The Texas A&M System Employee Benefits Administration June 15, 2011.

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Presentation transcript:

The Texas A&M System Employee Benefits Administration June 15, 2011

Employee Benefits The System administers employee benefit plans for the employees and retirees of the System and its members. These offerings are primarily in the areas of: Health, Dental, and Life Insurance Retirement Programs Ancillary insurance such as LTD and ADD Other value added employee benefits 2

Employee Benefits Operations TAMUS - Strategic Developing, Bidding, and Contracting Benefit Plans Financial/Actuarial Analysis Accountability Compliance with State and Federal Regulations Medicare Secondary Payer, HIPAA, COBRA, etc. Eligibility vendor file feeds Maintain imaging system and policies and procedures for all Members Systemwide Benefit Plan Communications and Enrollment Programs 3

Total Contributions - $255.3 million Group Insurance Programs Employer & Employee Contributions – FY

Enrollment A&M System offers Group Insurance Plans to its employees and retirees Health Plan Offerings: EmployeesRetirees A&M Care Plan: 14,350 5,820 Scott & White: 4,150 1,235 First Care: 1, In addition, 25,400 dependents are covered 5

Controlling Medical Cost Contracting: Seek to evaluate cost savings/improved outcomes through contracting for the Group Insurance Program Adherence: Working with Blue Cross and Medco to identify undiagnosed conditions or non-compliance with standards of care for diagnosed conditions Wellness: A healthy group is a less expensive group 6

Federal Health Care Changes Remove lifetime maximums for coverage Make health coverage available for dependents, married and unmarried, through age 26 No pre-existing limitations for coverage for children under age 19 No cost sharing for preventive services 7

Group Insurance Environment A&M Care Plan 350 and A&M Care Plan 1250 experienced a 9.5% increase in cost last year State Group Insurance Program funding has been reduced for the next two years by 5% With no decrease in trend and a decrease in funding, the employee contribution to the premium would increase significantly even if no plan design changes were made 8

Why Consolidate Plan Offerings Group Insurance is less expensive than individual coverage because it diversifies risk across the population, avoiding adverse selection The more plans being offered, the more likely that adverse selection will impact the plans An example of adverse selection would be when healthy individuals elect the cheapest premium, regardless of the insurance plan being offered 9

Offering only two plans in the future will decrease the cost to the group as a whole To that end, the A&M System will offer the following plans for Fiscal Year 2012: A&M Care Plan: A self-insured PPO plan administered through the Blue Cross Blue Shield of Texas Network Scott & White: A fully-insured HMO plan offering through the Scott & White Health Plan Why Consolidate Plan Offerings 10

System Benefits Administration 200 Technology Way, Suite 1120 College Station, TX