BENEFITS ADVISORY
COMMITTEE
MINUTES OF MEETING
DECEMBER 18, 2003
[In these
minutes: Stop Loss Insurance, Open
Enrollment Update, MinuteClinic Update, Coverage for Erectile Dysfunction,
Dental Claims Appeals Process, PatientChoice Identification Cards, BAC
Preliminary Spring Semester Schedule and Agenda Items, Wellness Program Report]
[These
minutes reflect discussion and debate at a meeting of a committee of the
University Senate or Twin Cities Assembly; none of the comments, conclusions,
or actions reported in these minutes represent the view of, nor are they
binding on the Senate or Assembly, the Administration, or the Board of
Regents.]
PRESENT: Fred Morrison (chair), Linda Aaker,
Gavin Watt, Pam Wilson, Karen Wolterstorff, Jody Ebert, Ronald Enger, Don
Cavalier, Wendy Williamson, George Green, Gailon Roen, Susan Brorson, Amos
Deinard, Richard McGehee, Peh Ng, Theodor Litman, Rod Loper, Dann Chapman,
REGRETS: Joseph Jameson, Carla Volkman-Lien,
Rita McCue, Steve Chilton
ABSENT: Carol Carrier, Frank Cerra, Keith
Dunder
OTHERS: Linda Blake, Karen Chapin, Jennifer
Durocher, Gladys McKenzie
I). Professor Morrison called the meeting
to order.
II). Karen Chapin reported that the Board of
Regents approved the Stop Loss Insurance Committee’s recommendation to:
- Continue using HealthPartners as its
stop loss insurance carrier for their portion of the UPlan. In actuality, the stop loss
carrier for HealthPartners is Midwest Assurance, a sister company to
HealthPartners.
- Use NBR (National Benefit Resources),
a United Healthcare Company, as the stop loss carrier for the remaining
three plans, PatientChoice, PreferredOne and Definity.
In addition, the
Board of Regents approved the University to:
- Set its stop loss insurance at $5
million. This means that the
University’s stop loss coverage and lifetime maximum amounts will be
the same, $5 million.
- Increase its deductible on its stop
loss coverage from $350,000 to $500,000. This means that the University accepts the risk on the
first $500,000 of coverage. Amounts above $500,000, on an annual basis,
will be covered by stop loss insurance. By increasing the deductible to $500,000 the University
saves $500,000 in premium.
The University does, however, expect there to be claims submitted
in the corridor between the old deductible of $350,000 and the new
deductible of $500,000. Based
on experience data from 2002, these claims are expected to be
approximately $200,000 thus leaving the University with roughly $300,000
in savings as a result of making this change.
Professor Morrison
requested at the next meeting on January 22, 2004 an anonymous report on the
top two or three highest accumulations towards the $5 million lifetime
maximum. Ms. Chapin noted that
this information was included in the Stop Loss Request for Proposal and will be
shared with members at the January meeting.
III). OPEN ENROLLMENT REPORT: Dann Chapman distributed a handout and
explained the format used to calculate the changes between 2003 enrollment
figures and 2004 enrollment figures.
Reports incorporated within this handout included:
- UPlan Medical Coverage Report
(enrollment figures).
- UPlan Dental Coverage Report
(enrollment figures).
- 2004 Medical Plan Changes
‘To/From’ Report.
- 2004 Dental Plan Changes
‘To/From’ Report.
- 2004 Medical and Dental Program
Waivers Report broken out by employee group.
Mr. Chapman
emphasized that this is not a final open enrollment report because three groups
are still being contacted:
- Employees enrolled in PatientChoice
Duluth Tier III - For current Duluth PatientChoice Tier III participants
it is no longer necessary to remain in tier III for 2004 because the
Duluth Clinic can be accessed through PatientChoice Tier II as of January
1, 2004. Employee Benefits is
contacting Duluth employees that made the PatientChoice Tier III election
to make sure they are aware of this change.
- Employees that, in the past, have
defaulted into a plan and Employee Benefits does not have a signature on
an open enrollment form.
Because there will be a cost for all the health plans, the
University cannot take deductions from an employee’s paycheck
without a signature authorizing that deduction. Unless these individuals act by January 1, 2004 they
will have no coverage and default to a waiver. Employee Benefits has sent these individuals open
enrollment materials as well as a very specific letter to their home
addresses outlining the consequences of their inaction. There are 158 employees that have
defaulted into both medical and dental coverage and 115 employees that
have been defaulted into dental only and another 313 employees that have
been defaulted into medical insurance only. It is unclear at this point whether those that have
defaulted in the past have also failed to respond during the most recent
open enrollment period; in actuality these numbers could be smaller. Members brainstormed about other
ways to contact these individuals.
Suggestions were made to contact these individuals via e-mail and
also through a confidential mailing to the employee’s work
address. Mr. Chapman assured
members that Employee Benefits will actively try to contact these
individuals in ways that will protect their privacy and in ways the
University is legally allowed to do.
He added that an appeal process has been put in place for those
employees that fail to meet the January 1, 2004 deadline and want to
reinstate their medical and/or dental insurance. If reinstated, coverage would be retroactive to January
1, 2004 and require the employee to pay all missed premiums dating back to
January 1, 2004.
- Employees that chose DeltaCare in the
past because DeltaCare no longer exists. There are 49 people impacted by change. Employee Benefits will be
contacting these individuals to let them know they have been defaulted
into the base plan within their zone unless they contact Employee Benefits
with another choice.
IV). MINUTECLINIC UPDATE: Karen Chapman reported that the CEO of
MinuteClinic is meeting with several individuals in Duluth on Monday, December
22 to strategize about opening the Duluth MinuteClinic.
V). COVERAGE FOR ERECTILE DYSFUNCTION: Ms. Chapin reported that currently
HealthPartners covers Viagra only for treatment of erectile dysfunction. The University’s other three plan
administrators, Definity, PatientChoice and PreferredOne, cover the entire
therapeutic class, Viagra and Levitra, and, in 2004 as they are released,
Cialis and UPrima. The University
has approached HealthPartners and requested that they also offer the entire
therapeutic class. Effective
January 1, 2004 coverage for the entire therapeutic class of erectile
dysfunction drugs on all UPlan medical options will be available to plan
participants. The University,
however, reserves the right to modify this coverage should future drugs
released in this class be significantly more expensive, or be shown to provide
significantly less therapeutic value than the drugs previously released in this
class.
VI). Ms. Chapin announced that the UPlan
will now cover the flu mist inhalation vaccine now that supplies of the
injectable flu vaccine are exhausted.
VII). DENTAL CLAIM APPEAL PROCESS: Mr. Chapman announced that because the
University is self-insuring its dental coverage it is required to put in place
an appeals process as it did when it began self-insuring its medical coverage. The dental appeals process is the same
as the medical appeals process with one exception, the Employee Benefits
Director makes final decisions on dental appeals rather than having appeals be
sent to an external review panel.
The reason for this exception is twofold, cost and the simplicity in
determining what is a covered expense and what is not.
VIII). Ms. Chapin reported that PatientChoice
is issuing identification cards without social security numbers. PreferredOne is the only plan that
still uses social security numbers as an identification number but they plan to
do away with social security numbers sometime this year. Secondly, with regard to PatientChoice,
they are reissuing identification cards because they printed the wrong co-pay
amount on the original cards.
A member announced
that Blue Cross/Blue Shield (retiree plan) will also eliminate the use of
social security numbers on its identification cards for its plan participants
in the future. Ms. Chapin added
that NEW retirees to the Blue Cross/Blue Shield plan will not have their social
security numbers on their identification cards.
IX). Professor Morrison distributed a
handout outlining a spring semester BAC meeting schedule with preliminary
agenda items:
·
January
22, 2004 – Miscellaneous business items, general discussion of plan
performance, and directions for 2006 – 2011.
- February 5, 2004 – PatientChoice
plan review.
- February 19, 2004 –
HealthPartners plan review.
- March 4, 2004 – PreferredOne
plan review.
- April 1, 2004 – Definity plan
review.
- April 15, 2004 – Discussion of
plan options for 2006 – 2011.
- May 6, 2004
- May 20, 2004
- June 17, 2004
Other agenda items
to be scheduled for spring semester 2004 include:
- Tiered premium structure.
- Effects of MediCare changes on
retirees’ policies.
- Management of pharmacy benefits
– the State’s “Canadian option”.
- Financial (UPlan Annual Report) report
for 2003 – may not be available until the 3rd quarter.
- Rates for 2005.
A member requested
that when pharmacy benefits are discussed a well-informed individual on the
subject be invited to share with the Committee the benefits versus the risks of
importing Canadian drugs.
X). Professor Morrison called on Wellness
Coordinator Ruth Rounds to provide members with a Wellness Program Report. Ms. Rounds distributed a PowerPoint
handout for members to reference during her presentation. In addition, Ms. Rounds distributed an
‘Employee Benefits and Wellness Calendar’, which emphasizes
resources that are currently in place as well as a University publication dealing
with obesity. Mr. Chapman prefaced
Ms. Rounds’ presentation with a slight word of caution. Because there exists a lot of pent-up
expectation for a wellness program at the University, there is the desire to
immediately rollout a full-blown program.
Mr. Chapman stressed that to properly rollout a scientific, measurable
wellness program it will take time.
Next, Ms. Rounds
shared with members her thoughts on a proposed UPlan Wellness Program. She highlighted the following
information:
- The vision of the University’s
wellness program is to support the health and well-being of its employees
and their dependents with hopes of extending this to some degree to
University retirees as well.
- Objectives of a wellness program
include:
- Improve morale.
- Improve productivity.
- Improve culture and image of the
University.
- Help manage health care costs.
- Examples of preventable high risk
conditions include:
- Stress.
- Previous tobacco use.
- Weight.
- Lack of exercise.
- Current tobacco use.
- High glucose levels.
- Depression.
- High blood pressure.
- Medical costs increase with risk and
age.
- A wellness program should:
- Support low risk individuals to keep
their risks low through health promotion and programs.
- Support high risk individuals by
reducing these risks.
- Support individuals with chronic
conditions by helping them manage these diseases.
- In order to make a wellness program
visible there needs to be:
- Planned activities.
- Communication concerning existing and
planned resources.
- With the help of Boynton Health
Service, the Department of Recreational Sports and the School of Public
Health a baseline survey will be conducted to measure the health risks of
University employees through a random sample survey. Mr. Chapman added that this survey
will utilize, to the extent possible, the resources on campus as a means
to gain buy-in to the program.
Additionally, this survey needs to be conducted in such a way so
that the results of the survey will be undisputable.
- To kick-off the program, Ms. Rounds
proposes a ‘being active’ type campaign e.g. send all
employees and retirees in the UPlan a pedometer and activity log during
the first quarter of 2004.
Included in this mailing of pedometers will be the random sample
survey to some University employees.
The entire University community will be encouraged to participate
in the program. This type of
activity-based campaign will emphasize that the University cares about its
employees and encourage everyone to be active.
- The wellness program will involve both
individual and team activities.
- Make UPlan participants aware of the
great resources each of the health plans has in place that promote
wellness e.g. health risk assessments, health coaching, disease
management, etc.
- Develop a website containing:
- Information on current wellness
programming and/or events.
- Resources available through UPlan
administrators.
- Resources that are currently
available on the four campuses.
- Links to local and national health
resources.
- Investigate purchasing consumer health
education books and/or providing on-line access.
- Encourage UPlan participants take
advantage of preventive exams following guidelines for their age and sex.
- Investigate purchasing a disease
management service for employees who do not receive this service through
their health plan administrator.
Disease management services are already available in HealthPartners
and Definity Health plans.
- Determine incentives e.g. pedometers,
water bottles, activity and nutrition journals, etc.
- Develop a methodology for evaluating
the wellness program.
- Participate in new employee
orientation and let these individuals know about the University’s
commitment to their health.
- Work in conjunction with University
departments to support their wellness initiatives.
- Establish wellness coordinator
contacts (communication links) in all departments/units.
- Continue offering free flu shots to
all University employees and their dependents.
To conclude, by
the end of 2004 the goal is to have all University employees be aware that a
wellness program exists at the University of Minnesota.
Comments/questions
from members following Ms. Rounds’ presentation:
- There exist great disparities in how
each of the four plan administrators approaches wellness. What can the University do to move
each of the plans closer to the HealthPartners model and have them build
wellness into their institutional structure? Can/should the University factor this into its next RFP
as a required capability for each of its plan administrators? Professor Morrison attributes part
of this disparity to how the last RFP was formulated. The RFP did not require plan
administrators to incorporate wellness promotion offerings into their
pricing structure. Some of
the plans included these resources despite the fact the RFP did not
require it and others chose not to.
Professor Morrison stated the issue before this Committee is to
decide whether the University is willing to accept the additional cost
associated with each plan factoring in wellness resource charges.
- What role is Recreational Sports
playing in the University’s wellness initiative? Ms. Rounds stated Recreational
Sports is open to supporting the University’s wellness initiative in
any way it can. In the past,
Jim Turman, Assistant Vice President of Recreational Sports expressed
concern over the fact Recreational Sports funding base is student
driven. A member proposed
approaching Vice President and Executive Vice Provost for Faculty and
Academic Programs Robert Jones to fund employee access to the
University’s Recreational Sports facilities.
- A member asked to have markers put on
campus showing distances between certain points so individuals will know
how far they walked.
- Has an economical analysis been
conducted for the University’s proposed wellness program? Ms. Chapin stated that this is
being investigated and meetings are set up with organizations that have
conducted similar economical analysis.
Professor Morrison
thanked Ms. Rounds for her presentation.
He added that he plans to have her report back in May to provide members
with another progress report.
XI). Hearing no further business, Professor
Morrison adjourned the meeting.
Renee
Dempsey
University
Senate