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Public Employees' Benefit Board Meeting Minutes, May 20, 2008
Public Employees’ Benefit Board
Tuesday, May 20, 2008, 10:30 a.m. to 4:30 p.m. – Minutes
DAS General Services Building/PEBB-OEBB Board Room
1225 Ferry St SE, Salem OR
Approved June 17, 2008

Board Members Present
Diane Lovell, Chair
Sue Nelson, Vice Chair
Peter Callero
Paul McKenna
 
Rich Peppers
Jeanene Smith
Bret West
 
PEBB Staff Present
Bobbie Barott
Adrienne Binam
Dena Comer
Ed Deery
Wendy Edwards
Chelsea Hollingsworth
Isabel Joslen
 
Joan Kapowich
Jordan Lewis
Lydia Lissman
Mona McMullen
Nicole Merrithew
Ingrid Norberg
Margaret Smith-Isa
 
Guests Present
Jennifer Aberg, VSP
Kristina Herron, Providence Health Plans
Sally Hill, Providence Health Plans
Gordon Hoberg, ODS
Diana Jones, Regence BCBSO
Zue Matchett, PERS
Megan Myrick, Willamette Dental
Jean Poling, Kaiser Permanente
Paul Pfnister, ALFAC
 
David Scearce, The Standard Insurance Co.
Dennis Sigrist, Emergency Management
Diane Skutack, BenefitHelp Solutions
Tamara Strauss, Samaritan Health Systems
Rob Sumner, Regence BCBSO
Deborah Tremblay, Oregon Judicial Department
Dallas Weyand, Legislative Fiscal Office
Kim Whitley, Samaritan Health Systems
 
Consultants Present
Mikel Gray, Mercer
Hans Leitzinger, Mercer
 
Sheree Swanson, Mercer
 
Agenda
Welcome and Approval of Minutes
Overview of Meeting
Public Comment
Third Party Administrator RFP
Allocation of 2007-09 Policy Option Package Wellness Funds
Transfer of Stabilization Funds FSA
Public Comment Guidelines
Reports
Overview of Member Input Regarding Benefit Plan Designs
Medical, Dental and Vision Plans
OregonHealth Fund Board – Essential Benefits Package
Adjourn
 
Welcome and Approval of Minutes
Diane Lovell called the meeting to order.
 
Bret West moved to approve the April 15, 2008 meeting minutes.
Sue Nelson seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Overview of Meeting
Lydia Lissman provided an overview of the meeting agenda items.
 
Public Comment
None.  
 
Third Party Administrator RFP
Wendy Edwards referred to Bdattach.2 and explained that in January 2008, the Board approved PEBB staff recommendation to issue a Request for Proposal (RFP) for a third party administrator (TPA) for benefit administration functions for all self-pay members, including retirees, members in eligible semi-independent agencies and members eligible for COBRA.  The current TPA contractor for these services is BenefitHelp Solutions (BHSS).  The contract expires on December 31, 2008.
 
Peter Callero moved to approve the staff recommendation to renew the contract with BenefitHelp Solutions for the 2009 contract year, and to place a rate hold on all services with a reduction of $2,609.00 per month in the Service Representative fee.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Allocation of 2007-09 Policy Option Package Wellness Funds
Wendy Edwards referred to Bdattach.3 and explained that PEBB staff have been working to implement approved activities related to Board work group priorities for wellness, communications, evidence based plan design and medical homes. Staff recommended that the Board reallocate funds from one specific project to another.
 
Rich Peppers moved to approve the staff recommendation to authorize the $196,050 previously allocated to pay for Mercer HealthOnline to procure 45,000 pedometers in addition to the $50,000 approved in March 2008. Any excess funds will be reported to the Board to be used at the Board’s direction.
Sue Nelson seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Transfer of Stabilization Funds FSA
Wendy Edwards referred to Bdattach.4 and outlined the 2008 PEBB Dependent Care and Health Care Flexible Spending Account (FSA) activity. Staff instituted measures to monitor the commercial bank account for payment to our vendor; however, logistical issues are making the provision of an adequate level of funding a significant issue.
 
Staff recommended the transfer of $300,000 from the Stabilization Account to the Flexible Spending Account commercial bank account. This will prevent the account from running a negative balance and allow staff to follow protocol developed for this program with internal and external stakeholders. 
 
Peter Callero moved to approve the staff recommendation to transfer $300,000 from the Stabilization Fund to the Flexible Spending Account (FSA) commercial bank account, and utilize the transferred funds as a continuous buffer for the PEBB FSA commercial bank account. These and all other forfeitures remain in the commercial bank account upon Board termination of this specific FSA program would be transferred back into the Stabilization Fund.
Paul McKenna seconded the motion.
PEBB staff will provide the Operations Subcommittee with quarterly interest reports on the commercial bank account.
 
Public Comment Guidelines
Wendy Edwards and Ingrid Norberg referred to Bdattach.5 and provided an overview of the Guidelines for Public Comments During Board Meetings form. The Board discussed revisions and authorized staff to update the form with their suggestions and make the form available to members.
 
Reports
Work Group Update and Next Steps
Report deferred to future meeting.
 
History of the Stabilization Fund
Wendy Edwardsreferred to Bdattach.6 and summarized the history of the Stabilization Fund.
 
Tobacco Cessation
Margaret Smith-Isa and Nicole Merrithew referred to Bdattach.7 and provided an overview of the Free & Clear® Tobacco Cessation Program.  
 
2007 Worksite Screening & 2008 Program Overview
Adrienne Binam and Nicole Merrithew referred to Bdattach.8 and reported that each year PEBB sponsors health screenings in partnership with contracted health plans. These screenings provide members with easy access to biometric testing and health risk counseling at agency worksites throughout the state. Members who participate in the screenings complete a brief questionnaire that asks about certain health behaviors and also have tests performed to measure blood pressure, triglyceride levels, blood glucose, blood cholesterol levels (including total cholesterol, LDL or “bad” cholesterol, and HDL or “good” cholesterol), and body mass index (BMI). Results are immediate and members receive one-on-one counseling with a health educator to assist them with interpreting their results and provide them with information about actions they can take to improve their health status. In 2007, both the biometric testing and counseling services were provided by Wellness 2000, with additional follow-up support for those members who had identified health risks provided by the PEBB health plans. They explained possible refinement to the worksite screenings program, based on findings and member feedback regarding the 2007 screenings
 
The 2008 worksite screenings are scheduled to begin in mid-June and will run through the end of December. She outlined additional enhancements to be included in the 2008 screening program.
 
READI Program Update
Report deferred to future meeting.
 
OEBB
Joan Kapowich stated she will send the OEBB report to the Board via e-mail.
 
OregonHealth Fund Board
Report deferred to future meeting.
 
Overview of Member Input Regarding Benefit Plan Design
Wendy Edwards referred to Bdattach.10 and reported that at its May 13 meeting, the Board’s Operations Subcommittee reviewed a summary of member suggestions for changes to plan designs for 2009. She summarized comments submitted through the 2008 Annual Member Survey as well as through inquiries.pebb and pebb.connect.
 
Medical, Dental and Vision Plans
Medical Benefit Changes and Premium Rates
 
Barrier Free Tobacco Cessation
 
Rich Peppers moved to provide barrier free tobacco cessation at $0 premium impact for the Kaiser, Providence, Regence, and Samaritan medical plans for the 2009 benefit year.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Sue Nelson moved to approve the implementation of a $0 bupropion and $5 Chantix copayment with no increase in premium or premium equivalent for the Kaiser, Providence, Regence, and Samaritan medical plans the 2009 benefit year.
Rich Peppers seconded the motion.
Peter Callero expressed concern regarding negative side effects reported from the use of Chantix.
Rich Peppers would like to have a broader discussion at a future meeting regarding concerns surrounding medications with negative side effects.
  • Hearing no further discussion, the motion passed unanimously.
Barrier Free Cancer Screenings
 
Peter Callero moved to approve the implementation of barrier free colorectal screening with no increase in premium or premium equivalent, and to ensure barrier free benefit is not dependent on coding as a preventive service for the Kaiser, Providence, Regence, and Samaritan medical plans for the 2009 benefit year.
Jeanene Smith seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Rich Peppers moved to approve the implementation of barrier free colorectal breast and cervical cancer screening with no increase in premium or premium equivalent for the Kaiser, Providence, Regence, and Samaritan medical plans for the 2009 benefit year.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Other Barrier Free Benefits
 
Bret West moved to approve the implementation of barrier free coverage of generic ACE inhibitors, beta blockers, and statins with no increase in premium or premium equivalent for the Kaiser, Providence, Regence, and Samaritan medical plans for the 2009 benefit year.
Peter Callero seconded the motion.
 
Jeanene Smith moved to amend the motion to add generics for asthma, depression and diabetes.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Bret West moved to approve the implementation of barrier free coverage of generic ACE inhibitors, Beta blockers, statins, and generics for asthma, depression, and diabetes, with no increase in premium or premium equivalent for the Kaiser, Providence, Regence, and Samaritan medical plans for the 2009 benefit year.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Weight Management
 
Jeanene Smith moved to approve the implementation of a weight management program per specifications for the Kaiser, Providence, Regence, and Samaritan medical plans for the 2009 benefit year.
Sue Nelson seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Jeanene Smith moved to approve the implementation of a four visit per lifetime model for all members, and four visits per year for those with chronic health conditions or who are enrolled in a weight management program with uniform benefits across all plans, and to examine costs before determining a general benefit.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Regence Renewal Actions
 
Jeanene Smith moved to continue the Regence READI program pilot for the 2009 benefit year.
Rich Peppers seconded the motion.
 
Jeanene Smith moved to amend the motion to include performance standards to monitor enrollment with a cost corridor.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Jeanene Smith moved to continue the Regence READI program pilot with performance standards to monitor enrollment with a cost corridor for the 2009 benefit year.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Bret West moved to replace Advicare with Regence’s internal disease management program, with specific performance guarantees for the 2009 benefit year.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Jeanene Smith moved to accept Regence’s fully insured proposal with a year-end settlement with excess surplus returned to PEBB for the 2009 benefit year.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
ProvidenceRenewal Actions
 
Bret West moved to approve Providence’s implementation of Web MD at no cost for use as a health risk assessment tool for a new weight management program for Providence for the 2009 benefit year.
Jeanene Smith seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Rich Peppers moved to accept Providence’s proposal for no increase in administrative fee for the 2009 benefit year.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Samaritan Renewal Actions
 
Rich Peppers moved to change the language describing eligibility to live or working service area for Samaritan, effective immediately.
Paul McKenna seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Bret West moved to continue to provide a self-insured plan for Samaritan, and to accept a 6% increase in the administrative fee, and to analyze this decision further before discussing a 2010 decision.
Sue Nelson seconded the motion.
Peter Callero expressed concern regarding the rate increase and further negative management issues reported by staff, and stated he could not support the motion. He further stated that if these concerns were corrected he would like to consider renewing a relationship with Samaritan in the future.
Diane Lovell stated that Samaritan has great vision but currently is not working well with PEBB. The staff resources needed to invest in Samaritan at this time are too great.
Sue Nelson Concurred. She suggested that if Samaritan were not part of PEBB it might allow them the opportunity to make the necessary improvements and return to PEBB in the near future.
Paul McKenna stated that he supports the motion and does not want to stop a relationship with Samaritan for 2009. He suggested that the communication between Samaritan and PEBB was unclear and Samaritan did not fully understand PEBB’s expectations, and that these problems could be addressed and monitored until 2010.
Bret West expressed his reluctant support for the motion only because members have not yet expressed any complaints about Samaritan.
Peter Callero asked if members will have problems accessing their provider if Samaritan is not renewed.
Diane Lovell replied that any switch in providers would be transparent for the members.
Rich Peppers suggested that the Board verify the rate increase before deciding on a renewal with Samaritan.
 
Hearing no further discussion, the Board voted as follows:
Peter Callero:
Nay
Rocky King:
Absent
Diane Lovell:
Caused a tie; did not allow motion to pass.
Paul McKenna:
Aye
Sue Nelson:
Nay
Rich Peppers:
Aye
Jeanene Smith:
Abstain
Bret West:
Aye
  • The motion failed: Board Chair caused a tie; did not allow motion to pass.
 
Dental Benefit Changes and Premium Rates
 
Kaiser
 
Jeanene Smith moved to approve no cost cleanings and that cleanings are not subject to the deductible for Kaiser dental for the 2009 benefit year.
Bret West seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Paul McKenna moved to request that Kaiser provide a quote that mirrors the ODS plan design.  He also moved to have Kaiser quote without $1750 out-of-pocket maximum and without a deductible, and to price the two options separately for the 2009 benefit year.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Willamette
 
Peter Callero moved to eliminate missed appointment fee for Willamette and to develop a means of incenting appointment compliance for the 2009 benefit year.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion failed unanimously.
Rich Peppers moved to maintain the $20 missed appointment fee for Willamette for the 2009 benefit year.
Paul McKenna seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Rich Peppers moved to accept a 9.69% increase in Willamette’s premium.
Paul McKenna seconded the motion.
 
Hearing no further discussion, the Board voted as follows:
 
Peter Callero:
Nay
Rocky King:
Absent
Diane Lovell:
Nay
Paul McKenna:
Nay
Sue Nelson:
Nay
Rich Peppers:
Aye
Jeanene Smith:
Nay
Bret West:
Nay
  • The motion failed with a vote of 6-1.
ODS
 
Bret West moved to accept a 2.1% increase in the ODS premium equivalent for the 2009 benefit year.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Vision Benefit Changes and Premium Rates
 
Sue Nelson moved to accept the VSP premium increase to cover exams and hardware every 12 months for the 2009 benefit year.
Rich Peppers seconded the motion.
 
Rich Peppers moved to amend the motion to obtain price quotes and to defer decision to the June 2008 Board meeting.
Sue Nelson seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Sue Nelson moved to obtain price quotes and to defer the decision regarding a VSP premium increase to cover exams and hardware every 12 months for the 2009 benefit year to the June 2008 Board meeting.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Bret West moved to approve a 2.5% decrease in the VSP premium with a continued gain sharing agreement for the 2009 benefit year.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion failed unanimously.
Rich Peppers moved to implement VSP’s proposal to cover 18 year-olds as children for the 2009 benefit year.
Paul McKenna seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Bret West moved to implement VSP’s proposal to allow “banking” of unused material allowance during the service period for the 2009 benefit year.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
OregonHealth Fund Board – Essential Benefits Package
Lydia Lissman explained that the PEBB and OEBB Boards plan to hold a joint meeting on July 2, 2008 to hear an Oregon Health Fund Board (OHFB) presentation regarding their essential benefits package.
Jeanene Smith outlined the OHFB Benefits Committee’s essential benefits package and suggested the Board examine the package, distributed by e-mail, prior to the July 2 meeting.
 
Adjourned