Health and Employee Benefits Pool Plan Year 2020, Effective October 1, 2019
Health and Employee Benefits PoolPlan Year 2020, Effective October 1, 2019
IntroductionandTACHEBPOverviewPlanYearReview
RenewalTimelines
OtherNews
RNBCProcessReviewandUpdates
EmployeeSelf-ServicePortalUpdates
Questions
OASysUpdates
Agenda
PlanYear2020Outlook
TAC HEBP OVERVIEW
Health and Employee Benefits Pool
Ø County-owned and county-governedØ Not for profit (no stockholders to satisfy)Ø No state premium taxØ Stable membership – 221 county entities
§ 212 Pool (fully insured) and 9 ASO (self funded)§ 48,000+ members
Ø Stabilize rates for TAC supported counties and districts
TAC HEBP Product SuiteMedical&PrescriptionwithTeleHealth
Dental [WithorWithoutOrthodontia]
RetireeMedical[CountyChoiceSilverMedicareSupplement]
LifeInsurance[BasicandSupplemental]
VisionInsurance
DisabilityInsurance[Short&Long-term]
HEBPHealthyCounty
EmployeeWellnessØ Countyconsultationandtargetedincentiveprograms
Ø HealthyCountywellnesschallenges(poweredbySonicBoom)
Ø EmployeeempowermenttrainingsØ Annualconference(nochargetogroupWellnessCoordinatorandWellnessSponsor)
TAC HEBP Healthy County
EmployeeWellnessØ Countyconsultationandtargeted
incentiveprogramsØ HealthyCountywellnesschallenges
(poweredbySonicBoom)Ø EmployeeempowermenttrainingsØ Annualconference(nochargetogroupWellnessCoordinatorandWellnessSponsor)
TAC HEBP Renewal
Ø Renewal Process OverviewØ Prior Year ReviewØ Current Loss RatioØ Projected TrendØ Pool Needed Amount
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/PredictabilityØ LossRatio:Claimsvs.ContributionsØHighCostClaimsØ ShockClaims/PoolingPointØDemographicandAreaMedicalCostfactors
* Individual Review:
Plan Year Review
TAC HEBP Renewal Plan Year (PY2019) Membership
Change in MembershipØ TAC HEBP added 4 groups in PY19 (10/1/18 – 9/30/19): Carson, Crane,
Starr, and Zavala CountiesØ 221 Members (212 Pooled & 9 Self-Insured)
Ø Average Pool membership is 36,553 an increase of 8% year over yearØ Subscribers: + 5.34%Ø Spouses: + 3.01%Ø Dependents: + 3.68%
Ø Average member age remained stable at 38.8 years
TAC HEBP Renewal Medical Trend CY2018
Top3Conditions:Circulatory($26M),Cancer($25M),andMusculoskeletal($24M)
TAC HEBP Renewal Plan Year (PY2018) High Cost Claimants
TAC HEBP Renewal Rx Trend (Jan – Sept 2018) Prior PBM
Ø 29.2%Specialty Trend Ø 4.4%Non-SpecialtyTrendØ 11%RxTrend
TAC HEBP Renewal Rx Trend (Oct’18–March’19) Current PBM
Ø 0.6%Specialty Trend Ø -3.2%Non-SpecialtyTrendØ -2.1%RxTrend
TAC HEBP Renewal Impact of PBM Change
Current Loss Ratio
TAC HEBP Renewal – Medical Loss Ratio
Plan Year 2020Projected Trend
Plan Year 2020 Projected Trend
Ø PY 2020 Trend (10/1/2019-12/31/2020)
Ø TAC Blended Trend 7.5%Ø 8% MedicalØ 6% Rx
Plan Year 2020Pool Needed Amount
Plan Year 2020 Pool Needed Amount
Ø PY 2020 Pool Needed, eff. 10/1/2019 -12/31/2020
Ø Overall 2.79%
Renewal Timelines
Key Renewal Dates: October 1 Anniversary Date
Key Renewal Dates: November 1 Anniversary Date
Key Renewal Dates: December 1 Anniversary Date
Key Renewal Dates: January 1 Anniversary Date
OASys Updates
NEW!!OASys login
OASys - Multi-factorAuthentication(MFA)login
UpgradestoOASysrequireTACtoadaptamulti-factor authentication
(MFA) login.Using MFA require users to
provide more than one method of authentication to login.
OASys - Multi-factorAuthentication(MFA)login
Newhomepage.Enteryour
currentOASysemail.
OASys - Multi-factorAuthentication(MFA)login
Checkthisboxonlyifyouareusingaprivateorworkcomputer,andif
allowedperyourITpolicy.
Entercurrentpassword,orcreatea
newpassword
OASys- multi-factorAuthentication(MFA)login
Verificationcode– enteremailorphonenumber
OASys - Multi-factorAuthentication(MFA)login
Anemailwiththeverificationcodewillbesendto
you.
Note:TheemailwillcomefromWillisTowersandWatson.
PleasehaveyourITDepartment“Whitelist”thisemailaddress.
OASys - Multi-factorAuthentication(MFA)login
YoucanchoosefortheVerificationCodetobesentviatext oraphone
call.
OASys - Multi-factorAuthentication(MFA)login
Entercodetologin
OASys - Multi-factorAuthentication(MFA)login
Oncevalidated,youwillbetakentotheWebAdminscreen.
Ø ValidemailaddressØ EmployeeClassificationCode(sameasWorkersCompcodefrompayroll)
Ø NewOptionalField:ØMobilePhoneNumber
OASys – Data Entry ChangesEntryfieldsinOASysthatarenowrequiredfornewhires:
RNBC Process Review and Updates
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Clickonthe‘RNBC’tab
Electronic Renewal: Alternate RNBC Available
WithintheRNBCtabclicktheAlternate
RenewalInformationtabtoselectan
alternatemedicalandRXplan.
NEW!!ALTRNBC!!
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
EnterEmployerandEmployeecontributionamounts
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Firstof3screens-ReviewandUpdateeachContactType:
ContractingAuthority,PrimaryContact,
andBillingContact
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Retireecoveragedesignation
WaitingPeriods
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
ConfirmhowyourentityhandlesCOBRA.Clicksubmit.
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
PrintRNBC.
Have yourContractingAuthorityinitialeachpageofcompletedRNBCformandsignonlastpage.Then
faxoremailtoyourEmployeeBenefits
Specialist.
Electronic Renewal: Completing your Renewal Notice and Benefit Confirmation (RNBC)
Employee Self-ServicePortal Updates
Employee self-service (ESS) portal is getting an upgrade.
EffectiveJuly1,2019,TACwillrolloutanupgraded EmployeeSelf-Service
portal.
NEW!!ESS
Navigatetoyourbenefits,changebeneficiaries,
obtain forms,andviewotherTACprograms.Canalsoaddlinkstovendorwebsitesforothernon-TACbenefits.SimilartothecurrentESS,
just better!
Employee self-service portal (ESS) capabilities
Startingthisyear,theESSwillbeusedduringtheOpenEnrollmentperiods.Employeescanenrollinbenefitsthemselves!
Employee self-service portal (ESS) capabilities
Employee self-service portal (ESS) capabilities
Viewyourelectedbenefitsandtotalcosts.
ESSOASysReports
InOASys,youcanaccessReportsatanytime onchangesmadeby employees inESS.
EmployeeSelf-Service(ESS)- Multi-factorAuthentication(MFA)login
ESSloginwillalsouseMFA.
Firsttimeusers willneedtoconfirmtheiridentitybyenteringeithertheir
UIDorSSN.
Enhanced Registration
Enhanced Registration
Ifthedateofhireisunknown,theexactyearis
acceptable.
DOB anddateofhiremustmatchuser’srecordonfile.
An authenticationcode willbesenttotheuser’semail.
Establish/Verify User
Note:TheemailwillcomefromWillisTowersandWatson.Please
haveyourITDepartment“Whitelist”thisemailaddress.
Userswillhavetheoptiontohavetheverificationcodesentviatextor
to receivea phonecall.
Phone Call or Text Authentication
Oncetheverificationcodeisentered,accepttheOnlineAuthorization
terms.Accessisgranted.
Successful Log-in
Other News
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 employeeØ Eligible Spouses and Dependents
Ø Please contact your Employee Benefit Specialist with any enrollment questions
Renewal ProcessNew ID Cards
Concierge Customer Service
One toll-free phone number for:
BCBS Customer ServicePre-Authorizations
Condition Management
BlueCareConnectionsisbeingreplacedbyBCBSWellbeingManagement
Renewal ProcessOrdering 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
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)
Renewal Process
Ø RNBC Changes – view alternates and complete selectionand contributions online!
Ø New login security for OASys admin usersØ 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
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
CONSULTANTEAMS
SPECIALISTEAM
Renewal Process
Questions
Renewal Process
For questions regarding the information presented, please contact your Employee Benefits Consultant
at
(512) 478-8753 | (800) 456-5974FIRST NAME + FIRST INITIAL OF LAST NAME
@county.org
Thank you!