Brevard Public SchoolsSchool Board Workshop Presentation

June 10, 2014June 10, 2014

Group Medicare Medical and Pharmacy Plans

Presented by:John D. Robinson, CEBS

RobinsonBush

1. IBC Retiree Program Initiative Overview2. How the Program Works3. Retiree Program Benefits and Features

Medicare Plan RFP Results4. Medicare Plan RFP Results5. RFP Recommendations for Award6. Next Steps and Timeline7. 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◦ Florida Association of District School Superintendents

(Senator 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

IBC Created Statewide Florida Retired School Employee Benefits Program Consortium (Consortium) for Retirees Eligible for Medicare

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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 ◦ 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 ◦ 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)

Treasurer Polk FADSS(or Her Alternate)

Vanessa Tillman Member St. Lucie FEA

Debra Pace Secretary Brevard FASA

Daneen Regna Member Retiree IBC Consensus

David Ford Vice Chair 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 700Escambia 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, 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 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 ◦ Up to Two (2) Companies Will be Recommended◦ Each Participating District Will Have the Option to Select Only

One of the Two Companies

Medicare Part D (EGWP) Pharmacy Plans on a Statewide Medicare Part D (EGWP) Pharmacy Plans on a Statewide and National Basis◦ Only One Company Will be Selected

Medicare Advantage Plans Specifically Selected to Meet Individual School District Needs◦ Each District Will Recommend the Option(s) That Best Meet

the Needs of That Specific District◦ Each District May Recommend Up to Two (2) Companies

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Medicare Supplement Plans A, F, and N ◦ Cigna Health Plan and United Healthcare

Medicare Part D EGWP Basic and Comprehensive Plan United Healthcare

Medicare Advantage Plans◦ Brevard Schools United Healthcare for Zero Premium and Comprehensive Option 3 Health First Health Plan for Zero Premium and Comprehensive Options 1 and 2

◦ Duval Schools◦ Duval Schools United Healthcare for Zero Premium and Comprehensive Options 2,3, and 4

◦ Escambia Schools United Healthcare for Zero Premium (Low Premium) and Comprehensive Option 3

◦ Miami-Dade Schools No Medicare Advantage recommendation at this time

◦ Orange Schools (October 2015) United Healthcare for Zero Premium and Comprehensive Option 4

◦ Polk Schools Aetna for Comprehensive Option 3 United Healthcare for Comprehensive Option 4

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Medigap Benefits Plan A Plan F Plan NPart 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 $131.49 $183.63 $132.03Age 66-69 $141.87 $203.05 $146.39Age 70-74 $163.16 $226.93 $162.89Age 75-79 $177.24 $246.28 $177.28Age 80 + $192.48 $266.90 $191.98Age 80 + $192.48 $266.90 $191.98

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Cigna 2015Issue Age

Plan A Plan F Plan N

Age 65 $179.44 $207.49 $155.60Age 66-69 $149.44 $207.49 $155.60Age 70-74 $166.68 $242.58 $187.33Age 75-79 $178.71 $272.82 $213.48Age 80 + $186.29 $305.36 $242.31

Rx Benefit Basic ComprehensiveInitial Coverage PeriodDeductible $0 $0Generic $2 to $10 $2 to $7Brand Preferred/Non-preferred $45/$75 $30/$60Specialty 33% $75GapGeneric Preferred $2 to $10 $2 to $7Generic Preferred $2 to $10 $2 to $7Brand Preferred/Non-preferred 50% Discount $30/$60Specialty 50% Discount $75CatastrophicGeneric $2.55 or 5% $2.55 or 5%Brand $6.35 or 5% $6.35 or 5%Mail OrderAll Tiers 2 X 2 XMonthly Premium $86.18 $156.31

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Pharmacies Basic ComprehensiveCostco No Yes

CVS No YesK Mart No YesKroger Yes YesPublix No YesPublix No Yes

Rite Aid Yes YesSam's Yes YesTarget Yes Yes

The Medicine Shoppe Yes YesWalgreens Yes YesWal-Mart Yes Yes

Winn Dixie No Yes

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Benefit Zero Premium Option 1 Option 2Medical HMO HMO POS OON

Annual Deductible $0 $0 $0 $0Annual OOP $6,650 $2,000 $3,000 $6,000Hospital Admit $260/Day to

7 Days$250 $150/Day to

5 Days20%

Office Visits $15/$45 $10/$20 $10/$15 20%Emergency Care $65 $50 $50 $50Outpatient Surgery $300 $125 $150 20%Rx

Generic $0 to $10 $2 to $10 $2 to $10 N/A

Brand $45/$95 $25/$45 $45/$90 N/ASpecialty 33% $90 33% N/ACoverage Gap Applies No Gap AppliesMonthly Premium $0.00 $189.00 $110.00

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

Annual Deductible $0 $0Annual OOP $4,500 $2,500Hospital Admit $200/Day to

8 Days30% $175 $175

Office Visits $15/$40 $35/$50 $5/$15 $5/$15Emergency Care $65 $65 $65 $65Outpatient Surgery 20% 30% $15 $15Rx

Generic $10 N/A $5 N/A

Brand $40/$90 N/A $30/$60 N/ASpecialty $90 N/A $80 N/ACoverage Gap Applies No GapMonthly Premium $0.00 $308.20

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In Network Health First UHC

Health First Hospitals Yes No

Florida Hospital Partial Yes

Halifax Hospital No Yes

M.D. Anderson Cancer Center No Yes

Orlando Health Center Yes Yes

Parrish Medical Center Yes No

Wuesthoff Medical Center No Yes

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Retirees on the Current District Plan Will Save Over $50 per Month in Premiums Moving to the Supplement Plan N and Comprehensive Rx Plan

Retiree Premiums for Medicare Plans Will be the Same or Lower Than Current District Medicare PremiumsThe Current Active Employee Health Plan Cost Will be The Current Active Employee Health Plan Cost Will be Reduced When Retirees Change to Medicare Plans

GASB Liability Will be Significantly Reduced Consortium Retiree Benefits, Including Non-medical

Plans, Will be Administered by FBMC Retirees Can Change Coverage if They Move Retirees Who Left the District Plan May Join the

Consortium Plan Next Year

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Current New Difference

Monthly Retiree Premiums Compared to Active Plan $359.00

Plan N and Comp Rx Age 67

$305.89

$53 per Retiree per

Month

Administrative Savings of $284,444

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Administrative Savings of Cigna ASO Fees and TASC Administration

589 Retirees$284,444

Annual Savings

Active Health Plan Savings With Medicare Retirees on Consortium Plans

715 Retirees and

Dependents

$104,744 Annual Savings

Savings to GASB Liability Over Next 20 Years

$102 Million $51 Million - 50%

The Consortium is Finalizing the Contracts with the RFP Awardees

The Consortium is Finalizing the Non-medical Benefit Options With FBMC Following an RFP Process

School Districts Interested in Joining the Consortium Will Take Action on the Plan Recommendations, and the Take Action on the Plan Recommendations, and the Participation and Interlocal Agreements

School Districts Will Pay a One Time Administrative Fee of $1.00 per Health Plan Participant, Refundable to Early Adopters

Eligible Retirees Over 65, and Dependents, Will Get Their District Sponsored Health Plan Benefits Through the Consortium Retiree Program Beginning No Later Than January 1, 2015

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Issue Date

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

June-July

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

August

Beginning of Program for New Retirees of Participating SeptemberBeginning of Program for New Retirees of Participating Districts That Opt for Early Participation

September

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

Oct.-Nov. 2014

Effective Date of Full Program January 1, 2015

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Group Medicare Medical and Pharmacy Plans

Questions and CommentsQuestions and Comments