Formulary List of covered prescriptions Medical Trend
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1 December 13,
2 Acronyms CAT Plan Catastrophic Plan EAP Employee Assistance Program HMO Health Maintenance Organization HRA Health Reimbursement Account OPEB Other Post Employee Benefits Liability POS Point of Service (Triple Option) PPO Preferred Provider Organization RFP Request for Proposal WAT Wll Wellness Action Team 2
3 Definitions Formulary List of covered prescriptions Medical Trend The projected cost of medical inflation Retention The projected cost to administer i the plan including network access, claims processing and administration Target Loss Ratio The projected amount of total claims divided by total premiums 3
4 May 11, 2010 Entered into a two year contract with Blue Cross Blue Shield and Florida Health Care with conditions (BCBS purchased FHC 1/1/2009) Brought on a new Florida Health Care Catastrophic plan Made plan design changes to all four existing plans (PPO, HRA, Triple Option, HMO) Florida Health Care expanded their formulary This two year contract ends this plan year (9/30/2012) 4
5 Insurance Committee & Meetings Volusia County School Board Insurance Committee (union representation and voting members as required by contracts) Rita Ware (AFSCME) Laura Cloer (VESA eff. 3/1) Diane Vaissiere (VESA eff. 6/1) Dr. Maryann Bull (Non barg) Russ Tysinger (Non barg) Joe Zaffuto (AFSCME) John Darby (VTO) Jacqueline Sadler (VTO) Denise Dietrich (Non barg) Insurance Committee meetings for (monthly during school year) September 15, 2011 October 13, 2011 November 10, 2011 Next meeting is scheduled for December 15,
6 Review of Rates and Renewals VCSB Renewals National Trend (blended) (blended) % 14.83% % 14.24% %* 12.97% % 11.18% % 10.94% % 8.54% 10.50% %** 8.00% % 10.50% Prior RFP was done in March, 2002 *RFP was done in November, 2005 (remained with BCBS/FHC) **Vote against RFP in November, 2009 and March,
7 Enrollment Health Enrollment Totals As of 10/1/2007 8,286* As of 10/1/2008 7,867* As of 10/1/ * 7,512* As of 10/1/2010 7,585* As of 10/1/2011 7,402* Health lhenrollment by Plan 10/1/07 10/1/08 10/1/09 10/1/10 10/1/11 Preferred Provider Organization (PPO) 2,809 1,484 1,436 1,525 1,434 Health Reimbursement Account (HRA) 126 1, Ti Triple Option (Point of Service) 2,869 2,946 3,117 3,550 3,723 Health Maintenance Organization (HMO) 2,482 2,206 2,016 1,848 1,737 Catastrophic Plan (*Numbers do not include dependents or retirees) (These numbers include both hhusband & wife that are enrolled under split family approx. 250 couples) 7
8 Benchmarking VCSB Total Premium vs. Surrounding Districts Total Premium Cost Per Employee Per Month $800 $684 $734 $722 $700 $635 $600 $514 $474 $500 $400 $355 $300 $200 $100 $0 Volusia Brevard Flagler Lake Marion Putnam Seminole 8
9 Benchmarking VCSB Employer Cost Surrounding Districts Net Employer Cost Per Employee Per Month $700 $591 $600 $500 $472 $474 $500 $394 $367 $400 $292 $300 $200 $100 $0 Volusia Brevard Flagler Lake Marion Putnam Seminole 9
10 Performance Review Medical Plan Experience by Plan Current Plan Name 10/2010-9/2011 Loss Ratio Prior 10/2009-9/20109/2010 Loss Ratio Triple Option 74.5% 80.2 % HMO 83.1% 88.1% Catastrophic Plan 36.8% N/A PPO 79.6% 89.6% HRA 80.1% 100.4% Total 78.2% 87.0% 10
11 Preliminary Renewal Projection Prepared by Aon Hewitt (VCSB Consultant) Based on claims experience through September Plan design changes made for the plan year proved to be effective with improved claims experience compared to prior years. About 3% of the overall enrollment moved from Blue Cross Blue Shield to Florida Health Care Plans during annual enrollment,
12 Preliminary Renewal Projection Prepared by Aon Hewitt (for , subject to update) Blue Cross Blue Shield of Florida Florida Health Care Plans Trend 13.6% Trend 10.5% Retention 10.5% Retention 13% Target Loss Ratio % 5% Target Loss Ratio 87% Projected Increase Projected Increase 0% 6.3% 12
13 Financial Impact The exhibit below illustrates an estimated financial impact to VCSB and employees for the Medical Renewal. This analysis compares the premiums for the BCBS and FHC plans using Aon Hewitt s preliminary renewal projection for the plan year. The exhibit is based on active enrollment as of November 1, 2011, and excludes retirees and HRA contributions. Total Annual District Paid Employee Premium Portion (Net) Portion Plan Year $63,086,244 $51,915,949 11,170, Plan Year (Estimated) $65,907,694 6 $54,273,541 $11,634,153 $ Increase over Current $2,821,451 $2,357,592 $463,859 % Increase over Current 4.5% 4.2% 4.5% Updates to the Medical Plan Renewal Projection will be provided to the Insurance Committee as additional claims experience becomes available. Aon Hewitt will present the final negotiated renewal from Blue Cross Blue Shield and Florida Health Care to the Insurance Committee in February,
14 Potential Topics of Consideration Florida Legislative changes to health insurance programs Change to Health Insurance Subsidy (HIS)? Statewide District Insurance Consortium (Gaetz) Statewide Insurance (Stargel similar to Gaetz) Integrate future plan design changes based on data from Wellness Program Health Care Reform Other Post Employee Benefits (OPEB) Liability 14
15 Wellness Program Updates Health Risk Assessment Attendance 2009 = 2, = 3, = 2,931 Overall Wellness Score 2007 = = = = =72 Improvements usually take between 3 5 years (A score of <80 indicates the likelihood that individuals will develop certain medical conditions) 15
16 Wellness Program Updates Tobacco use is down from 13% to 9% There were 52,938 gym visits in Diabetes risk is down 2% from prior year Cholesterol risk is down 4% from prior year Hypertension is up 3% from prior year Stress is down by 3% from prior year 4,115 pounds were lost through Weight Watchers during additional 779 lbs were lost during in at work meetings 295 employees participated in the local meeting voucher program 16
17 Wellness Program Updates TOP RISK AREAS: Diabetes Nutrition Weight Exercises 17
18 Wellness Program Updates Wellness Program enhancements Walking Works program (on line) Competitions between schools Utilizing EAP program under Wellness Additional Weight Watchers option online Weight Watchers eportal which includes no wait and no summer lapse Expansion of gym list to include Volusia YMCA s Workforce Wellness educational & clinical component 18
19 NEW Workforce Wellness Off Site Clinic Enhancement On Site Clinic Simulation Talks began in February, 2011, with Florida Health Care about possible On Site Clinic Simulation since VCSB could not afford to open a clinic i due to costs (staffing, tffi rent, equipment, etc) Simulation talks turned into a Workforce Wellness Program 19
20 NEW Workforce Wellness Off Site Clinic Enhancement The purpose of the Workforce Wellness Program Providing convenience and priority access (not exclusive) for ALL employees (BCBS &FHC) through extended hours (evenings and weekends included) To place intense focus on improving health outcomes for ALL VCSB employees (BCBS members have the same access the program as FHC members) Emphasis on wellness, preventative and primary care services Managing cost and quality of care 20
21 NEW Workforce Wellness Off Site Clinic Enhancement Wellness Contract signed October 19, 2011 Wellness Action Team (WAT) established Rita Ware (AFSCME) Joe Zaffuto (AFSCME) Laura Cloer (VESA eff. 3/1) Diane Vaissiere (VESA eff. 6/1) John Darby (VTO) Jacqueline Sadler (VTO) Denise Dietrich (Non barg) Dr. Maryann Bull (Non barg) Russ Tysinger (Non barg) Wellness Action Team meets quarterly during school year 21
22 NEW Workforce Wellness Off Site Clinic Enhancement Implementation Team Created Dr. Joseph Zuckerman FHC Chief Medical Officer Tony Harroun FHC Marketing Bissy Holden FHC Marketing Brittnee Taylor FHC Wellness Coordinator Irene Talarico FHC Administration Ann Gebhard AON Hewitt Debbie Poole AON Hewitt Jeff Clair AON Hewitt Sandy Higginbotham Director, Volusia County Schools 22
23 NEW Workforce Wellness Off Site Clinic Enhancement Pilot Site Edgewater location as of November 1, 2011 Other Sites Other sites (East & West side of Volusia County) will be brought on early (February?) in 2012 Orange City Port Orange Urgent Care 23
24 NEW Workforce Wellness Off Site Clinic Enhancement Services provided Acute & Urgent Care Adult and child wellness exams Initial and follow up primary care provider visits Office based lab testing Preventative immunizations Injections of medications that do not require pre authorization Annual wellness exams are covered at 100% under both plans (FHC & BCBS) 24
25 Conclusion of the Health Insurance Update Presentation Questions? 25
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