ALBUQUERQUE PUBLIC SCHOOLS
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1 ALBUQUERQUE PUBLIC SCHOOLS FY17 Insurance Appropriation Request Presented to the Legislative Education Study Committee Representative Dennis Roch, Chair Senator John Sapien, Vice Chair November 19, 2015
2 HISTORICAL INFORMATION APS offers a comprehensive benefits program in comparison to other state public entities Key differentiator for attracting and retaining employees Key for maintaining this structure is to shift our culture from a tendency of entitlement to one of personal accountability, employee wellness and prevention of chronic disease Premium increases over the last 5 years have been minimal (single digit) as have benefit plan design changes The primary determinant of costs are claims, not administrative costs, and the primary driver of claims are the risk factors and health of plan members APS currently realizes improved unit costs and administrative costs through the IBAC RFP procurement process APS has and will likely continue to face pressure to spend down our health plan insurance reserves to the minimum level. (Incurred But Not Reported) (IBNR) is approximately $9 million 2
3 LEGISLATIVE APPROPRIATION REQUEST Medical Insurance Request: $0.0 Workers Compensation Request: $0.0 Property and Liability Request: $0.0 *This request is based off of information presented to the APS Board of Education in August of Please refer to slide 7 for additional information. 3
4 BREAKDOWN OF ESTIMATED 2016 MEDICAL COSTS Total Dollars Medical $89,136, Contributions $82,766, Projected Costs $6,370,316 Difference -7.1% Decrease Total *Based on headcount as of May
5 BREAKDOWN OF DENTAL AND VISION COSTS Total Dollars Dental $5,991, Contributions $6,321, Projected Costs ($329,539) Shortfall 5.5% Increase Needed Total Dollars Vision $866, Contributions $848, Projected Costs $18,214 Shortfall -1.79% Decrease Total 5
6 COMBINED MEDICAL/RX, VISION & DENTAL 2016 COSTS Plan Total Dollars Medical $82,152,013 Dental $6,321,150 Vision $848,642 Total Cost $89,321,805 Total 2015 Contributions $95,333,430 Total Decrease Amount $6,011,625 Shortfall $0.0 6
7 SELF-FUNDED MEDICAL/RX, DENTAL & VISION PLANS INSURANCE RESERVE FUND BALANCE Description June 2015 July 2015 August 2015 Sept Beginning Reserve Balance TOTAL CONTRIBUTIONS $15,166, $19,880, ,996, $13,943, $12,051, $3,151, $5,786, $15,489, TOTAL PLAN COSTS ($7,340,122.05) ($7,038, ) ($7,842, ) ($21,741,347.99) INTEREST EARNING $2, $2, $2, $7, Ending Reserve Balance $19,880, ,996, ,943, $13,635, *August and September ending balances cause concern for APS. The district may adjust its insurance appropriation request once the remainder of the calendar year claims are reported. **Statutorily Required Incurred but Not Reported Fund Balance Level $9.0 million Board of Education and Superintendent Required Fund Balance $13.0 million 7
8 2016 BENEFIT PLAN RECOMMENDATIONS Medical Plan Changes We are recommending no plan design changes or premium increases for the medical plans. Dental Plan Changes We are recommending no plan design changes to the dental plans. We are recommending a 5.5% increase to dental plan premiums, which will result in an increase of approximately $1.00 per month for Individual Coverage and approximately $5.00 per month for Family Coverage Vision Plan Changes We are recommending no plan design changes or premium increases for the vision plan. 8
9 PY16 APPROVED MEDICAL BENEFITS (REFLECTS MEDICAL PLAN DESIGN CHANGES ) Benefit 2013 In-Network 2014 In-Network 2015 & 2016 Deductible (3x Family) None $250 $250 Coinsurance (3x Family) None 20% 20% Coinsurance Max $2,000 $2,000 $2,000 Out-of-Pocket Max (ded + coins) PCP & Primary Care Co-Pays $2,000 $2,250 $2,250 $25 $25 $25 Specialist Co-Pays $40 $40 $40 IP Hospital Admission $750 copay Ded/Coins Ded/Coins OP Surgery $250 copay Ded/Coins Ded/Coins Advanced Radiology $100 copay $100 copay, then Ded/Coins Emergency Room $150 copay $150 copay, then Ded/Coins $100 copay, then Ded/Coins $150 copay, then Ded/Coins Urgent Care Co-Pays $50 $50 $50 9 Radiation, Dialysis, Chemotherapy Paid at 100% Ded/Coins Ded/Coins
10 BENEFIT PLAN COST SAVINGS STRATEGY Medical Claims Audit Estimated $825k in savings (savings can vary greatly based on payer s adherence to plan language) Flexible Spending Maximum Increase to $2550 Negligible savings on taxes from payroll Changes to the Prescription Drug Plan Detailed prior authorization for PCSK9 drugs (already implemented) Other Plan Change Options Change Eligibility Requirement for Dental and Vision plan administration to cover children until age 26 10
11 COST SAVING STRATEGY: ON-SITE HEALTH CLINIC APS is moving forward with opening an on site health clinic. The RFP was issued August 10, 2015 RFPs were reviewed the second week of November. 11
12 COST SAVING STRATEGY: IBAC IBAC RFP for Project Manager for medical, dental and vision RFP Decision to be made in August 2015 IBAC RFP for medical, dental and vision coverage is scheduled to be released in the fall of 2015 (effective date for APS is January 1, 2017) 12
13 COST SAVING STRATEGY: HEALTHCARE VALUE New Mexico Coalition for Healthcare Value Executive Committee and Board Members met with Governor Martinez s Staff on August 3, 2015 to introduce the Coalition s mission and goals Presented to Legislative Finance Committee on August 20, 2015 Topic was Delivering Better Healthcare for Less 13
14 SELF-FUNDED RISK MANAGEMENT INSURANCE RESERVE FUND BALANCE Workers Comp End of FY15 Sept Beginning Reserve Balance $11,751, $9,626, TOTAL CONTRIBUTIONS $4,188, $264, TOTAL PLAN COSTS ($5,485,724.31) ($510, ) INTEREST EARNING $19, $1, Ending Reserve Balance $10,474, $9,382, Property & Liability End of FY15 Sept Beginning Reserve Balance $14,620, $16,014, TOTAL CONTRIBUTIONS $6,710, $517, TOTAL PLAN COSTS ($5,787,898.71) ($316,579.01) INTEREST EARNING $28, $2, Ending Reserve Balance $15,571, $16,217,
15 ACTUARIAL CONFIDENCE LEVEL FOR WORKERS COMPENSATION Actuarial Confidence level for W\C 70% 80% 90% Six year average 9,922,951 11,299,141 12,890,675 Estimated Outstanding Losses ,512,911 11,008,804 11,802, ,749,471 11,261,350 12,285, ,114,679 11,643,950 12,702, ,770,444 11,576,986 13,857, ,562,928 9,983,065 11,949, ,827,273 12,320,690 14,747,492
16 ACTUARIAL CONFIDENCE LEVEL FOR PROPERTY & LIABILITY Actuarial Confidence level for P/C 70% 80% 90% Six year average 7,193,271 8,414,356 10,553,649 Estimated Outstanding Losses ,748,641 5,401,190 6,661, ,540,305 7,315,972 8,732, ,805,775 9,077,527 11,478, ,443,841 8,805,251 11,311, ,606,353 9,102,888 11,513, ,014,711 10,783,310 13,623,934 16
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This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/cuhealthplan or by calling 1-800-735-6072.
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