20161108 HR Benefits Council Presentation 2017(1)Town of Prosper
2017 Employee Benefits
Presentation
Presented By:
Baby Raley, Human Resources Director
Lance Pendley, Senior Vice President, MSW, Inc.
Cristina Palacios, Senior Account Manager, MSW, Inc.
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2017 Renewal
Health Plan –Blue Cross Blue Shield (current carrier)
Renewal: +34.45% Increase or $412,373.28
Medical claims combined loss ratio: 86.5%
PPO claims loss ratio: 143.4%
HDHP claims loss ratio: 54.1%
Rate Guarantee until 12/31/2017
Dental Plan –Delta Dental (current carrier)
No changes
Rate Guarantee until 12/31/2017
Vision Plan –EyeMed (current carrier)
No changes
Rate Guarantee until 12/31/2017
Ancillary Benefit Plan –Mutual of Omaha (current carrier)
No changes (Life, AD&D, and LTD) through 12/31/2017
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Town of Prosper
Request for Proposal (RFP) Response
Medical Carrier Medical
(Fully-insured)
Medical
(Self-insured)
Aetna X Declined to quote
BCBS Renewal 34.45%X
UHC X Declined to quote
NOT CONSIDERED:
Bridge Health Not considered –Center of Excellence
Continental Benefits Late bid –not considered
NO RESPONSE:
Benefit Mall, Boon Chapman, Cigna, Gilsbar, Surgery Center of Oklahoma
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2017 Renewal Strategy
Health Plan:
Recommend moving from fully-insured to self-insured funding option
Recommend Blue Cross Blue Shield as the medical plan
administrator; estimated annual cost $1,303,738.84 (8.92% from current)
Recommend no change for HDHP and HSA contribution levels
Recommend decreasing the PPO deductible from $5,000 to $1,500 per individual
Recommend Symetra as the stop loss carrier; estimated annual cost
$269,084.64
Recommend eliminating the MERP and applying funds to benefit
enhancements
Recommend 24/7 Call-A-Doc for basic medical services; estimated annual cost
$4,968/year
Estimated annual cost for self-insured medical: $1,303,738.84
(8.92% from current)
Recommend continuation of the Wellness incentive amount of
$50/mo. for employees who meet wellness program requirements
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MERP Financial Performance
Claims Budget
Recommended
Δ Budget Projection
2008-2009 $42,363 $40,770 N/A
2009-2010 $36,502 $46,980 Increase
2010-2011 $48,826 $48,950 Decrease
2011-2012 $46,533 $44,050 Increase
2012-2013 $52,416 $57,201 Decrease
2013-2014 $45,722 $34,000 Increase
2014-2015 $4,069 $30,000 Decrease
2015-2016 $17,010 $25,000 Decrease
Note: Reported claims on plan year. Budget is on fiscal year.
Medical Plan Design Comparison
Proposed 2017 Plan Design
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Current 2016 Plan Design
2017 Renewal Strategy (continued…)
24/7 Call-A-Doc:
Recommend benefit at no-cost to employees
Estimated annual cost: $4,968/yr.
Utilization cap over 18% -$0.25 pmpm for every additional percent
24/7 Call-A-Doc services:
Member online portal 24/7
Member basic triage by a nurse over the phone and to schedule
appointment within 3 hours of call
Member’s medical information sent to a licensed Company Doctor in the
member’s state for follow-up and diagnosis
Company Doctor can write a prescription solely at his/her discretion
where allowed by law with sufficient medical information is available,
excluding narcotics or DEA controlled substances
Monthly reporting
Portable electronic health record
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Health Plan Financials
Note: *Assumes enrollment at 121; assumptions exclude projected new hires.
Town Financials Current Negotiated Renewal
Medical Premium*$1,196,921.04 $1,303,738.84
HSA Funding*$87,750 $87,750
HRA Funding*$25,000 $0.00
Compass*$7,260 $7,260
Total Cost $1,316,931.04 $1,398,748.84
% Change 6%
$ Change $81,817.80
Medical ONLY Employee Cost $342,908 $342,908
% Change 0%
$ Change $0.00
Medical ONLY Town Cost $854,013 $973,705
% Change 14%
$ Change $119,692
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Employee Contribution Options
BCBS Current Rates (2016)
BCBS Renewal Rates (2017)
HDHP Plan PPO Plan
Employee Only $39.16 $83.48
Employee + Spouse $288.73 $448.04
Employee + Children $192.74 $309.96
Employee + Family $442.29 $668.91
HDHP Plan
$ Δ from
Current PPO Plan
$ Δ from
Current
Employee Only $39.16 $0.00 $83.48 $0.00
Employee + Spouse $288.73 $0.00 $448.04 $0.00
Employee + Children $192.74 $0.00 $309.96 $0.00
Employee + Family $442.29 $0.00 $668.91 $0.00
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2017 Final Benefits Recommendation
Fully-insured to self-insured funding
Blue Cross Blue Shield plan administrator
Stop Loss Carrier –Symetra
Decrease medical PPO in-network deductible from $5,000 to $1,500
Eliminate MERP and apply toward benefit enhancements
Add Call-A-Doc telemedicine services
Keep the medical premiums the same for employees and the Town
absorb the 10.37% premium increase.
Research and review the Oklahoma Surgery Center and wellness
program vendors to determine cost-effectiveness and follow-up with the
Employee Benefits Committee and Council Benefits Subcommittee prior
to the 2nd quarter of 2017.
QUESTIONS?
Baby Raley, Human Resources Director
Lance Pendley, Senior Vice President, MSW., Inc.
Cristina Palacios, Senior Account Manager, MSW, Inc.
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APPENDICES
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