Presented by: David Ford, Executive Director of Florida School Retiree Benefit Consortium Employed By: Polk County School Board

Transcription

1 Presented by: David Ford, Executive Director of Florida School Retiree Benefit Consortium Employed By: Polk County School Board 1

2 Other Post-Employment Benefits Liability For benefits offered at retirement. Measures potential demands on the employer s future cash flows for such Benefits. Liability is calculated by an Actuary. 2

3 Include: Medical and Prescription Drug Dental Vision, Life insurance Other Health Benefits if not a part of a pension Generally Not Included Pension income benefits Sabbaticals Vacation Benefits Special Termination Benefits COBRA 3

4 Discontinue Employee Benefits At Retirement Session is over!!! 4

5 Any employer who provides insurance coverage under s or s must notify those employees who retire of their eligibility to CONTINUE to participate in either same group insurance plan or selfinsurance as provided in ss

6 Required all employers make available the SAME insurance coverage to all retired employees Retirees covered under Medicare may be experience-rated, coverage must be basically the same as active group. BENEFIT VALUE 6

7 10,000 Baby Boomers are turning 65 each day for the next 19 years (69,350,000) 50% of workers indicated they will be unable to pay for medical expenses during retirement 50% probability of at least one member of a married couple being alive 25+ years after age 65 7

8 2015 Medical Trending around 10% 2015 Pharmacy Trending around 13.1% Traditional 6.9% Specialty 30.9% Drugs in the pipeline Traditional 31% Specialty 69% Compounding increased 128.4% in 2014 Specialty expected to increase 40-50% in 5 years 8

9 76% report having saved less than $100,000 for retirement 40% of employees feel they will never be able to retire 34% plan to work well past retirement age because they have to 40% plan to work well past retirement age because they want to 9

10 Employees 12,243 Employees over 65 working 381= 3.5% Employees ,162 = 9.5% Employees ,696 =14.0% Total Employees over 55 3,239 = 27.0% 10

11 Tentative plans to report full liability Effective fiscal years after 6/15/17 Changes with the evaluation method 11

12 Avg. Annual Salary $41,670 Avg. Benefit 2013 $19,230 Avg. Teacher Salary of the big seven at the top 2014 estimated at $69,000 Avg. FRS pension with 30 years $33,120 Social age 62 $16,869 Avg. Total Income $49,898 12

13 Total Income Before Taxes $49,898 Less Income Taxes $ 5,350 Less Health Care Costs $ 6,500 Spendable Income $38,048 Monthly Income $ 3,170 13

14 Retirees Over Age 65 Offer The Following: Offer Medigap/Supplement Plans With Drug Coverage That Is Equal To The District Plan Value Offer Medicare Advantage Plan Same As Above Plans Must Be Equal to District Plan Value 14

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16 Part A Part B Must Pay Premium Part D Must Purchase Plan Hospital Care Preventive Services Prescription Drugs Skilled Nursing Facility Doctor Visits May Have Deductible Nursing Home Care Lab Tests / Ambulance Copays Hospice Surgeries Coverage Gap Home Health Services Durable Medical Equipment Catastrophic Coverage Level Deductible $ Per Visit Plus $ Days $ Days Plus Excess Charges Up To (15%) Ded. $ Co-insurance 20% Of Charges Purchase From Private Carriers 16

17 Medigap Plans Plans A, B, C, F, G, K, L, M, N Covers Some Or ALL Of The Out-Of-Pocket Expenses Covered By Medicare Part A and B Medicare Part D Plans Drug Coverage May Have Deductible, CoPays, Donut Or Gap, Catastrophic Level Medicare C Plans Medicare Advantage Plans Replaces Medicare Part A, B and May Include Drug Coverage 17

18 Medigap Benefits Plan A Plan F Plan N Part A Coinsurance and Hospital Costs Medicare Part B Coinsurance or Copayment Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for an emergency room visit that does not result in an inpatient admission Blood (First 3 Pints) Part A Hospice Care Coinsurance or Copayment Skilled Nursing Facility Care Coinsurance Medicare Part A Deductible Medicare Part B Deductible Medicare Part B Excess Charges (15%) Foreign Travel Emergency (To Limits) Average Rate 65 Non-Smoker $150 $210 $149 18

19 Rx Benefit Low Premium Value Premium EGWP W/GAP EGWP NO GAP Initial Coverage Period Deductible $360 $0 $0 $0 Generic $1-$7 $2-$20 $10 $7 Brand Preferred/ Non-preferred $23-30/ 30%-40% $36-$47/ 40%-50% $45/$75 $30/$60 Specialty 25% 33% 33% $75 Gap ($3,310) Generic 58% 58% $10 $2 to $7 Brand Preferred/ Non-preferred 45% 45% 45% $30/$60 Specialty 45% 45% 45% $75 Catastrophic ($4,850) Generic $2.95 or 5% $2.95 or 5% $2.95 or 5% $2.95 or 5% Brand $7.40 or 5% $7.40 or 5% $7.40 or 5% $7.40 or 5% Monthly Premium $30.00 $64.00 $ $

20 Benefit Zero Premium Plan PPO Value Plan National PPO Comprehensive Plan National PPO Medical PPO OON National PPO OON Same National PPO OON Same Annual Deductible $0 $250 $0 Annual OOP $5,900 $10,000 $6,700 $2,500 combined Hospital Admit $275/Day to 40% $230/Day to 7 Days $175 6 Days Office Visits $20/$50 $35/$60 $20/$30 $5/$15 Emergency Care $75 $65 $65 $65 Outpatient Surgery 20% 40% 20% $15 Rx Generic $10 N/A $7 $5 N/A Brand $45/$100 N/A $40/$90 $30/$60 N/A Specialty $100 N/A $90 $80 N/A Coverage Gap Applies N/A No Gap No Gap N/A Monthly Premium $0.00 $ $

21 Medigap/Supplement Plan With Drug Plan Drug Plan Low Value EGWP/Gap EGWE/no GAP Plan A $ $ $ $ Plan F $ $ $ $ Plan N $ $ $ $ Medicare Advantage Plans Plans Zero $0 Value $ Comprehensive $

22 District Retirees Revenue Expenses Cost Brevard 715 $3,080,220 $3,469,408 $389,188 Duval 665 $7,883,000 $8,533,000 $650,000 Escambia 396 $2,005,000 $2,728,000 $723,000 GASB Current New Reduction of Liability Brevard 102 Million 51 Million 51 Million Duval 135 Million 62 Million 73 Million Escambia 30.8 Million 15.4 Million 15.4 Million 22

23 Public Bid Of Benefits Offered Must Provide Drug Coverage Through The Gap Period Offered With Medigap Plan N Must have more than 50 lives to put together a EGWP drug program Size matters Offer Medicare Advantage Plan With No Gap On Drugs And Out Of Pocked Costs Similar To District Plan 23

24 Nothing, take what we have or leave Allowing outside vendors to solicit Retirees for some or all of the above Offering Options Medicare Advantage Plan Optional Medicare Supplement Plan with Drug Only Plan Seven Consortium Districts moved all retires to Advantage or Supplement Plans with Drug Plan Offering and Voluntary Benefits 24

25 Brevard Charlotte Duval Escambia Orange Polk Miami-Dade 25

26 Options, Not Here It Is Take It Or Leave It 26

27 Medigap Coverage Plans (A,F,N) Prescription Drug Coverage Options Medicare Advantage Plans ($0, $150, $320) Dental Insurance Plans PPO, DHMO Vision Insurance Plan Identity Theft Protection Plan IT Tech Support Program Life Insurance Pet Insurance 27

28 Reduce District OPEB Provide Retirees Access To Medical Coverage Lower Retiree Premiums Plan Options Meeting Specific Retire Needs Improve Retiree Satisfaction Of Benefits Reducing Medical Costs On District Active Plan 28

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