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Public Employees' Benefit Board Meeting Minutes, May 16, 2006
Public Employees’ Benefit Board
Tuesday, May 16, 2006 12:45 to 3:30 p.m. - Minutes
PEBB Board Room
775 Court St NE, Salem OR
                                                                                                                                                         Approved 6/20/06
Board MembersPresent
Diane Lovell, Chair
Peter Callero
David Hartwig
Rocky King
 
Rep. Jeff Kropf
Paul McKenna
Rich Peppers
Jeanene Smith

PEBB Staff Present
Bobbie Barott
Dena Comer
Isabel Joslen
Lisa Krois
 
Lydia Lissman
Susan Pritt
Ingrid Norberg
Jean Thorne
 
Consultants Present
Pam Hodge, Aon
Dennis Tierney, Aon
 
Guests Present
Gordon Hoberg, ODS
Diana Jones, Regence BCBSO
Bill Lindekugel, Kaiser Permanente
Renee McDonald, Regence BCBSO
Megan Myrick, Willamette Dental
Greg Perez, Aon Consulting
 
Paul Pfinster, AFLAC
Tamatha Tracer, Samaritan Health Systems
Kim Waldroff, BenefitHelp Solutions
Ryan Webster, Providence Health Plans
Cheryl Willcoxen, SEIU
Denise Yunker, Oregon University System
Agenda
Welcome and Approval of Minutes
Overview of Meeting
Operations Subcommittee Report
2007-09 Agency Request Budget Policy Options Package
Plan Performance Measures
Update on Rx Exceptions Activity and Bariatric Surgery Preauthorizations
Update on Communications and Engagement Advisory Committee
Other Business
General Public Comment
 
Welcome and Approval of Minutes
Diane Lovell called the meeting to order.
 
Peter Callero moved to approve the minutes from the April 18, 2006 meeting.
Rocky King seconded the motion.
Hearing no further discussion, the motion passed unanimously.
 
Overview of Meeting
Jean Thorne explained that the Board will take actions on items from the May 9 Operations Subcommittee meeting; The Board will continue discussion on the Agency Request Budget Policy Option Packages (POPs); and discuss uses of the Stabilization Fund for 2007-09. Lisa Krois will provide a presentation on plan performance measures. The Board will also hear updates on the reporting elements for longer and shorter term activities for prescription exceptions and bariatric surgery; and Lisa Krois will provide an update on PEBB’s Communication and Engagement Advisory Committee.
 
Operations Subcommittee Report
Paul McKenna reported that the May 9 Subcommittee meeting included a discussion of the Administrative POPs and a customer service team update from Bobbie Barott, who will provide monthly reports to the Subcommittee on tracked phone calls and emails received from members.
 
The Subcommittee also discussed the lack of consistent administration of eligibility determination for over age dependent children aged 19 to 24 years. Carriers currently differ in how they administer the over age dependent eligibility, and some carriers do not send notification letters. The carriers believe that the notification should be the responsibility of PEBB, and PEBB staff believes this can be done with the pebb.benefits system in place. The administrative rules put the responsibility on the member to notify PEBB regarding eligibility for dependents. As a solution, PEBB will administer the over age dependent eligibility and will be responsible for member notification and the termination of dependent benefits as necessary. Members will be responsible to provide notification to PEBB when dependents no longer qualify for benefits.
 
The Subcommittee advanced the following items for Board approval:
 
The Subcommittee moved to increase the PEBB Administrative Fee for 2007 to 0.6 percent, to increase the Retiree Administrative Fee to 1.1 percent, and to increase the COBRA Administrative Fee to 2.6 percent.
Rich Peppers seconded the motion.
Rocky King explained that he would like to see the dollar figure increases in addition to the percentages.
Rep. Kropf explained that he would like to see the differences in actual dollar figures between .5 and .6 percent.
Hearing no further discussion, the motion passed unanimously.
 
The Subcommittee moved to approve the continuation of the consultant’s commission rate for 2007 of 0.16 percent of medical, dental, and routine vision premiums for 2007.
Rocky King seconded the motion.
Hearing no further discussion, the motion passed unanimously.
 
The Subcommittee moved to offer a two-year contract renewal to Aon Consulting, Inc.
Rocky King seconded the motion.
Hearing no further discussion, the motion passed unanimously.
 
The Subcommittee moved to offer a one-year contract renewal to BenefitHelp Solutions (BHS).
Peter Callero seconded the motion.
Rocky King expressed his concern over BHS performance issues.
Jean Thorne explained that PEBB is addressing these.
Jeanene Smith suggested a quarterly performance report on BHS to the Operations Subcommittee.
Hearing no further discussion, the motion passed unanimously.
 
The Subcommittee moved to offer a one-year contract renewal to Unum for the optional long-term care insurance benefit.
Rich Peppers seconded the motion.
Hearing no further discussion, the motion passed unanimously.
 
2007-09 Agency Request Budget Policy Option Packages
Administrative POPs
Lydia Lissman referred to Bd attach.7 and provided a summary of the proposed 2007-09 administrative POPs, including the following:
  • pebb.benefits (1 permanent Program Analyst position)
  • pebb.benefits – System improvements
  • PEBB Operations (1 permanent clerical support position)
  • PEBB Office Space – Funding for Relocation to State Facility
  • PEBB Vision – Support to Quality and Prevention Initiatives (2 permanent positions and funding for Physician Consultant)
  • PEBB – Other Post Employment Benefits (OPEB) Actuarial Valuation
 
Jean Thorne explained that based on discussion in today’s executive session, PEBB staff will research the need for an additional position.
 
Rocky King moved to approve the recommendation for the Administrative POPs, as follows:
  • pebb.benefits (1 permanent Program Analyst position)
  • pebb.benefits – System improvements
  • PEBB Operations (1 permanent clerical support position)
  • PEBB Office Space – Funding for Relocation to State Facility
  • PEBB Vision – Support to Quality and Prevention Initiatives (2 permanent positions and funding for Physician Consultant)
  • PEBB – Other Post Employment Benefits (OPEB) Actuarial Valuation
David Hartwig seconded the motion, and added that the pebb.benefits positions are extremely valuable.
Rocky King complimented staff efforts to implement pebb.benefits during 2005 open enrollment.
Hearing no further discussion, the motion passed unanimously.
 
Jean Thorne referred to Bd attach.8 and provided an overview of the proposed 2007-09 budget packet for the Stabilization Fund, including:
  • Monitoring performance and outcomes;
  • Evidence-based studies and development of health information infrastructure and exchange;
  • Agency support for employee wellness; and
  • Performance fund
Rocky King moved to approve the Stabilization Fund POP as proposed, but with an increase of $89,000 for the element of evidence-based studies and development of health information infrastructure and exchange.
Paul McKenna seconded the motion.
Diane Lovell expressed concern that the language evidence-based studies doesn’t include looking at various evidence-based benefit designs. $250,000 for evidence-based studies might not be sufficient.
Peter Callero suggested the flexibility in the entire package could allow for additional funding as needed.
Jean Thorne explained that the narrative will be revised to include looking at models for evidence-based plan design in addition to studies.
Hearing no further discussion, the motion passed unanimously.
 
Plan Performance Measures
Lisa Krois referred to Bd attach.9 (doc) and provided an overview of PEBB’s latest performance measures, and the principles behind selecting those measures. She explained that there are placeholders for two additional measures regarding the appropriate prescribing of antibiotics for children and adults as recommended by PEBB’s Council of Innovators (COI).
 
Rocky King asked if PEBB has the ability to impact the outcomes of the performance measures, and what can be done if the outcomes aren’t optimal.
Lisa Krois explained that the COI is working on targeted areas for improvement and if experience indicates problems, the COI will work to address the area.
Jean Thorne explained that the response to such problems may include a number of actions (by DHS Public Health, education, etc.), based on the performance area. If there isn’t enough data and PEBB can’t come to meaningful conclusions, that data will still be rolled into overall performance for members.
Lisa Krois explained that some of the reports will come to the Board on a quarterly basis, and some will be included in the annual disease management report. The Technical Committee will prepare an annual report and the COI will make recommendations from the raw data.
Jeanene Smith gave examples of what the Office of Oregon Health Policy and Research (OHPR) has on their website, but explained that a level of translation (beyond Lisa’s and Jeanene’s ability) is necessary so that the data makes sense.
Rep. Kropf stressed the importance of having timely data that is filtered so that it makes sense, to allow for action.
Lisa Krois explained that a challenge is that in order for a full year’s experience to be examined, it will always one year behind. This is the nature of claims data.
Rich Peppers asked if it would be possible to examine the outcomes from a shorter timeframe than an annual report.
Lisa Krois will prepare a proposed reporting process and bring it to the Board for consideration.
Diane Lovell suggested that the reporting process is something that should be continually examined as data is accumulated, not just provided in a single report.
Rep. Kropf asked if there are other available models to consider.
Jeanene Smith replied that Maine has a model.
 
Updates on Rx Exceptions Activity and Bariatric Surgery Preauthorizations
Jean Thorne referred to Bd attach.10 (doc) and provided an overview of the plan reports on prescription drug exceptions activity from the first quarter. Referring to Bd attach.11, (doc) she provided an overview of the reports from the plans on bariatric surgery activity for the first quarter. She clarified that Regence requires two preauthorizations prior to surgery, and that there were no surgeries reported as of March 31, 2006.
Update on Communications and Engagement Advisory Committee
Lisa Krois reported that the Committee discussed evaluation tools and methodologies, and she will bring a menu of these to the next Board meeting.
 
The Committee also discussed the process for communication and testimonials from members, physicians, and union representatives. Testimonials should include both positive and negative member experiences to provide a full picture as well as provide an opportunity for learning. Other discussion included identification of topic areas and wellness issues that are currently underdeveloped on PEBB’s website.
 
The Committee will meet monthly for the next three to four months.
 
Other Business
Lisa Krois explained that the Chronic Disease Management group, its technical committee, and the Coding Committee will be disbanded and combined into one Technical Committee. This group will be streamlined, resulting in one committee examining all performance measures, not just those relating to disease management.
 
Jean Thorne reported that Tera Cushman began on May 10 as a temporary Operations and Policy Analyst. Susan Pritt will be leaving PEBB on June 9 to transfer to the State Police Department.
 
General Public Comment
None.
 
Meeting Adjourned