06-20-07 Chapter 172 Employee Retiree Insurance and Benefits Board Meeting Minutes

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Question Matt Daeumer: So, we set the co-pays on the Doctors visits and the prescription drugs? Answer Donnie Wright: The bottom line is yes. Obviously there is a cost consideration that goes with each of those decisions. Once you decide which carrier you are going to go with they will sit down with District Representative and go thru plan design. They will be able to tell you plus or minus what percent that impact has on your claims. Comments Matt Daeumer: If we went out with regards to the current co-pay that we have. The reason I am asking is because right now some maintenance drugs that are in tier three cost $61 with a $50 co- pay. It is not much ofa benefit especially after the provider discount to see the Doctor is $52 with a $35 dollar co-pay it becomes a $17 dollar benefit. If you see the P A it is a $35 co-pay and with a $37 bill you get a $2 benefit. Answer Donnie Wright: These are the kind of questions that need to be brought to the table during plan design after selecting a carrier. You are self-insured and have a lot of flexibility there. Donnie Wright Presentation continued: The next slide is very proprietary information. We asked the carriers what their average discounts were. However, we have a verification process that we use. We get a sample of claims from your current carrier and we send those claims to the other carriers and we ask them to re-price those claims using their Network Discount. Humana's discount was 36% which is very close to what they say it was. Blue Cross showed the discount at 62% which is higher than what they had previously stated. Aetna was 62% which is right at what the others were. The last three would not disclose that information by hospital. We do a number of different analyses to look at carriers. I know this is overkill when it comes to analysis. However, it is something the Plan Administrators needs to look at. It is the cost that each plan is going to charge to plans for drugs. They are all different by networks. This shows what those percentages are.