1. Self-Funded Medical Plan Management for 2013-2014 April 8, 2013 Board Meeting

2. Medical Plan Performance current year versus prior year Impact2012-20132013-2014 Premium Increase15%5% Stop Loss Claims70 Medical Plan ProviderUnited HealthCareCigna Prescription ProviderUnited HealthCareCatamaran

3. Medical Plan Performance current year versus prior year Impact2012-20132013-2014 Changes associated with Patient Protection and Affordable Care Act All preventative services paid at 100% with no plan maximum Prescription and over the counter birth control for females paid at 100% Genetic Testing for BRAC (Breast cancer) gene paid at 100% Administrative Changes for Patient Protection and Affordable Care Act Special W-2 identification of medical premiums paid by employee Employees must be notified 90 days in advance of any premium increases and plan design changes Administration Costs associated with Patient Protection and Affordable Care Act Summary benefits notification must be issued to all participants $1,500 cost to the plan A $1.00 per covered participant tax for self-funded medical plan cost to the plan A $63.00 per participant assessment to fund insurance networks in Texas for the uninsured in Texas cost to the plan

4. 2011-2012 Medical Premiums 2011-2012 Premiums COREPremiumNISDEmployee $378$225$153 Employee + Spouse$846$225$621 Employee + Children$734$225$509 Employee + Family$1,042$225$817 District Couple with Family Coverage$1,042$450$592 BASICPremiumNISDEmployee $300$225$75 Employee + Spouse$656$225$431 Employee + Children$566$225$341 Employee + Family$805$225$580 District Couple with Family Coverage$805$450$355

5. 2012-2013 Medical Premiums 2012-2013 Premiums COREPremiumNISDEmployee $435$225$210 Employee + Spouse$973$225$748 Employee + Children$844$225$619 Employee + Family$1,198$225$973 District Couple with Family Coverage$1,198$450$748 BASICPremiumNISDEmployee EE$345$225$120 ES$754$225$529 EC$651$225$426 EF$926$225$701 District Couple with Family Coverage$926$450$476

6. 2013-2014 Proposed Premiums with PHA Participation Core PlanRate District ContributionEmployee Cost Monthly Premium IncreasePHA Fee Total Monthly Increase Total Annual Increase Employee$445.00$225.00$220.00$10.00$0.00$10.00$120.00 Employee + Spouse$991.00$225.00$766.00$18.00$0.00$18.00$216.00 Employee + Children$856.00$225.00$631.00$12.00$0.00$12.00$144.00 Employee + Family$1,218.00$225.00$993.00$20.00$0.00$20.00$240.00 Basic PlanRate District ContributionEmployee Cost Monthly Premium IncreasePHA Fee Total Monthly IncreaseAnnual Increase Employee$349.00$225.00$124.00$4.00$0.00$4.00$48.00 Employee + Spouse$762.00$225.00$537.00$8.00$0.00$8.00$96.00 Employee + Children$657.00$225.00$432.00$6.00$0.00$6.00$72.00 Employee + Family$935.00$225.00$710.00$10.00$0.00$10.00$120.00

7. 2013-2014 Proposed Premiums without PHA Participation Core PlanRate District ContributionEE Cost Monthly Premium Increase Non PHA Participation Fee Total Monthly IncreaseAnnual Increase Employee$470.00$225.00$245.00$10.00$25.00$35.00$420.00 Employee + Spouse$1,041.00$225.00$816.00$18.00$50.00$68.00$816.00 Employee + Children$881.00$225.00$656.00$12.00$25.00$37.00$444.00 Employee + Family$1,268.00$225.00$1,043.00$20.00$50.00$70.00$840.00 Basic PlanRate District ContributionEE Cost Monthly Premium Increase Non PHA Participation Fee Total Monthly IncreaseAnnual Increase Employee$374.00$225.00$149.00$4.00$25.00$29.00$348.00 Employee + Spouse$812.00$225.00$587.00$8.00$50.00$58.00$696.00 Employee + Children$682.00$225.00$457.00$6.00$25.00$31.00$372.00 Employee + Family$985.00$225.00$760.00$10.00$50.00$60.00$720.00

8. Personal Health Assessment Advantages Assist with disease management Assist with clinic formulary management Identifies risk factors that can be addressed through education and or medication

9. Personal Health Assessment Participation In February covered employees and dependents had the opportunity to participate in the PHA throughout the District Over 435 employees and dependents took the assessment

10. How will we get maximum participation? Schedule a specific date for maintenance personnel at Support Services Building Schedule additional dates and time at designated secondary campuses Schedule times directly with the clinic To receive the reduced premiums through the open enrollment system in July, PHA must be completed by June 30, 2013

11. How will we get maximum participation? Adjustments will be made manually after open enrollment is complete All PHAs must be completed by September 1, 2013 to receive discounted premiums Employees, Spouses on the medical plan required Dependents over the age of 18 are strongly encouraged to participate in the PHA

12. Annual Participation in PHA Annually PHA will take place in February All assessments must be completed by May 31, 2014 to receive the premium discount for the 2014-2015 plan year.

13. What about New Hires? All new hires must complete the PHA within 90 days of effective date of coverage For example: – Professional employee with an effective date of coverage September 1, 2013 would have until January 1, 2014 to complete the PHA process or be subject to the higher premium

14. NISD Premiums versus TRS Premiums Active Care 2NISD Basic Plan with PHA Participation Active Care 3NISD Core Plan with PHA Participation Employee Only$529$349$796$445 Employee and Children $841$657$1,269$856 Employee and Spouse $1,203$762$1,810$991 Employee and Family $1,323$935$1,990$1,218 Does not reflect monthly district contribution