Joint Health Care Committee
October 16 & 17, 2012 Draft Notes
Audio/Video Conference
The agenda and attachments for the meeting are available at
The Committee met face to face in Anchorage on October 16th. Fourteen members were presentincludingTod Chambers, Abel Bult-Ito, Leah Berman, Nalinaksha Bhattacharyya, Jane Weber, Carolyn Smith, Tim Powers, Jenifer Madsen, Kevin Purcell, Melodee Monson, Connie Dennis, Gwenna Richardson, Donald Smith, Mischelle Pennoyer. Also present were Erika Van Flein, Cyndee West, David Hinkley, Brian Short, Timothy Armbruster and Michelle Pope. Absent were James Danielson, Sandy Culver, Jay Sowell,Jim Styers, Dominic Lozano and Alternates Nancy Bish and Stephan Golux.
The Agenda for the meeting wasapproved as amended. The meeting notes from the September 20th meeting were approved.
FY12 Plan Actuals Report
Timothy Armbruster and Michelle Pope presented the actual numbers. The FY12 rates were set for employee recovery of $11,985,106.32. The Actual recovery was $10,458,934.06. The recovery rates were affected by a larger number of migrations to the HDHP plan, opt outs and not implementing the tobacco surcharge.
High dollar claims decreased by 4.7M from FY11. The number of claims decreased from 220,248 in FY11 to 187,812 in FY12. The average cost per claim (excluding high dollar claims) increased from $203 to $206.89. There was $2.96M in under recovery in FY12. $2.89M was built into FY13 employee rates.
The decrease in the claims costs in FY12 is a reset due to the restructuring of the plan. A normal increase in claims cost is expected in future years because of medical inflation.
RFP update
The vision RFP closed on the 16th. It is expected to be to the committee by the end of the week. There were five for healthcare and 8 for pharmacy that are being reviewed. The HSA and health reimbursement account RFPs are being finished up and will be going out soon. Wellness will be going out later. The pharmacy, healthcare and vision contracts will be awarded by December. Tim Powers is the JHCC representative to evaluate the proposals.
WIN Utilization
There were 48 mass screening events between July 1, 2011 and June 30, 2012 on all campuses with 2,715 screening tests performed. There were 70 wellness breaks during the same period with 900 screening tests performed. The WIN-WIN program had 67 participants who lost a total of 441 pounds and 105 inches. Get the point prizes claimed decreased 9% from 2010 to 2011. IHP sessions had 88% completion rate for phase 5. 700 participants set short-term goals and 86% completed them. IHPs had 13,791 screening tests performed. Rural IHPs were done telephonically between February 2012 through June 2012. There were 20 rural participants.
Health care reform impact
There are upcoming regulations that will have an impact on the UA health plan including items such as limited FSAs, additional Medicare tax, health insurance taxes, and Cadillac taxes on plans. There are several models to be considered as regulations come into place.
Health Care Task force report
The Health Care Task Force report was presented by Donald Smith.
The committee adjourned for the day after this presentation.
On October 17, 2012, the committee reconvened with 12 members presentincluding Tod Chambers, Abel Bult-Ito, Leah Berman, Jane Weber, Carolyn Smith, Tim Powers, Kevin Purcell, Melodee Monson, Connie Dennis, Gwenna Richardson, Donald Smith, Mischelle Pennoyer. Also present were Erika Van Flein, Cyndee West, David Hinkley, Brian Short, Timothy Armbruster and Michelle Pope. Absent were Nalinaksha Bhattacharyya, James Danielson, Jennifer Madson, Sandy Culver, Jay Sowell, Jim Styers, Dominic Lozano and Alternates Nancy Bish and Stephan Golux.
Plan Design changes were presented and discussed as follows:
Discussion regarding enhancing the wellness plan was held. This referenced King County in Washington, and the benefits they found from implementing a similar program. Cyndee will check to see if she can share that information with the Committee.
The Committee discussed a 3-year plan with biometric data to be managed by a third party vendor (wellness vendor). The plan would include taking biometrics and completing a health risk assessment (HRA) in the first year, awarding points for activities such as completing the HRA, getting physicals and flu shots, etc the second year and moving toward wellness outcomes during the third year. Participants would receive preferred pricing with this plan.
The Committee moved to have a wellness program strategy as presented in the general presentation having biometrics and HRAcomplete for preferred pricing in year one, a certain set of wellness behaviors in the second year and a third year being outcomes based be implemented so an RFP can go out. Details on the program will be discussed at a later meeting.
The motion passed.
The Committee discussed the 500 plan. The plan has fewer than 4% of the employee population enrolled. Some members felt that the users looked at this plan as a safety net. There was also discussion that the 500 plan is the only one with orthodontia as a benefit. After discussion a motion was made to eliminate the 500 plan and move the orthodontia benefit to the 750 plan.
The motion passed.
Discussion on Health Savings Accounts (HSAs) and qualifications for them was held. Some employees are not eligible for HSAs. Flexible spending accounts (FSAs) would still be available for those employees. There would have to be a plan with the pharmacy benefitembedded in it to qualify for an HSA. The committee moved to develop a HSA plan with identical deductibles as the 1250 HDHP and with whatever necessary changes would need to be made (including pharmacy).
The motion passed.
A spousal surcharge was discussed. The surcharge would only apply to spouses who are eligible for other coverage, but elected to be on the University plan as their primary carrier. Where both spouses are employed by the University, an exemption would be made. A motion to have a spousal surcharge, not to exceed $1200 per health plan year, was made.
The motion passed.
There was quite a bit of discussion regarding eliminating the opt-out option. Data regarding the 110 additional opt outs this year was presented. The 110 opt outs equaled $469,286 in lost employee contributions. The health plan claims costof these employees in FY12 was $1,197,896, but only 18% of that cost was born by the employees, or $215,621. Data on the same group for FY11 showed $2,154,124 in claims costs with a cost to employees of $372,742 (18%). There was also discussion of how the State of Alaska does not allow employees to opt out, and many other plans do not allow an opt-out option either. A motion was made to eliminate the opt-out option beginning in FY14. The sole exception would be for an employee and spouse who are both employees of the University.
The motion passed.
A discussion regarding charges for part-time employees was held. Questions regarding BOR policy and what defines part time was held. The discussion was tabled for the Januarymeeting in order to get more information.
The next item of discussion was plan tiers. As we have only one tier for families regardless of how many children, the committee moved to increase the plan tiers to EE, ES, ES+1C, ES+2C, ES+3C, E+1C, E+2C, E+3C. The rates would be capped at 3 children with employees with more than 3 paying the 3 children rate.
The motion passed.
Telemedicine was introduced to the committee. Telemedicine would offer24x7x365 access to a doctor. Members would pay a small consultation fee ($38-$40) per consult. A variety of input could be used, i.e., online video or phone. Doctors would be licensed to prescribe in Alaska, or whatever state the member was calling from. A variety of conditions could be diagnosed such as sinus problems, allergies, pinky eye, ear infections, etc. This is looked at as a way to cut down on emergency room visits and minor care episodes. The committee moved to send an RFP for implementation of a telemedicine option.
The motion passed.
Domestic and Foreign medical tourism was discussed. Premera is rolling out a domestic program in January. This can be added to the plan at any time. The committee felt this needed more discussion and so the topic was tabled for a later time.
Discussion on an on-site medical clinic was held. Typically a single location needs 1,000 employees to be feasible. There are two models to look at, UA setting up the clinic and hiring all employees, carrying insurance, etc. The second model is a turnkey option. There are still quite a few questions regarding an on-site clinic. There is still a lot to be learned about this option. This issue can be discussed at later meetings.
A patient advocacy/transparency option was discussed. Patient transparency would provide comparison costs for procedures and through advocacy explain the plan benefits. Advocacy would also assist with claimsissues. The Staff Health Care Committee and Staff Alliance have passed motions supporting this option. A motion was put forth to issue an RFP for a patient transparency/advocacy option for the plan.
The motion passed.
The Get the Point program for FY13 was discussed. It was moved to continue the WIN Get the Point program at the same prize level as FY12.
The motion passed.
The meeting adjourned on October 17th at approximately 4:00pm.
The next meeting will be on November 29, 2012 by audio/video conference.
Additional meetings scheduled
December 13 & 14 – Anchorage – Premera Blue Cross/Blue Shield Knowledge Management