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SchoolCare Health Benefit Plans of the NH School Health Care Coalition

SchoolCare Health Benefit Plans of the NH School Health Care Coalition. Business Reports. Lisa J. Duquette, Executive Director Melissa M. Perreault, Program Manager. 2012-13 Highlights. Staff made scheduled visits to 90%+ of members’ offices Wellness participation increased in all programs

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SchoolCare Health Benefit Plans of the NH School Health Care Coalition

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  1. SchoolCareHealth Benefit Plans of theNH School Health Care Coalition Business Reports Lisa J. Duquette, Executive Director Melissa M. Perreault, Program Manager

  2. 2012-13 Highlights • Staff made scheduled visits to 90%+ of members’ offices • Wellness participation increased in all programs • Dental program became self-funded • Developed Go-Green Initiative • 100% renewal of existing groups • 5 new groups, enrollment increased • Medical 3.7%; Dental 6.5%

  3. 2012-13 Financial Results (draft audited) • Contributions/Investments/Income • $135.08 million • Claims Expense/Insurance/Admin • $136.60 million • Excess of Expense over Revenue • $1.52 million Why?Claims ↓ Premium Holiday $7.66 million expense

  4. Net Assets • Fund Balance = Members’ Equity $33.1 million • Designated $17.8 million • SchoolCare 65+ - $1.9 million • Medical Risk Corridor- $15.9 million • Undesignated $15.3 million (Surplus to be returned to as Premium Holiday in future years)

  5. Your Premium Dollar 2012-13

  6. Health Care Update 2013 was the 1st year in the past decade that health care trend was below 10% Continued impact of health care reform PCORI Fee & Transitional Reinsurance Fees Out of Pocket Maximums for ALL plans 2013 medical trend for U.S. is expected to be 6.5% compared to 8.7% for New Hampshire Affordability for employers and employees is a major issue

  7. Rating Objectives Predictability Guarantee rates for negotiations and budgeting by December 1 Stability Minimize fluctuations from year to year

  8. SchoolCare Rate History (Average)

  9. Premium Holiday continues…. • Return of Surplus • previously Rate Stabilization • Increased Transparency • Budgeting • use Effective Increase/Rates • Calculate Employee Share • Future Premium Holidays

  10. PreliminaryCigna Medical Rate Indication Medical Trend 6.5% Average “Gross” Renewal 8.3% no increase greater than 13% Average “Effective” Renewal $10M of Premium Holiday (previously Rate Stabilization) “effective” average increase would be 1% no increase greater than 8%

  11. PreliminaryCigna Dental Rate Indication Dental Trend 5.7% Average Renewal 4.8% no increase greater than 5.15%

  12. Preliminary65+ Medical Rate Indication Medicare Supplement United American 7/1/13 increased 1.9% $207.00 Prescription (Rx) Express Scripts 7/1/13 no increase $205.00 1/1/14 decreasing 15%! 173.48 Employer Group Waiver Program (EGWP) New Monthly Rates 1/1/14 – 12/31/14: 65+ Medicare supplement only $207.00 65+ Medicare supplement and Rx $380.48

  13. 2014-2015 Rates Notices to each member by Dec. 1 Employer and Employee To renew and lock in, sign by Feb. 1

  14. Choices If member accepts rate by February 1, the Coalition can guarantee it for 2014-15, regardless of how claims may change If member does not accept by February 1, the Coalition reserves the right to re-rate, based on more recent claims experience Members must notify the Coalition within 45 days of July 1 if wishing to non-renew

  15. Thank you for your participation.Questions?

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