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

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Kathy Clark's Comments: One of the things in the financial analysis is the rate guarantee. A lot of carriers like Blue Cross/Blue Shield are not offering a multiple year rate guarantee. This means after one year we might have to start all over again and do all of the analysis over again. Humana offered a one year rate guarantee, Aetna TML and Pfizer are all giving us a three year rate guarantee. Comment Donnie Wright: When Kathy is talking about rate, she is talking about the Administrative fees not the premium. Kathy Clark continued: Summary Plan Description: These (SPDs) are basic descriptions of your plan. They are offered at no additional charge by most of the carriers and they are also online. Enrollment Meetings: They are provided. Robert wants the new carrier to come out and inform everyone employee and retiree about the new product well in advance of Open Enrollment. Usual and Customary: U&C is basically a percentage for non-network charges in that geographical area. Normally it pay 90% of that amount, after that the employees pays out the remainder amount out of pocket. Maintaining records after termination: This is very important because it tells us what happens if the plan terminates. TML is the only one that cuts-off at the time the plan terminates. The other carriers will maintain the records up to three years after the plan termination. Disease Management: We ask about 32 disease states. Question: Juliane Graham What is disease management? Answer Kathy Clark: One of the things we do is attempt to bring specialist in a given expertise to assist employees in managing a disease. Diabetes Centers of America is currently working with the City of La Porte employees in a specialty area. They have physicians and other sources of assistance.