Kern Community College District Information regarding joining SISC’s statewide pool March 2016

Advantages of joining SISC’s Statewide Pool Stability – Long term solutions to rate fluctuation (increases) – As part of the statewide pool the school’s risk of high claims experience is removed by sharing claims with almost 400 schools throughout the state Plan Options – Based on size, the college would be allowed to offer up to six medical plans to fit each individual employee/family’s need – Options could include additional PPO plans and/or an Anthem HMO and Kaiser HMO plan for those who live in the service area Up to date plan design enhancements or changes for cost containment – As a result of reviewing outliers in cost, abuse and high cost claims, SISC reviews cost containment strategies presented by our medical carriers. With a great deal of research and review of affected membership, SISC administration will makes recommendation to the SISC Board of Directors for plan design changes. Clinical decision making is eliminated. Participation in SISC’s Health Smarts –Health Improvement Program – At no additional cost to the college, employees can participate in free on-site flu shot clinics as well as on-site health screenings with awards for participation provided

Plan Design Updates with SISC pool Change in Emergency Room Co-pay $50 - $100 (waived if admitted) Addition of American Specialty Health (ASH) review for chiropractic and physical or occupational therapy services with removal of maximum limitation (SISC added 2010) Additions of Centers of Medical Excellence for Bariatric surgeries includes travel benefits (SISC added 2010). COEs already on Transplants. Addition of Pervasive Developmental Disorder or Autism (ABA Services, SISC added 2012) Change to Hearing Aid coverage (SISC added $700 every 24 months) Change to Hip, Knee and Spine Inpatient Surgery requires Blue Distinction Plus facility (SISC changed 2015) Change to out-of-network benefits for X-ray, Lab, DME and Physical Medicine (SISC Changed 2015) Custom Molded Orthotics (Therapeutic shoes) – limit to 2-pair per calendar year (SISC changed 2015) Change to Acupuncture (includes limit of 12 visits) Out-of-network limits to be aligned with SISC standard (hospital limit) Addition of member cost sharing feature for outpatient prescription This sheet serves as a high level summary of the benefit differences

The down side of being part of the pool The district will no longer receive claims experience because your in a blind pool The district will no longer have autonomy on decisions for certain benefit design changes such as autism, Blue Distinction Plus, American Specialty Health, etc.