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PEBB Operations Subcommittee Meeting Minutes, May 13, 2008
Public Employees’ Benefit Board
Operations Subcommittee
Tuesday, May 13, 2008, 11:00 a.m. to 1:30 p.m. - Minutes
DAS/General Services Bldg/PEBB-OEBB Board Room
1225 Ferry St SE, Salem OR

Subcommittee Members Present
Paul McKenna, Chair
Peter Callero
Rich Peppers
Diane Lovell
Bret West
PEBB Staff Present
Bobbie Barott
Adrienne Binam
Dena Comer
Wendy Edwards
Ed Deery
Chelsea Hollingsworth
Isabel Joslen
Ingrid Norberg
Brian Olson
Margaret Smith-Isa
Sandy White-Gallardo
Larie Nicholas
Nicole Merrithew
Guests Present
Elizabeth Gartman, Samaritan Select
Paul Pfnister, Aflac
Tamara Strauss, Samaritan Select
Megan Myrick, Willamette Dental
Gordon Hoberg, ODS
Deb Tremblay, ODJ
Steve Schmick, Kaiser Permanente
Call to Order and Approval of Minutes: April 8, 2008
Public Comment – 2009 Plan Design
Call to Order and General Discussion
Paul McKenna called the meeting to order. He stated that the main purpose of today’s meeting is to provide an opportunity for public comment on plan design. Dena Comer monitored those signing in for public comment and updated the committee every fifteen minutes.
Nicole Merrithew and Ed Deery were introduced as new operations and program staff. Nicole is a program analyst and Ed is a research analyst.
Wendy Edwards stated that four individuals had responded through the public comment email. Two of the responses are not about plan design changes. Staff has developed a form for capturing information from members who do want to present public comment.
A number of comments have gone through the pebb.connect process. A summary of the  member benefits comments will be presented at next week’s board meeting. (See Bdattach.10). The magnitude of the number of comments per issue will be outlined in the presentation.
Among the member comments are:
  1. Cover yearly physical exams for children under 18
  2. Cover massage therapy
  3. Weight loss programs
  4. In-vitro fertilization
  5. Gym memberships
Board and staff discussed the difference and discrepancies within plans. Diane Lovell stressed that the renewal process offers a good opportunity to understand evidence based design. Wendy stated that rate impacts would need to be addressed. Research can be done regarding immunizations and well child exams. Collection of data and plan evidence can provide a reading on whether or not children are getting what they need. Service area for Samaritan’s plan doesn’t need to wait until 2009.
PEBB received 500 member comments regarding dental coverage. The members are asking that the minimum of two annual cleanings for adults and children be restored. Contract changes include the elimination of Kaiser’s billing fee, and more flexibility of appointment settings through Willamette, including cancellations at no charge. Some Kaiser members want VSP available to them. The service and frames are factors.
Rich Peppers asked if, due to the volume of ideas, previous research would be brought to the Board. Rich also asked what needs more research. What does the evidence say? And, what needs to be considered more seriously? Wendy stated that a list can be provided of what is already in the renewals.
Another requested change is a commuter flex account. IRS does allow for commuter cost. Bret West asked what a commuter FSA would cover. Ingrid Norberg stated that IRS specifies any kind of public transit, van pooling, plus the cost of parking; no gasoline, tires, insurance or upkeep qualify. The idea is oriented to encouraging public transportation and is not under IRS Code 125 Cafeteria plan rules. It is a benefit that is provided by the employer, not PEBB. Bret reiterated that other venues are more appropriate for a commuter FSA.
Rich Peppers asked for clarification on the Kaiser design plan changes with regard to the question of cleanings. Wendy and Bobbie met with Kaiser last week and walked through ODS plan design. Kaiser was to go back and administer the plan as discussed for 2008. Kaiser is to provide answers by next week, as well as a recommendation on how they will correct billing and other issues connected with dental cleaning issues. Data gathering is an issue, due to a five month lapse of time since the plan began.
Joan Kapowich provided other news, announcing the July 2 combined PEBB-OEBB meeting. She is trying to line up Jeanene Smith to talk about Oregon Health Board design. Kudos have been received from the Governor’s office who expressed surprise that OEBB is doing such an excellent job with start up. Joan will provide an OEBB update at next week’s board meeting, outlining the road they have traveled and where they are now. OEBB is looking at 22,000 – 30,000 members. The phase in within three years is tied to the collective bargaining agreement. Community colleges are not required to come in.
Paul McKenna announced a 10 minute break at 12:30 p.m. Participants were asked to return at 12:40 p.m.
Paul McKenna reconvened the meeting. He restated that staff is to continue checking every 15 minutes for public comment.
Wendy Edwards elaborated on how the public comment process could be made more useful. Posted on the Web site is a planning schedule that will help. In November member input can be incorporated in plan development. Any recommendations will work into the next process. The form states that those planning to attend need to check the appropriate box.
Peter suggested that the newsletter state that the notification be made by noon. Diane stressed the need for a deadline, so the time slot can be cancelled, if no one is to appear. Paul stated that since it is on the website, a cut-off time needs to be included to meet the pubic notice rule. Wendy reiterated that the protocol needs to be understood, expressing concern about the value for people to fill slots of time. Paul emphasized the need for discussion at a future board meeting and additional time required to research public comment.
Wendy commented that people are much more eager to express their opinion through e-mail. Peter commended staff on the responses sent to members. Responses are very good, conveying patience and understanding.
Bobbie mentioned that last week, 165 e-mails were received through the Member Services Team. Ingrid commented that PEBB.connect responses are mixed; some go directly to member services and some to the Board. Members seem to prefer this method and the opportunity to communicate. Peter stressed the ongoing need to improve all communication.
The current benefit plan design is based on last year’s membership comments. The time frame was a little over two months. Discussions began in January, and the report went to the board in April. On May 17, the board voted on the recommendations.
Overall, each year PEBB adds to the benefit package with a good loss ratio when compared nationally. Diane recommended that PEBB’s history be added to the web site. It would be good for new board members, as well as new staff to learn some background. Peter added that many members think their union negotiates the package. Members need to be reminded of how the process works. Again, communication is always going to be the biggest challenge.
Ingrid outlined the future of communications that will include potential use of video streaming Open Enrollment meetings and utilizing e-mail (or instant messaging). Wendy added that the Board meetings will be saved as an audio wave file. TSC will need to TVO the meetings.
Joan talked about the issue of meeting minutes. Video stream becomes the record, and interested parties can go to the Web site to listen. The challenge of providing transcription to the hearing impaired will be explored. Paul mentioned that it is easier to look at hard copy, rather than listen for four hours.
Wendy stated that video conferencing could also be used for PEBB’s consultants in Seattle. Anyone interested in watching the meetings would not need to travel. It would be a good method for providing public comment. The logistics will be addressed gradually.
Joan asked about plan design changes for vision. Wendy stated that VSP will be included in the board meeting discussion on May 20.
Approval of Minutes
Bret West moved to approve the April 8, 2008 meeting minutes.
Paul McKenna seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Public Comment – Plan Design
The Board Operations Subcommittee heard the following public comments on 2009 plan design:
Public Comment #1
Dennis Sigrist commented that he is an employee with Oregon Emergency Management. Dennis stated that his question is related to opting out in general. He asked if the cafeteria plan determines options and if input is solicited on those kinds of options. Dennis also asked if the IRS drives the cafeteria plan process and if an administrative rule would be required to make changes. In summary, Dennis stated that TRICARE and the Department of Defense (DOD) are currently out for comment. Rulemaking will continue for a couple of months. He requested that PEBB allow the process to play itself out for the next few months, so it will be established when PEBB members can opt out. He stressed, that certainly by 2009, this will sort itself out. In addition, Dennis asked, rhetorically, has any state agency been fined $5,000 for not following a rule that wasn’t clarified in the first place?  Dennis hopes that 2008 be considered a year for clarity and 2009 will be a time of clarification from DOD.
Bobbie Barott responded that the cafeteria plan document is driven by IRS regulations. However, there are at time optins chosen by the Board. The document receives updates as needed. If opting out were part of the plan, it could be allowed. IRS and the Department of Labor drives the cafeteria plan process. PEBB follows the plan document. IRS is the overall umbrella, along with Oregon state statute, and ERISA. All regulations are out there. Member election plan choices are irrevocable during the plan year. Choices cannot be changed during the plan year, unless they fall within qualified status changes, Oregon recognizes 8 or 9 of the possible 14 changes. PEBB falls within some regulations and not within others.
Public Comment #2
Gerry Juster commented that he is an ODOT employee with Association of Engineering Employees (AEE), representing the Oregon Department of Transportation, Oregon Parks and Recreation, and the Oregon State Department of  Forestry. In summary, he is impressed by the work PEBB does and wishes to provide input on the biggest concerns from AEE membership.  Gerry stated he has conducted research on evidence-based plan design. Member concern is that it is a new paradigm swing and there is skepticism about it. Gerry stressed that the change to annual dental cleanings is an issue that was not communicated well to members. He believes when people signed up, it came as a surprise. Also, generic drugs need to be made a choice. There need to be more options for prescription drugs. Gerry asked that information be communicated to him, so he can   get it out to members via the AEE Web site. Members are restricted in research capabilities. Information needs to go out to unions, so membership can be informed. Employees need to be in the loop to be able to provide input at the front end of planning. Gerry also expressed concern about the new consultants, Mercer, and asked if it was a good fit. Gerry further requested that as plans be developed, a side-by-side cost comparison be provided. He stressed the importance of getting information out to members in a way that makes sense to them when they are making choices. Gerry stated that when he reviewed the information, he had to ferret out what was changed. A lot of research and homework was required, making the task complex. He understands that attachments help tell the whole story. Gerry asked that PEBB keep the plans as affordable as possible. Overall, he has been very pleased with the benefits he has had.
Diane Lovell responded that last July there was a very extensive newsletter article about the change in dental. PEBB is constantly looking for better ways to communicate. All of the plan design occurs in the summer. The pattern is that information is sent out, but not being read.
Paul McKenna stated that key information is distributed to contacts representing state agencies.
Joan Kapowich stated that Mercer is new this year. They conduct research for PEBB and provide information. It always takes a while to get up to speed when new. Wendy added that the member handbook includes a side-by-side comparison. Exact changes will be reflected in a new, smaller format this year. The handbook will be on the Web site. PEBB.benefits will offer drop down choices when enrolling online.
Rich Peppers commented that this is very complex work. There is a lot of detail that needs to be communicated due to legal requirements. People have to sift through many layers, since there is such a volume. Some sections are technically difficult to understand and frightening for people. PEBB’s challenge is to be complete, as well as accurate. Relevant groups need to be targeted and communications must convey what people need to see.
Joan Kapowich stated that with the advent of video streaming, members can watch the meetings. For many drugs there is no generic. Sometimes the physician writes “dispense as written.” Plan design is to maximize generic usage. Wendy added that 60% generics are dispensed currently.
Peter Callero represents AFT (higher education). He doesn’t communicate directly to members, mostly because he hasn’t had a need to. The University does a good job by taking the newsletter information and communicating to the members.
Wendy commented that the communications coordinator could provide a newsletter. She stated that PEBB will be getting back to Mr. Juster with enhanced ways to better communicate. Diane commended him for trying to take this time and represent member interest.
Paul McKenna announced a break at 1:10 pm. The meeting was to be reconvened, if any additional members appeared for public comment.
Meeting Adjourned
No additional members appeared to present testimony. Paul adjourned the meeting at 1:30 p.m.