“Closing the Loop”Helping Districts Understand

and Implement Codified Best Practices in Public School

Health Plans

All districts must Comply with statute

Ohio Revised Code Section 9.901

Comply with rules Ohio Administrative Code

Sections 3306-2-01 through 3306-2-06

Closing the Loop Understanding what your district has to do

Understanding when your district has to do it

Might want a translator...

Legalese “All health care benefits provided to persons employed by

the school districts of this state shall be provided by health care

plans that contain best practices

established pursuant to this section by the school employees health care board.”

Translation Districts must offer health plans that contain the four best practice standards adopted by SEHCB.

Legalese “Twelve months after the release of

best practices by the board all policies or contracts for health

care benefits provided to public school district employees

that are issued or renewed after the expiration of any applicable collective bargaining agreement

must contain best practices established pursuant to this section by the board.”

Translation All policies or contracts for

healthcare benefits which are issued or renewed after January 1, 2010 at the expiration of a collective bargaining agreement

must contain the best practice standards.

Legalese “Each health care plan sponsor offering health care benefits to persons employed with the public

school districts of this state shall furnish to the board evidence of its

compliance with all best practices as

established by this chapter.”

Translation Districts must provide the SEHCB with evidence that health plans offered contain each of the best practice standards.

Legalese “Each public school district shall file

annually on or before the first day of July a written report, on a form prescribed by

the board, which describes the progress made to reduce the rate of increase in insurance

premiums and employee out of pocket expenses and the progress made to improve the health status of public

school district employees and their allowable dependents. The report shall also document the implementation of the

best practice standards adopted by the public school district.”

Translation Districts must file an annual

written report On or before July 1, 2010 Describing efforts taken to

Reduce rate of premium increases Reduce employee out of pocket

expenses Improve health status of employees and

dependents Implementation of best practices

SEHCB Responsibilities Also set by statute or rule

Certify compliance Review the annual status report

received from each public school district

Prepare and disseminate an annual report to the public

Work with health plan sponsors through educational outlets and consultation

SEHCB Annual Report The board shall prepare and

disseminate to the public an annual report on: the status of each health plan sponsors’

effectiveness in reducing the rate of increase in insurance premiums and employee out of pocket expenses and

the progress made to improve the health status of public school district employees and their allowable dependents.

Outstanding questions Work in progress Ambiguity

Nature and extent of review of plans and programs

Appropriateness of ‘bright line’ definitions to resolve ambiguities, establish uniformity regardless of district size or other factors

Information to be included in SEHCB annual report

Lots of other things...

The point Collaborative processShared goalsOpen, regular communication

TransparencyCommon sense can and will prevail