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Health and Employee Benefits Pool
Plan Year 2020, Effective October 1, 2019
Health and Employee Benefits Pool Plan Year 2020, Effective October - - PowerPoint PPT Presentation
Health and Employee Benefits Pool Plan Year 2020, Effective October - - PowerPoint PPT Presentation
Health and Employee Benefits Pool Plan Year 2020, Effective October 1, 2019 Agenda Introduction and TAC HEBP Overview Plan Year Review Plan Year 2020 Outlook Renewal Timelines OASys Updates RNBC Process Review and Updates Employee
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TAC HEBP OVERVIEW
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Health and Employee Benefits Pool
Ø County-owned and county-governed Ø Not for profit (no stockholders to satisfy) Ø No state premium tax Ø Stable membership – 221 county entities
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212 Pool (fully insured) and 9 ASO (self funded)
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48,000+ members
Ø Stabilize rates for TAC supported counties and districts
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TAC HEBP Product Suite
Medical & Prescription with TeleHealth Dental [With or Without Orthodontia] Retiree Medical
[County Choice Silver Medicare Supplement]
Life Insurance [Basic and Supplemental] Vision Insurance Disability Insurance [Short & Long-term]
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HEBP Healthy County
Employee Wellness
Ø County consultation and targeted incentive programs Ø Healthy County wellness challenges (powered by Sonic Boom) Ø Employee empowerment trainings Ø Annual conference (no charge to group Wellness Coordinator and Wellness Sponsor)
TAC HEBP Healthy County
Employee Wellness
Ø County consultation and targeted incentive programs Ø Healthy County wellness challenges (powered by Sonic Boom) Ø Employee empowerment trainings Ø Annual conference (no charge to group Wellness Coordinator and Wellness Sponsor)
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TAC HEBP Renewal
Ø Renewal Process Overview Ø Prior Year Review Ø Current Loss Ratio Ø Projected Trend Ø Pool Needed Amount
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Renewal Process
Actuary determines Medical and Rx trend for current and coming year Actuary determines Pool contribution requirements for coming year TAC Management Team reviews* each individual Pool group Actuary reviews TAC Team rate recommend- ations Recommended rate scenarios prepared by TAC staff for Board review Board approves renewal rates Renewal processed for release to groups based on Plan Anniversary dates
ØCredibility / Predictability ØLoss Ratio: Claims vs. Contributions ØHigh Cost Claims ØShock Claims / Pooling Point ØDemographic and Area Medical Cost factors
* Individual Review:
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Plan Year Review
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TAC HEBP Renewal
Plan Year (PY2019) Membership
Change in Membership
Ø TAC HEBP added 4 groups in PY19 (10/1/18 – 9/30/19): Carson, Crane,
Starr, and Zavala Counties
Ø 221 Members (212 Pooled & 9 Self-Insured) Ø Average Pool membership is 36,553 an increase of 8% year over year Ø Subscribers: + 5.34% Ø Spouses: + 3.01% Ø Dependents: + 3.68% Ø Average member age remained stable at 38.8 years
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TAC HEBP Renewal Medical Trend CY2018
Top 3 Conditions: Circulatory ($26M), Cancer ($25M), and Musculoskeletal ($24M)
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TAC HEBP Renewal
Plan Year (PY2018) High Cost Claimants
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TAC HEBP Renewal Rx Trend (Jan – Sept 2018) Prior PBM
Ø 29.2% Specialty Trend Ø 4.4% Non-Specialty Trend Ø 11% Rx Trend
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TAC HEBP Renewal Rx Trend (Oct’18–March’19) Current PBM
Ø 0.6% Specialty Trend Ø -3.2% Non-Specialty Trend Ø -2.1% Rx Trend
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TAC HEBP Renewal Impact of PBM Change
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Current Loss Ratio
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TAC HEBP Renewal – Medical Loss Ratio
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Plan Year 2020 Projected Trend
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Plan Year 2020 Projected Trend
Ø PY 2020 Trend (10/1/2019-12/31/2020) Ø TAC Blended Trend 7.5% Ø 8% Medical Ø 6% Rx
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Plan Year 2020 Pool Needed Amount
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Plan Year 2020 Pool Needed Amount
Ø PY 2020 Pool Needed, eff. 10/1/2019 - 12/31/2020 Ø Overall 2.79%
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Renewal Timelines
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Key Renewal Dates: October 1 Anniversary Date
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Key Renewal Dates: November 1 Anniversary Date
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Key Renewal Dates: December 1 Anniversary Date
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Key Renewal Dates: January 1 Anniversary Date
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OASys Updates
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NEW!! OASys login
OASys - Multi-factor Authentication (MFA) login
Upgrades to OASys require TAC to adapt a multi-factor authentication (MFA) login. Using MFA require users to provide more than one method of authentication to login.
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OASys - Multi-factor Authentication (MFA) login
New homepage. Enter your current OASys email.
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OASys - Multi-factor Authentication (MFA) login
Check this box only if you are using a private or work computer, and if allowed per your IT policy. Enter current password, or create a new password
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OASys - multi-factor Authentication (MFA) login
Verification code – enter email or phone number
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OASys - Multi-factor Authentication (MFA) login
An email with the verification code will be send to you.
Note: The email will come from Willis Towers and Watson. Please have your IT Department “Whitelist” this email address.
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OASys - Multi-factor Authentication (MFA) login
You can choose for the Verification Code to be sent via text or a phone call.
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OASys - Multi-factor Authentication (MFA) login
Enter code to login
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OASys - Multi-factor Authentication (MFA) login
Once validated, you will be taken to the Web Admin screen.
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Ø Valid email address Ø Employee Classification Code (same as Workers Comp code from payroll) Ø New Optional Field:
ØMobile Phone Number
OASys – Data Entry Changes
En Entry fields in OA OASys that are now required for new hires:
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RNBC Process Review and Updates
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Click on the ‘RNBC’ tab
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Electronic Renewal: Alternate RNBC Available
Within the RNBC tab click the Alternate Renewal Information tab to select an alternate medical and RX plan.
NEW!! ALT RNBC!!
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Enter Employer and Employee contribution amounts
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
First of 3 screens - Review and Update each Contact Type: Contracting Authority, Primary Contact, and Billing Contact
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Retiree coverage designation Waiting Periods
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Confirm how your entity handles COBRA. Click submit.
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Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Print RNBC.
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Have your Contracting Authority initial each page
- f completed RNBC form
and sign on last page. Then fax or email to your Employee Benefits Specialist.
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
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Employee Self-Service Portal Updates
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Employee self-service (ESS) portal is getting an upgrade.
Effective July 1, 2019, TAC will rollout an upgraded Employee Self-Service portal.
NEW!! ESS
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Navigate to your benefits, change beneficiaries,
- btain forms, and view other
TAC programs. Can also add links to vendor websites for
- ther non-TAC benefits.
Similar to the current ESS, just better!
Employee self-service portal (ESS) capabilities
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Starting this year, the ESS will be used during the Open Enrollment periods. Employees can enroll in benefits themselves!
Employee self-service portal (ESS) capabilities
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Employee self-service portal (ESS) capabilities
View your elected benefits and total costs.
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ESS OASys Reports
In OASys, you can access Reports at any time on changes made by employees in ESS.
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Employee Self-Service (ESS) - Multi-factor Authentication (MFA) login
ESS login will also use MFA.
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First time users will need to confirm their identity by entering either their UID or SSN.
Enhanced Registration
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Enhanced Registration
If the date of hire is unknown, the exact year is acceptable.
DOB and date of hire must match user’s record on file.
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An authentication code will be sent to the user’s email.
Establish/Verify User
Note: The email will come from Willis Towers and Watson. Please have your IT Department “Whitelist” this email address.
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Users will have the option to have the verification code sent via text or to receive a phone call.
Phone Call or Text Authentication
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Once the verification code is entered, accept the Online Authorization terms. Access is granted.
Successful Log-in
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Other News
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Dental Open Enrollment
Ø Beginning this year, TAC HEBP will have annual Dental Open Enrollment. Ø Here's who can enroll:
Ø Any full-time benefits-eligible employee Ø Eligible Spouses and Dependents
Ø Please contact your Employee Benefit Specialist with any enrollment questions
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Renewal Process New ID Cards
Concierge Customer Service One toll-free phone number for: BCBS Customer Service Pre-Authorizations Condition Management Blue Care Connections is being replaced by BCBS Wellbeing Management
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Renewal Process
Ordering Replacement ID Cards – One Request, Four Ways
Call BCBS Customer Service Use Blue Access for Members mobile app Log in to Blue Access for Members If your employee is in a pinch, call a TAC Employee Benefit Specialist
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ACH Payments
Ø Groups will be able to pay their TAC HEBP invoices via ACH by early 2020 Ø Detailed instructions will be provided when this payment option becomes available Ø In order to use ACH, group must pay exact invoice amount (pay as billed)
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Renewal Process
Ø RNBC Changes – view alternates and complete selection and contributions online! Ø New login security for OASys admin users Ø Employee Self-Service – new look, more information, and available for Open Enrollment elections Ø Dental Open Enrollment Ø New ID Cards – 1 number for BCBS services Ø ACH Payments coming soon
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ONLINE ON TIME
REMEMBER: SEND IN YOUR RENEWAL
&
Renewal Due Dates 10/1 AD: August 2 11/1 AD: September 20 12/1 AD: October 11 1/1 AD: November 1
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C O N S U L T A N TEAMS
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S P E C I A L I S TEAM
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Renewal Process
Questions
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