2014-2015 Benefit Plan Recommendations April 14, 2014 Board Meeting.

2014-2015 Benefit Plan Recommendations

April 14, 2014Board Meeting

2014-2015 Recommendations

• Increase District contribution from $225 to $260• Increase premiums by 15%• Enter Interlocal agreement with Region 4 ESC for:

• Online benefit enrollment• Dental plan administration• Supplemental disability plan administration• Basic life insurance administration• Supplemental life insurance administration• Vision plan administration• Supplemental cancer administration• Supplemental accident administration

District Contribution

• 2002 district contribution $225• 2004 district contribution $232• 2005 district contribution $240• 2006 district contribution $260 • 2011 district contribution $225• 2014 district contribution $260

District Contribution Comparisons

DISTRICT PLAN YEAR CONTRIBUTIONBridgeport ISD 2013-2014 $225.00

Eagle Mountain Saginaw ISD 2013 - 2014 $225.00

HEB ISD 2013 - 2014 $225.00

Denton ISD 2013 - 2014 $235.00

Birdville ISD 2013 - 2014 $240.00

Lake Dallas ISD 2013-2014 $245.00

Lewisville ISD - ActiveCare 1HD 2013 - 2014 $245.00

Argyle ISD 2013-2014 $250.00

Plano ISD 2013 - 2014 $259.00

Northwest ISD 2014-2015$260.00

Proposed

Carrollton-Farmers Branch ISD 2013 - 2014 $262.00

Lewisville ISD -ActiveCare 1 2013 - 2014 $266.00

Keller ISD 2013-2014 $275.00

Krum ISD 2013-2014 $275.00

Grapevine-Colleyville ISD 2013 - 2014 $285.00

Carroll ISD 2013 - 2014 $290.00

Garland ISD 2013 - 2014 $325.00

Irving ISD 2013 - 2014 $325.00

Decatur ISD 2013-2014 $337.00

Lewisville ISD - ActiveCare 2 2013 - 2014 $348.00

Lewisville ISD - ActiveCare 3 2013 - 2014 $356.00

Stop Loss Claims

• NISD pays the first $150,000 in claims

• Stop loss picks up after the individual exceeds $150,000

• Average 5 stop loss for past 3 years• Total plan loss $2.25 million dollars

Self-Insurance Fund Balance

• 2006 fund balance $536,000• 2011 fund balance $2,100,000• 2011 Clinic Opens• 2011 State budget cuts begin• 2014 fund balance $500,000

• Implementation of Affordable Care Act• Stop loss claims• Raising costs of benefits

Affordable Care Act impact on Self-Insurance Fund

• Unlimited Wellness• Elimination of pre-existing conditions for children under 19• Extension of dependent children coverage up to 26

regardless of marital status• Increase access to mental counseling and treatment• Shared Responsibility Mandate• Maintenance of efforts• Creation of plan that cost less than $110 per month and

pays 60% of the benefits• Federal Reporting Annually• Penalties for non compliance

Benefits of Health and Wellness Center

• Annual administration cost $1,030,021

• Annual plan savings $1,400,000• Overall health costs have increased• Wellness Center has allowed NISD’s

increase to grow at a much slower pace

Medical Plan Participation

• 65% of the employee population participate in the medical plan

• The majority of the participants carry employee only coverage

• There are 70 district couples who carry employee and family coverage

• Estimated cost to increase the district contribution is approximately $756,000

Proposed Premium Increases

• Increase premiums by 15%• $17 per month increase for employee only in the

Basic Plan• $147 per month increase for employee and family

in the Core Plan• Employees receive $25 per month PHA Incentive

for employee only or employee and child coverage• Employee receives $50 per month PHA Incentive if

employee and spouse participate in the PHA with employee and spouse or employee and family coverage

Premium RecommendationsProposed 2014-2015 Medical Premiums

Core Plan with PHA Participation Premium NISD

PHA Participation Incentive

Proposed Premimum

Monthly Increase

Annual Increase

EE 537.00 260.00 (25.00) 252.00 32.00 384.00 EE+SP 1,190.00 260.00 (50.00) 880.00 114.00 1,368.00 EE+CH 1,009.00 260.00 (25.00) 724.00 93.00 1,116.00 EE+FM 1,450.00 260.00 (50.00) 1,140.00 147.00 1,764.00

Basic Plan with PHA Participation

PHA Participation Incentive

Proposed Premimum

Monthly Increase

Annual Increase

EE 426.00 260.00 (25.00) 141.00 17.00 204.00 EE+SP 926.00 260.00 (50.00) 616.00 79.00 948.00 EE+CH 781.00 260.00 (25.00) 496.00 64.00 768.00 EE+FM 1125.00 260.00 (50.00) 815.00 105.00 1,260.00

Core Plan without PHA Participation

PHA Participation Incentive

Proposed Premium

Monthly Increase

Annual Increase

EE 537.00 260.00 0.00 277.00 57.00 684.00 EE+SP 1,190.00 260.00 0.00 930.00 164.00 1,968.00 EE+CH 1,009.00 260.00 0.00 749.00 118.00 1,416.00 EE+FM 1,450.00 260.00 0.00 1,190.00 197.00 2,364.00

Basic Plan without PHA Participation

PHA Participation Incentive

Proposed Premium

Monthly Increase

Annual Increase

EE 426.00 260.00 0.00 166.00 42.00 504.00 EE+SP 926.00 260.00 0.00 666.00 129.00 1,548.00 EE+CH 781.00 260.00 0.00 521.00 89.00 1,068.00 EE+FM 1125.00 260.00 0.00 865.00 155.00 1,860.00

NISD Comparability Plan to TRS Plan Benefit

Network Non-network Network Non-networkDeductible

Individual Family

Coinsurance(plan pays afterdeductible) 80% 60% 70% 50%

(employee pays after 20% 40% 30% 50%deductible)

Out of Pocket Maximum(in addition to deductible)

IndividualFamily

Prescription Drug

Lifetime Maximum

Office visit Primary/Specialist $20/$30 Deductible and

CoPay Coinsurance

Emergency Room

Hospital Admission

High Tech Radiology

Prescription Drugs *

Retail Short Term - 31 dayGeneric $15 $15* > of $5 or 30% > of $5 or 30%*

Preferred Brand $35 $35* > of $35 or 30% > of $35 or 30%*Non-Preferred Brand $60 $60* > of $35 or 30% > of $35 or 30%*

Specialty Drug $200 $125 N/A*plus over cost *plus over cost

Retail Maintenance - 31 dayGeneric $15 $15* $25 $15*

Preferred Brand $35 $35* $75 $35*Non-Preferred Brand $60 $60* $75 $60*

Specialty Drug $200 $125*plus over cost *plus over cost

Mail Order -90day

Generic $45 N/A $25 N/APreferred Brand $105 N/A $75 N/A

Non-Preferred Brand $180 N/A $75 N/ASpecialty Drug N/A N/A $125 N/A

Employee OnlyEmployee/Child(ren)Employee/SpouseEmployee/Family

$100 copay plusDeductible and

Unlimited

Coinsurance

Coinsurance

$150 copay plusDeductible and 20% Coinsurance

Coinsurance

$150 copay plusDeductible andCoinsurance

$100 plan year prescription deductible until met by any

combination of Network & Non-Network prescriptions plus

copay(s)

$512$984

$1,084$1,400

Proposed with PHA2014/2015

NISD Core Plan

N/AN/A

$8,000$2,000

Unlimited

$200 Copay & Coinsurance

Coinsurance(CT scan, MRI, nuclear medicine)

$1,810$1,990

$796$1,269

$75 plan year prescription deductible until met by any

combination of Network & Non-Network prescriptions plus

copay(s)

2013/2014Rates

N/A

$1,000 $4,000

$900

per person

$300

TRS ActiveCare 3

Premiums do not reflect district contribution

Creation of High Deductible Plan

High Deductible Plan with PHA Participation

Premium NISD Proposed Premium

PHA Fee

Proposed Premium

Employee 341.00 260.00

81.00 0.00 81.00

Employee + Spouse 745.00 260.00

485.00 0.00 485.00

Employee + Children 645.00 260.00

385.00 0.00 385.00

Employee + Family 914.00 260.00

654.00 0.00 654.00

High Deductible Plan without PHA Participation

Premium NISD Proposed Premium

PHA Fee

Proposed Premium

Employee 341.00 260.00

81.00 25.00 106.00

Employee + Spouse 745.00 260.00

485.00 50.00 535.00

Employee + Children 645.00 260.00

385.00 25.00 410.00

Employee + Family 914.00 260.00

654.00 50.00 704.00

NISD (ACA Compliance) vs TRS (ACA Compliance)Benefit

Network Non-networkDeductible

Individual Family

Coinsurance(plan pays afterdeductible) 80% 60% 80% 60%

(employee pays after 20% 40% 20% 40%deductible)

Out of Pocket Maximum(in addition to deductible)

IndividualFamily

Prescription Drug N/A

Lifetime Maximum Unlimited

Office visit Primary/Specialist Deductible and

CoPay Coinsurance

Emergency Room Deductible and Coinsurance

Hospital Admission Deductible andCoinsurance

High Tech Radiology Deductible andCoinsurance

Prescription Drugs *

Retail Short Term - 31 dayGeneric > of $5 or 20% > of $5 or 30%*

Preferred Brand > of $35 or 20% > of $35 or 30%*Non-Preferred Brand > of $35 or 20% > of $35 or 30%*

Specialty Drug $125 N/A*plus over cost

Retail Maintenance - 31 dayGeneric $25 N/A

Preferred Brand $75 N/ANon-Preferred Brand $75 N/A

Specialty Drug $125 N/A

Mail Order -90day

Generic $25 N/APreferred Brand $75 N/A

Non-Preferred Brand $75 N/ASpecialty Drug $125 N/A

Employee OnlyEmployee/Child(ren)Employee/SpouseEmployee/Family

$4,200$4,000$8,000

$341$645

$2,400$4,800

(Discount cardIncluded)

Medical Deductible

$2,200$4,400

(CT scan, MRI, nuclear medicine)

$3,850

$794$1,060

$745$914

$325$572

Rates 2013/2014

plus Coinsurance

Medical Deductible plus Coinsurance

plus Coinsurance(Discount card

Included)

Medical Deductible

NISD HD PlanTRS ActiveCare 1HD

Premiums do not reflect

district contribution

Plan cost can’t

exceed $110

Must pay 60% of benefits

Interlocal Agreement with Region 4 ESC

• Online Enrollment savings of $80,000• 403(b) Administration savings of

$5,500• Basic life insurance savings of

$15,000

Fully Insured Dental Plan

• Cigna Dental Providers• All benefits remain the same except

root canals paid at 80% instead of 50% 2014 -2015Dental High Plan

Premium increase2.5%

Employee $ 47

Employee + Spouse $ 88

Employee + Children $ 74

Employee + Family $ 120

Dental Low Plan

Employee $ 25

Employee + Spouse $ 45

Employee + Children $ 37

Employee + Family $ 58

Other Recommended Changes

• Supplemental long term disability all current employees guaranteed issue policies

• Supplemental life insurance guaranteed issue policies

• Vision insurance provider network will remain VSP with a change in administrator

• Supplemental Cancer and Accident Plans• Discontinue offering AFLAC plans. Current

participants can continue to have payroll deductions.