educational conference – april 23 rd, 2014 greg dimartino | john wallen | marcus morrell | karni...

WSCFF & DiMartino Associates

• Benefits Consulting firm formed in 1990 by Greg DiMartino

• In partnership with WSCFF since 1999

• Provides consulting and member service for multiple WSCFF-

Sponsored Insurance Programs

Overview of WSCFF Programs

• WSCFF Life & Disability Plans

• WSCFF MERP

• Northwest Fire Fighters Trust (NWFFT)

• Regence Medical

• Moda Dental (Delta Dental)

• NWFFT Medicare Pool

• NWFFT VEBA

WSCFF Life & Disability Plans• Program launched by WSCFF in 1978

• Western Life / Fortis: 1978-2002

• The Standard: 2002-2013

• Cigna: 2014-

• Numerous plan amendments have been made to enhance benefits and to make

the plan unique to fire fighter needs

• Pre-Disability Earnings

• Sick Leave Buy Back

• Waiver of Premium

• LEOFF Integration

• Claims utilization has spiked over the last 2-3 years

• Q3 2012 through 2013: $4.2M in Premium / $3.3M in Paid Claims / $1.2M IBNR

• Standard was proposing a 45% overall increase

WSCFF Life & Disability Plans• Effective 1/1/2014, all WSCFF Life & Disability plans moved from The Standard to Cigna

• Current contracts were taken over “as-is”, with the exception of a handful of very minor

contractual changes

• Cigna’s proposal came with a 5% increase to the package plans for both STD and LTD

rates, with a rate pass for the Life/AD&D and Voluntary Life – guaranteed until 1/1/2016

• WSCFF is subsidizing more than half of the proposed increase so the direct impact to

the member is only 2% for each coverage line

• Plan 1 premiums increased about $0.77 - $1.40 pepm

• Plan 2 premiums increased about $0.77 - $1.40 pepm

• Custom plans may have seen a different increase depending on claims experience

• Increases do not take into account any salary changes

WSCFF Life & Disability Plans

Plan 1 Plan 2 Plan 3 Plan 4Life / AD&D $15,000 $15,000 $15,000 $15,000Dependent Life $1,000 $1,000 $1,000 $1,000Short Term Disablity Waiting Period 30 Days 30 DaysBenefit Period Days 31-180 Days 31-180Benefit Amount - off duty 60% to $1,000/week 60% up to $1,000/weekBenefit Amount - on duty $100/week $100/weekLong Term Disability Waiting Period 180 days 90 daysBenefit Period To SSNRA To SSNRABenefit Amount 60% to $5,000/month 60% to $5,000/monthVoluntary Life Insurance Optional Optional Optional Optional

No LTD Coverage No LTD Coverage

No STD Coverage No STD Coverage

WSCFF Voluntary Life • Voluntary Life insurance is available to any Local with a WSCFF Life &

Disability plan

• Members can purchase up to $500,000 of Life on themselves and up to $250,000 on their spouses (up to $5,000 on dependent children)

• Guarantee Issue available during initial open enrollment and to new hires - $100,000 with no medical questions ($20,000 for spouse)

• Rates are age-banded in 5 year increments

WSCFF Life & Disability Plans• All disabilities beginning 12/31/13 and prior will remain with Standard.

Only disabilities occurring on and after 1/1/14 will be adjudicated by CIGNA

• All coverage was automatically transferred to Cigna, including Voluntary Life – no new enrollment forms were needed

• Your current beneficiary designations are still valid – don’t forget to update them as needed

• New policy certificates will be sent to the Local contact as soon as they are available

• Added Benefits: EAP, Will Prep & Estate Planning (online tool), Identity Theft and Health & Wellness discounts @ www.cigna.com/rewards (password: savings)

http://www.cigna.com/rewards

WSCFF Life & Disability Plans• Claim Filing – Cigna takes claims directly over the phone!

Contact DiMartino Associates for information on how to file.• TIP: Always file early!

• Administration of Program – DiMartino Associates is still your liaison with the insurance carrier• Claims: Becky Wallen or Karni Adamson• Billing/Eligibility: Shannon Brauner or Laura Ziebell

• We are here to help in educating your membership and providing member service!

WSCFF MERP• Available to 7th District IAFF Locals

• Reimburses you – for your lifetime – for:

• Premiums for medical, dental, vision, long term care coverage for you and your family (spouse/domestic partner and IRS dependent children)

• Other medical, dental and vision expenses (that aren’t covered by insurance) for prevention, diagnosis, and/or treatment of a medical situation for you and your dependents. (Defined by IRC 213(d).)

WSCFF MERP• Began in 1999 with 1 Local

• Now: 122 Participating Locals, > 6,000 members• 108 in Washington • 11 in Idaho• 2 in Alaska• 1 in Montana

• Fund is over $50 Million, growing by approximately $650,000 each month

• 250+ retirees currently accessing benefits

WSCFF MERP• WSCFF Benefit Trust Board of Trustees• The Board of Trustees is made up of 9 fire fighters all

from separate participating locals on staggered terms• 6 are elected at WSCFF Annual Convention

• Brian Hurley- Tumwater• Jeff Wainwright – Spokane Co. FD #8• Rich Knight – SeaTac Fire Fighters• Craig Soucy – Renton Fire Fighters• Kenny Stuart – Seattle Fire Fighters• Brian Murphy – Anchorage Fire Fighters

• 3 are appointed by the WSCFF • Kelly Fox• Greg Markley• Ricky Walsh

WSCFF MERP• Monthly Contribution: Minimum of $75/month; Local

can increase over time in increments of $25• 24 Locals have increased their monthly contribution

amount• No maximum monthly contribution; highest is

currently $300/month• 1 Active Service Unit (ASU) = $25• ASU’s are accumulated throughout your career and

multiplied by Unit Multiplier to determine your lifetime monthly benefit

• Unit Multiplier (UM) = 0.39• Actuarial Review occurs every 3 or so years

WSCFF MERPFire Fighter #1 - $75 contribution for 10 years$75 = 3 ASU per month X 12 X 10 years = 360 ASU360 X .39 = $140.40 monthly benefit

Fire Fighter #2 - $100 contribution for 20 years$100 = 4 ASU per month X 12 X 20 years = 960 ASU960 X .39 = $374.40 monthly benefit

Fire Fighter #3 - $75 contribution for 7 years; Local votes to increase contribution to $100 and FF contributes this for 18 years; 25 total years of contributions3 X 12 X 7 years = 252 ASU4 X 12 X 18 years = 864 ASU252 + 864 = 1,116 total ASU X .39 = $435.24 monthly benefit

The Concept• Labor-sponsored Trusts• Available to any IAFF Participating Local• Recognized, Reputable, and Reliable Carriers• Highly Competitive Plans – Rates & Benefits

Team of Advisors• Consultant: DiMartino Associates• Administrator: Benefit Solutions, Inc.• Legal Counsel: Mckenzie Rothwell Barlow & Coughran

• Sponsored by WSCFF• Governance through board of 9 fire fighter Trustees• Currently offering 10 fully-insured medical plans,

underwritten by Regence Blue Shield• 7 fully-insured dental plans, underwritten by Moda Health (a

Delta Dental plan)• Retiree Medical & Dental plans available – must be attached

to a participating Local

Medical Plans

Plan Design Plan $50 Plan $100 Plan $200 Plan $200A Plan $500 Plan $750 Plan $1,000 Plan $1,500 Plan $2,000 HSA $1,500

Deductible $50 $100 $200 $200 $500 $750 $1,000 $1,500 $2,000 $1,500

Coinsurance(In-Network/Out-of-Network)

100%/70% 90%/70% 80%/60% 80%/60% 80%/60% 80%/60% 80%/60% 80%/60% 80%/60% 80%/60%

Out-Pocket-Maximum $1,050 $1,100 $1,700 $500 $2,500 $2,750 $2,000 $2,000 $2,500 $4,500

Office Visit Copay(Primary Care/Specialist)

$0 $10 $10 $10 $15 $15 $20 $20 $25 Ded/Coins

Rx Copay Ded/Coins

Vision Coverage Exam Every Year, No Copay, 100% / $200 Hardware Every Year

$5 Generic / $25 Formulary / $50 Non-Formulary

-Deductible and Out of Pocket Maximum are 2x for family

Dental Plans

Plan Design Plan 2 Plan 3 Plan 4 Retiree

Type of Plan PPO Premier Premier Premier Incentive Plan Premier

Deductible $0 $0 $0 $25 $0 $50

Type 1 100% 100% 100% 100% 70-100% 100%

Type 2 90% 80% 80% 80% 70-100% 50%

Type 3 50% 50% 50% 50% 50% 50%

Annual Max $1,500 or $2,000 $1,500 or $2,000 $2,000 $1,000

TMJ Yes Yes Yes No

$1,500 or $2,000

Plan 1

Yes

Orthodontics Options - Adult/Child

50% to $2,00050% to $1,000

Medicare Pool

• Medicare plans are available to any IAFF retired fire fighter, regardless of Active group participation

• Also available to Eligible Member’s Medicare-entitled spouses• Direct bill from NWFFT via DRS deduction, ACH, etc.• Menu of MedAdvantage, Medigap and standalone

Prescription Drug plans• Must be Medicare-eligible and enrolled in Part A and Part B• Contact DiMartino Associates for more information!

VEBA• *New product in 2014* – NWFFT is partnering with BPAS to bring you

the only VEBA on the market with debit card technology!• Each employee gets 2 Benny Cards

• What makes a VEBA different than an HRA?• Investment earnings via target or self-directed funds

• Starting at $6.50 pepm + 35bp per year (vs. competing VEBA at $1.50 pepm and 125 bps)

• Nightly trades with the NSCC (allows 48 hour claims turnaround)• Mobile applications for iPhone and Droid• Plan consulting services included• Best of all – no set up fees when you sign up through NWFFT!

Consulting Services•Lon

g Term Planning with Local Executive Boards

•Planning, Implementation, and Monitoring of Population Health Management(PHM)

•Overall Benefits Package Review

Strategic Consulting

•Initial Setup and Audit of Plan Documents

•Assist in Filing Reports and Disclosures

•Bi-Monthly Bulletins and Periodic Educational Seminars

Federal & State Law Compliance

•Plan Performance Review

•Interactive Plan Modeling

Operational

•Open Enrollment Materials

•Educational Sessions for Members & Leadership

•Benefit Fairs

Communications

Administrative Services

• Consolidated Billing

• Member Service – Dedicated NWFFT Team

• Online Eligibility / Management – Coming Soon!

• HRA/HSA/FSA Administration - $5.50 pepm, no annual

or set-up costs!

Current Trust ParticipantsEffective 1/1/2013• WSCFF Staff• Woodinville Fire & Rescue• Grays Harbor Fire Fighters• King County #45 – Duvall• Fairbanks Fire Fighters• Spokane County FD #9Effective 3/1/2013• North County RFA• Bothell Fire FightersEffective 9/1/2013• Pullman Fire Fighters

Effective 1/1/2014• Local 726 H&W Trust

– CPFR Fire Fighters & Mechanics– SPFR – Fire + Admin Staff

• Central Pierce F&R – Admin Staff• Valley Regional Fire Authority• Stevens County FD #1Effective 4/1/2014• Tumwater Fire Fighters• Skamania County EMSEffective 5/1/2014• Lake Stevens Fire

1501 Fourth Avenue | Suite 2400 | Seattle, WA 98101Tel: (206)623-2430 | Fax: (206)682-8027

Proprietary & Confidential

Questions?