benefit choices in a changing environment pat haines svp, benefits
TRANSCRIPT
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Benefit Choices in a Changing Environment
Pat HainesSVP, Benefits
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• 2013: A Year of Difficult Choices• The World in Which We Live: The Context for
Making Choices• The Choices Facing Each of Us
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Topical Overview
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• Retirement Plan• Modify Apportionment Policy
• Disability Plan• Increase Benefit
• Medical Plan• Increase Dues• Change Pharmacy Benefit Management (PBM) partner• Increase Rx Copay for Generic Drugs• Design Health Accountability Program
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2013: A Year of Difficult Choices
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• Retirement Plan• Rationale
• Maintain plan solvency• Provide generational equity• Protect benefits against inflation
• Impact• 1% apportionment = $57.7 mil
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Choices: Rationale and Impact
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• Disability Plan• Rationale
• Protect benefits against inflation• Impact
• The increase in liability = $714,000
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Choices: Rationale and Impact
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• Medical Plan• Rationale
• Provide some limited flexibility• Provide quality coverage• Continue support of Community Nature• Ensure financial solvency
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Choices: Rationale and Impact
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• Medical Plan• Impact (2014)
• Cost Savings• New pharmacy benefit partner = $2.9 mil• Dues action (21% → 23%) = $13.6 mil• Rx copay change ($8 → $10) = $400,000
• Call to Health = improved member health
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Choices: Rationale and Impact
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• Declining enrollment• Aging population• Healthcare Reform• Inherent volatility
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Medical Plan: Other Factors Affecting Costs
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Medical Plan Before and After: Forecasts
2013 ForecastAs of: June 2013 February 2014
Total Revenue $174,538 $174,200
Total Expenses(claims & admin) $180,759 $184,079
Net Income ($6,222) ($9,878)
Fund Balance(reserve)
$58,258(32.2%)
$52,111(28.3%)
$ in 1000s
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2014 ForecastAs of: June 2013 February 2014
Total Revenue $167,689 $182,492
Total Expenses(claims & admin) $182,940 $186,430
Net Income ($15,251) ($3,938)
Fund Balance(reserve)
$40,929(22.4%)
$46,058(24.7%)
$ in 1000s
Medical Plan Before and After: Forecasts
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Medical Plan Before and After: Forecasts
2015 ForecastAs of: June 2013 February 2014
Total Revenue $166,321 $190,872
Total Expenses(claims & admin) $189,241 $193,310
Net Income ($22,920) ($2,438)
Fund Balance(reserve)
$16,916(8.9%)
$42,493(22.0%)
$ in 1000s
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• Exchanges: Public and Private• Partner Coverage: no subsidy; surcharge; none• High Deductible Health Plans• High Performing, More Restricted Networks• Health Accountability and Responsibility: more
carrots and sticks• Reference-Based Pricing
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Choices by Other Large Employer Plans
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• Online store or marketplace• Public (government) or Private (industry)• Single or multi-carrier• Health only or other coverage options• Decision support
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Exchanges: Expanded Choices for Individuals and Employers
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• Members in transition• Seminary students• Early retirees• Part-time church workers (< 20 hours)• Non-mandated emerging ministries
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Public Exchanges: Who Might Benefit
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• 2015 Dues Model• Mid councils: Terms of Call• Employing organizations:
Share or not; pre-tax or post-tax• Members: enroll or not
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Choices That YOU Have
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• Be a responsible consumer• Understand your benefits• Seek care at the right time and at the right
place• Look for value (cost and quality)
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Choices That YOU Have
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• Answer the Call to Health• Preventive care• Telephonic coaching• Health assessment• Know your numbers• Vision exam• Tobacco cessation• CREDO
• myactivehealth.com/pcusa
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Choices That YOU Have