKinney ISD $306.00 Carroll ISD $300.00 Fort Worth ISD $290.00 Grapevine-Colleyville ISD $285.00 Plano ISD $300.00 Carrollton-Farmers Branch ISD $278.00 Keller ISD $275.00 Birdville ISD $260.00 Denton ISD $260.00 Ferris ISD $250.00 Lake Dallas ISD $245.00 Eagle Mountain Saginaw ISD $250.00 Hurst-Euless Bedford ISD $225.00

QUESTIONS