health and employee benefits pool - county · health and employee benefits pool Øcounty-owned and...

Health and Employee Benefits PoolPlan Year 2020, Effective October 1, 2019

IntroductionandTACHEBPOverviewPlanYearReview

RenewalTimelines

OtherNews

RNBCProcessReviewandUpdates

EmployeeSelf-ServicePortalUpdates

Questions

OASysUpdates

Agenda

PlanYear2020Outlook

TAC HEBP OVERVIEW

Health and Employee Benefits Pool

Ø County-owned and county-governedØ Not for profit (no stockholders to satisfy)Ø No state premium taxØ Stable membership – 221 county entities

§ 212 Pool (fully insured) and 9 ASO (self funded)§ 48,000+ members

Ø Stabilize rates for TAC supported counties and districts

TAC HEBP Product SuiteMedical&PrescriptionwithTeleHealth

Dental [WithorWithoutOrthodontia]

RetireeMedical[CountyChoiceSilverMedicareSupplement]

LifeInsurance[BasicandSupplemental]

VisionInsurance

DisabilityInsurance[Short&Long-term]

HEBPHealthyCounty

EmployeeWellnessØ Countyconsultationandtargetedincentiveprograms

Ø HealthyCountywellnesschallenges(poweredbySonicBoom)

Ø EmployeeempowermenttrainingsØ Annualconference(nochargetogroupWellnessCoordinatorandWellnessSponsor)

TAC HEBP Healthy County

EmployeeWellnessØ Countyconsultationandtargeted

incentiveprogramsØ HealthyCountywellnesschallenges

(poweredbySonicBoom)Ø EmployeeempowermenttrainingsØ Annualconference(nochargetogroupWellnessCoordinatorandWellnessSponsor)

TAC HEBP Renewal

Ø Renewal Process OverviewØ Prior Year ReviewØ Current Loss RatioØ Projected TrendØ Pool Needed Amount

Renewal Process

Actuary determines Medical and Rx trend for current and coming year

Actuary determines Pool contribution requirements for coming year

TAC Management Team reviews* each individual Pool group

Actuary reviews TAC Team rate recommend-ations

Recommended rate scenarios prepared by TAC staff for Board review

Board approves renewal rates

Renewal processed for release to groups based on Plan Anniversary dates

ØCredibility/PredictabilityØ LossRatio:Claimsvs.ContributionsØHighCostClaimsØ ShockClaims/PoolingPointØDemographicandAreaMedicalCostfactors

* Individual Review:

Plan Year Review

TAC HEBP Renewal Plan Year (PY2019) Membership

Change in MembershipØ TAC HEBP added 4 groups in PY19 (10/1/18 – 9/30/19): Carson, Crane,

Starr, and Zavala CountiesØ 221 Members (212 Pooled & 9 Self-Insured)

Ø Average Pool membership is 36,553 an increase of 8% year over yearØ Subscribers: + 5.34%Ø Spouses: + 3.01%Ø Dependents: + 3.68%

Ø Average member age remained stable at 38.8 years

TAC HEBP Renewal Medical Trend CY2018

Top3Conditions:Circulatory($26M),Cancer($25M),andMusculoskeletal($24M)

TAC HEBP Renewal Plan Year (PY2018) High Cost Claimants

TAC HEBP Renewal Rx Trend (Jan – Sept 2018) Prior PBM

Ø 29.2%Specialty Trend Ø 4.4%Non-SpecialtyTrendØ 11%RxTrend

TAC HEBP Renewal Rx Trend (Oct’18–March’19) Current PBM

Ø 0.6%Specialty Trend Ø -3.2%Non-SpecialtyTrendØ -2.1%RxTrend

TAC HEBP Renewal Impact of PBM Change

Current Loss Ratio

TAC HEBP Renewal – Medical Loss Ratio

Plan Year 2020Projected Trend

Plan Year 2020 Projected Trend

Ø PY 2020 Trend (10/1/2019-12/31/2020)

Ø TAC Blended Trend 7.5%Ø 8% MedicalØ 6% Rx

Plan Year 2020Pool Needed Amount

Plan Year 2020 Pool Needed Amount

Ø PY 2020 Pool Needed, eff. 10/1/2019 -12/31/2020

Ø Overall 2.79%

Renewal Timelines

Key Renewal Dates: October 1 Anniversary Date

Key Renewal Dates: November 1 Anniversary Date

Key Renewal Dates: December 1 Anniversary Date

Key Renewal Dates: January 1 Anniversary Date

OASys Updates

NEW!!OASys login

OASys - Multi-factorAuthentication(MFA)login

UpgradestoOASysrequireTACtoadaptamulti-factor authentication

(MFA) login.Using MFA require users to

provide more than one method of authentication to login.

OASys - Multi-factorAuthentication(MFA)login

Newhomepage.Enteryour

currentOASysemail.

OASys - Multi-factorAuthentication(MFA)login

Checkthisboxonlyifyouareusingaprivateorworkcomputer,andif

allowedperyourITpolicy.

Entercurrentpassword,orcreatea

newpassword

OASys- multi-factorAuthentication(MFA)login

Verificationcode– enteremailorphonenumber

OASys - Multi-factorAuthentication(MFA)login

Anemailwiththeverificationcodewillbesendto

you.

Note:TheemailwillcomefromWillisTowersandWatson.

PleasehaveyourITDepartment“Whitelist”thisemailaddress.

OASys - Multi-factorAuthentication(MFA)login

YoucanchoosefortheVerificationCodetobesentviatext oraphone

call.

OASys - Multi-factorAuthentication(MFA)login

Entercodetologin

OASys - Multi-factorAuthentication(MFA)login

Oncevalidated,youwillbetakentotheWebAdminscreen.

Ø ValidemailaddressØ EmployeeClassificationCode(sameasWorkersCompcodefrompayroll)

Ø NewOptionalField:ØMobilePhoneNumber

OASys – Data Entry ChangesEntryfieldsinOASysthatarenowrequiredfornewhires:

RNBC Process Review and Updates

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

Clickonthe‘RNBC’tab

Electronic Renewal: Alternate RNBC Available

WithintheRNBCtabclicktheAlternate

RenewalInformationtabtoselectan

alternatemedicalandRXplan.

NEW!!ALTRNBC!!

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

EnterEmployerandEmployeecontributionamounts

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

Firstof3screens-ReviewandUpdateeachContactType:

ContractingAuthority,PrimaryContact,

andBillingContact

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

Retireecoveragedesignation

WaitingPeriods

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

ConfirmhowyourentityhandlesCOBRA.Clicksubmit.

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

PrintRNBC.

Have yourContractingAuthorityinitialeachpageofcompletedRNBCformandsignonlastpage.Then

faxoremailtoyourEmployeeBenefits

Specialist.

Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)

Employee Self-ServicePortal Updates

Employee self-service (ESS) portal is getting an upgrade.

EffectiveJuly1,2019,TACwillrolloutanupgraded EmployeeSelf-Service

portal.

NEW!!ESS

Navigatetoyourbenefits,changebeneficiaries,

obtain forms,andviewotherTACprograms.Canalsoaddlinkstovendorwebsitesforothernon-TACbenefits.SimilartothecurrentESS,

just better!

Employee self-service portal (ESS) capabilities

Startingthisyear,theESSwillbeusedduringtheOpenEnrollmentperiods.Employeescanenrollinbenefitsthemselves!

Employee self-service portal (ESS) capabilities

Employee self-service portal (ESS) capabilities

Viewyourelectedbenefitsandtotalcosts.

ESSOASysReports

InOASys,youcanaccessReportsatanytime onchangesmadeby employees inESS.

EmployeeSelf-Service(ESS)- Multi-factorAuthentication(MFA)login

ESSloginwillalsouseMFA.

Firsttimeusers willneedtoconfirmtheiridentitybyenteringeithertheir

UIDorSSN.

Enhanced Registration

Enhanced Registration

Ifthedateofhireisunknown,theexactyearis

acceptable.

DOB anddateofhiremustmatchuser’srecordonfile.

An authenticationcode willbesenttotheuser’semail.

Establish/Verify User

Note:TheemailwillcomefromWillisTowersandWatson.Please

haveyourITDepartment“Whitelist”thisemailaddress.

Userswillhavetheoptiontohavetheverificationcodesentviatextor

to receivea phonecall.

Phone Call or Text Authentication

Oncetheverificationcodeisentered,accepttheOnlineAuthorization

terms.Accessisgranted.

Successful Log-in

Other News

Dental Open Enrollment

Ø Beginning this year, TAC HEBP will have annual Dental Open Enrollment.

Ø Here's who can enroll:Ø Any full-time benefits-eligible employeeØ Eligible Spouses and Dependents

Ø Please contact your Employee Benefit Specialist with any enrollment questions

Renewal ProcessNew ID Cards

Concierge Customer Service

One toll-free phone number for:

BCBS Customer ServicePre-Authorizations

Condition Management

BlueCareConnectionsisbeingreplacedbyBCBSWellbeingManagement

Renewal ProcessOrdering Replacement ID Cards – One Request, Four Ways

Call BCBS Customer Service Use Blue Access for Members mobile app

Log in to Blue Access for Members

If your employee is in a pinch, call a TAC Employee Benefit

Specialist

ACH Payments

Ø Groups will be able to pay their TAC HEBP invoices via ACH by early 2020

Ø Detailed instructions will be provided when this payment option becomes available

Ø In order to use ACH, group must pay exact invoice amount (pay as billed)

Renewal Process

Ø RNBC Changes – view alternates and complete selectionand contributions online!

Ø New login security for OASys admin usersØ Employee Self-Service – new look, more information,

and available for Open Enrollment elections

Ø Dental Open Enrollment

Ø New ID Cards – 1 number for BCBS services

Ø ACH Payments coming soon

ONLINE

ON TIME

REMEMBER: SEND IN YOUR RENEWAL

&Renewal Due Dates

10/1 AD: August 2

11/1 AD: September 20

12/1 AD: October 11

1/1 AD: November 1

CONSULTANTEAMS

SPECIALISTEAM

Renewal Process

Questions

Renewal Process

For questions regarding the information presented, please contact your Employee Benefits Consultant

at

(512) 478-8753 | (800) 456-5974FIRST NAME + FIRST INITIAL OF LAST NAME

@county.org

Thank you!