2016 AWC Employee Benefit Trust Regional Forum/Annual Meeting Colville – Moses Lake – Burlington - Lacey

Agenda  Governance  Trust Mission, Vision, Goals  Report from 2015 Regional Forums  2015/2016 Plan Enhancements & Changes  What is on the Horizon for 2017 & Beyond?  Excise Tax, and Board Policy Decisions  Trust’s Claims, Expenses, & Enrollment History  Cost Containment Efforts  Communications & Training

Annual Meeting In compliance with requirements of local government self-insurance health & welfare programs, under Chapter WAC Health Care Program (Self Insured) Regence/Asuris (all plans except Medicare Advantage) Group Health (all plans except Medicare Advantage) Delta Dental Vision Service Plan Trust (Fully Insured) Regence/Asuris/Group Health Medicare Advantage Plans Willamette Dental ComPsych EAP Standard Life & LTD VS.

Association of Washington Cities – Employee Benefit Trust AWC Trust  Member service of AWC  Member Driven Pool o Board of Trustees o Employee Benefits Advisory Committee  270+ participating entities  16,000 employees  36,000 lives

Board of Trustees  Four Regional Trustees  Two AWC Trustees  Employee Benefit Advisory Committee Chair  Employee Benefit Advisory Committee Vice Chair

Employee Benefit Advisory Committee  Eleven District positions  Two At-Large Statewide positions  One At-Large East position  One At-Large West position

Feedback from 2015 Regional Forums  ACA education  On-demand webinars  Offer plans that allow 4 visits without being subject to deductible; offer plan in- between HF and HF 250  Lower HF 500 out-of-pocket maximum  Add $500 deductible plan for Group Health  Revisit tiers for the RBS HDHP that were shown at 2015 Forum  Do not offer plans that will hit the Excise Tax  Expansion of optional benefits  Individual selection (allow choice between any HF plan)  Guidance & strategies to implement higher deductible plans; information on what other employers are doing

Plan Enhancements & Changes 2015  Medical plans (except HF $10/GH $10) change from Coordination of Benefits to Maintenance of Benefits  New Group Health Access PPO  Standard Long Term Disability maximum payout increases from $8,000 to $12,000/month  Vision Service Plan changes from full family rate structure to 3-tier premium level

Giving Back to Members 2015  Long Term Disability premium holiday  EAP included with all Trust coverage (continued in 2016)  WellCity 2% medical premium discount (continued in 2016)

Plan Enhancements & Changes 2016  HealthFirst 250 & 500  First four office visits not subject to deductible (co- insurance still applies)  Chiropractic/Spinal Manipulation visits increase from 10 to 15 per year  HealthFirst 500  Out of pocket maximum decreases  Regence/Asuris and Group Health HDHP  Individual out of pocket maximum when enrolled as family Regence/Asuris: $5,000 Group Health: $3,750

Plan Enhancements & Changes 2016  Regence/Asuris supplemental dialysis program – all plans, except HDHP  LTD reduced rates for non- high risk professions (18% lower!)  HealthFirst 250  Prescription co-pay changes

What Is On The Horizon?  Request for Proposals  Wellness Vendor  Claims Audit  Long Range Strategic Planning Retreat  Agenda  Survey to membership coming soon  Reserve Policy  Rates

Individual Selection?  Discussion with EBAC and BOT  Direction to move forward in exploring individual selection as a possible way to offer benefits in the future

Are we offering plans that enable plan movement? Regence BlueShield/ Asuris Northwest Health Group Health Cooperative/ Group Health Options, Inc. Delta Dental of Washington Willamette Dental Vision Service Plan Active Coverage AWC HealthFirst® Plan (term )$10 Copay Plan (term )Plan A$10 Copay Plan$0 Copay Plan AWC HealthFirst® 250 Plan $20 Copay, $200 Deductible Plan Plan B$15 Copay Plan$10 Copay Plan AWC HealthFirst® 500 PlanAccess PPOPlan C $25 Copay Plan High Deductible Health Plan, HSA Qualified Plan D Low Option Plan Plan A – LEOFF 1$0 Copay Plan – LEOFF 1Plan E Second Pair Option Rider – can be added to $0, $10, or $25 Copay Plan Plan F Plan G Ortho Rider I, II, III, IV, V – can be added to any active dental plan

ACA Excise Tax  Two year delay – effective January 1, 2020  Further studies on appropriate benchmarks  Indexing continues  Tax is Deductible

Excise Tax Increases as Plan’s Cost Increases

Excise Tax – Active Plans

Excise Tax – Active Plans – High Risk

Excise Tax – Non-Medicare Retirees

Excise Tax –Medicare Retirees

Board of Trustees Decision  Maintain termination date of Regence/Asuris HealthFirst $10 & Group Health $10 (plans will terminate effective )  Delay implementing a tiered rating approach to the Regence/Asuris HDHP, from to

Health Care Program 2015 Revenues & Expenses  Operating Revenues (member contributions): $211,349,144  Operating Expenses  Claims costs: $191,896,984  Administrative Services Only (ASO) fees: $10,321,389  Reinsurance & stop loss premiums/fees: $1,710,111  General administrative expenses: $3,932,546 Total Operating Expenses: $207,861,030 *Information referenced in the 2015 Health Care Program Annual Report*

Regence/Asuris Claims & Expenses Note: 2016 data only includes Jan-March

Regence/Asuris (HCP) Cost Breakdown 2015

Group Health Claims & Expenses Note: 2016 data only includes Jan-March

Group Health (HCP) Cost Breakdown 2015

Delta Dental Claims & Expenses Note: 2016 data only includes Jan-March

Delta Dental (HCP) Cost Breakdown 2015

VSP Claims & Expenses Note: 2016 data only includes Jan-March

VSP (HCP) Cost Breakdown 2015

Trust Trend Compared to Industry Trend

Regence/Asuris Enrollment History

Group Health Enrollment History

Delta, Willamette & VSP Enrollment History

Cost Containment Efforts  Transition to self-insurance:  Reduced administrative fees  Reduced stop loss fees  48-69% less  Eliminated state premium tax: 2% savings to medical  Avoided the ACA insurer fee: 1%-4% savings  Dependent Verification  Audit in 2013 – all dependents verified  Ongoing verification since May 2014  2015 projected annual savings to member employers: $809,019  Maintenance of Benefits for dual coverage  Estimated claims cost impact annually: $1.2 million

Cost Containment Efforts  Supplemental dialysis program  Projected savings of $445,000 per year, per patient  Implementation of Medicare Advantage Plans (LEOFF 1 & regular retiree)  LEOFF 1: $515 savings per retiree, per month  Health Promotion

Health Management Programs & Service For EmployersFor Individuals Health CentralHealth ScreeningsHealth InformationHealth Advisors Lunch & Learns Training & Networking Program Planning Campaigns

Health Management Partners  Employee Assistance Program  Nurse Advice Line  Tobacco Cessation  Condition Management  Health Coaching  Health Screening

Health Management 2015 Highlights  Screenings offered to all members in one year  Screenings moved to align with HQ promotion  Lab option added to screening program  ComPsych Lunch & Learn webinars archived  Health Central moved to Platinum Plus home page  2 nd year with new style HQ  New HQ Cohort Reports available to members  Grouped small cities to run Management Reports

Website Revamp

Communication Efforts Employee Communications Employer Communications

Training Wellness Networking & Planning Forums Health Care Regional Forums EAP Lunch & Learn, Wellness

AWC Trust Member Services Call AWC Trust for… Claims assistance Eligibility issues Dependent verification assistance Benefit plan question COBRA question Retiree consultation or send your question to

Thank you for attending the AWC Trust’s Regional Forum/Annual Meeting We welcome your feedback!