5. NAPEBT – Trends National health premium trend data is from the Hay Benefits Reports (Hay Group) adjusted from a calendar year basis to correspond with NAPEBT's fiscal year. The 2010 trend data was not available from Hay, therefore, the 2009 trend increase percentage was used. For the 2006-2007 plan year the NAPEBT contribution rates are a blend of the one plan offered (7/1/06-12/31/06) and three plans offered (1/1/07-6/30/07) weighted by enrollment. For the 2008-2009 and 2009-2010 plan years the NAPEBT rates are a blend of all three plans weighted by enrollment.
6. NAPEBT – Total Medical Claims Paid $525.59 $ 482.60 3,615 3,442 $22,797,920 $ 9,967,061 FY10 7/10-12/10 $476.41 3,687 $21,078,317 FY09 $450.30 3,609 $19,499,142 FY08 Claims per Employee per Month Average # of Employees Total Claims Fiscal Year
8. NAPEBT Medical Plans Blue Cross Blue Shield of Arizona Group # 19676 NAPEBT Rx Plans CVS/Caremark #3172 Plan Year July 1, 2011 – June 30, 2012
9. MEDICAL PLAN EFFECTIVE July 1, 2011 After ded – 20%/$5 min $5/$35/$55/$105 $5/$35/$55/$105 Rx Retail Copay 20% after ded $100* $100* Inpatient Hospital Admit Fee In-Network Buy-Up Plan Base Plan HDHP Calendar Year Deductible: Per person Per family $500 $1,000 $750 $1,500 $1,250** $2,500** PCP Copay – Per visit $25 $35 80%/20% Specialist Copay – Per visit $35 $45 80%/20% Chiropractic Copay $35 $45 80%/20% Urgent Care Copay $50 $75 80%/20% Emergency Room Access Fee $100* $150* $100* Member Coinsurance 20% after ded 20% after ded 20% after ded Out of Pocket Maximum: Per person Per family $3,000 $6,000 $3,000 $6,000 $4,000 $8,000 Rx Retail 90 day Copay 2.5x Copay 2.5x Copay After ded – 20%/$5 min Rx Mail Order 90 day Copay 2x Copay 2x Copay After ded – 20%/$5 min Out-of-Network Calendar Year Deductible: Per person Per family $1,000 $2,000 $1,500 $3,000 $1,250** $2,500** Member Coinsurance 40% after ded 40% after ded 40% after ded *Access/Admit Payment and Deductible applied prior to 80%/20% coinsurance **The In and Out-of-Network deductibles are combined for HDHP.
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14. MEDICAL PLAN EFFECTIVE July 1, 2011 Dependent Employee HDHP/HSA - $1,250 Deductible * $47.68 per month/$572.15 per year employer contribution to HSA or FSA Dependent Employee Base Plan - $750 Deductible Total for Family Dependent Employee Buy-Up Plan - $500 Deductible Medical Plan FY12 $ 657.30 $ 425.10 $ 731.04 $ 472.78 $1,310.28 $ 795.70 $ 514.58 Monthly Premium $ 402.07 $ 452.78* $ 402.07 $ 452.78 $ 854.85 $ 402.07 $ 452.78 County Contribution $ 0.00 $ 20.00* $ 0.00 $ 20.00 $ 20.00 $ 0.00 $ 20.00 FY12 Employee Cost Share County Contribution $255.23 $ 0.00 $ 328.97 $ 0.00 $ 435.43 $ 393.63 $ 41.80 Employee Cost per Month $ 9.56 $ 127.62 $ 0.00 $ 0.00 $ 12.31 $ 164.48 $ 0.00 $ 0.00 $ 16.31 $ 217.72 $ 14.74 $ 196.82 $ 1.57 $ 20.90 Difference Employee Cost Per Paycheck Effective July 1, 2011 Employee Cost Per Paycheck
15. Employee Premium Holiday The Month of December at Last Year’s Rates! Total Cost to NAPEBT for Employee Premium Increase Holiday: $ 75,100 MEDICAL PLAN EFFECTIVE July 1, 2011 $ 0.00 $ 9.56 $ 0.00 $ 12.31 $ 1.57 $ 14.74 $ 16.31 Savings Per Paycheck $ 0.00 $ 19.12 $ 0.00 $ 24.62 $ 3.14 $ 29.48 $ 32.62 Savings For Month HDHP Employee Dependent Base Plan Employee Dependent Buy-Up Plan Employee Dependent Total for Family Medical Plan FY12
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19. NAPEBT Dental Plans Delta Dental of Arizona Group # 1331 Plan Year July 1, 2011 – June 30, 2012
20. DENTAL PLAN EFFECTIVE JULY 1, 2011 50% $1,000 Maximum Lifetime Benefit Orthodontia (Age 8 – 19) $50 per person $150 per family Calendar Year Deductible 100% Routine Services 80% Basic Services 50% Major Services $2,000 Annual Maximum Benefit per Person Buy- Up Plan Dental Plan FY12 $50 per person $150 per family 50% $1,000 Maximum Lifetime Benefit 50% 80% 100% $1,000 Base Plan
21. DENTAL PLAN EFFECTIVE JULY 1, 2011 Total for Family Dependent Employee Base Plan - $1,000 Annual Benefit Total for Family Dependent Employee Buy-Up Plan - $2,000 Annual Benefit Dental Plan FY12 $ 71.20 $ 40.12 $ 31.08 $ 111.24 $ 62.66 $ 48.58 Monthly Premium $ 31.08 $ 0.00 $ 31.08 $ 31.08 $ 0.00 $ 31.08 County Contribution $ 40.12 $ 40.12 $ 0.00 $ 80.16 $ 62.66 $ 17.50 Employee Cost per Month $ 0.97 $ 20.06 $ 0.97 $ 20.06 $ 0.00 $ 0.00 $ 1.56 $ 40.08 $ 1.31 $ 31.33 $ 0.25 $ 8.75 Difference Employee Cost Per Paycheck Effective July 1, 2011 Employee Cost Per Paycheck
22. NAPEBT Vision Plans VSP Group # 12239817 Plan Year July 1, 2011 – June 30, 2012
23. VISION PLAN EFFECTIVE JULY 1, 2011 $25 Material Co-pay Lenses and/or Frames $120 Allowance 20% off additional cost 15% discount off contact lens exam $120 allowance for exam & contacts $25 Material Co-pay Lenses and/or Frames $15.00 Co-pay Buy-Up Plan 15% Discount on Contact Lens Exam 20% Discount on a complete pair of glasses. $15.00 Co-pay Core Plan Employee Only In-Network Frames Once every 24 months Contacts Instead of Glasses Prescription Lenses Once every 12 months Eye Exam Once every 12 months Vision Plan FY12
24. VISION PLAN EFFECTIVE JULY 1, 2011 So what’s the bottom line? There is no change to employee payroll deductions for vision coverage for 2011-2012. $ 7.10 $ 14.20 $ 0.77 $ 14.97 $ 4.00 $ 8.00 $ 0.00 $ 8.00 $ 3.10 $ 6.20 $ 0.77 $ 6.97 Buy-Up Plan Employee Dependent Total for Family Core Plan -Employee ONLY $ 0.00 $ 0.00 $ 0.77 $ 0.77 Employee Employee Cost per Paycheck Employee Cost per Month County Cost Monthly Premium Vision Plan FY12
25. NAPEBT Life Insurance Plans Minnesota Life Policy # 33585 Plan Year July 1, 2011 – June 30, 2012
Coconino County has been a member of the Northern Arizona Public Employees Benefit Trust (hereinafter NAPEBT) since July 1993 . Other Trust members include the City of Flagstaff, Coconino Community College, Flagstaff Unified School District, Accommodation School, NAIPTA, and Flagstaff Housing Authority. The Trust was formed for the purpose of price stability and cost containment in the purchase of benefits for employees. 1993 County membership in the Trust 2003 we switched to Blue Cross Blue Shield 2006 the Trust became Self Funded NAPEBT directly assumes major costs of claims and expenses – Determines premiums – Determines changes to plan – This can help better align cost of claims/expenses with contributions.
Around the time the Trust went self funded you can see the premium costs have decreased to below the National Trend FY06
Blue Cross Blue Shield provides the claims administration – They do not set the premiums. The premiums are based on group experience and utilization Went out to bid and now the Pharmacy benefit is carved and will be administered by CVS/Caremark – we will provide more detail in later slides
Review the existing plan design – no change to deductibles/PCP copays Highlight the new items Hospital Admit Fee Retail 90 day supply at 2 ½ copay Primary Care versus Specialist Care Why …Total cost of Primary care is less than the cost of a Specialist Advantages …Cost savings to you and NAPEBT Urgent Care versus Emergency Room Going to a personal care doctor or urgent care prior to the emergency room (your condition permitting) for things like the flu, sprains, and sore throats In-Network versus Out-of-Network Why ...The plan has lower negotiated rates with providers Cost difference much higher out-of-network Advantages …You pay less out-of-pocket staying in-network Saves the plan money and makes coverage more affordable for everyone
Generic Drugs versus Brand-name Drugs Why …For total cost savings The cost for equivocally the same drug is on average $130 more for brand-name Generics are medically equivalent to their brand-name counterpart Use generic rather than brand-name drugs whenever available Advantages …You and NAPEBT save money Extranet available on 6/1/11 for employees to review Caremark information on line Dedicated NAPEBT phone line will be available on 6/13/11 877-456-0109 Fast Start program available 7/1/11 Employees will just need to call customer care number and ask for the Fast Start program the representative will assist and ask some questions. CVS/Caremark will reach out the physician and request a mail order RX be called in
Push toward Wellness initiatives
The Trust is a self-funded plan utilizing BC/BS of AZ to administer claims. We are responsible for payment of claims from premium collected from employers. Our strategic initiative for the future focuses on wellness. A healthy workforce is critical to controlling costs related to benefits. We are responsible for our own costs
Beginning in FY13, we will offer employees the opportunity to waive the $20 employee cost share by participating in wellness programs. BC/BS of AZ’s “My Blueprint” Health Assessment and Biometrics Screenings will be two of the activities employees will be required to participate in to be eligible for the $20 waiver. The NAPEBT Wellness Committee is working on the details and will scheduling and promoting these activities. Your voluntary participation in biometric testing, BCBS health assessment and other programs identified by the Trust will eliminate the $20 employee cost share for FY 13
New premiums will be reflected on the 1 st paycheck in July – Thursday, July 14
Benefit eligible employees (30 hours per week-regular status) are automatically enrolled in the Basic Term Life and AD & D Accelerated Death Benefit –May be available if you have a terminal illness. Please visit with Human Resources for additional information.
Employees who choose to elect additional supplemental term life insurance coverage will see an increase to monthly cost based on their age and amount of elected coverage.
2011 Annual Maximum: $3050 Single $6150 Family + additional $1,000 if age 50 or older.
You can find more information on NAPEBT.com Summary of group benefits Cost sheets General notices Or visit cocoweb IF YOU DO NOT WISH TO MAKE CHANGES, NO ACTION IS REQUIRED . IF YOU WISH TO CONTINUE OR ENROLL IN THE FLEXIBLE SPENDING ACCOUNT, YOU MUST COMPLETE ENROLLMENT FORMS.
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