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PEBB Operations Subcommittee Minutes
Public Employees’ Benefit Board
Operations Subcommittee
Tuesday, September 12, 2006
9:30 to 11:30 a.m.
Board Room, PEBB
775 Court St NE, Salem OR
Meeting Minutes
Approved 10/10/2006

Subcommittee Members Present
Paul McKenna, Chair
 
Diane Lovell
Sue Nelson
PEBB Staff Present
Bobbie Barott
Claire Kemmerer
Isabel Joslen
 
Lydia Lissman
Jean Thorne
Guests Present
Megan Myrick, Willamette Dental
Paul Pfinster, AFLAC
 
Kim Waldroff, BenefitHelp Solutions
 
Agenda
Call to Order and Approval of Minutes: August 8, 2006
Over Age Dependents
Customer Service Team Update
Budget Update
DAS Strategic Plan
Contract for GASB 45
Public Comment
October Agenda
 
Call to Order and Approval of Minutes
Paul McKenna called the meeting to order. The minutes from the August 8, 2006 meeting were approved.
 
Lydia Lissman introduced Claire Kemmerer as the new Executive Assistant for PEBB.
 
Over Age Dependents
Pam Hodge presented Ops attach.2 and summarized as follows:  PEBB’s current eligibility rules are set forth in OARs 101-015-005, 101-010-005 (10)(b), and 101-010-005(7).  There are three issues to address for the expansion of the Dependent Eligibility Rule: 1) extend exception for individuals with mental illness, 2) broaden mental retardation exception to include all developmental disabilities, and 3) not require that an otherwise eligible over age dependent be covered by PEBB at the time of the limiting age.
 
Requests for information were circulated to the carriers (in several rounds) re: rate impact for overage dependents (OAD).  First was in regards to the extension to OAD with mental illness.  For the most part the carriers indicated there would be no rate impact.  ODS was the exception and cited  a .10% increase.  Regence has been administering for mental illness and have provided coverage outside of the OAR. Aon has requested Regence provide a report giving specific data on the characteristics of this group (age, conditions, years of service, etc.).  Aon has not received a response on the impact of changes for OAD with developmental disabilities and for removal of the requirement of prior coverage from all carriers.  It appears that there will be no impact for OAD with developmental disabilities.  One response from Kaiser indicates that the removal of requirement of prior coverage would result in an overall increase of 4%.  Additional information is needed from each of the careers.
 
Aon Recommendation:
  • Direct PEBB staff to prepare a revised eligibility policy and administrative rule based on Board feedback on the issues addressed in the white paper including whether eligibility for overage dependents with disabling conditions should be based on:
    • When the incapacitating condition occurred
    • Whether the dependent is required to be covered by PEBB or any other insurance policy at the onset of disability
    • Whether the dependent has received a determination of disability under the Social Security Act
    • Whether the dependent otherwise satisfies PEBB’s current eligibility requirements for “Dependent Child” e.g., unmarried and without a domestic partner, and meets the requirements of IRC 152.
  • The administrative policy should also establish uniform criteria for vendor administration of overage dependent eligibility and provide for annual reporting of the additional cost to PEBB for coverage of overage dependents.
  • The administrative rule should be reviewed to determine any instances in which PEBB’s existing or proposed eligibility policies create a tax liability for PEBB members and a withholding liability for the state. 
Lydia Lissman presented a letter from the Oregon Council on Developmental Disabilities speaking to the above issues of over age dependent coverage (handout).  Also noted was the Senior and People with Disabilities administrative rule stating that the condition(s) must have occurred prior to 22, except in the case of mental retardation where the condition must be manifested prior to the age of 18.  They do not include impairments attributable to mental illness, substance abuse, emotional disorder, attention deficit disorder, hyperactivity disorder, learning disability, personality disorder, or sensory impairment.  We would need to be thoughtful as to what is included under developmental disability because the Federal law is significantly broader than the language currently utilized by Oregon.
 
Paul McKenna expressed need for the group to have more information from the carriers, specifically Kaiser, outlining how they have come to the determination of impact/no impact for extending services in these three areas.     
 
Jean Thorne recommended that options be prepared for extending the over age dependent coverage to include information on how the determination will be made that the over age dependent who is mentally ill is incapable of self-support, how often the determination should be made, and how consistency in application would be ensured.
 
Diane Lovell would be open to the discussion of  the policy implications of permitting an employee to add an over age dependent to coverage when the dependent disability occurs after the qualifying age and the dependent was not a dependent at the time they became disabled.
 
Jean Thorne noted that this item is on the Board’s agenda and they may want to consider small steps and move quickly on a number of issues heard today (i.e., move from/to PEBB coverage, broader definition of developmental disabilities, etc.).   Lydia Lissman suggested the group prepare different scenarios and ask the carriers to respond with more specificity (based on their data and policy).
 
Paul McKenna identified the following issues for continued discussion: 
  • adding mental illness,
  • broadening mental retardation to all developmental disabilities, 
  • options in the event of disability occurring after the limiting age.  Sub piece of how to administratively carry this out that is comparable and addresses the inability [of the dependent] to be self-sufficient.  
Customer Service Team Update
Bobbie Barott reported that all appeals 45 days and older have been cleared and the group is ready for open enrollment. 
 
Budget Update
Scott Smyth handed out changes.  Three policy packages will be included in the agency request budget: 1) one position for pebb.benefits and funding for improvement/modifications to the system, 2) one permanent position for wellness coordination, and 3) stabilization package for the PEBB Vision.
 
Jean Thorne reviewed the policy packages that were not included in the agency request budget: Not approved were requests for a clerical position, an additional position to support work related to the Board vision, funding for the GASB actuarial valuation, funding for the proposed office relocation in 2007 and an additional package related to Vision work.
 
DAS Strategic Plan
Copies of the published Department of Administrative Services Strategic plan and the PEBB business plan were distributed.
 
Contract for GASB 45
LydiaLissman (Ops attach.4 ) briefly discussed the handout and recommendation to amend the current Aon contract for the purpose of conducting the actuarial study.
The recommendation was unanimously approved.
 
Public Comment
None.
 
October Agenda
 
 
Meeting Adjourned