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Public Employees' Benefit Board Meeting Minutes, February 20, 2007
Public Employees’ Benefit Board
Tuesday, February 20, 2007, 1:30-4:30 p.m.
PEBB Board Room
775 Court St NE, Salem OR
Approved 3/20/07
Board MembersPresent
Diane Lovell, Chair
Peter Callero
David Hartwig
Rocky King
Sue Nelson
Paul McKenna
Rich Peppers
Jeanene Smith
PEBB Staff Present
Bobbie Barott
Sandy Johnson
Claire Kemmerer
Lisa Krois
Zue Matchett
Ingrid Norberg
Rick Schoonover
Rebecca Sweatman
Jean Thorne
Consultants Present
Barbara Wall, Aon
Guests Present
Sally Hill, Providence
Kristina Herron, Providence
Gordon Hoberg, ODS
Diana Jones, Regence
Bill Lindekugel, Kaiser
Julie Marshall, Casecade EAP
Renee McDonald, Regence
Paul Pfinster, AFLAC
Sara Rengler, Willamette Dental
David Scearse, Standard Ins.
Tamara Strauss, Samaritan
Kim Waldroff, BenefitHelp Solutions
Kathleen Weaver, OHPR
Diane Yunker, OSU
Welcome and Approval of Minutes
Overview of Agenda
Operations Subcommittee Report
Life and Disability Insurance for 2008
Legislative Update
Health Resources Commission Findings on Bariatric Surgery
Wellness Update
General Public Comment
Other Business
Welcome and Approval of Minutes
Diane Lovell called the meeting to order. 
Jean Thorne reported that March 2 will be Lisa Krois’s last day and Claire Kemmerer will be moving to State Services to work on projects.  Dena Comer has agreed to return to PEBB to assist the Board.
Operations Subcommittee Report
Paul McKenna shared discussion on a denied member request. Member’s over age dependent was terminated in April 2006. PEBB heard from the member in November 2006 requesting reinstatement retroactive to April. PEBB followed the late enrollee rule in denying the members request. At the time of the incident, the Plan was sending termination notification to members.  The notification to PEBB was received later than 120 days after of the event. Primary factors of the discussion centered on failure by the member to respond to four separate notification letters regarding their dependent’s status, timing of communication with PEBB (after 120 day period), and the consistent manner in which PEBB reviews late enrollee requests. Note:  PEBB now sends notification to members regarding continued eligibility and will require the member to sign an online affidavit of dependent eligibility in the future. The Subcommittee voted to uphold the denial. The member will be informed of the decision and possible next steps.
Jean Thorne commented that the subcommittee ran out of time for work discussions at the February meeting. During the meeting March 20, the Operations Subcommittee will have a deeper discussion of their work plan, open enrollment, and items for the Board will be discussed.
Paul McKenna reviewed Bdattach.1, which outlined the Open Enrollment process for 2007. Costs dropped dramatically. The member handbook, forms and application were available online which reduced printing costs. The amended Oregon Administrative Rule (OAR) changing the timeframes for corrections also helped to make it a smoother enrollment year.
David Hartwig recognized Isabel Joslen and Bobbie Barott for the formation of the PEBB Advisory Committee and the important work the committee has done for the enrollment process.
Life and Disability Insurance
Diane Lovell shared some history of the issues around life and disability insurance, renewing with Standard Insurance, and/or issuing an RFP to see what is available in the market. 
Jean Thorne shared the fall Board decision to issue a renewal request letter to Standard, review their response, and decide later if issuing an RFP was appropriate. Timelines require a quick decision to allow for the process of issuing an RFP, if that is chosen.
Rocky King moved that the Board instruct Aon to continue negotiations with Standard Insurance for renewal for the 2008 contract period. Peter Callero seconded. Diane Lovell asked for discussion.
David Hartwig stated support for the motion, given all the Board is currently involved in. The Board could issue an RFP at a later time.
Rich Peppers also voiced support for the motion, but wants possible design changes to continue to be on the table.
The motion passed unanimously.
Legislative Update
Jean Thorne reviewed Bdattach.2, Summary of Legislative Bills of Interest to PEBB.
SB426A Establishing the Oregon Educators Benefits’ Board: At the last meeting, the Board moved to request that the fiscal impact statement recognize the impact on PEBB that would occur because of OEBB being established. Specifically the Board requested on the PEBB side a deputy administrator, a program development coordinator and an additional clerical position. Jean Thorne met with DAS and Governor’s office and they are willing to support the additional positions funded out of the PEBB assessment.  
The bill is through the Senate Education Committee, was heard by Ways & Means Education Subcommittee, and public testimony was held last week. PEBB will be asked to explain the fiscal impact and challenges to implementation in the near future. When the bill moves out, it will go to the full Ways & Means Committee, then to the Senate floor, and on to the House floor. 
SB5502 Budget: Appropriates general funds to DAS. Provides limitation. Includes PEBB policy option packages for pebb.benefits improvements; staff support for quality & prevention initiatives; Vision implementation efforts (all Other Funds); implementation of OEBB bill (General Funds).
HB 2503: Establishes Retired Senior Volunteer Program in DAS. The purpose is to encourage pre-Medicare-eligible-retiree-volunteer services to governments and nonprofits, with DAS to provide health insurance in exchange, if funds are available.  It is unsure whether this bill will receive a hearing. 
Jean Thorne noted that a fiscal impact statement has not been done and DAS is taking a “wait and see” stance for now. 
SB329: Establishes Oregon Health Fund Program & Board.This is the Interim Senate Healthcare Access Committee healthcare reform bill. Includes consideration of public employee healthcare benefit contributions in reform process.  The bill has been refereed to the Senate Health Care Committee and then Ways & Means. 
HB 2467: Permits employer to deduct employee benefits contribution if employee is given written notice. If notice must be in writing, rather than digitally (as through pebb.benefits), could increase PEBB administrative costs.
Health Resources Commission Findings on Bariatric Surgery
Dr. Kathleen Weaver, Medical Director, Health Resources Commission (HRC) and
Dr. Wally Shaffer, Medical Director, Division of Medical Assistance Programs.
Jean Thorne reminded the Board that they had asked for a presentation by the HRC on its work around the evidence base for bariatric surgery, given that PEBB began covering the surgery for persons meeting certain criteria as of January 2006.
Dr. Kathleen Weaver presented the Bariatric Surgery MedTAP Report, October 2006 and noted that the HRC began its work by reviewing the report prepared for PEBB in May 2005 by the OHSU Evidence-Based Practice Center. The report was updated with studies completed since that time. The HRC arrived at conclusions similar to PEBB.  Dr. Weaver reviewed the findings of the HRC (attachment). She indicated that a newly-released study abstract shows a 31% reduction in mortality after a 16-year follow-up. Mortality seemed to vary based on volume by surgeon and volume by center. The HRC is recommending using Medicare-certified Centers of Excellence. The paper was accepted by the HRC in October, then sent to the Health Services Commission (HSC) for its consideration; the HSC list serves as the underpinning of benefits for the Oregon Health Plan population.
Dr. Wally Shaffer discussed the current status in considering inclusion of bariatric surgery in the OHP benefit package. Concerns expressed by the medical directors of the OHP health plans relate to the cost-effectiveness of the service for a Medicaid population. It could be very costly to the Medicaid program, meaning that reductions in other services may be required. They are considering the possibility of a pilot program (for treatment of diabetes), which would allow them to look at outcomes prior to more fully including it as a benefit.
Dr. Weaver noted that the HRC is also looking at evidence-based reviews of non-surgical interventions for obesity and would be happy to share that with PEBB when it is completed.
Diane Lovell thanked Drs. Weaver and Shaffer for their presentations.
Wellness Update
Rebecca Sweatman presented Bdattach.3, 2006 PEBB Wellness Update
Although PEBB faced significant challenges in supporting wellness activities with the closure of the PEBB health center and elimination of funding for other PEBB-sponsored wellness services at the end of 2005, PEBB was able to integrate and expand its health and wellness efforts for members in 2006.
  • PEBB adopted a new way for providing worksite health screenings to employees and successfully arranged screening clinics statewide. Similarly, in 2006 PEBB coordinated 141 separate on-site flu clinics statewide through the selected flu shot vendor. Both programs received high praise from employees, the health plans, and the agency coordinators. 
  • PEBB continues to offer the Free & Clear tobacco cessation at no cost to members through the health plans. The latest survey information of those enrolled in the program allowed that at least 33% were tobacco free after 12 months in the program. This fits withan expected quit rate of 25-34%. Enrollment in the program is down from 2005 and PEBB is working with Free & Clear, the health plans, and agency wellness coordinators to raise awareness of the program in 2007.
  • Utilization of the Cascade Employee Assistance Program grew in 2006 and the program was expanded with a number of new services for members. 
  • PEBB partnered with the Healthy Worksites Initiative and the Statewide Safety and Wellness Leadership Initiative to promote worksite programs to support employee health and wellness. 
  • In 2007 PEBB is planning to develop a wellness web page to provide members with much needed health and wellness information at their fingertips, expand the wellness collection at the State Library and, upon legislative approval of PEBB’s request for limitation, offer small grants to agencies to support sustainable worksite wellness programs.
Activities and improvement for 2007 include the:
  • PEBB Wellness Websitewhich will contain information about the health screenings, flu shots, Free & Clear, Cascade EAP, the health plans’ health and wellness programs and services as well as links to credible health information resources, and
  • PEBB Wellness Grant Program. PEBB is working collaboratively with the Department of Human Services Public Health to encourage comprehensive worksite-based health promotion programs and activities, primarily focusing on physical activity, nutrition and other issues such as tobacco cessation. State agencies participating in these efforts have identified the need for some financial support to infuse their efforts and PEBB has asked for $250,000 in limitation for the 2007-2009 biennium to develop a grant program which would provide agencies with financial support for worksite wellness.
Diane Lovell commended Rebecca Sweatman for pulling all the information into a report and shared her excitement at the findings.
General Public Comment
Other Business
Meeting Adjourned