1. 2016 AWC Employee Benefit Trust Regional Forum/Annual Meeting Colville – Moses Lake – Burlington - Lacey

2. 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

3. Annual Meeting In compliance with requirements of local government self-insurance health & welfare programs, under Chapter 200-110 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.

4. 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

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

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

9. 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

10. 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

11. 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)

12. 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

13. 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

14. 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

15. 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

16. 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 1-1-18)$10 Copay Plan (term 1-1-18)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

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

18. Excise Tax Increases as Plan’s Cost Increases

19. Excise Tax – Active Plans

20. Excise Tax – Active Plans – High Risk

21. Excise Tax – Non-Medicare Retirees

22. Excise Tax –Medicare Retirees

23. Board of Trustees Decision  Maintain termination date of Regence/Asuris HealthFirst $10 & Group Health $10 (plans will terminate effective 1-1-18)  Delay implementing a tiered rating approach to the Regence/Asuris HDHP, from 1-1-18 to 1-1-20

24. 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*

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

26. Regence/Asuris (HCP) Cost Breakdown 2015

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

28. Group Health (HCP) Cost Breakdown 2015

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

30. Delta Dental (HCP) Cost Breakdown 2015

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

32. VSP (HCP) Cost Breakdown 2015

33. Trust Trend Compared to Industry Trend

34. Regence/Asuris Enrollment History

35. Group Health Enrollment History

36. Delta, Willamette & VSP Enrollment History

37. 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

38. 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

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

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

41. 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

42. Website Revamp

43. Communication Efforts Employee Communications Employer Communications

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

45. AWC Trust Member Services Call AWC Trust for… Claims assistance Eligibility issues Dependent verification assistance Benefit plan question COBRA question Retiree consultation 1-800-562-8981 or send your question to benefitinfo@awcnet.org

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