1 S CHOOL C ARE H EALTH B ENEFIT P LANS OF THE NH S CHOOL H EALTH C ARE C OALITION Business Reports Lisa J. Duquette, Executive Director Melissa M. Perreault, Program Manager
Highlights Staff made scheduled visits to 90%+ of members’ offices Wellness participation increased in all programs Dental program became self-funded Developed Go-Green Initiative 100% renewal of existing groups 5 new groups, enrollment increased –Medical 3.7%; Dental 6.5%
Financial Results (draft audited) Contributions/Investments/Income –$ million Claims Expense/Insurance/Admin –$ million Excess of Expense over Revenue – $1.52 million Why? Claims ↓ Premium Holiday $7.66 million expense
4 Net Assets Fund Balance = Members’ Equity $33.1 million Designated $17.8 million –S CHOOL C ARE $1.9 million –Medical Risk Corridor- $15.9 million Undesignated $15.3 million (Surplus to be returned to as Premium Holiday in future years)
5 Your Premium Dollar
6 Health Care Update 2013 was the 1 st year in the past decade that health care trend was below 10% Continued impact of health care reform –PCORI Fee & Transitional Reinsurance Fees –Out of Pocket Maximums for ALL plans 2013 medical trend for U.S. is expected to be 6.5% compared to 8.7% for New Hampshire Affordability for employers and employees is a major issue
7 Rating Objectives 1.Predictability –Guarantee rates for negotiations and budgeting by December 1 2.Stability –Minimize fluctuations from year to year
8 S CHOOL C ARE Rate History (Average) Year Medical Trend Need Increase Rate Stabilization / Premium Holiday Actual or “Effective” Increase %11.5%-5.7% ($3.8M)5.8% %4.9%-2.7% ($2.0M)2.2% %11.5%-5.3% ($5.0M)6.2% %12.1%-7.3% ($8.3M)4.8% % 5.0%-3.3% ($4.25M)1.7%
9 Premium Holiday continues …. Return of Surplus –previously Rate Stabilization Increased Transparency Budgeting –use Effective Increase/Rates Calculate Employee Share Future Premium Holidays
10 Preliminary Cigna Medical Rate Indication Medical Trend 6.5% Average “Gross” Renewal 8.3% –no increase greater than 13% Average “Effective” Renewal $10M of Premium Holiday ( previously Rate Stabilization) –“effective” average increase would be 1% –no increase greater than 8%
11 Preliminary Cigna Dental Rate Indication Dental Trend 5.7% Average Renewal 4.8% –no increase greater than 5.15%
12 Preliminary 65+ Medical Rate Indication Medicare Supplement United American –7/1/13 increased 1.9% $ Prescription (Rx) Express Scripts –7/1/13 no increase $ –1/1/14 decreasing 15%! Employer Group Waiver Program (EGWP) New Monthly Rates 1/1/14 – 12/31/14: 65+ Medicare supplement only $ Medicare supplement and Rx $380.48
Rates Notices to each member by Dec. 1 Employer and Employee To renew and lock in, sign by Feb. 1
14 Choices If member accepts rate by February 1, the Coalition can guarantee it for , regardless of how claims may change If member does not accept by February 1, the Coalition reserves the right to re-rate, based on more recent claims experience Members must notify the Coalition within 45 days of July 1 if wishing to non-renew
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