2016 Employee Health Benefits Update CHALLENGING YOU TO MAKE A - PowerPoint PPT Presentation

2016 Employee Health Benefits Update CHALLENGING YOU TO MAKE A DIFFERENCE

Where we are today. • Low Rate Increase: 3% • No changes to the Plan design or Schedule of Benefits • Same low deductible, co ‐ insurance and co ‐ payments • State of Ohio lowered dependent eligibility from age 28 to age 26 • Affordable Care Act (ACA) Mandates • Major changes to Plan • Play or Pay – Shared Responsibility Assessments • Results in employee eligibility rules changes

Plan Costs 2011 to 2015 YTD (9/30) 2015 2014 2013 2012 2011 $0 $2,000,000 $4,000,000 $6,000,000 $8,000,000 $10,000,000 Health Prescription Vision Dental Life Wellness Administration

2016 Monthly Rates Coverage Total Employer Employee* Health & Rx $ 609.48 $ 518.06 $ 91.42 Vision $ 7.84 $ 6.66 $ 1.18 Single Dental $ 31.62 $ 26.88 $ 4.74 Life $ 7.22 $ 7.22 $ 0__ Total Single $656.16 $558.82 $97.34 2015 Rates $ 635.92 $ 541.76 $ 94.16 Health & Rx $ 1,584.62 $ 1,346.92 $ 237.70 Vision $ 20.42 $ 17.36 $ 3.06 Family Dental $ 82.18 $ 69.86 $ 12.32 Life $ 7.22 $ 7.22 $ 0__ Total Family $1,694.44 $1,441.36 $253.08 2015 Rates $ 1,640.38 $ 1,395.56 $ 244.82 * Split between first and second pay dates of the month. May be deducted on a pre-tax basis. Employees are responsible to pay 15% of the total cost for coverage. Spousal Premium rates are in addition to a family contract.

• ACA mandates changes to Employee Eligibility • Based on 30 Hours of Service per week • Hours worked • Paid leave • County to apply new Hours of Service Includes Hours of Service rules to all benefits All Paid Hours Do Not include Plus • Health/Prescription • Vision, Dental & Life • Create new processes effective 2016 plan year • New hires • Ongoing employees

Look ‐ back Measurement Method Measurement Administrative Stability Period Period Period Two Types of Look ‐ back: Initial and Standard • ALL employees hours are measured each year • Standard Look ‐ back Method (Oct ‐ Oct) • Coverage offered for next calendar year • New non ‐ full time hires: part time, seasonal or variable hour • Initial Look ‐ back Method (12 mo. from date of hire)

Monthly Measurement Method • New Hires with 30 or more Hours of Service hours per week (non ‐ seasonal) • Applies to hires after Oct. 6, 2014 • Measures until they complete a full standard measurement period • Measure each month to determine eligibility • Eligibility may change monthly based on hours of service Looks at employee’s hours each month until placed in a Standard Stability Period.

Newly Eligible Sign ‐ off on Employee Meeting determination form 3 pm at Wood Haven due to Insurance on Nov. 24 Group Rep by Nov. 23

ACA Challenges • Additional federal reporting requirements • 1095 ‐ C distributed in 2016 – shows coverage offered and enrollment for employee & dependents • Ongoing changes in federal guidance • Measurement methods may change based on employment status change • Insufficient Wages for Payroll Deductions • If an employee fails to make payment, coverage will terminate for the remainder of the stability period (calendar year or 12 mo.)

What we are up against. $8,000,000 ▪ Increased Costs Health & Prescription Market $7,000,000 ▪ ACA Eligibility Changes $6,000,000 $5,000,000 $4,000,000 $3,000,000 $2,000,000 $1,000,000 $0 2014 2013 2012 2011 Health Prescription

We challenge you to…. • Know your Plan – review your SPD • Be wise consumers save money for you & the Plan • Select Quality Outcome Providers • Price Shopping for Best Value • Improve/Maintain your current health status • Participate in the monthly wellness programs Our Health Benefits Trust Be an engaged Employer consumer when 85% pulling money out Payment Employee of Claims of our pocket. 15%

How we can tackle increased costs to the Plan? FrontPath Healthcare Quality Choose quality providers Improvement Program Identifies useful data on providers that deliver quality care. • Cost Reports • Composite Condition & Procedure Ratings • Composite Overall Ratings • Composite Surgical Ratings • Detailed Quality Rating and Score • Inpatient Medical Ratings • Inpatient Surgical Ratings • Patient Satisfaction Survey Ratings

Username: wood Password: WCMER003

How we can tackle increased costs to the Plan? • Have a Primary Care Physician • Avoid Urgent Care and ER when not necessary • Choose lower costs options • These bill at a Doctor’s office rate • Pharmacy services provided

How we can tackle increased costs to the Plan? Price Shop for Lowest Cost Lantus Solostar Pharmacy A Pharmacy B Pharmacy C Pharmacy D Medications 15ml Total Claim $373.36 $377.49 $381.46 $75.46 • Co ‐ payments may not Charge Employee change, but you can save $35 $35 $35 $27.09 Co ‐ Payment the Plan money by Plan Payment $343.36 $342.49 $346.46 $48.37 Amount switching to a different pharmacy. Atorvastatin Pharmacy A Pharmacy B Pharmacy C Pharmacy D • Utilize the Database of 20mg Tab Total Claim Low Cost or Free $51.98 $0 $10.61 $6 Charge Medications Available at Employee $5 $0 $5 $5 Co ‐ Payment Pharmacies Plan Payment $46.98 $0 $5.61 $1 • Link on employee website Amount • Mobile app available

Earn a Deductible Credit Monthly Challenges Win Monthly Prizes Participate in Wellness Programs WE CHALLENGE YOU TO TAKE AN ACTIVE ROLE IN YOUR HEALTH

Program features monthly challenges to help you focus on healthy habits. Make/Break the Habit! Shake the Salt! Reduce Your Stress! Form a team within your office or participate on your Stand Up for Heart own. Health! Get 5! Monthly tracking logs will be posted on the employee Stay Hydrated! website. Challenges must be started and completed Couch to 5K! within the same calendar month. Catch Some ZZZs! Each month will feature a different challenge, but you Focus on Fitness! can complete them in any order you like. Brown Bag It! Stretch & Flex! Monthly prizes are draw from employees completing a monthly challenge. More challenges = more entries. Walk It Off!

In addition to monthly challenges, benefit eligible Earn a Deductible Credit employees can earn one challenge credit for the following completed programs: $50 Complete at least 5 Challenges Wellness Screening Fitness Program Nutrition for Life Complete at least 10 Challenges $100 Tobacco Termination Summer Swim See Summary Plan Description for additional information

Representatives Available for Questions Mercer Consultants Jason Beaver, Gauri Airi Wellness Network & Third Party Administrators Nick Strausbaugh, FrontPath Susan Allen, Meritain Health Jocelyn Bolling, PDMI Plan Karen Chapman, Delta Dental Design Administrative Support Andrew Kalmar, Pamela Boyer, Employee Janese Diem, Cheryl Albrecht, Engagement Rachel Richmond, Steve Puffer Special Thanks Employee Health Benefits Committee Wellness Subcommittee It takes everyone working together to keep the Plan running smoothly.