1. Proposed Medical Premiums 2017-2018 Plan Year
Good evening board members,
Thank you for the opportunity to discuss the proposed benefit and premiums for the benefit plan year.

2. Recommendations
Zero premium increases for Basic and High Deductible Plans
Increase the Core premiums by 15%
Increase the HDP Plan deductibles:
Individual deductible from $2,200 to $2,500
Family deductible to $4,400 to $5,000
Increase out-of-pocket maximums for all plans:
Network providers from $6,250 to $7,000
Out-of-network providers from $12,500 to $14,000
We are not proposing a premium increase for the second year in a row for the Basic and High Deductible Plan.
We are proposing a 15% increase to the Core premiums
The deductible increases for the high deductible fits within the confines of the Affordable Care Act along with the Maximum out of pockets for all three plans.

3. Recommendations
Implement a $100/month spousal surcharge for spouses who have coverage through their employer but elect to enroll in the district’s insurance
Add a telemedicine option for medical plan participants
Continue to provide the PHA participation incentive, reducing the premium cost $25 per month for an employee and $50 per month for employee/spouse or employee/family
We are proposing a spousal surcharge for all spouses who are enrolled in the district’s health plan that have access to coverage through the spouses employer. Those spouses who do not work or work for an employer with less than 50 employees and do not have coverage will not be subjected to the $100 per month surcharge. This surcharge would not apply to district couples. Each spouse who is enrolled in the district’s insurance will complete an affidavit that indicates their employer and if they have access to coverage. If they have access to coverage but elect to participate in the district’s health plan they will be subject to the surcharge.
In addition to the NISD Health and Wellness Center we are recommending a Telemedicine option for all medical plan participants. Employees would have access to a physician 24/7. This will help for non-life threatening illnesses or injuries that occur after the clinic is closed. The agreement will be made through an Interlocal Agreement with Public Employees Benefit Alliance with an annual cost of $6,500.
We will continue to offer a PHA participation incentive. Employees have the PHA results available through the Texas Health Resources Portal. When they see a physician outside of the network they are able to provide the data from their PHA to the provider. This cuts down on duplicate testing whenever possible.

4. 2017-2018 Recommendations Increase the Dental High Plan premiums by 9%
Decrease the Dental Low Plan premiums by 10%
Basic Life Insurance paid by the District will increase by $24,500 annually
We are recommending that the High Dental Plan premiums increase by 9%. The high plan has a $1,000 lifetime orthodontia benefit for children under the age of 18 along with 2 annual cleanings at 100%. Certain services are paid at 80% with a $50 deductible. Other services such as crowns are paid at 50%. This increase is as a result of utilization. We have young families that take advantage of the orthodontia benefits. We have individuals who may have neglected their dental treatment during their college years and need to have extensive work.
The low plan will decrease by 10%. This plan has zero orthodontia and all benefits are paid at 50% with a $50 deductible.
The increase in the basic life insurance is simply due to the number of claims for both employees and covered dependents. Over the past 2 years there have been a number of life insurance claims.