Escambia County School DistrictSchool Board Presentation

Group Medicare Medical and Pharmacy Plans

August 14, 2014

Presented by:John D. Robinson, CEBS

RobinsonBush

1. IBC Retiree Program Initiative Overview2. Organizational Structure3. How the Program Works4. Retiree Program Benefits and Features 5. Medicare and Non-Medicare Plan RFP

Results6. RFP Recommendations for Award7. Timeline and Next Steps8. Questions

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Formed in 2001 to Assist School Districts with Benefit and Retirement Related Initiatives

Member Organizations and Board Members◦ Florida School Boards Association (Wayne Blanton,

Chairperson)

◦ Florida Association of District School Superintendents

(Bill Montford and Don Griesheimer)

◦ Florida Association of School Administrators (Juhan Mixon)

◦ Florida Education Association (Clara Cook)

Decisions on Initiatives Reached Through Consensus of Organizations

Transparency of Operations

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Established Under Fl. Statute 163.01 as The Florida Retired School Employee Benefit Program (Retiree Program)

Consortium Responsibilities ◦ Outlined in their Bylaws

◦ Consortium Procures Health Plan Benefits Through a Host District, Polk Schools

◦ Select, Implement and Manage the Retiree Program

◦ Execute Contracts with Third Parties as Needed to Provide Benefits and Administer the Retiree Program, FBMC

◦ Execute Participation and Interlocal Agreements With School Districts

Governed by Nine (9) Member Board of Directors

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Name Office District Appointment

Lee Swift Chairperson Charlotte FSBA

Marianne Capoziello Member Polk FEA

Kathryn LeRoy (or Her Alternate)

Member Polk FADSS

Vanessa Tillman Member St. Lucie FEA

Debra Pace Member Brevard FASA

Daneen Regna Member Retiree IBC Consensus

David Ford Member Duval IBC Consensus

Kevin Windham Member Escambia IBC Consensus

Nuri Ayres Member Retiree IBC Consensus

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District Retirees

Brevard Public Schools 1,200

Duval County Public Schools 1,250

Escambia County School District 700

Miami-Dade Public Schools 3,200

Orange County Public Schools (2015)

1,900

Polk County Public Schools 1,750

Total 10,000

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Retirees Will Have Guarantee Issue, More Benefit Choices, Same or Better Premiums, and Can Change Coverage if They Move

Non-Medical Benefits, Specifically Designed for the Retirees, Will be Provided and Expanded

Cost of the Active Employee Health Plan Will be Positively Impacted by the Retiree Program

Additional Retiree Benefits Assistance Will be Provided by FBMC

Retirees Who Left the District Health Plan Will Have the Option to Re-join Next Year

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Medicare Supplement (Medigap) Plans on a Statewide and National Basis ◦ Two (2) Companies Have Been Approved

Cigna United Healthcare

◦ Best Premium Option for ECSD is United Healthcare

Medicare Part D (EGWP) Pharmacy Plans (Comprehensive and Premier) on a Statewide and National Basis◦ United Healthcare Has Been Approved

Medicare Advantage Plans Specifically Selected to Meet ECSD Needs◦ United Healthcare Low Premium and Option 3 Plan

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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 emergency

room visits that don’t 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 ($1,184) √ √

Medicare Part B Deductible ($147) √

Medicare Part B Excess Charges (15%) √

Foreign Travel Emergency (To Limits) √ √

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United Healthcare 2014

Issue AgePlan A Plan F Plan N

Age 65 $135.69 $186.76 $134.61

Age 66-69 $145.12 $201.73 $145.25

Age 70-74 $160.79 $225.12 $161.54

Age 75-79 $174.92 $244.90 $175.90

Age 80 + $191.29 $266.10 $191.29

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Rx Benefit Enhanced Comprehensive

Drug Coverage

Drug List 100% + Bonus 100% + Bonus

Initial Coverage Period

Deductible $0 $0

Generic $2 to $10 $2 to $7

Brand Preferred/Non-preferred $45/$75 $30/$60

Specialty 33% $75

Gap

Generic Preferred $2 to $10 $2 to $7

Brand Preferred/Non-preferred 50% Discount $30/$60

Specialty 50% Discount $75

Catastrophic

Generic $2.55 or 5% $2.55 or 5%

Brand $6.35 or 5% $6.35 or 5%

Monthly Premium $84.18 $155.31

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Pharmacies Comprehensive Premier

Costco No Yes

CVS No Yes

K Mart No Yes

Kroger Yes Yes

Publix No Yes

Rite Aid Yes Yes

Sam's Yes Yes

Target Yes Yes

The Medicine Shoppe Yes Yes

Walgreens Yes Yes

Wal-Mart Yes Yes

Winn Dixie No Yes

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Benefit Low Premium Comprehensive Option 3Medical National PPO OON Same National PPO OON Same

Annual Deductible $400 Med & $320 Rx $0 $0

Annual OOP $6,700 $2,500

Hospital Admit $230/Day to

7 Days

$230/Day to

7 Days

$175 $175

Office Visits $25/$50 $25/$50 $5/$15 $5/$15

Emergency Care $65 $65 $65 $65

Outpatient Surgery 20% 20% $15 $15

Rx

Generic 25% $5

Brand 25% $30/$60

Specialty 25% $80

Coverage Gap Applies No Gap

Monthly Premium $25.00 $232.00

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In Network Zero Premium Comprehensive

Andrews Institute Yes Yes

Imaging Center of Pensacola Yes Yes

Baptist Hospital No No

Sacred Heart Hospital Yes Yes

West Florida Hospital Yes Yes

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ECSD Has the Option to Consider Offering the Non-Medical Benefits as Well

Options Available Through the Consortium, and Administered by FBMC, for 2015

◦ Group Dental Insurance Plans

PPO

DHMO

◦ Group Vision Insurance Plan

◦ Identity Theft Protection Plan

◦ IT Tech Support Program

Non-Medical Plan Options Will be Expanded to Meet the Unique Needs of Retirees in the Future

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Benefits Low PPO Plan High PPO Plan

In Network Out of Network In Network Out of Network

Annual Maximum $800 per person per year $1,500 per person per year

Annual Deductible

$50/ person to max $150 for Basic or Major Services

$100/ person to max $300 for Basic or Major

Services

$50 per person to max $150 for Basic or Major Services

Diagnostic &Preventive 100% 100% 100% 100%

Basic 70% 70% 80% 80%Major 50% 50% 50% 50%Plan Inclusions 2 Preventive

Cleanings and 2 Perio. Basic

Cleanings/Year

2 Preventive Services

Cleanings per Year

2 Preventive Cleanings and 2

Perio. Basic Cleanings/Year

2 Preventive Cleanings and 2

Perio. Basic Cleanings/Year

OON Allowance PPO Schedule 80th percentile

Monthly Rates

Retiree Only $28.25 $38.69Retiree + 1 $56.24 $77.04Retiree + Family $73.29 $100.04

Services Low DHMO Plan High DHMO Plan

Network Network Only Network OnlyAnnual Maximum NA NADeductible $0 $0Office Visit Copay $0 $0Panoramic X-ray & Bitewings $0 $0Prophylaxis $0 $0Amalgam – One Surface – Permanent $5 $0Resin – Based Composite – One surface, Anterior

$30 $0

Endodontic Therapy, Molar $250 $210Periodontal Scaling & Root Planning- 4 or More Teeth

$55 $50

Complete Denture – Maxillary $375* $325*Crown – Porcelain Fused to Nobel Metal $270* $245*Extraction, Erupted Tooth or Exposed Root

$0 $5

Monthly RatesRetiree Only $9.95 $16.15Retiree + 1 $19.70 $31.98Retiree + Family $35.02 $56.85

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Plan In Network Benefits

Frequency (Exam /Lenses/ Frames) 12/12/24

Exam/Spectacle Lenses $10/$15Eyeglass Benefit – Frame

Non-Collection Frame Allowance (Retail):Up to $130 OR

Up to $180 at Vision WorksDavis Vision Frame Collection (in lieu of Allowance):

Fashion Level and Designer Level IncludedPremier Level $25Eyeglass Benefit – Spectacle Lenses Member ChargesClear Plastic Lenses & Scratch-Resistant Coating IncludedPolycarbonate Lenses Adults $30Progressive Lenses (Standard / Premium / Ultra) $50/$90/$140Contact Lens Benefit (in lieu of Eyeglasses) Up to $130Monthly Rates:Retiree $6.17Retiree + 1 $11.11Retiree + Family $17.28

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Plan Features Premium Ultimate

Restoration services Yes Yes

Lost wallet assistance Yes Yes

Identity safety resource center Yes YesInternet surveillance monitoring and alerts

Yes Yes

Social security monitoring and alerts Yes Yes

Change of address monitoring and alerts Not Available Yes

Court/criminal monitoring and alerts Not Available Yes

Sex offender monitoring and alerts Not Available YesAnti-Virus, anti-spyware protection Not Available YesAnti-phishing, anti spam protection Not Available YesJunk mail-list removal Not Available YesMonthly RatesRetiree $7.00 $10.50Retiree + Family $15.00 $22.50

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Remote Support via Internet, Live Chat, Telephone

◦ 24/ 7/ 365

Assistance With Various Devices Including:

◦ Computers (PC and MAC)

◦ Smartphones

◦ Cameras

◦ Printers and Scanners

◦ Modems

◦ Gaming Consoles

Computer Protection Software

Self Help Database for Assistance With Technology Issues

Secure Data Back Up Data Protection

Onsite Support Available at $80 per Hour

Unlimited Support Unlimited Support with Data Backup

$10.00 per Household $14.00 per Household

Retirees Will Have Guarantee Issue, More Benefit Choices, and Can Change Coverage if They Move

Retirees Will Have Non-Medical Benefit Options Available Through the Consortium

Retiree Premiums Will be Significantly Lower Than Current District Premiums

Savings Will Occur in the Active Employee Health Plan

GASB Liability Will be Significantly Reduced

Consortium Retiree Benefits Will be Administered by FBMC at No Cost to ECSD

Retirees Who Left the District Plan May Re-Join the Consortium Plan Next Year

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Current New Difference

Monthly Retiree Premiums Compared to Active Plan $422

Plan N and Comp Rx Age 67

$300.56

$121.44 per Retiree per

Month

Savings due to removal of monthly subsidy

$25 month /retiree

$0 $122,000

Annual Savings

Administrative Savings of ASO Fees, Stop Loss and Administration

396 retirees$275,000

Annual Savings

Active Health Plan Savings With Medicare Retirees on Consortium Plans

396 retirees and their

Dependents

$326,000Annual Savings

Savings to GASB Liability Over Next 30 Years

30.8 Million 15.4 Million -50%

Core School Districts Are Taking Action on the Plan Recommendations, and the Consortium Agreements for:

◦ Medical and Pharmacy Benefits for Medicare- Eligible retirees and dependents

◦ Considering the Non-Medical Benefits for Medicare- Eligible retirees and dependents

Core School Districts Will Pay a One Time Administrative Fee of $1.00 per Health Plan Participant, Refundable to Core Districts (ECSD)

Retirees Over 65, and Dependents, Will Get Their District Sponsored Health Plan Benefits Through the Consortium Retiree Program Beginning January 1, 2015

Program Will be Known as the “Florida School Retiree Benefits Consortium” (FSRBC)

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The Escambia County School Board approve participation in the Florida Independent Benefit Council’s Florida Retired School Employee Benefit Program Consortium (Consortium) for:

◦ Medical and Pharmacy Benefits for Medicare- Eligible retirees and dependents effective 1/1/15.

The Escambia County School Board authorize the Chairman and the Superintendent to affix their signatures to the Consortium’s Interlocal and Participation agreements.

Non-Medical Benefits will be reviewed and information will be presented at a future School Board meeting.

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Issue Date

Individual District Deliberation and Action on Medicare Plans, and the Participation and Interlocal Agreement

June-August

District Deadline for Acceptance and School Board Approval of Consortium Plans and Agreements

End of August

Annual Enrollment at Participating Districts for All Medicare Eligible Retirees and Dependents

Oct.-Nov. 2014

Pilot Open Enrollment at a Selected Core District for Medicare Eligible Retirees and Dependents Who Previously Dropped District Coverage

Nov. 2014

Effective Date of Full Program January 1, 2015

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Group Medicare Medical and Pharmacy Plans

Questions and Comments