School EmployeesSchool EmployeesHealth Care BoardHealth Care Board

Stephanie Hearn, BHP Stephanie Hearn, BHP

Executive DirectorExecutive Director Richard Packer Richard Packertt, BHP , BHP TrusteeTrustee

January 5, 2010

AGENDAAGENDA

I. Butler Health Plan

II. Best Practice

Standards

III. Questions

Butler Health PlanButler Health Plan

STRUCTURESTRUCTURE

Butler Health Plan is a self-funded health trust.

The objective of the consortium remains the same after two decades of service: To provide competitive medical and

dental benefits at affordable prices.

Butler Health PlanButler Health Plan

Butler Health PlanButler Health PlanKey StatsKey Stats

Represent 15 school districts

7,500 school employees

20,000 covered lives

Annual budget $70 million

Butler Health Plan Butler Health Plan MembersMembers

Butler County Educational Service CenterButler County Board of MR/DD

Butler Technology & Career Development Schools Edgewood City SchoolsFairfield City Schools

Great Oaks Institute of TechnologyHamilton City Schools Lakota Local Schools Madison Local Schools

Middletown City SchoolsMonroe Local Schools

New Miami Local SchoolsRoss Local Schools

Sycamore Community SchoolsTalawanda School District

Butler Health Plan Butler Health Plan StructureStructure

Butler Health Plan (BHP) was formed in 1985 and is governed by a seven member fiduciary Board of Trustees.

2009-2010 Board of Trustees: Dan Hare - Chairman, Superintendent, Butler County Educational

Service Center

Craig Jones – Treasurer, Lakota Local Schools

Jan Kesselring - VP Operations , Butler Tech

Nancy Lane - Treasurer, Fairfield City Schools

Marsha Mueggenberg – Classified Trustee, Ross Local Schools

Richard Packert – Certificated Trustee, Middletown City Schools

Robin White - President/CEO Great Oaks

Each district has three representatives: One Administrative One Certificated One Classified

45 Member Committee reviews information and suggests plan changes for medical and dental. (3 common plan designs)

Butler Health Plan StructureButler Health Plan StructureBenefit Information CommitteeBenefit Information Committee

Butler Health Plan Butler Health Plan Plan DesignsPlan Designs

Classic Plan Choice Plan Basic PlanPPO

No deductible

Annual out-of-pocket maximum for Rx

PPO

$350 annual deductible

Flat copays for Rx

PPO

HDHP

Lower premium with higher out-of-pocket costs

Butler Health PlanButler Health Plan

MARKET ANALYSISMARKET ANALYSIS

S.E.R.B. / O.E.A. Health Care Survey

Summary Findings

2009

$448 $413 $393$284

$1,165 $1,134$984

$854

$709

$0

$200

$400

$600

$800

$1,000

$1,200

SINGLE FAMILY

OHIO Public - PPOCinci Public GroupsBHP - ClassicBHP - ChoiceBHP - Basic

$341

Butler Health Plan (BHP)Butler Health Plan (BHP)January 1, 2009January 1, 2009

Median Premium Rate Comparison - SERB / OEA Median Premium Rate Comparison - SERB / OEA DataData

Medical and RxMedical and Rx

Overall ConclusionOverall Conclusion

All the BHP plans are LOWER in

premium rates and

competitive in coverages.

Best Best

Practice Practice

StandardsStandards

Standard Butler Health Plan

1) Health plans must offer wellness programs, including HRAs, biometric testing, health coaching.

1) Exceeds standard – Offer on site HRAs, biometric testing, and access to nurse health coach.

Included in premium “Free to all BHP members”

Offer on-site screenings at 120 buildings

34 lab panel (venous puncture) with an extensive Personal Health report and follow up with Nurse Coach Cont.

Butler Health PlanSEHCB Best Practice Standards

•Easy to Understand•Easy to Measure•Nationally Accepted Standards•Consistent and Fair•Modifiable & Controllable

Focuses on Five Risk Categories that account for 70% of Health Costs:

SmokingLDL CholesterolTriglyceridesGlucoseBlood Pressure

Participants Tested with Abnormal

Conditions

Men Over 40: PSA (Prostate Cancer)8

Thyroid Disease 29

Total participants who may need medication but are not currently taking medication for diabetes, high blood pressure, or high cholesterol

144

0

10

20

30

40

50

60

70

80

Incentives School Promotion Only

Employee Meetings

Cont.

Standard Butler Health Plan

2) Health plans shall include a disease management program covering:

• asthma

• diabetes

• COPD

• obesity

2) Exceeds standard – Offer disease management program covering:

• asthma

• diabetes

• COPD

• obesity

Butler Health PlanSEHCB Best Practice Standards

Cont.

Standard Butler Health Plan

2) Additional disease management programs include:

•Acute bronchitis

•Congestive heart failure

•ADHD

•Cancer

•Depression

•Epilepsy

•Hepatitis C

•HIV/Aids

•Hyperlipidemia

•Hypertension

•Low back pain

•Migraines

•Multiple sclerosis

•Osteoporosis

•Rheumatory arthritis

Butler Health PlanSEHCB Best Practice Standards

Standard Butler Health Plan

3)Health plans must include access to providers that offer care for complex medical conditions.

.

3)Meets standard – Many tertiary providers in network.

3 NetworksHealthSpanMultiPlanEmerald Health

Cont.

Butler Health PlanSEHCB Best Practice Standards

Standard Butler Health Plan

4)Health plans shall undertake periodic dependent eligibility audits.

4)Meets standard – Audits conducted every three years. 100% sample size for every school district.

Butler Health PlanSEHCB Best Practice Standards

Butler Health Plan Butler Health Plan 25 Year Success Story25 Year Success Story

All members have input

Focus on wellness

Financial Management

Butler Health Plan Butler Health Plan Financial ManagementFinancial Management

A. Minimal overhead (6 cents on the dollar)– Direct contracts with all vendors (Separate

contracts with networks, claims payer, stop loss, etc.)

B. Assertive claim management− Custom provider discount arrangements− Independent vendor audits− Member education (HealtheReports)

C. “All for one – one for all” operating philosophy (Common plan designs; Common rates)

Questions