03162010 HEALTH CARE UPDATEII I.
3/16/2010
Health Care Goals
Offer affordable, quality health care as part of a total compensation
package
Control costs by managing the health care trend and reducing the
GASB 45 liability
Maintain a healthy and productive workforce
Achieve best prices for goods and services
Focus on health risks that are significant cost drivers
Promote a culture of change and accountability
Promote health awareness, education and involvement of enrollees
in their health and wellness
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GASB 45 Liability
Annual Required Contribution to Pooled Trust Fund
• June 2008 - $5M City / $3.9M Schools
• June 2009 - $4,777,652 City / $3,681,099 Schools
2010 GASB 45 Valuation
Assumptions
• Rate of Return -continue to use VRS assumption
• Spousal Enrollment -Virginia Beach-Specific
Mercer Completion -March 2010
Audit by City Auditor -April 2010
Payment to Trust Fund -June 2010
C~ependent Audit
2009 Audit Results
• Dependent Eligibility Certificates requested for signature
• Employees - 2,734 City/4,285 Schools
• Retirees -Not requested as all dependents were audited
• Audited
• Employee - 613 City/944 Schools; Retirees - 278 City/149 Schools
• Dependents Terminated -Divorce; Lack of 50%Support
• Employee Plans - 1 73 City/189 Schools; Retirees - 0 City/0 Schools
2010 On-Going Efforts Requiring Proof of Eligibility
• Qualifying Events -All dependents
• New Hire/Open Enrollment -Dependents with different last names
• Other -Targeted audits will be conducted
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Wellness & Prevention Programs
Disease and Condition Management
. Diabetes Disease Management Program
Respiratory Disease Management Program
. "Partners in Pregnancy" Prenatal Program
Fitness Programs
. Fitness Incentive Tracking Program (FIT)
WalkAbout
Screenings and Vaccinations
. Cancer Screening Initiatives
. Flu Shot Clinics
Health Screenings
Personal Health Profile
Support Services
. Care Management
. Employee Assistance Program
. Tobacco Cessation Program
Health Education
Classes & Resource Library
Weight Management
. Eating for Life
. Maintain Don't Gain
Weight Watchers
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Yaw GUIDE ro A
HEpi THY 2010
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/Vew Initiatives
Programming
. Implemented new Tobacco Cessation Program -Quit for Life® by
Free & Clear®
• Expanded Weight Watchers offerings
• Introduced new on-line Health Risk Assessment tool and designed
a follow-up strategy for those with health concerns
. Increased offerings for Health Screenings (cholesterol, blood
pressure, BMI)
. Added Tobacco Cessation Medications (including Chantix) as a
covered benefit
• Expanded disease management programming to include Chronic
Obstructive Pulmonary Disease (COPD) -now entitled Respiratory
Disease Management
• Implemented screening to detect those at risk for diabetes and
encouraged physician follow-up
• Expanded flu shot coverage to spouses covered by our health plan
Newlnitiatives --continued
Education
• Provided educational material and classes on high deductible health
plan with health savings accounts
• Provided education classes on Health Reimbursement Arrangements
• Provided educational material and classes on diabetic resources
• Developed new Guide to Wellness & Prevention
• Providing Benefit Seminar Series
• Provided Health Fair during Open Enrollment
• Enhanced Wellness Ambassador awareness through conferences and
"best of recognition
• Provided enhanced opportunity for on-site health education classes
• Conducted Dependent Audit
Newlnitiatives --continued
Collaboration
• Participate on eValue8 Strategic Partnership through Virginia Business
Coalition on Health for health plan/employer/provider collaboration
• Enhanced collaboration with Occupational health
• Enhanced collaboration with Optima Case Management
Recognition
• Recognized by American Heart Association as "Start! Fit-Friendly"
company, listed in September 28, 2009 issue of Fortune magazine
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Results /Projections
2009 Trend
• Experienced a 6% increase in trend
2010 Plan Changes/Enrollment
• Plan Changes -Added High Deductible Health Plan with a Health
Savings Account; Eliminated Basic PPO
• Contribution Strategy - No changes
• Enrollment -HMO 13,577; PPO 79; Equity 210; POS 812
• Double EE/Retirees make up an additional 1001 receiving employer
contribution
• Employee/Retiree Only - 56.8%; Dependent Coverage 43.2%
2010 Projection
. 7% Trend
Next Steps
April/May
• GASB valuation completion
• Reviewl5c quarter claims experience
Development of 201 1 options
• Contribution Strategy
• Continue flat contribution rate (same amount for all tiers)
• Provide increased contribution to dependent tiers
• Provide contribution based upon a percentage of cost by employee and
dependent tiers
• Plan Design Changes
• Impact to Health Fund and GASB liability
June -Discussion and presentation of options
August -Completion of claims audit
December -Issuance of RFP for fully and self insured health plans
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