MEMBERS PRESENT:
Mike
Brown – UM Missoula
Jim Handley – MT Tech
Jackie Salveson – MSU Northern (phone)
Tom Schneider – MPEA
Maggie Peterson – MT Tech
Kathy Crego – UM
Earl Salley – IUOE Local 400
Ken Emerson – Retiree
DJ Whitaker – UM HCT
Shani Dues – MSU Bozeman
Don Mathre – MSU Bozeman
Michael Francisconi – WMC (phone)
Sandy Copenhaver – MSU Northern (phone)
Sue Hill – OCHE
Vicki Miller – MSU Billings (phone)
Deb Peters – MSU Billings (phone)
Sue Briggs – WMC (phone)
Kathy Haggart – MSU COTGreat Falls
Terre Gruba – UM Missoula
Susan Alt – MSU Bozeman
Richard Miller – Carpenters
OTHERS PRESENT:
Glen
Leavitt – OCHE
Kris Jones – Buck Consultants
Linda Ryckman – OCHE
Tammy Christiansen – OCHE
Rob Gannon – UM
Rita Garland – UM
Alison Justman –
Janet Simon – MSU
Jerry Coffee – MSU
MINUTES OF
Chairman Mike Brown called the meeting to order at 10:25
The plan numbers are holding up, no significant changes from a month ago. Jointly (state & MUS) through MAHCP has just released RFP for ASO services to look at total savings that a vendor can bring us. We may need a new plan administrator by the end of June 2003. State share is probably going to be $44.00 the next year and $50.00 the second year if the HB13 passes.
The state health plan lost $8 million last year, as a result of that they are either just barely preserved at a level that would produce a level of comfort what so ever. Or they may not be reserved at a level that is comfortable. Retiree costs are a large issue. The cost for an average state retiree is $1.32 for each dollar spent.
Questions have risen regarding the Flexible spending account funds left unused. EBR has provided us with a report on the actual numbers. Money left in the plan netted against the forfeitures for last three years were at $38 to 39 thousand dollars total. 1.4% for last year. These numbers are very, very low net numbers. The plan design has a $5000 self cap on it. We can increase the dollar amount if the need arises. UNUM has raised their rates on basic life and AD&D 10% this year to $2.22 for $10,000 policy and $4.44 for the $20,000 policy. Final numbers from UNUM (no RFP completed this year) show no rate increase in LTD. A new V.E.B.A. (Voluntary Employee Benefit Association) Committee trustee was elected. The VEBA plan document has been completed and has been sent to the IRS for approval. The trustee will be Washington Bank.
A new report, with the corrected prescription drug plan numbers included in the year-end quarterly report are trending at an overall 16% increase. The previous report showed 26%. The numbers are looking better than first thought for the CHO plans. Prescription drug claims now reflect a 15% trend. Combining active, cobra and retiree people in the previous report was at a 21% trend. The average cost per employee had said it was $130.00 has been revised to $155 because of correct numbers on drug utilization for the CHO.
The co-pays are currently at retail is $10 for generic, preferred brand is $15 and non-preferred is $25. On the mail side it is $15, $30 and $50. Retail members can get a 30-day supply and with mail order a member can get a 90- day supply. Currently we have a $100 deductible for individual, $200 for family, it applies to retail. The current annual out of pocket maximum for an individual is $700, and $1400 for family. DAW1 stands for dispense as written by the physician. DAW2 is refers to the members’ preference. On the dispense statistics, for July through December 02 (eligible members include member, spouse and dependents) 15,732 eligible members utilizing at retail with 7,183 eligible members using retail. This represented about 45.7% of our population. Based against the same timeframe for our book of business at EHS is actually higher at 70%. The mail utilization is very good. Utilizing members was 3, 371 with 21.4%. The EHS BOB is 14%. The retail total prescriptions 47,695, at mail are 16,243, about 25% of the total scripts. Generic prescription use is at about 47.3%; at mail it was 35% generic. 52% of prescriptions were filled by the mail service. EHS has suggested implementing mandatory mail order for maintenance drugs and penalties for not using generic drugs. The plan paid per member $34.67 (July through December) well below EHS BOB of $43.42. Preferred formulary is at 95% compliance. EHS BOB is running 94%. The average script per member per year in 2001 it was 6.7% at retail it is now at 6.5%.
Lunch
Motion: A motion was made and seconded to add the wording regarding home health care limit. The limit would be 90 days per plan year, 180 days lifetime, with preauthorization from APS. This is to guard the MUS from getting into “custodial” case issues.
Action: The motion carried.
IUBC had a discussion to include an option to elect partial insurances. Verses take the insurance or none at all.
No motion or action taken.
Motion:A motion was made and seconded to change the prescription plan change to out of pocket maximum per year to $800 for individual, $1600 family per year.
Action: The motion carried.
Motion: A motion was made and seconded to increase prescription drug co-pays to $10/20%, $20/30% and $30/40% minimum prescription at retail. Mail order co-pays will increase to $20 per 90- day supply, $40 formulary drug 90-day supply, and $60 for 90-day supply of a non-preferred non-formulary drug.
Action: The motion carried. 3 opposed.
IUBC discussed whether to have the plan member pay the difference between brand name and generic when a generic drug is available.
No motion or action taken