St Louis Public Schools St Louis Public Schools

2010 Benefits Renewals2010 Benefits RenewalsMEDICAL = 9.7% MEDICAL = 9.7%

Effective 1/1/2010 Effective 1/1/2010

November 5, 2009November 5, 2009

1. 2009 Historical Renewal Summary

2. Medical - 2010 Renewal Summary and Joint Benefit Committee Recommendation

3. RX - 2010 Renewal Summary and Joint Benefit Committee Recommendation

4. Dental - 2010 Renewal Summary and Joint Benefit Committee Recommendation

5. Life, STD, LTD, Vision - 2010 Renewal Summary and Joint Benefit Committee Recommendation

6. Cost Containment Strategies for 2011

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1. Holmes Murphy managed the RFP Process and 66 Insurance Companies and TPA’s were asked to quote. 62 Proposals were received.

2. Joint Benefit Committee participated in finalist presentations by UHC, Anthem, Caremark, Medco, Express Scripts, MetLife, Guardian, and BJC.

3. Pharmacy vendor change from CareMark to Medco.

4. Dental carrier change from Guardian and St. Louis Dental Care to UnitedHealthcare.

5. Life insurance carrier change from Reliance Standard Life to UnitedHealthcare. Increased benefit from $30,000 Life to $40,000 Life and AD&D.

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Coverage 2009 Carrier 2009 Rate Change

Rate Guarantee(s)

Comments

MEDICAL UHC 3.6% 2010: 14% Max.2011: loss ratio determines increase

Increased ER copays. Includes full Wellness Program

RX Medco (was Caremark)

Est. 1.8%*

2010: no increase*2011: no increase*

* Medco fee guarantees does not mean Premium guarantees as Premiums are determined by utilization. Rate increase estimate was based on historical claims experience

DENTAL UHC (was Guardian & Dental Source)

(7.8%) 2010: 6% Max. Packaged savings discount brings savings to (21.9%) each year for two years

BASIC LIFE UHC (was Reliance Standard)

(25.3%) 2010: no increase2011: no increase

Packaged savings discount brings savings to (97.4%) each year for two years

STD Cigna (21.9%) 2010: no increase

LTD Cigna (5.9%) 2010: no increase

VISION VBA 1.7% 2010: no increase

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MEDICAL RENEWAL SUMMARY:

14% Initial premium increase from UnitedHealthcare as expected from 2009; however, revised to 9.7% increase after medical marketing.

This reduced the annual estimated District responsibility for the Active population from $21,012,731 to $20,203,147.

88% Loss Ratio – Paid Premium versus Paid Claims 6/08-5/09

Renewal includes continuation of the Wellness Plan

Wellness eligible incentive dollars totals $556,675 which is funded by UnitedHealthcare

Modest plan design changes were reviewed; however, no significant premium savings available without drastically reducing employee/retiree benefits

Joint Benefit Committee Recommendation: Renew with current plan designs at 14% rate increase. However, now

increase is 9.7%5

Rx RENEWAL SUMMARY:

8.3% Premium increase recommended

Premium increase determined by claims utilization from 6/08-5/09 plus 9% annualized trend

Joint Benefit Committee Recommendation: Maintain current benefit levels at recommended 8.3% premium

increase

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DENTAL RENEWAL SUMMARY:

6% Premium increase from UnitedHealthcare

71.5% Loss Ratio – Paid Premiums versus Paid Claims 1/09 – 5/09

Joint Benefit Committee Recommendation: Maintain current benefit levels at 6% rate increase

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LIFE, STD, LTD, VISION RENEWAL SUMMARY:

All under rate guarantee for 2010 (no increase from 2009)

Life and Dental Packaged Savings Discount still applies to the Medical Premium throughout 2010

Joint Benefit Committee Recommendation: Maintain current benefit levels at current rates

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The District is considering several options to help control future costs:

Dependent audit

More emphasis on premium statement reviews/audits

Continued Wellness efforts

More Wellness and Disease Management claim analysis

Aggressive dialogue with JBC regarding additional strategies

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