FSRBC A Winning Combination For Retiree Benefits May 19, 2015 19, - - PowerPoint PPT Presentation

FSRBC – A Winning Combination For Retiree Benefits

May 19, 2015 19, 2015 Presen ented ed b by: FSRBC, F FBMC MC, B Brev evard P Pub ublic S Schoo hools

1.

IBC Retiree Program Initiative Overview

2.

How the Program Works

3.

Retiree Program Benefits and Features

4.

Consortium Administration

5.

Non-Medical Benefits

6.

Participating District Experience

7.

Questions

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 Formed in 2001 to Assist School Districts with Benefit

and Retirement Related Initiatives

 Member Organizations and Board Members

• Florida School Boards Association (Bill Graham)
• Florida Association of District School Superintendents

(Senator Bill Montford and Don Griesheimer)

• Florida Association of School Administrators (Juhan Mixon)
• Florida Education Association (Pat Dix)

 Decisions on Initiatives Reached Through Consensus

• f Organizations

 IBC Created Statewide Florida Retired School Employee

Benefits Program Consortium (Consortium) for Retirees Eligible for Medicare

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 Established Under Fl. Statute 163.01 as The Florida

Retired School Employee Benefit Program (Consortium)

 Consortium Responsibilities

• Outlined in their Bylaws
• Consortium Procured Health Plan Benefits Through a Host

District, Polk Schools

• Select, Implement and Manage the Consortium Program
• Execute Contracts with Third Parties as Needed to Provide

Benefits and Administer the Consortium Program

• Execute Participation and Interlocal Agreements With School

Districts

 Governed by Nine (9) Member Board of Directors  FSRBC Full Time Executive Director to Begin June 1

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Nam Name Office Dis Distric rict Appo ppoin intment Lee Swift Chairperson Charlotte FSBA Marianne Capoziello Member Polk FEA Kathryn LeRoy (Mike Perrone) Treasurer Polk FADSS Vanessa Tillman Member

• St. Lucie

FEA Debra Pace Secretary Brevard FASA Daneen Regna Member Retiree IBC Consensus David Ford Vice Chair Duval IBC Consensus Kevin Windham Member Escambia IBC Consensus Nuri Ayres Member Retiree IBC Consensus

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Retirees and their eligible dependents shall be offered the same health and hospitalization insurance coverage as is offered to active employees at a premium cost of no more than the premium cost applicable to active employees. …To determine health and hospitalization plan costs, the employer shall commingle the claims experience of the retiree group with the claims experience of the active employees …. Retirees ees c cover ered ed under er Medicar are m e may b be experien ence- ra rated ed s sep eparately f fro rom m the ret e retir irees n not c covered by Med edic icare a and fro rom m activ ive emp emplo loyees, pro rovided ed that th the tota total premium d doe

• es n

not e

• t exceed th

that of t of th the a acti tive group an and c d coverage i is bas basically the sam ame as as for the active g group up.

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 Medicar

are e Supplemen ement (Medigap) Plans on a Statewide and National Basis

• Two (2) Companies Are Approved - United Healthcare (UHC)

and Cigna

• Each Participating District Will Have the Option to Select Only

One of the Two Companies

 Medi

dicare P Par art D D (EGWP) Pharmacy Plans on a Statewide and National Basis

• One Company is Approved – United Healthcare

 Medicar

are e Advantag age e Plans Specifically Selected to Meet Individual School District Needs

• Approved Companies – Aetna, Cigna, Health First, and UHC
• Each District May Select Up to Two (2) Companies

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Dis Distric rict Medicar care Advanta ntage Medicar care Supple pplement Medicar care Phar armac acy Brevard Public Schools 570 404 255 Duval County Public Schools 45 54 1,232 Escambia County School District 343 81 43 Miami-Dade Public Schools 1,469 490 246 Orange County Public Schools (Oct. 2015) Upcoming Polk County Public Schools 80 56 Total 2,427 1,109 1,832

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Medig digap B p Benefit its

Plan lan A Plan lan F

Pla lan N N

Part art A A Coi

• ins

nsurance and d Hos

• spi

pital C Cos

• sts

√ √ √ Medicar are Part art B Coin insuran ance or r Copaym ayment √ √

Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 $20 for som

• me of
• ffice visits an

and up to a $50 $50 co copayment for em emer ergency ro room vis isit its that don’t result in an inpatient admission

Blo lood ( (Firs irst 3 Pin ints) √ √ √ Part art A Hospic ice Care are Coin insuran ance or r Copaym ayment √ √ √ Skille illed Nursing Fac acilit ility y Car are Coinsur uranc nce √ √ Medicar are Part art A De Dedu ductibl ble √ √ Medicar are Part art B Ded educt ctible ($147) $147) √ Med edica care Part B Ex Exce cess Ch Charges (15% 15%) √ Foreig ign Trav ravel l Emerg rgency y (T (To Limits ts) √ √

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Unite ted H Healthc thcare 2 2015 Issu ssue Ag e Age Pla lan A A Pla lan F F Pla lan N N

Age ge 65 65 $131.49 $131.49 $183.63 $183.63 $132.03 $132.03 Age ge 66 66-69 69 $141.87 $141.87 $203.05 $203.05 $146.39 $146.39 Age ge 70 70-74 74 $163.16 $163.16 $226.93 $226.93 $162.89 $162.89 Age ge 75 75-79 79 $177.24 $177.24 $246.28 $246.28 $177.28 $177.28 Age ge 80 80 + $192.48 $192.48 $266.90 $266.90 $191.98 $191.98

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Cigna na 201 2015 Issu ssue Ag e Age Pla lan A A Pla lan F F Pla lan N N

Age ge 65 65 $179.44 $179.44 $207.49 $207.49 $155.60 $155.60 Age ge 66 66-69 69 $149.44 $149.44 $207.49 $207.49 $155.60 $155.60 Age ge 70 70-74 74 $166.68 $166.68 $242.58 $242.58 $187.33 $187.33 Age ge 75 75-79 79 $178.71 $178.71 $272.82 $272.82 $213.48 $213.48 Age ge 80 80 + $186.29 $186.29 $305.36 $305.36 $242.31 $242.31

Rx Rx B Ben enef efit Compreh ehen ensive Pre remie ier Dru rug Coverag age Dru rug Lis ist 100% + Bonus 100% + Bonus Init itial ial Coverag age Perio riod Deducti tible $0 $0 Gen ener eric $2 to $10 $2 to $7 Bran rand Preferred/N /Non

• n-pre

referre rred $45/$75 $30/$60 Specialt alty 33% $75 Gap ap Gen ener eric P c Pref eferred $2 to $10 $2 to $7 Brand Preferred/N /Non

• n-pre

referre rred 55% Discount $30/$60 Specialt alty 55% Discount $75 Cat atas astrophic ic Gen ener eric $2.65 or 5% $2.65 or 5% Bran rand $6.60 or 5% $6.60 or 5% Mo Mont nthly Pr Premium um $84.18 $84.18 $155.31 $155.31

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Be Bene nefit Zero Premium Comprehensive Option 3

Medi dical

PPO OON National PPO OON Same

Annual nual Deduc ductibl ble $0 $0 Annual nual OOP $4,500 $2,500 Hospita tal A l Admit it $200/Day to 8 Days 30% $175 $175 Office e Visit its $15/$40 $35/$50 $5/$15 $5/$15 Emerg rgency C Care re $65 $65 $65 $65 Outp tpati tient t Surg rgery ry 20% 30% $15 $15 Rx Rx Gener eric $10 N/A $5 N/A Brand and $40/$90 N/A $30/$60 N/A Specia ialt lty $90 N/A $80 N/A Coverage Gap Applies No Gap Month thly ly Premi mium $0 $0 $232 $232-$328 328 Local A Avai vailabi ability Selec ect Count unties All ll F Florida C Counti ties

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Curre rent New ew Differ eren ence

Monthly Retiree Premiums Compared to Active Plan $359.00

Plan N and Comp Rx Age 67

$305.89 $53 per Retiree per Month Administrative Savings of Cigna ASO Fees and TASC Administration 589 Retirees $284,444 Annual Savings Active Health Plan Savings With Medicare Retirees on Consortium Plans 715 Retirees and Dependents $104,744 Annual Savings Savings to GASB Liability Over Next 20 Years $102 Million $51 Million

• 50%

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Curre rent New ew Differ eren ence

Monthly Retiree Premiums Compared to Active Plan $422

Plan N and Comp Rx Age 67

$300.56 $121.44 per Retiree per Month Savings due to removal of monthly subsidy $25 month /retiree $0 $122,000 Annual Savings Administrative Savings of ASO Fees, Stop Loss and Administration 396 retirees $275,000 Annual Savings Active Health Plan Savings With Medicare Retirees on Consortium Plans 396 retirees and their Dependents $326,000 Annual Savings Savings to GASB Liability Over Next 30 Years $30.8 Million $15.4 Million

• 50%

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Medig digap U p UHC

Age 65 65 Age 66 66-69 69 Age 70 70-74 74 Age 75 75-79 79 Age 80+ 80+

Plan A + Comp. Rx $211.31 $222.57 $239.26 $252.63 $266.82 Plan F + Comp. Rx $260.63 $276.09 $299.41 $318.23 $338.60 Plan N + Comp. Rx $211.11 $222.12 $239.10 $252.59 $266.92 Plan A + Premier Rx $282.44 $293.70 $310.39 $323.76 $337.95 Plan F + Premier Rx $331.76 $347.22 $370.54 $389.36 $409.73 Plan N + Premier Rx $282.24 $293.25 $310.23 $323.72 $338.05

Polk County Schools Health Plan = $50 $505

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 Project Management for New Client Implementation  Communications  Annual Enrollment Planning and Coordination

• Eligibility, Including New Retirees and Aging-In
• Benefit Fair Scheduling
• Customer Call Center
• Enrollment in Non-Medical Benefits
• (Carriers Enroll Medical)

 Premium Billing, Collection (FRS, ACH and Direct Bill)

and Direct Payment to Carriers

• Premium Payments to Districts for Dependents Under 65

 Districts Have the Option to Offer Non-Medical

Benefits as Well

 Options Available Through the Consortium, and

Administered by FBMC, for 2015

• Group Dental Insurance Plans

 PPO  DHMO

• Group Vision Insurance Plan
• Identity Theft Protection Plan
• IT Tech Support Program

 Non-Medical Plan Options Will be Expanded to Meet

the Unique Needs of Retirees in the Future

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Benefits its Low PPO PPO Pl Plan High PPO PPO Pl Plan In Network

• rk

Out of Network

• rk

In Network

• rk

Out of Network

• rk

Annua nnual Ma Maximum

$800 per person per year $1,500 per person per year

Annua nnual De Dedu ductible le

$50/ person to max $150 for Basic

• r Major Services

$100/ person to max $300 for Basic or Major Services $50 per person to max $150 for Basic or Major Services

Dia Diagnostic ic & Preve ventive ve

100% 100% 100% 100%

Basic ic

70% 70% 80% 80%

Major jor

50% 50% 50% 50%

Plan I n Inc nclus usions ns

2 Preventive Cleanings and 2

• Perio. Basic

Cleanings/Year 2 Preventive Services Cleanings per Year 2 Preventive Cleanings and 2

• Perio. Basic

Cleanings/Year 2 Preventive Cleanings and 2

• Perio. Basic

Cleanings/Year

OON A N Allo llowance

PPO Schedule 80th percentile

Mon

• nth

thly R Rate tes Retiree Only

$28.25 8.25 $38.69 8.69

Retiree + 1

$56.24 6.24 $77.04 7.04

Retiree + Family

$73.29 3.29 $100 $100.04

Service ces Low

• w D

DHMO P Pla lan High D h DHMO P Plan an Network Network Only Network Only Annual Maximum NA NA Deductible $0 $0 Office Visit Copay $0 $0 Panoramic X-ray & Bitewings $0 $0 Prophylaxis $0 $0 Amalgam – One Surface – Permanent $5 $0 Resin – Based Composite – One surface, Anterior $30 $0 Endodontic Therapy, Molar $250 $210 Periodontal Scaling & Root Planning- 4 or More Teeth $55 $50 Complete Denture – Maxillary $375* $325* Crown – Porcelain Fused to Nobel Metal $270* $245* Extraction, Erupted Tooth or Exposed Root $0 $5 Month thly ly Rate tes Retiree Only $9.95 .95 $16.15 6.15 Retiree + 1 $19.70 9.70 $31.98 1.98 Retiree + Family $35.02 5.02 $56.85 6.85

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Pla lan In Network

• rk B

Benefits

Freq equency cy (Exam /Lenses/ Frames) 12/12/24 Ex Exam/Spect ctacl cle Len enses $10/$15 Eyeglass Benefit t – Fram ame Non-Colle lectio ion F Fram ame Allo llowan ance (Retai ail) l): Up to $130 OR Up to $180 at Vision Works Davis is Vis isio ion Fram ame Colle lectio ion (i

(in lieu of

• f Allowa

wance) e):

Fashion Level and Designer Level Included Premier Level $25 Eyeglass Benefit t – Spect ctacle L e Lenses es Member er Charges es Clear Plastic Lenses & Scratch-Resistant Coating Included Polycarbonate Lenses Adults $30 Progressive Lenses (Standard / Premium / Ultra) $50/$90/$140 Co Contact ct Len ens Be Bene nefit (in lieu of Eyeglasses) Up to $130 Mo Mont nthly Rates: Retiree $6.17 $6.17 Retiree + 1 $11.11 $11.11 Retiree + Family $17.28 $17.28

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Plan an Feat atur ures Premi mium m Ultim timate

Restoration services Yes Yes Lost wallet assistance Yes Yes Identity safety resource center Yes Yes Internet surveillance monitoring and alerts Yes Yes Social security monitoring and alerts Yes Yes Change of address monitoring and alerts Not Available Yes Court/criminal monitoring and alerts Not Available Yes Sex offender monitoring and alerts Not Available Yes Anti-Virus, anti-spyware protection Not Available Yes Anti-phishing, anti spam protection Not Available Yes Junk mail-list removal Not Available Yes Mo Mont nthly Rates Retiree $7.00 $7.00 $10.50 $10.50

Retiree + Family $15. 5.00 00 $22. 2.50 50

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 Remote Support via Internet, Live Chat, Telephone

• 24/ 7/ 365

 Assistance With Various Devices Including:

• Computers (PC and MAC)
• Smartphones
• Cameras
• Printers and Scanners
• Modems
• Gaming Consoles

 Computer Protection Software  Self Help Database for Assistance With Technology Issues  Secure Data Back Up Data Protection  Onsite Support Available at $80 per Hour

Unlim limit ited Supp pport Unlim limit ited Support t with ith Data ta Backup $10.00 per Household $14.00 per Household

• Reduce self-funded health plan costs.
• Reduce liability under Government Accounting Standards

Board (GASB) requirements to report liabilities for Other Post-Employment Benefits (OPEB).

• Reduce administrative costs (medical Third-Party

Administrator and TPA for retiree accounts receivable).

• Potentially better/broader mix of retiree benefits.

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• RobinsonBush met with a Select Group of Retirees to

Provide Information and Request Feedback.

• Brevard Public Schools Participated in RFP Process for

Medical Products to be Offered in Brevard.

• Office of Employee Benefits Submitted Board Agenda Item

in June 2014, Which was Approved.

• Set Up Weekly Implementation Calls with TPA—FBMC

Benefits Management, Inc.

• Worked with FBMC to Communicate to Retirees and

Conduct Open Enrollment Meetings.

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• The Change was Very Emotional for our Retirees.
• Expect Your Enrollment Meetings to be SRO.
• Create a Diagram of the Process Flow for Every Step
• f Implementation.
• Communicate, Communicate, Communicate (early

and often)!

• Factor in Loss of Retiree Drug Subsidy (RDS) when

Completing Financial Analysis.

 Determine the Medicare Plans to be Offered  Determine the Non-Medical Benefit Offerings  Presentations to District Committees and School Board  Take School Board Action on the Participation and Interlocal

Agreements

 Districts Will Only Pay a One Time Administrative Fee of

$1.00 per Health Plan Participant to the Consortium

 Eligible Retirees Over 65, and Dependents, Will Get Their

District Sponsored Health Plan Benefits Through the Consortium Retiree Program Beginning No Later Than January 1, 2016

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 Retiree Medical Plans Are Selected Through Public RFP

Process

 Retirees Have More Options, Guarantee Issue, Same or

Better Premiums, and Can Change Coverage if They Move

 District Cost of the Active Employee Health Plan Has

Been Reduced Because the Consortium Program

 Non-medical Benefits, Specifically Designed for the

Retirees, Will be Provided and Expanded Annually

 Additional Retiree Administrative Assistance Is

Provided by FBMC, Freeing Up District Service Time

 GASB Liability of the Districts Has Been Reduced

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Questions and Comments Survey