The Public Employees Benefits Program

Transcription

1 The Public Employees Benefits Program Quarterly Update 4 th Quarter Plan Year 2017 Presented By: Willis Towers Watson s OneExchange Date: September 28, 2017

2 The Public Employees Benefits Program 2 Executive Summary Plan Enrollment: At the end of Q4 2017, PEBP s total enrollment into Medicare policies through Willis Towers Watson s OneExchange increased to 13,125. Since inception, 90 carriers have been selected by PEBP s retirees with current enrollment in 957 different plans offered through OneExchange. Medicare Supplement (MS) plan selection remains at 74% of the total population with the majority of participants selecting AARP and Anthem BCBS of Nevada as their insurer; each carrier holds plans for 5,997 and 2,078 enrollees respectively. The average monthly premium cost for MS plans increased slightly to $149. The percentage of Medicare Advantage (MA or MAPD) plans selected remains constant at 26%. Top MA carriers include Health Plan of Nevada with 1,174 individual plan selections and Hometown Health Plan with 1,130 individual plan selections. The average monthly premium cost to PEBP participants increased slightly to $23. Customer Satisfaction: For customer satisfaction there are 3 areas that are measured: Enrollment Calls, Service Calls, and HRA. For Q4 2017, PEBP participant satisfaction with Enrollment Calls decreased slightly to an average satisfaction score result of 4.7 out of 5.0 based on 87 surveys returned. The participant satisfaction score results for Service Calls increased for Q4 when compared to the prior quarter. For Q3 2017, the average satisfaction score results were 4.3 out of 5.0. For Q4 2017, the score was 4.4 with 417 survey responses. The combined average satisfaction score for Enrollment Calls and Service Calls was 4.5 for out of 5.0 for Q4. For the HRA, PEBP participant satisfaction was 4.3 out of 5.0. This was a significant increase when compared to Q3 where the result was 4.0 out of 5.0. There were 316 survey responses in Q4 compared to 451 surveys for Q3. Health Reimbursement Arrangement: There were 11,660 Health Reimbursement Arrangement (HRA) accounts established by PEBP participants at the end of Q3. There were 76,393 claims submitted against the HRA for reimbursement in Q4, with 81.6% being submitted via Auto-Reimbursement, meaning that participants did not have to manually submit 62,345 claims for Premium Reimbursement. The total reimbursement amount processed for Q4 was $3,719,660.

3 The Public Employees Benefits Program 3 CONTENTS Executive Summary 2 Summary of Retiree Decisions and Costs 4 Summary of Retiree Carrier Choice 5 State of Nevada Post-65 Market Summary 6 Customer Service Voice of the Customer (VoC) 7 Customer Service Issues Log Resolution 8 Performance Guarantees 11

4 The Public Employees Benefits Program 4 Summary of Retiree Decisions and Costs RETIREE PLAN SELECTION THROUGH 6/30/2017 PREVIOUS QTR Total Enrolled Through OneExchange 13,125 13,122 Number Of Carriers** Number Of Plans** PLAN TYPE SELECTION THROUGH 6/30/2017 PREVIOUS QTR Medicare Advantage (MA, MAPD) 3,437 (26%) 3,725 (26%) Medicare Supplement (MS) 9,677 (74%) 9,433 (74%) Medicare Advantage Medicare Supplement 74% 26% The percentage of Medicare Advantage plans selected by PEBP s retiree population is slightly above the average for OneExchange s Book of Business. OneExhcange believes this is a result of the high-quality offering of Medicare Advantage plans to State of Nevada retirees through OneExchange. PLAN TYPE NUMBER ENROLLED AVERAGE PREMIUM Medicare Supplement 9,677 $149 Medicare Advantage 3,427 $23 Part D Drug Coverage 8,351 $27 Dental Coverage 1,240 $34 Vision Coverage 1,595 $14 ** Reflects total carriers and plans that PEBP retirees have enrolled in nationwide, since inception.

5 The Public Employees Benefits Program 5 Summary of Retiree Carrier Choice TOP MEDICARE SUPPLEMENT PLANS TOTAL AARP 5,997 Anthem BCBS of NV 2,078 United of Omaha 513 Humana 309 Cigna Total Choice 234 COST DATA FOR MS PLANS COST Minimum $22 Average $148 Median $143 Maximum $339 5% 22% Medicare Supplement Plan Choice 3% 2% 6% 62% AARP Anthem BCBS of NV United of Omaha Humana Cigna Total Choice All Others TOP MEDICARE ADVANTAGE PLANS TOTAL Health Plan of NV 1,174 Hometown Health Plan 1,130 Humana 428 Aetna 184 United Healthcare 129 5% 4% Medicare Advantage Carrier Decisions 10% 37% Health Plan of NV Hometown of Health Plan Humana COST DATA FOR MA PLANS COST Minimum $0 Average $22 Median $0 Maximum $208 13% 33% Aetna United Healthcare All Others TOP MEDICARE PART D (RX) TOTAL Humana 3,701 AARP Part D from United Healthcare 2,529 SilverScript 728 Coventry Health 487 Aetna 336 COST DATA FOR PART D COST Minimum $12 Average $27 Median $23 Maximum $157 4% 6% 9% 30% 7% Medicare Part D (RX) 44% Humana AARP Part D from UH SilverScript Coventry Health Aetna

6 The Public Employees Benefits Program 6 State of Nevada Post-65 Market Summary STATE OF NEVADA MEDICARE ADVANTAGE PLANS PLAN TOTAL Plan Options 9 Reno: Sparks and Carriers 4 Washoe County Price Range $0 - $168 Carson City Las Vegas: Clark County Plan Options 4 Carriers 1 Price Range $0 - $203 Plan Options 10 Carriers 5 Price Range $0 - $126 STATE OF NEVADA MEDICARE SUPPLEMENT PLANS PLAN TOTAL Plan Options 20 Reno: Sparks and Carriers 4 Washoe County Price Range $77 - $310 Carson City Las Vegas: Clark County Plan Options 20 Carriers 4 Price Range $77 - $310 Plan Options 20 Carriers 4 Price Range $90 - $348 STATE OF NEVADA MEDICARE PART D (RX) PLAN TOTAL Plan Options 19 Reno: Sparks and Carriers 9 Washoe County Price Range $16-$157 Carson City Las Vegas: Clark County Plan Options 19 Carriers 9 Price Range $17 - $157 Plan Options 19 Carriers 9 Price Range $17 - $157 NOTE: Plan availability reflect 2017 options as of 4/1/2017 for a 65 year old male.

7 The Public Employees Benefits Program 7 Customer Service Voice of the Customer (VoC) TWOE conducts phone and surveys of all participant transactions. Each survey contains approximately questions. Responses are scanned by IBM Mindshare Analytics which expose trends within one hour, alerting OneExchange of issues and allowing for real-time feedback and adjustments. Q4 ENROLLMENT SATISFACTION CSAT SCORE COUNT % % % 3 5 6% 2 2 2% 1 0 0% % Q1 Q2 Q3 Q4 Q4 SERVICE SATISFACTION CSAT SCORE COUNT % % % % % % % Q1 Q2 Q3 Q4 Q4 ENROLLMENT & SERVICE COMBINED CSAT SCORE COUNT % % % % % % % Q1 Q2 Q3 Q4

8 The Public Employees Benefits Program 8 Q4 HRA SATISFACTION CSAT SCORE COUNT % % % % % % % Q1 Q2 Q3 Q4

9 The Public Employees Benefits Program 9 Customer Service Issues Log Resolution Each quarter a certain number of participant inquiries are received by both PEBP and OneExchange that require escalation to OneExchange s Issues Log. Items on the Issues Log are carefully evaluated and continuously monitored by seasoned TWOE staff until resolution is reached. The total number of inquiries reviewed during Q4-PY17 is 71 and are associated with the following categories: Reimbursement / Claims 20 General Questions 4 Enrollment Status 15 Enrollment Request 16 Eligibility Data 15 Carrier Issue 1 Update Participant Info 0% Automatic Reimbursement 0% Call Review 0% Carrier Issue 1% Reimbursement / Claims 28% Eligibility Data 21% HRA 0% General Questions 6% Enrollment Request 23% Enrollment Status 21%

10 The Public Employees Benefits Program 10 Health Reimbursement Arrangement (HRA) CLAIM ACTIVITY FOR THE QTR TOTAL HRA Accounts 11,660 Number of Claims Paid 42,930 Accounts with no Balance 5,371 Claims Paid Amount $3,719, CLAIMS BY SOURCE TOTAL A/R File 62,345 Mail 11,570 Web 2,478 CALL CATEGORY TOTAL General / Instructional 859 Other 204 Denial Reason Explanation 150 Form Requests 124 Date EFT/ Mail issued 37

11 The Public Employees Benefits Program 11 Performance Guarantees CATEGORY COMMITMENT OUTCOME PG MET Claims Turnaround Time 2 days 0.46 Days Yes Claim Financial Accuracy 98% 98.88% Yes Claim Processing Financial Accuracy 98% 98.72% Yes HRA Call Center Abandon Rate 5% 2.12% Yes HRA Customer Service - Avg Speed To Answer 30 sec 20.1 Seconds Yes Reports 10 Business days As Scheduled Yes HRA Web Services 99% Uptime > 99% Yes Benefits Admin Customer Service Avg Speed to Answer Q4 5 Q4 13 Seconds Yes