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Employee Benefit Workshop 2009

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Employee Benefit Workshop 2009. National Trends IBBP Information Analysis of the Plan Wellness. National Health Care Trends. Over the past five years, the percentage of U.S population covered by health insurance has been constant – hovering around 84%. - PowerPoint PPT Presentation

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Page 1: Employee Benefit Workshop 2009

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Page 2: Employee Benefit Workshop 2009

Employee Benefit Workshop 2009

• National Trends

• IBBP Information

• Analysis of the Plan

• Wellness

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Page 3: Employee Benefit Workshop 2009

National Health Care Trends

• Over the past five years, the percentage of U.S population covered by health insurance has been constant – hovering around 84%

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Page 4: Employee Benefit Workshop 2009

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Page 5: Employee Benefit Workshop 2009

Coverage by Type of Health Insurance

• The most recent data shows nationally, 72% of individuals have a traditional plan design, 20% HMO coverage and 8% HDHP HSA qualified

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Page 6: Employee Benefit Workshop 2009

Employer Contributions

• Nationally, the average annual employer premium contribution for family health coverage is 73.5%

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Page 7: Employee Benefit Workshop 2009

Healthcare in Iowa

• The number of Iowans without health insurance is 9.9%, compared to the national average of 15.3%

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Page 8: Employee Benefit Workshop 2009

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Page 9: Employee Benefit Workshop 2009

Employee Benefit Workshop 2009

• National Trends

• IBBP Information

• Analysis of the Plan

• Wellness

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Page 10: Employee Benefit Workshop 2009

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Page 11: Employee Benefit Workshop 2009

Iowa Bankers BenefitPlan insures 28,501people for healthcoverage.

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Page 12: Employee Benefit Workshop 2009

IBBP Trust Reserve August 2009 $18,090,059December 2008 $17,133,978 2008 Actuarial Certification

Amount $8,050,445December 2007 $16,996,278 2007 Actuarial Certification

Amount $6,835,781 December 2006 $12,426,176 2006 Actuarial Certification

Amount $7,419,510December 2005 $5,539,728 2005 Actuarial Certification

Amount $6,809,749December 2004$9,301,531 2004 Actuarial Certification

Amount $$7,589,751December 2003 $9,910,486 2003 Actuarial Certification

Amount $6,038,208 $0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

$16,000,000

$18,000,000

$20,000,000

Dec-03 Dec-04 Dec-05 Dec-06 Dec-07 Dec-08 Aug-09

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Page 13: Employee Benefit Workshop 2009

2008 Administrative Expense Ratio• 2008 Total Premiums

$86,822,871• Wellmark Administrative Fees -

$4,627,118• Plus IBIS Administrative

Expense -$4,253,371• Other Expense - Audit Expense

-$23,983, Legal Expense - $30,591,Misc $642

• Total Administrative Expense $8,935,705 or

• 10.3% Administrative Expense Ratio

Wellmark Adm Fees

5.41%

2008 claims , 89.7%

IBIS Adm. Expense

4.8% Other Expense

.09%

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Page 14: Employee Benefit Workshop 2009

Employee Benefit Workshop 2009

• National Trends

• IBBP Information

• Analysis of the Plan

• Wellness

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Page 15: Employee Benefit Workshop 2009

IBBP Total Claims Paid

$56,138,618

$69,480,205

$78,170,837 $74,228,824

$67,806,081

$75,096,344

$0

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

$70,000,000

$80,000,000

2003 2004 2005 2006 2007 2008

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Page 16: Employee Benefit Workshop 2009

Average Cost per Member

• Over the past 12 months, the Plan paid $3,049 per member, increase of 15% over the past 4 years

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Page 17: Employee Benefit Workshop 2009

May 2008 – April 2009

Total Claims Paid Paid Per MemberPercent of Change

Per Member

Active

Health $62,451,891 $2544 7.8%

Pharmacy $11,976,485 $488 14.2%

Combined $74,428,376 $3,032 8.8%

Retiree

Health $526,355 $6,192 (1.3%)

Pharmacy $141,587 $1,666 31.5%

Combined $667,942 $7,858 4.2%

Combined

Health $62,978,247 $2,557 7.6%

Pharmacy $12,118,097 $492 14.3%

Combined $75,096,344 $3,049 8.7%17

Page 18: Employee Benefit Workshop 2009

Major Trend Drivers• Health and Pharmacy claims

paid per member increased 9% mainly due to inpatient services

• Provider Savings totaled $44,547,715 or 36% of covered charges

• Members were liable for $12,557,980 or 20% of covered charges, down 1% from the previous year

• Medicare coordination and other COB savings totaled $2,122,639

• 143 members had claims in excess of $50,000 accounting for 22% of claims paid

• One claim hit stop loss-the total dollar amount is in excess of - $1,600,000

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Page 19: Employee Benefit Workshop 2009

PROVIDER NAME CITY STPROVIDERCHARGES CLAIMS PAID

Children’s Hospital Omaha NE $1,739,886 $1,437,960

St. Mary’s Hospital Rochester MN $1,446,095 $1,276,231

Rochester Methodist Hospital Rochester MN $720,126 $552,472

The Nebraska Medical Center Omaha NE $895,626 $472,732

Mayo Clinic Rochester MN $450,460 $328,175

Nearly 29% of facility claims are paid outside the state of Iowa

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Page 20: Employee Benefit Workshop 2009

• The Plan paid out over $11 million in prescription drug claims in 2008—a cost increase of more than 11% from the year prior.

• 63.6% of Plan members purchased a generic drug, which is 3.5% less compared to other health plans.

• The three most costly drug classes paid for under the Plan are:

– Therapeutic drugs (prescribed for cancer treatment or organ transplants) (10%)

– Antidepressants (9%)– Anti-cholesterol drugs (8%)

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Drug Claims 2004 to Current Date

Page 22: Employee Benefit Workshop 2009

Iowa BankersQ1 2009 Wellmark Book of Business

% Generic Prescriptions (#RX) 63.7% 66.2%

$ Covered Charge per RX $94.47 $87.38

#RXPMPY 10.72 11.51

$Covered Charge PMPY $1,012.41 $1,005.82

Pharmacy

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