Text Size:   A+ A- A   •   Text Only
Site Image
PEBB Operations Subcomittee Meeting Minutes, Oct. 10, 2006

Public Employees’ Benefit Board
Operations Subcommittee
Tuesday, October 10, 2006 9:30 – 11:00 a.m. - Minutes
PEBB Board Room
775 Court St NE, Salem OR
Approved 11/14/2006
Board MembersPresent
Paul McKenna, Chair
Diane Lovell
Sue Nelson
PEBB Staff Present
Bobbie Barott
Sandy Johnson
Claire Kemmerer
Lydia Lissman
Zue Matchett
Rick Schoonover
Scott Smyth
Jean Thorne
Consultants Present
Pam Hodge, Aon
Guests Present
Dotha Canning, SMS
Jennifer Hall, ODS
Gordon Hoberg, ODS
Megan Myrick, Willamette Dental Paul
Deborah Trembley, OJD
Kim Waldroff, BenefitHelp Solutions
Call to Order/Approval of Minutes
Over Age Dependents
Budget Update
Self Insurance
Customer Service Team / Open Enrollment Update
General Public Comment
November Agenda
Call to Order and Approval of Minutes
Paul McKenna called the meeting to order.  The minutes from the September 12, 2006, meeting were approved unanimously.
Over Age Dependents
Pam Hodge presented the revised white paper from the September 12 session (Opsattach.2 doc).  The revision includes additional information and provides criteria clarification for administering over age dependent eligibility (page three).  Except for the requirement that there be a determination under the Social Security Act, the City of Portland’s criteria are very similar (if not identical) to Regence current practice.  Washington PEBB staff administrator shared their frequency of exceptions for mental illness and developmental disabilities and their experience is very similar with what Regence reports.
Financial Analysis Discussion with Kaiser and Regence
  • Kaiser states no rate impact from expansion for mental illness or developmental disability.  Kaiser is concerned about dropping the requirement of PEBB coverage at the time of reaching the limiting age.  Kaiser is willing to accept changes if adopted by the Board and track the financial impact.  If there is a financial impact, the additional cost would be absorbed by PEBB either as future rate load or as a year-end settlement similar to the process for mental health parity between PEBB and Regence.     
  • Regence reports 106 overage dependents; 70% meet eligibility, 21% do not meet OAR (do meet what is being considered by further expansion), 9% are still under investigation.  Regarding their administrative approval process, Regence requires two certification forms, employee and attending physician’s certification.  Regence does not require PEBB coverage at the limiting age, but does require that the dependent has had continuous insurance coverage – either group or individual. Unanswered questions are a) how frequently monitoring happens, b) cost accounting practice, and c) length of time this practice has been in place.
There were no revisions to the section regarding the advantages/disadvantages of changing the policy. 
Recommendations Review(page 6).
Paul McKenna asked for clarification on the definition of developmentally disabled.  Lydia Lissman replied that PEBB should apply the State definition and that carriers would be instructed to apply the State definition in the current benefit design. 
Recommendation #3:  Paul McKenna asked if OHP would count as an insurer.  Pam Hodge felt they would count as an insurer.  Diane Lovell laid out a scenario regarding the possibility of a gap in coverage and concern that a 3-month gap fifteen years ago would make the dependent ineligible.  Pam Hodge suggested a course of action to be relaxation of the rule in 2007, collect fiscal data, and in a year look at financial impact.   Jean Thorne asked for clarification on Regency’s “continuous coverage” meaning.  Is it 0-24 years old or just the last few years?   Pam Hodge will get more data for presentation at the Board next week. 
Paul McKenna asked the committee to move to adopt the recommendations as a group with a caveat relative to how continuous coverage is determined.  Lydia Lissman asked for latitude to explore any outstanding cases with the Benefit Analysts regarding implementation.    Paul McKenna asked for plan year implementation and Lydia Lissman expressed adoption as soon as possible, reminding the group of the need to resolve some current appeals. 
Motion recommending the Board adopt the six recommendations in the Aon report passed unanimously.  Effective date issue will be decided at the Board level.
Budget Update
Scott Smyth stated the administrative fees paid by COBRA/Retirees would be insufficient to cover costs to BHS by November 2006 (Opsattach.3 doc).  Question at hand is how to fund the 2006 shortfall (projected to be $8,000). The projected revenue and expenditures for 2007 should be very close.   Scott recommended using stabilization funds for 2006 and 2007, if necessary, to fill the gap.
Motion to adopt the recommendation to use stabilization funds passed unanimously.
Self Insurance
Administrative Fees for Self-Insured Plans:
Lydia Lissman  (Opsattach.4 doc)  In June the Board approved the premium rates for 2007.  For some carriers, administrative fees were imbedded in the premiums and now need Board approval.  The recommendation is to approve the administrative feels for Providence, Samaritan, and ODS as stated in their respective renewal letters. (Opsattach.4)  CORRECTION – ODS .10 PEPM is included.)   PEBB is asking for approval from Operations Subcommittee and a recommendation that the Board adopt these administrative fees for self-insured plans as outlined in Opsattach.4 (revised).
Recommendation to the Board to approve fees stated for each carrier passed unanimously.
Expansion of Self-Insurance:
Lydia Lissman presented the first steps in the discussion for expansion of self-insurance as requested (Opsattach.5). 
Paul McKenna addressed the assumption of risk around self-insurance and expressed concern that it is not reflected in the presented policy implications.  Diane Lovell suggested language be added regarding how additional self-insurance products might affect legislative/member perception of stability of our plan.  Sue Nelson asked what would be an acceptable return on investment.
Policy definition and implications with suggested language will be moved forward to the Board.
Customer Service Team / Open Enrollment Update
Bobbie Barott discussed Open Enrollment activities (handout distributed at meeting). Handbook production was 22,000 with distribution to requesting agencies and a reserve . Online member information provides members with more information and direct links to the insurance plans. Two statewide e-mails have been sent reminding members about Open Enrollment. Three temporary staff have been added to assist Benefit Analyst with general questions.  The voice mail system has been modified and new voice-mail options added to assist members.   
Statistics for September were provided.  756 calls were received during the first week of open enrollment.   The same week in 2005 had 2986 calls (this was a mandatory enrollment year) and 683 in 2004.  Two-thirds of the calls are related to username/password issues. E-mail inquiries have doubled and PEBB policy is to return the message the same day.  Voice-mail has a 24 hour turnaround.  Changes made to the online system have resulted in significant improvement in the ease of use for both members and agency staff. 
A computer training room has been set-up for benefit and system training for agency payroll staff, agency human resource and benefit staff, and PEBB staff.  This has been an excellent addition to support staff and members.
Lydia Lissman announced that Regence and the Bend Memorial Clinic have reached an agreement.  She will follow-up with information regarding a news release and information on the website and to members. 
General Public Comment
November Agenda
Lydia Lissman 
Open Enrollment Wrap-up                              
Contract Renewal Update
ODS Administrative Services Agreement 
Possible preliminary plan to move to a state building – previewed DAS East (Ferry St.)