06-13-16 Regular Meeting of the La Porte City Council

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between the HSA Plan and Kelsey Care Plan where the Sample Company establishes a consistent funding amount across both plans. Rate structures were re-developed based upon plan utilization and the Sample Company standardized its contribution to all plans at 93.9% of the employee only rate and 72.9% of dependent rates. Employee rates for the HSA were increased by7.8% for Employee Only and approximately 44% for dependents. There were not increases to the Kelsey Care rates. Further the Sample Company discontinued its contribution to the HSA plan in order to continue its migration to a cost neutral funding strategy. Gradual reductions in dependent subsidies are recommended to align with benchmarks. The Sample Company took a first step in evaluation of dependents subsidies and standardized its subsidies at 72.9% across all plans. The Sample Company continues to exceed benchmarks of approximately 62% (2015 Benchmark). Cost sharing adjustments are recommended to the Kelsey Care plan to encourage efficient utilization of benefits. See Exhibit D for for adjustments made in 2016. The Sample Company Consider implementation of coinsurance and increasing the out of pocket maximum amount.) for the Health Savings Account Consumer Driven Health Plan. This change will encourage continued consumerism after the deductible has been met. Completed coinsurance was implement of 90% and out of pocket maximums were increased January 2016. Consider changing the amount of Sample Company or the schedule of these contributions: consider quarterly or semi-annual contributions for HSA enrollees who have held an account for one or more years. Completed HSA contributions discontinued as of January 2016. Consider implementation of programs targeting musculoskeletal spend as it is the highest cost diagnostic category at the Sample Company. The Airrosti program is recommended for evaluation as their treatment approach has had significant success in mitigating surgeries, high cost imaging and pharmaceuticals. Airrosti is part of the Cigna network for the HSA Plan, however not part of the Cigna network for Kelsey Care Plan. A direct contract with Airrosti is recommended for consideration. Completed Airrosti has been added as an in-network provider at a $20 copay level for Kelsey Care. Obtain annual performance guarantees from Cigna surrounding claims processing, account management, network discounts and client / participant satisfaction. Completed and are being offered by Cigna Annually. Consider implementation of a Telemedicine program as an alternative to using ER and urgent care for minor illnesses and conditions. Telemedicine currently implemented for Kelsey Care evaluation for HSA participants is also recommended for 2017. Conduct a request for proposal process for the partial self-insured health plan for the 1/1/17 renewal date. Scheduled to be released April 2016. Begin using Zywave data warehousing tools through IPS Advisors to monitor Health and Prescription claims to provide greater insight into plan cost drivers and utilization patterns. - Zywave Reporting scheduled for delivery in March 2016. Long Term Strategies: Evaluate direct contracting with local high quality hospital providers to provide bundled / all-inclusive pricing for targeted health conditions (musculoskeletal, obesity, etc.)