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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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Employee Benefit Workshop 2009
• National Trends
• IBBP Information
• Analysis of the Plan
• Wellness
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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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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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Employer Contributions
• Nationally, the average annual employer premium contribution for family health coverage is 73.5%
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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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Employee Benefit Workshop 2009
• National Trends
• IBBP Information
• Analysis of the Plan
• Wellness
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Iowa Bankers BenefitPlan insures 28,501people for healthcoverage.
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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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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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Employee Benefit Workshop 2009
• National Trends
• IBBP Information
• Analysis of the Plan
• Wellness
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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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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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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
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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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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• 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
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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