SchoolCare Health Benefit Plans of the NH School Health Care Coalition

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SCHOOLCARE HEALTH BENEFIT

PLANS OF

THE NH SCHOOL HEALTH CARE COALITION

Business Reports

Lisa J. Duquette, Executive DirectorMelissa M. Perreault, Program Manager

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2012-13 Highlights

• Staff made scheduled visits to 90%+ of members’ offices• Wellness participation increased in all programs• Dental program became self-funded• Developed Go-Green Initiative

• 100% renewal of existing groups• 5 new groups, enrollment increased

– Medical 3.7%; Dental 6.5%

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2012-13 Financial Results (draft audited)

• Contributions/Investments/Income– $135.08 million

• Claims Expense/Insurance/Admin– $136.60 million

• Excess of Expense over Revenue– $1.52 million

Why? Claims ↓ Premium Holiday $7.66 million

expense

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Net Assets

• Fund Balance = Members’ Equity

$33.1 million

• Designated $17.8 million– SCHOOLCARE 65+ - $1.9 million– Medical Risk Corridor- $15.9 million

• Undesignated $15.3 million (Surplus to be returned to as Premium Holiday in future years)

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Your Premium Dollar 2012-13

Cigna Admin 3.7%Stop Loss Ins 1.2%

Operations 1.3%Wellness 1.6%

Claims Expense/Reserve 92.2%

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Health Care Update• 2013 was the 1st year in the past decade that

health care trend was below 10%• Continued impact of health care reform

– PCORI Fee & Transitional Reinsurance Fees– Out of Pocket Maximums for ALL plans

• 2013 medical trend for U.S. is expected to be 6.5% compared to 8.7% for New Hampshire

• Affordability for employers and employees is a major issue

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Rating Objectives

1. Predictability– Guarantee rates for negotiations and

budgeting by December 1

2. Stability– Minimize fluctuations from year to year

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SCHOOLCARE Rate History (Average)

YearMedical Trend

Need Increase

Rate Stabilization / Premium Holiday

Actual or “Effective” Increase

2009-10 10.6% 11.5% -5.7% ($3.8M) 5.8%

2010-11 10.5% 4.9% -2.7% ($2.0M) 2.2%

2011-12 11.0% 11.5% -5.3% ($5.0M) 6.2%

2012-13 10.0% 12.1% -7.3% ($8.3M) 4.8%

2013-14 9.3% 5.0% -3.3% ($4.25M) 1.7%

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Premium Holiday continues….

• Return of Surplus – previously Rate Stabilization

• Increased Transparency• Budgeting

– use Effective Increase/Rates

• Calculate Employee Share• Future Premium Holidays

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Preliminary Cigna Medical Rate Indication

• Medical Trend 6.5%

• Average “Gross” Renewal 8.3%– no increase greater than 13%

• Average “Effective” Renewal $10M of Premium Holiday (previously Rate Stabilization)

– “effective” average increase would be 1%– no increase greater than 8%

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Preliminary Cigna Dental Rate Indication

• Dental Trend 5.7%

• Average Renewal 4.8%– no increase greater than 5.15%

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Preliminary 65+ Medical Rate Indication• Medicare Supplement United American

– 7/1/13 increased 1.9% $207.00

• Prescription (Rx) Express Scripts– 7/1/13 no increase $205.00– 1/1/14 decreasing 15%! 173.48

• Employer Group Waiver Program (EGWP)

New Monthly Rates 1/1/14 – 12/31/14:65+ Medicare supplement only $207.0065+ Medicare supplement and Rx $380.48

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2014-2015 Rates

• Notices to each member by Dec. 1 Employer and Employee

• To renew and lock in,

sign by Feb. 1

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Choices• If member accepts rate by February 1, the Coalition can

guarantee it for 2014-15, regardless of how claims may change

• If member does not accept by February 1, the Coalition reserves the right to re-rate, based on more recent claims experience

• Members must notify the Coalition within 45 days of July 1 if wishing to non-renew

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Thank you for your participation.

Questions?