brevard public schools school board workshop presentationeagendatoc.brevardschools.org/06-10-2014...
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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