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Agenda

Agenda. Lunch 11:00 – 11:30 P.R.E.P – Sheri Gilbert, VSEBT 11:30 – 12:00 UnitedHealthcare Updates – Mark Baggot 12:00 – 12:15 HIPAA Compliance – Lisa Rafferty, Aon 12:15 – 12:30 VSEBT Claims Audit – Lisa Rafferty, Aon 12:30 – 1:00 Questions and Answers. P.R.E.P.

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Agenda

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  1. Agenda • Lunch 11:00 – 11:30 • P.R.E.P – Sheri Gilbert, VSEBT 11:30 – 12:00 • UnitedHealthcare Updates – Mark Baggot 12:00 – 12:15 • HIPAA Compliance – Lisa Rafferty, Aon 12:15 – 12:30 • VSEBT Claims Audit – Lisa Rafferty, Aon 12:30 – 1:00 • Questions and Answers

  2. P.R.E.P • Prevention Reward Employee Program2 + 1 Incentive ProgramPrimary Requirements • Completion of Annual Preventative Wellness Visit (Required for Reward) • Completion of Health Risk Assessment on myuhc.com (Required for Reward) • Employees must also complete 1 of the P.R.E.P. Items below to qualify for Reward: • Additional P.R.E.P. Choices • Enroll in DPCA Program if applicable (Diabetes Prevention & Control Alliance) • Complete 8 months of Work it Off Exercise Program (10 hours of exercise per month) • Complete a Smoking Cessation Program (state, county, or online with UHC coaching) • Complete a UHC Health Coaching Program • Attend 2 district sponsored Wellness Classes (Classes TBD by district) • Implementation • Send communication to employees in April alerting them of the opportunity. Provide in OE materials. • Employees have from 5/1/12 to 4/30/13 to complete the required action items to earn their additional deposit. • Proof of services for Wellness Visit, Health Risk Assessment & UHC health coaching (including smoking cessation coaching) will be provided to VSEBT via reporting in June. • Proof of completion for the Work it Off option will be provided to VSEBT via e-mail, fax or mail. • Proof of smoking cessation certificate (other than UHC health coaching) shall be faxed, e-mailed or mailed to VSEBT. • Proof of attendance for Wellness Classes will be verified by employee sign-in onsite and provided by district to VSEBT for confirmation. District should schedule classes between May and March to allow for recording of participation. • Rewards • HDHP Members - $250 deposit in HSA in July 2013 • Traditional Plan Members: $50 to $75.00 Sprouts gift card in July 2013.

  3. Pharmacy Benefit UpdateJuly 1, 2012 PDL and Benefit Plan UpdatesFor Self Funded Customers on the Advantage PDL

  4. Summary of July 1, 2012 Decisions With the exception of Lipitor, no medications in the top 100 by utilization are affected. Member impact should be minimal, but resulting savings should be significant.

  5. Lipitor Strategy Update Generic Lipitor launched in November and is anticipated to decrease in price around June 1, 2012.Upon the price drop of the generic, the following tier placements will be effective. The price will be monitored for eventual Tier 1 placement on the Advantage PDL. At the Pharmacy • Additional Tier 1 generic alternatives available: • lovastatin (generic Mevacor) • pravastatin (generic Pravachol) • simvastatin (generic Zocor) Point-of-sale messaging will direct the pharmacist to dispense the lowest cost option for the member. *Final timing for this tier change is dependent on the price decrease of the generic, which is anticipated to be near June 1, 2012.

  6. Hormonal Contraceptives Health Care Reform Update for Pharmacy Beginning Aug. 1, 2012, UnitedHealthcare will implement several tier changes as part of Health Care Reform. We arerequired to provide coverage for medications: • in Tier 1 • at $0 Cost Share • from each of these categories: • Emergency (e.g. Plan B) • Hormonal (e.g. Oral or other route) • Barrier (e.g. diaphragms)

  7. Hormonal Contraceptives PDL Management Strategies Numerous options in Tier 1 and Tier 2 provide members with affordable access. Approximately 50% of prescription claims for hormonal contraceptives will process at $0 cost share when zero cost share is implemented. Each unique progestin contraceptive medication will be represented in Tier 1, making sure women have access to each type of contraceptive. *Count is based on the chemical or each unique product represented; there may be multiple medication names for each. Decisions:

  8. HIPAA Compliance • HIPAA compliance required for all entities. • Current manual, forms, processes are being updated for any recent changes. • Replace all current materials with the new materials. • HIPAA training available soon.

  9. VSEBT – UHC Audit Results Quarterly Education Session March 27, 2012 Aon Hewitt - Health and Benefits Consulting

  10. Health Plan Audits — Aon Hewitt • Expertise and Experience—Aon Hewitt has performed more audits than any other firm, uses full-time auditors, has extensive experience with UHC , as well as other significant administrators • Aon Hewitt performs over 200 audits annually • We have over 20 expert auditors that do this work full time • Our auditors average 18 years of industry experience • Aon Hewitt “scores” an administrator’s performance and capabilities, and consistently identifies “opportunities” to lower plan costs and improve service • We focus on Process Improvement, Outcomes, and Results Aon Hewitt - Health and Benefits Consulting

  11. Sound Reasons for the Audit • Determine how accurately and effectively VSEBTs medical plans are being administered by UHC • Resolve plan service issues and benefits administration problems • Show VSEBT districts that a comprehensive “due diligence” process has been performed and controls have been tested • Indicate to UHC that VSEBT expects the plans to be administered accurately and effectively Aon Hewitt - Health and Benefits Consulting

  12. Claim Audit Process • Our claim assessment looks at • VSEBT benefit intent • Eligibility of claimant • Application of provider data • Benefit calculation accuracy • Application of plan design features • COB or TPL application, when applicable • Claims/coding accuracy • Controls in place to manage claims • Participant claim history • Documentation supporting final benefit determination • Claim processing turnaround time Aon Hewitt - Health and Benefits Consulting

  13. Aon Hewitt Audit Results • Aon Hewitt onsite @ UHC Florida facility – Week of 11/14/2011 • Operational Assessment – 11/3/2011 in Green Bay Specific Objectives: • Verify VSEBT medical benefits paid accurately and according to plan documents • Assess overall quality of claim administration being delivered by UHC personnel • Indentify opportunities and changes that will improve UHC overall performance on the account and increase level of service being provide to VSEBT participants Aon Hewitt - Health and Benefits Consulting

  14. VSEBT Performance Standards and Objectives for 2011 VSEBT Aon Hewitt - Health and Benefits Consulting

  15. UHC Claim Audit Results UHC performed well in handling VSEBT medical claims Aon Hewitt - Health and Benefits Consulting

  16. Claim Processing Time UHC is processing VSEBT claims on a very timely basis Aon Hewitt - Health and Benefits Consulting

  17. Call Resolution/Volume UHC Green Bay team exceed first call resolution objective of 90% VSEBT participants use of website varies by district: 44% to 83% Aon Hewitt - Health and Benefits Consulting

  18. Customer Service Responsiveness We found the customer service tools, capabilities and recent performance results to be quite good compared to other administrators. Aon Hewitt - Health and Benefits Consulting

  19. Customer Service Call Quality UHC personnel exceed the quality contract objective during the timeframe reported. Aon Hewitt - Health and Benefits Consulting

  20. Questions? Aon Hewitt - Health and Benefits Consulting

  21. Thank you!

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