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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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