health and employee benefits pool - county · health and employee benefits pool Øcounty-owned and...
TRANSCRIPT
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Health and Employee Benefits PoolPlan Year 2020, Effective October 1, 2019
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IntroductionandTACHEBPOverviewPlanYearReview
RenewalTimelines
OtherNews
RNBCProcessReviewandUpdates
EmployeeSelf-ServicePortalUpdates
Questions
OASysUpdates
Agenda
PlanYear2020Outlook
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TAC HEBP OVERVIEW
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Health and Employee Benefits Pool
Ø County-owned and county-governedØ Not for profit (no stockholders to satisfy)Ø No state premium taxØ Stable membership – 221 county entities
§ 212 Pool (fully insured) and 9 ASO (self funded)§ 48,000+ members
Ø Stabilize rates for TAC supported counties and districts
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TAC HEBP Product SuiteMedical&PrescriptionwithTeleHealth
Dental [WithorWithoutOrthodontia]
RetireeMedical[CountyChoiceSilverMedicareSupplement]
LifeInsurance[BasicandSupplemental]
VisionInsurance
DisabilityInsurance[Short&Long-term]
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HEBPHealthyCounty
EmployeeWellnessØ Countyconsultationandtargetedincentiveprograms
Ø HealthyCountywellnesschallenges(poweredbySonicBoom)
Ø EmployeeempowermenttrainingsØ Annualconference(nochargetogroupWellnessCoordinatorandWellnessSponsor)
TAC HEBP Healthy County
EmployeeWellnessØ Countyconsultationandtargeted
incentiveprogramsØ HealthyCountywellnesschallenges
(poweredbySonicBoom)Ø EmployeeempowermenttrainingsØ Annualconference(nochargetogroupWellnessCoordinatorandWellnessSponsor)
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TAC HEBP Renewal
Ø Renewal Process OverviewØ Prior Year ReviewØ Current Loss RatioØ Projected TrendØ Pool Needed Amount
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Renewal Process
Actuary determines Medical and Rx trend for current and coming year
Actuary determines Pool contribution requirements for coming year
TAC Management Team reviews* each individual Pool group
Actuary reviews TAC Team rate recommend-ations
Recommended rate scenarios prepared by TAC staff for Board review
Board approves renewal rates
Renewal processed for release to groups based on Plan Anniversary dates
ØCredibility/PredictabilityØ LossRatio:Claimsvs.ContributionsØHighCostClaimsØ ShockClaims/PoolingPointØDemographicandAreaMedicalCostfactors
* Individual Review:
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Plan Year Review
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TAC HEBP Renewal Plan Year (PY2019) Membership
Change in MembershipØ TAC HEBP added 4 groups in PY19 (10/1/18 – 9/30/19): Carson, Crane,
Starr, and Zavala CountiesØ 221 Members (212 Pooled & 9 Self-Insured)
Ø Average Pool membership is 36,553 an increase of 8% year over yearØ Subscribers: + 5.34%Ø Spouses: + 3.01%Ø Dependents: + 3.68%
Ø Average member age remained stable at 38.8 years
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TAC HEBP Renewal Medical Trend CY2018
Top3Conditions:Circulatory($26M),Cancer($25M),andMusculoskeletal($24M)
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TAC HEBP Renewal Plan Year (PY2018) High Cost Claimants
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TAC HEBP Renewal Rx Trend (Jan – Sept 2018) Prior PBM
Ø 29.2%Specialty Trend Ø 4.4%Non-SpecialtyTrendØ 11%RxTrend
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TAC HEBP Renewal Rx Trend (Oct’18–March’19) Current PBM
Ø 0.6%Specialty Trend Ø -3.2%Non-SpecialtyTrendØ -2.1%RxTrend
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TAC HEBP Renewal Impact of PBM Change
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Current Loss Ratio
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TAC HEBP Renewal – Medical Loss Ratio
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Plan Year 2020Projected Trend
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Plan Year 2020 Projected Trend
Ø PY 2020 Trend (10/1/2019-12/31/2020)
Ø TAC Blended Trend 7.5%Ø 8% MedicalØ 6% Rx
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Plan Year 2020Pool Needed Amount
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Plan Year 2020 Pool Needed Amount
Ø PY 2020 Pool Needed, eff. 10/1/2019 -12/31/2020
Ø Overall 2.79%
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Renewal Timelines
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Key Renewal Dates: October 1 Anniversary Date
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Key Renewal Dates: November 1 Anniversary Date
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Key Renewal Dates: December 1 Anniversary Date
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Key Renewal Dates: January 1 Anniversary Date
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OASys Updates
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NEW!!OASys login
OASys - Multi-factorAuthentication(MFA)login
UpgradestoOASysrequireTACtoadaptamulti-factor authentication
(MFA) login.Using MFA require users to
provide more than one method of authentication to login.
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OASys - Multi-factorAuthentication(MFA)login
Newhomepage.Enteryour
currentOASysemail.
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OASys - Multi-factorAuthentication(MFA)login
Checkthisboxonlyifyouareusingaprivateorworkcomputer,andif
allowedperyourITpolicy.
Entercurrentpassword,orcreatea
newpassword
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OASys- multi-factorAuthentication(MFA)login
Verificationcode– enteremailorphonenumber
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OASys - Multi-factorAuthentication(MFA)login
Anemailwiththeverificationcodewillbesendto
you.
Note:TheemailwillcomefromWillisTowersandWatson.
PleasehaveyourITDepartment“Whitelist”thisemailaddress.
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OASys - Multi-factorAuthentication(MFA)login
YoucanchoosefortheVerificationCodetobesentviatext oraphone
call.
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OASys - Multi-factorAuthentication(MFA)login
Entercodetologin
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OASys - Multi-factorAuthentication(MFA)login
Oncevalidated,youwillbetakentotheWebAdminscreen.
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Ø ValidemailaddressØ EmployeeClassificationCode(sameasWorkersCompcodefrompayroll)
Ø NewOptionalField:ØMobilePhoneNumber
OASys – Data Entry ChangesEntryfieldsinOASysthatarenowrequiredfornewhires:
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RNBC Process Review and Updates
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Clickonthe‘RNBC’tab
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Electronic Renewal: Alternate RNBC Available
WithintheRNBCtabclicktheAlternate
RenewalInformationtabtoselectan
alternatemedicalandRXplan.
NEW!!ALTRNBC!!
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
EnterEmployerandEmployeecontributionamounts
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Firstof3screens-ReviewandUpdateeachContactType:
ContractingAuthority,PrimaryContact,
andBillingContact
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Retireecoveragedesignation
WaitingPeriods
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
ConfirmhowyourentityhandlesCOBRA.Clicksubmit.
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
PrintRNBC.
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Have yourContractingAuthorityinitialeachpageofcompletedRNBCformandsignonlastpage.Then
faxoremailtoyourEmployeeBenefits
Specialist.
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
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Employee Self-ServicePortal Updates
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Employee self-service (ESS) portal is getting an upgrade.
EffectiveJuly1,2019,TACwillrolloutanupgraded EmployeeSelf-Service
portal.
NEW!!ESS
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Navigatetoyourbenefits,changebeneficiaries,
obtain forms,andviewotherTACprograms.Canalsoaddlinkstovendorwebsitesforothernon-TACbenefits.SimilartothecurrentESS,
just better!
Employee self-service portal (ESS) capabilities
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Startingthisyear,theESSwillbeusedduringtheOpenEnrollmentperiods.Employeescanenrollinbenefitsthemselves!
Employee self-service portal (ESS) capabilities
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Employee self-service portal (ESS) capabilities
Viewyourelectedbenefitsandtotalcosts.
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ESSOASysReports
InOASys,youcanaccessReportsatanytime onchangesmadeby employees inESS.
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EmployeeSelf-Service(ESS)- Multi-factorAuthentication(MFA)login
ESSloginwillalsouseMFA.
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Firsttimeusers willneedtoconfirmtheiridentitybyenteringeithertheir
UIDorSSN.
Enhanced Registration
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Enhanced Registration
Ifthedateofhireisunknown,theexactyearis
acceptable.
DOB anddateofhiremustmatchuser’srecordonfile.
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An authenticationcode willbesenttotheuser’semail.
Establish/Verify User
Note:TheemailwillcomefromWillisTowersandWatson.Please
haveyourITDepartment“Whitelist”thisemailaddress.
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Userswillhavetheoptiontohavetheverificationcodesentviatextor
to receivea phonecall.
Phone Call or Text Authentication
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Oncetheverificationcodeisentered,accepttheOnlineAuthorization
terms.Accessisgranted.
Successful Log-in
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Other News
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Dental Open Enrollment
Ø Beginning this year, TAC HEBP will have annual Dental Open Enrollment.
Ø Here's who can enroll:Ø Any full-time benefits-eligible employeeØ Eligible Spouses and Dependents
Ø Please contact your Employee Benefit Specialist with any enrollment questions
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Renewal ProcessNew ID Cards
Concierge Customer Service
One toll-free phone number for:
BCBS Customer ServicePre-Authorizations
Condition Management
BlueCareConnectionsisbeingreplacedbyBCBSWellbeingManagement
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Renewal ProcessOrdering Replacement ID Cards – One Request, Four Ways
Call BCBS Customer Service Use Blue Access for Members mobile app
Log in to Blue Access for Members
If your employee is in a pinch, call a TAC Employee Benefit
Specialist
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ACH Payments
Ø Groups will be able to pay their TAC HEBP invoices via ACH by early 2020
Ø Detailed instructions will be provided when this payment option becomes available
Ø In order to use ACH, group must pay exact invoice amount (pay as billed)
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Renewal Process
Ø RNBC Changes – view alternates and complete selectionand contributions online!
Ø New login security for OASys admin usersØ Employee Self-Service – new look, more information,
and available for Open Enrollment elections
Ø Dental Open Enrollment
Ø New ID Cards – 1 number for BCBS services
Ø ACH Payments coming soon
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ONLINE
ON TIME
REMEMBER: SEND IN YOUR RENEWAL
&Renewal Due Dates
10/1 AD: August 2
11/1 AD: September 20
12/1 AD: October 11
1/1 AD: November 1
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CONSULTANTEAMS
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SPECIALISTEAM
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Renewal Process
Questions
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Renewal Process
For questions regarding the information presented, please contact your Employee Benefits Consultant
at
(512) 478-8753 | (800) 456-5974FIRST NAME + FIRST INITIAL OF LAST NAME
@county.org
Thank you!