Report to Benefits Administration Committee
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1 Report to Benefits Administration Committee Agenda of: AUGUST 12, 2014 From: Thomas Moutes, General Manager ITEM: IV SUBJECT: 2015 MEDICAL INSURANCE PLAN RENEWALS AND POSSIBLE COMMITTEE ACTION Recommendation: That the Committee recommend to the Board approval of the 2015 medical insurance plan premiums. Discussion: LACERS administers medical, dental, and vision plans for its Retired Members and their dependents. Health plan contracts, which include plan design, monthly premiums, benefit coverage levels, and administrative responsibilities, are negotiated and renewed annually. Typically, LACERS, along with its health and welfare consultant, conducts Requests for Proposal (RFP) for health plan carriers every three to five years to test the marketplace for competitive premium rates and to identify new available products. In the years that LACERS does not conduct RFPs, contracted health plan carriers are asked to respond to a Request for Renewal (RFR). In response, the carriers provide proposed premium rates for the coming plan year, data to support their rating methodology, and plan design considerations for LACERS. This year, an RFR was conducted to obtain 2015 medical plan premiums. Keenan and Associates, LACERS health and welfare consultant, completed negotiations regarding the Kaiser Permanente non-medicare HMO Plan in early July. At a July 8, 2014 Committee meeting, staff and Keenan presented the 2015 Kaiser Permanente HMO premiums, which were approved by the Board on the same day. Premium rate negotiations continued with LACERS other medical plans and were concluded in late July. Based on the preliminary rates initially proposed by the medical insurance plans, the annual medical insurance plan premium cost was estimated to increase by $5,529,104, or 5.5%. Continued negotiations with the carriers resulted in a final increase of $4,796,451, or 4.8%, a savings of $732,653. Committee Report 1 August 12, 2014
2 The following table summarizes staff s recommendations regarding the 2015 health plan renewal, which are being presented for the Board s approval. SUMMARY OF THE 2015 MEDICAL PLAN RENEWAL MEDICAL INSURANCE PLAN PROJECTED CHANGE IN 2015 ANNUAL PLAN PREMIUM COST LACERS WELL CONTRIBUTION Anthem Blue Cross HMO 8.4% Anthem Blue Cross PPO -5.7% $100,000 Anthem Blue Cross Medicare Supplement 6.3% Kaiser Permanente HMO 8.1%* Kaiser Permanente Senior Advantage HMO 4.0% $75,000 Senior Care Action Network Medicare Advantage HMO UnitedHealthcare Medicare Advantage HMO (CA, AZ, and NV) 0.0% $8, % $7,500 All Medical Insurance Plans 4.8% $190,500 *Approved by the Board on July 22, 2014 Staff and Keenan will be present to discuss the 2015 medical insurance plan renewal recommendations in more detail and to answer the Committee s questions. This report was prepared by Juan Garcia, Senior Management Analyst II, of the Health Benefits Administration and Communications Division. TM:AR:JG Attachments: 1) Proposed Resolution 2) Keenan Report 2015 Health and Welfare Program Final Renewal Committee Report 2 August 12, 2014
3 ATTACHMENT LACERS MEDICAL PLAN PREMIUMS PROPOSED RESOLUTION Medicare Status 2015 CALIFORNIA MEDICAL PLAN PREMIUM RATES Anthem Blue Kaiser Anthem Blue Cross PPO/ Permanente Cross HMO / Med Supplement HMO/Senior UnitedHealthcare Anthem Blue Cross / Senior Care Action Network (SCAN) Advantage Med Adv HMO Single-Party Plan Retiree Only U $1, $ $ $ M $ $ $ $ Two-Party Plan Retiree and One Dependent UU $2, $1, $1, $1, UM $1, $1, $1, $1, MU $1, $1, $1, $1, MM $1, $ $ $ Family Plan Retiree and Family UUU $2, $2, $2, $2, UMU $1, $1, $1, $1, MUU $1, $1, $1, $1, MMU $1, $ $1, $1, MMM $1, $ $ $ UNITED HEALTHCARE MEDICARE ADVANTAGE HMO NON-CALIFORNIA PREMIUM RATES Medicare Status Arizona Nevada Single-Party Plan Retiree Only U N/A N/A M $ $ Two-Party Plan Retiree and One Dependent UU N/A N/A UM N/A N/A MU N/A N/A MM $ $ Family Plan Retiree and Family UUU N/A N/A UMU N/A N/A MUU N/A N/A MMU N/A N/A MMM $ $ August 12, 2014 Page 1 of 1
4 ATTACHMENT 2 Los Angeles City Employees Retirement System 2015 Medical Plan Renewal Status Report Benefits Administration Committee, August 12, 2014 Respectfully Submitted by: Steve Gedestad, Municipality Practice Leader Isabella Janus, Consultant Michael Ahn, Assistant Vice President Erin Robinson, Senior Service Representative
5 Contents Introduction Page Final Financial Renewal Page Anthem Blue Cross Renewal PPO Page Anthem Blue Cross Renewal HMO Page Anthem Blue Cross Renewal Medicare Supplement Page Kaiser Permanente Renewal HMO and Sr Advantage Page UnitedHealthcare Renewal Medicare Advantage Page 9 SCAN Renewal Medicare Advantage Page Renewal Recommendations Page 11 Acknowledgement Page 12 2
6 Introduction This report presents LACERS final 2015 medical insurance plan renewals Anthem Blue Cross (Anthem), Kaiser Permanente (Kaiser), UnitedHealthcare (UHC), and SCAN have provided plan year 2015 renewals This report contains the final medical plan renewals including rates, benefits, network, and prescription drugs 3
7 2015 Final Financial Renewal Current Renewal - Initial 2015 Renewal - Final Negotiated Enrollment Premium Premium $ Change % Change Premium $ Change % Change Savings MEDICAL Anthem 1 PPO Under 65 and 65+ Part B 905 $13,793,750 $13,012,698 ($781,052) -5.7% $13,012,698 ($781,052) -5.7% $0 HMO Under 65 and 65+ Part B 848 $11,299,440 $12,247,618 $948, % $12,247,618 $948, % $0 Medicare Supplemental 3,161 $18,418,692 $20,260,561 $1,841, % $19,586,324 $1,167, % $674,237 Total 4,914 $43,511,882 $45,520,877 $2,008, % $44,846,640 $1,334, % $674,237 Kaiser 2 HMO Under 65 3,731 $31,620,149 $34,178,219 $2,558, % $34,178,219 $2,558, % $0 Medicare Advantage 7,500 $20,280,000 $21,096,000 $816, % $21,096,000 $816, % $0 Total 11,231 $51,900,149 $55,274,219 $3,374, % $55,274,219 $3,374, % $0 UnitedHealthcare 2 CA Medicare Advantage 909 $2,555,744 $2,683,532 $127, % $2,632,417 $76, % $51,115 AZ Medicare Advantage 37 $131,846 $138,438 $6, % $135,801 $3, % $2,637 NV Medicare Advantage 93 $233,177 $244,836 $11, % $240,172 $6, % $4,664 Total 1,039 $2,920,767 $3,066,806 $146, % $3,008,390 $87, % $58,415 SCAN 2 Medicare Advantage 444 $1,332,160 $1,332,160 $0 0.0% $1,332,160 $0 0.0% $0 Total 444 $1,332,160 $1,332,160 $0 0.0% $1,332,160 $0 0.0% $0 Medical Total 17,628 $99,664,958 $105,194,062 $5,529, % $104,461,409 $4,796, % $732,653 1) Anthem current enrollment is total contracts. 2) Kaiser, UnitedHealthcare and SCAN current enrollments are total members. 4
8 2015 Anthem Blue Cross Renewal Renewal Action for Anthem PPO Available to Retired Members under age 65 or age 65+ without Medicare Part A Proposed and final renewal of a 5.66% decrease Anthem medical PPO trend is 9.13% Prescription Drugs Claims increased 5.6% compared to Rx trend of 9.4% ACA Insurer fee 3.48% Favorable experience will produce a year-end refund through the participating contract 5
9 2015 Anthem Blue Cross Renewal Renewal Action for Anthem HMO Available to Retired Members under age 65 or age 65+ without Medicare Part A Proposed and final renewal rate adjustment is an 8.40% increase for plan year 2015 with no changes to current benefits Anthem medical HMO trend is 9.89% Prescription Drugs Claims increased 8.9%, compared to Rx trend of 8.8% ACA Insurer fee 3.48% Non-participating contract Other Considerations for Anthem Renewal Wellness contribution - $100,000 Mobile Health Consumer 6
10 2015 Anthem Blue Cross Renewal Renewal Action for Medicare Supplement Available to Retired Members age 65+ with Medicare Parts A and B For 2015 there is a 10% increase renewal rate cap Initial calculated rate increase was 10.6%, but limited to 10.0% because of the renewal rate cap After negotiations, the final renewal is 6.3% Anthem Medicare Supplement trend is 7% Prescription Drugs Claims increased 14.3% ACA Fees Not applicable Other Considerations includes SilverSneakers 7
11 2015 Kaiser Permanente Renewal Renewal Action for Kaiser HMO Available to Retired Members under age 65 Proposed 8.09% increase with no changes to current benefits Medical & Rx Trend is 5.41% Prescription Drugs Claims increased 5.2% Federal Health Insurer Fee/PCORI Fee $3.84 PMPM Renewal Action for the Senior Advantage Available to Retired Members with Medicare Parts A and B 4.03% increase 0.82% are the ACA Fees No plan changes Reduces the Maximum-Out-of-Pocket, True Out-of-Pocket (TROOP) costs from $6,700 to $3,400 Other Considerations for Kaiser Renewal $75,000 contribution for LAERS Well and Open Enrollment 8
12 2015 UnitedHealthcare Renewal - Renewal action for UHC Medicare Advantage HMO Available to Retired Members with Medicare Parts A and B Proposed 5% increase for Medicare Advantage in CA, AZ and NV with no changes to current benefits Final increase is 3% Prescription Drugs Reduces the Maximum-Out-of-Pocket, True Out-of-Pocket (TROOP) costs from $6,700 to $3,400 ACA Insurer Fee 2.3% Other Considerations for UHC renewal Wellness contribution of $7,500 Includes Solutions for Caregivers and SilverSneakers 9
13 2015 SCAN Renewal Renewal action for SCAN Medicare Advantage HMO Available to Retired Members with Medicare Parts A and B Rate Pass SCAN Medicare Advantage HMO trend is community rated Prescription Drugs Reduces the Maximum-Out-of-Pocket, True Out-of-Pocket (TROOP) costs from $6,700 to $3,400 Tier 5 Specialty Part D Compound drug Change from a $20 copayment to a 25% co-insurance ACA Fees Not applicable Other considerations: Wellness contribution of $8,000 Renewal includes Independent Living Power and SilverSneakers 10
14 2015 Renewal Recommendation Keenan and LACERS staff recommend acceptance of the final medical plan renewals 11
15 Acknowledgement Keenan & Associates would like to thank Ms. Lita Payne, Mr. Alex Rabrenovich, and the LACERS Health Benefits Administration staff for providing the necessary data and engaging in this Renewal process. Their cooperation and guidance have been extremely valuable. 12
16 Questions and Answers 13
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