fsrbc a winning combination for retiree benefits
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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 IBC Retiree Program Initiative Overview 1. How the Program Works 2.


  1. 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

  2. IBC Retiree Program Initiative Overview 1. How the Program Works 2. Retiree Program Benefits and Features 3. Consortium Administration 4. Non-Medical Benefits 5. Participating District Experience 6. Questions 7. 2

  3.  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 of Organizations  IBC Created Statewide Florida Retired School Employee Benefits Program Consortium (Consortium) for Retirees Eligible for Medicare 3

  4.  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 4

  5. Nam Name Office Dis Distric rict Appo ppoin intment Lee Swift Chairperson Charlotte FSBA Marianne Capoziello Member Polk FEA Kathryn LeRoy Treasurer Polk FADSS (Mike Perrone) 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 5

  6. 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 oes n not e ot 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. 6

  7.  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 7

  8. Dis Distric rict Medicar care Medicar care Medicar care Advanta ntage Supple pplement Phar armac acy Brevard Public Schools 570 404 255 Duval County Public 45 54 1,232 Schools Escambia County School 343 81 43 District Miami-Dade Public 1,469 490 246 Schools Orange County Public Upcoming Schools (Oct. 2015) Polk County Public Schools 0 80 56 Total 2,427 1,109 1,832 8

  9. Pla lan N N Medig digap B p Benefit its Plan lan A Plan lan F Part art A A Coi oins nsurance and d Hos ospi pital C Cos osts √ √ √ Medicar are Part art B Coin insuran ance or r Plan N pays 100% of the Part B coinsurance, except for a Copaym ayment copayment of up to $20 $20 for √ √ som ome of office visits an and up to a $50 $50 co copayment for em emer ergency room vis ro 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) √ √ 9

  10. Unite ted H Healthc thcare 2 2015 Pla lan N N Pla lan A A Pla lan F F Issu ssue Ag e Age 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 Cigna na 201 2015 Pla lan N N Pla lan A A Pla lan F F Issu ssue Ag e Age 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 10

  11. Pre remie ier Rx Rx B Ben enef efit Compreh ehen ensive 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 on-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 on-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 11

  12. Be Bene nefit Zero Premium Comprehensive Option 3 Medi dical PPO OON National PPO OON Same Annual nual Deduc ductibl ble $0 $0 $4,500 $2,500 Annual nual OOP Hospita tal A l Admit it $200/Day to 30% $175 $175 8 Days $15/$40 $35/$50 $5/$15 $5/$15 Office e Visit its Emerg rgency C Care re $65 $65 $65 $65 Outp tpati tient t Surg rgery ry 20% 30% $15 $15 Rx Rx $10 N/A $5 N/A Gener eric Brand and $40/$90 N/A $30/$60 N/A Specia ialt lty $90 N/A $80 N/A Applies No Gap Coverage 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 12

  13. Curre rent New ew Differ eren ence Monthly Retiree Premiums $53 per Plan N and Comp Rx Compared to Active Plan $359.00 Retiree per Age 67 $305.89 Month Administrative Savings of $284,444 Cigna ASO Fees and TASC 589 Retirees Annual Administration Savings Active Health Plan Savings 715 Retirees $104,744 With Medicare Retirees on and Annual Consortium Plans Dependents Savings Savings to GASB Liability $102 Million $51 Million - 50% Over Next 20 Years 13

  14. Curre rent New ew Differ eren ence Monthly Retiree Premiums $121.44 per Plan N and Comp Rx Compared to Active Plan $422 Retiree per Age 67 $300.56 Month Savings due to removal of $25 month $122,000 $0 monthly subsidy /retiree Annual Savings Administrative Savings of $275,000 ASO Fees, Stop Loss and 396 retirees Annual Savings Administration Active Health Plan Savings 396 retirees $326,000 With Medicare Retirees on and their Annual Savings Consortium Plans Dependents Savings to GASB Liability $30.8 Million $15.4 Million -50% Over Next 30 Years 14

  15. Polk County Schools Health Plan = $50 $505 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 15

  16.  Project Management for New Client Implementation  Communications  Annual Enrollment Planning and Coordination o Eligibility, Including New Retirees and Aging-In o Benefit Fair Scheduling o Customer Call Center o Enrollment in Non-Medical Benefits o (Carriers Enroll Medical)  Premium Billing, Collection (FRS, ACH and Direct Bill) and Direct Payment to Carriers o Premium Payments to Districts for Dependents Under 65 16

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