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Botetourt County Public Schools 2009 Renewal

Botetourt County Public Schools 2009 Renewal. May 14, 2009. Presented By: Carol McGowan, CLU, CPCU, CEBS. Anthem Medical Claims Summary. Total claims were $3,434,750, a 7.7% increase with an 83% loss ratio.

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Botetourt County Public Schools 2009 Renewal

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  1. Botetourt County Public Schools 2009 Renewal May 14, 2009 Presented By: Carol McGowan, CLU, CPCU, CEBS

  2. Anthem Medical Claims Summary • Total claims were $3,434,750, a 7.7% increase with an 83% loss ratio. • Claims per member per year increased 8.3% to $399.71. In the prior review period they were $369.06. • Average enrollment decreased less than 1%. • Prescription drugs accounted for 24% of total claims. • 9,529 (65.3%) scripts were tier one - 20.9% of the plan’s drug expenses. • 3,858 (26.5%) scripts were tier two – 52.4% of the plan’s drug expenses • 1,195 (8.2%) scripts were tier three - 26.6% of the plan’s drug expenses • There were 23 large claims (40% of total claims) • 4 claims exceeded the $100,000 pooling level • $193,035 in excess dollars were removed from the claims projection • Adjusted loss ratio was 76% • Retirees account for almost 19% of the paid claims cost. For the upcoming year the projected claim cost for the early retiree group is expected to be 79% higher per contract than for the active employee group. • There are minimal Anthem mandated changes for the upcoming renewal. • Anthem Medical Trend is 11.4% and Drug Trend is 12%. 18 months of trend was utilized for the renewal. • Anthem’s increase is 8.8%. Various options reviewed.

  3. Anthem Claims Experience April 2007 – March 2009

  4. Large Claims April 2008 – March 2009

  5. Renewal OptionsOctober 2009 – September 2010

  6. Self Funded OptionOctober 2009 – September 2010

  7. Opportunity versus Risk Risk Opportunity

  8. Projected Retiree Charges

  9. Dental and Employee Assistance Program (EAP) Summary • Dental Renewal • Anthem initial renewal was no increase • Renewal negotiations resulted in 3.6% decrease to the dental rates • Dental Marketing • Marketed to 9 carriers – Ameritas, Assurant, Delta Dental, Dominion Dental, Guardian, Humana, MetLife, Mutual of Omaha and Sun Life • Looked at both self insured and fully insured plans • Network and plan cost important • Anthem has 5 of the top 25 providers in network • Delta has 17 of the top 25 providers in network • EAP marketed to two vendors • Current agreement expires 8/31/09 – can be extended one year at current rates.

  10. Combined Expense Base and High Option Dental Plan Rates Effective October 1, 2009

  11. Employee Assistance Program Rates Effective September 2009

  12. Recommendations • Move to a Self Insured Medical Arrangement • Implement the $10/$30/$50 or 20% with a $150 deductible drug plan (Option 1 Plan Design) • If decision is made to stay Fully Insured, move to Option 1 Plan design • Recommend looking at Delta Dental due to two year rate guarantee and better network • Move to Ceridian Employee Assistance program

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