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Mission of the Employee Benefits CommitteeEmployees and retirees working to provide
all of our benefitted employees and retirees with:
The Best Possible Benefits
With The Best Possible Service
At The Lowest Possible Cost2
EBC meetings at BHS Lecture Hall 3:30 to 5:30
EBC Nov 15 new members
EBC Dec 1EBC Jan 19EBC Feb 7 at Clovis Community Medical CenterEBC March 23 Delta Dental EBC April 27 VSPEBC May 11 CVS
All dates subject to change
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Attendance is critical.You are the representative for your site/department
SBC ECCSep 1 Nov 2Sep 20 Oct 27 Dec 19 Dec 12Jan 12 Jan 26Jan 31 Mar 9 March 1March 23 April 19May ?
EBC Topics for Today
Open Enrollment
Delta Dental
Clovis Unified Employee Health Center by miCare
Blue Shield / HealthNow
Provider Update
Other
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2017Online Open Enrollment
& Dependent Verification Audit Monday - April 17th – Friday, May 26th
Raffle Cut off – Friday, May 12th
Must have Online Enrollment completed to qualify to win one of 10 $100 Visa Gift Cards
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deltadentalins.com
ANNUAL REVIEWClovis Unified School District
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NETWORKSTHAT MAKE A DIFFERENCE
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WEB SITE CONNECTIONS
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TECHNOLOGYIn the palm of your hand
Ditch the card! Go mobile Check eligibility, benefits and claimsFind dentist by mobile locationFee finder for common servicesQuizzes, videos, dental health information
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BENEFIT HIGHLIGHTSPlan #1 PPO + Premier Incentive Plan #2 PPO Non-Incentive
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UTILIZATION REPORTGroup Numbers6516 – PPO + Premier Incentive Plan
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6749 – PPO Plan
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NETWORK UTILIZATION (Excluding Orthodontics)
Paid Period: July 1, 2015 - June 30, 2016
Paid Amount PEPM
Delta Dental PPO $826,711 $47.48 57.1%
Delta Dental Premier $579,016 $33.26 40.0%
Non-Contracted $41,584 $2.39 2.9%
Total $1,447,310 $83.13 100.0%
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Paid Period: July 1, 2015 - June 30, 2016
Paid Amount PEPM
Delta Dental PPO $2,140,017 $81.69 98.1%
Delta Dental Premier $33,065 $1.26 1.5%
Non-Contracted $7,338 $0.28 0.3%
Total $2,180,420 $83.23 100.0%
PPO + Premier Incentive Plan 1
PPO Plan 2
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DOLLAR-BANDED UTILIZATION REPORT (Excluding Orthodontics)
Paid Period: July 1, 2015 – June 30, 2016
Banded RangeNo Utilization 1,077 22.9%<= $339.99 2,359 50.2%
$340 to $679.99 640 13.6%$680 to $1,019.99 238 5.1%
$1,020 to $1,359.99 144 3.1%$1,360 to $1,699.99 132 2.8%
>= $1,700 105 2.2%Total* 4,695 100.0%
Utilizers
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Paid Period: July 1, 2015 – June 30, 2016
Banded RangeNo Utilization 2,225 29.6%<= $399.99 3,877 51.6%
$400 to $799.99 632 8.4%$800 to $1,199.99 340 4.5%
$1,200 to $1,599.99 153 2.0%$1,600 to $1,999.99 120 1.6%
>= $2,000 173 2.3%Total* 7,520 100.0%
Utilizers
PPO + Premier Incentive Plan 1 PPO Plan 2
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PROCEDURE UTILIZATION SUMMARY
Utilizers % of Paid Utilizers % of PaidD&P 3,468 41.8% 3,539 44.2%Basic 1,439 34.6% 1,396 32.3%Major 558 23.5% 507 23.4%Ortho 14 0.0% 11 0.0%Total Unique 3,548 100.0% 3,619 100.0%
7/1/2014 - 6/30/2015 7/1/2015 - 6/30/2016Procedure Utilizers
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Utilizers % of Paid Utilizers % of PaidD&P 4,821 38.4% 5,162 37.8%Basic 2,065 38.2% 2,314 39.7%Major 704 23.5% 734 22.4%Ortho 35 0.0% 35 0.0%Total Unique 4,945 100.0% 5,297 100.0%
7/1/2014 - 6/30/2015 7/1/2015 - 6/30/2016Procedure Utilizers
PPO + Premier Incentive Plan 1
PPO Plan 2
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COST SAVINGS REPORT (Excluding Orthodontics)
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Paid Period: July 1, 2015 - June 30, 2016
1) Total Submitted $2,825,562 100.0%
2) Provider Discounts $585,560 20.7% Other Savings** $152,917 5.4%
Total Savings $738,477 26.1%
3) Plan Pays $1,447,310 51.2%
4) Patient Liability *** $639,774 22.6%
Total
Paid Period: July 1, 2015 - June 30, 2016
1) Total Submitted $4,378,143 100.0%
2) Provider Discounts* $1,310,892 29.9% Other Savings** $218,900 5.0%
Total Savings $1,529,792 34.9%
3) Plan Pays $2,180,420 49.8%
4) Patient Liability *** $667,931 15.3%
Total
PPO + Premier Incentive Plan 1 PPO Plan 2
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deltadentalins.com
We’re pleased to take your questions…
THANK YOU FORYOUR TIME
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Location – South West Corner of Clovis & Herndon
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In-n-Out
Professional Learning Center
Clovis Unified Employee Health Center
by miCareEntrance
Health Center Entrance Only –West side of Professional Learning Center
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Clovis Unified Employee Health Center by miCare Health Benefitted Employees, Retirees and their
Dependents (12,000 members) Opening Late Fall 2017 Health Center will be operated by miCare Zero Copay Improved service utilizing online appointment system Improved access to health care, especially for members
who do not currently have a primary care physician Mitigates health cost increases for employees and the
district health plan Some Rx will be available at no cost to patients Facility dollars used to fund purchase of the building in lieu
of using Self-Insurance Fund to lease office space23
ARTHUR J. GALLAGHER & CO. | BUSINESS WITHOUT BARRIERS™
Comparing Regional Costs - Combined Medical Plans & Services
Per Member Per MonthClovis Unified School District $246National Overall $286Pacific Region $299Education Industry $303Education Industry (Pacific Region) $327
$200
$250
$300
$350
Per M
embe
r Per
Mon
th
Clovis
Total Cost ComparisonClovis Unified $246 x 12,000 members x 12 months = $35,000,000
If Ed Industry National $286 x 12,000 members x 12 months = $41,000,000If Ed Industry Pacific $327 x 12,000 members x 12 months = $47,000.000
EBC Action Items Provide updates to your colleagues Work with your supervisor to determine a
plan for dispensing information to your site/department
Kelly Avants will provide talking points
Next EBC Meeting: Thursday, April 23rd
At BHS Lecture Hall
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