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Business & Finance Team

Technology Update

Contract Process

Short Form contracts are intended for agreements for services less than $50,000. Minor Facilities contracts are intended to be used in conjunction with building modification.

Changes include: • A simplified process for campus/departments to utilize a Contract

Specialist who determines which form is applicable, will guide the campus/department throughout the process and will assist with all contract documentation.

• A dedicated email address has been established for contracts and related concerns.

The intent of this effort is to relieve campus/department staff of the burden of contracts processing, to the extent possible.

Initiator

• Sends request through email to contracts@fortbendisd.com • ALLOW FOR A MINIMUM OF 3 WEEKS TOTAL PROCESSING

Contract Specialist

• Completes contract documents and submits to vendor for review and signature • Returns signed documents to Initiator for Budget Manager review and approval

Initiator

• Returns contract signed by Budget Manager to contracts@fortbendisd.com

Contract Specialist

• Sends contract to E-Team member for review and signature

E-Team Member

• Reviews contract and signs CAR (Contract Approval Request ) form • Returns contract packet to Contracts Specialist

Contract Specialist

• Acquires approval signatures • Returns copy of fully executed contract to initiator for attachment to Requisition or Purchase Order • Provides copy of fully executed contract to vendor for their records

Mileage

Issues and Deficiencies Observed

• Bank deposit frequency

• Minimum weekly, more if add’l. $250 rec’d

• Careless miscoding

• Sales tax (collected on taxable sales/bank deposits)

• Deficits (not monitoring balances actively enough)

• Fundraisers request/approval online

• Post-fundraiser financial recap.

Activity Funds

Issues and Deficiencies Observed (cont’d.)

• Money turned in not checked thoroughly enough by bookkeeper. (e.g. verifying against backup support)

• Allowing parents to incur reimbursable expenses

• Gift cards as employee appreciations

• Reports or bank deposit paperwork turned in late • Monthly reports 10th bus. Day of new month (email reminder)

• Bank deposit paperwork immediately

• Slow response to requests for additional backup support

New for Fiscal-Year 2014-2015

• Itinerant Bookkeepers

• Activity Fund Financial Reviews

• Online collection with Revtrak Webstore-credit card collection

• Online Post Fundraiser Financial Recap

• Bank Deposit efficiencies

Activity Funds

FBISD Benefits Committee Medical Plan Administration August 13, 2014

Fort Bend ISD’s Benefit Package

Medical and Prescription Drug – three options, district subsidized Dental - two options, 100% employee paid Vision - 100% employee paid Basic Life and Accidental Death and Dismemberment - $25,000, fully paid by

district Voluntary Life and Accidental Death/Dismemberment - 100% employee paid Flexible Spending Accounts Disability - 100% employee paid AFLAC - 100% employee paid Legal Services – 100% employee paid What’s missing?

Source: FBISD Finance

Benefits Overview

Self-Funded Medical and Rx Plan What is a self funded plan? Any insurance plan in which the employer, not the insurance company, assumes the financial risk for providing benefits to its employees. Why do employer’s self fund? (1)To gain more control over the plan, by:

a) designing the benefits b) having access to claims data for analytics c) managing finances

(2)To save money through the following ways: a) minimizing administrative expenses b) reducing premium c) reducing financial exposure in good claim years

Source: FBISD Finance

Benefits Overview

Self-Funded Cost Structure

Self-Funded vs. Fully Insured Cost Comparison

12 Source: MHBT, Inc.

Components of our health plan

Medical Claims 76%

Prescription Claims 13%

MH Capitation 3%

Employer Funded HRA

1%

Cigna Admin Fees 5%

Stop Loss Reinsurance

Premiums 2%

Medical Plan Expenses

Source: FBISD Finance & CIGNA

Benefits Overview

Medical/Rx Plan Cost History

Enrollment 5,858 6,224 6,472 6,646 6,341 5,886 5,707Plan Cost $36,178,168 $41,466,024 $43,466,024 $51,186,792 $49,453,820 $47,554,739 $51,400,397 Per Employee Per Month

$515 $555 $563 $642 $650 $673 $751

Per Employee Per Month Contribution

$184 $187 $189 $192 $219 $244 $282

Per Employee Per Month District Funding

$340 $340 $340 $340 $340 $340 $420

Surplus/(Deficit) $9 ($28) ($34) ($110) ($91) ($89) ($49)Annual Surplus/(Deficit)

$641,148 ($2,091,264) ($2,640,576) ($8,772,720) ($6,924,372) ($10,718,568) ($3,355,716)

20132010-2011 2006-2007 2007-2008 2008-2009 2009-2010 2011-2012

$0.00

$100.00

$200.00

$300.00

$400.00

$500.00

$600.00

$700.00

$800.00

2006 - 2007 2007 - 2008 2008 - 2009 2009 - 2010 2010 - 2011 2011 - 2012 2012 2013

Medical claims increase year-over-

year

Source: FBISD Finance & CIGNA

Medical Plan Metrics Average Number of Covered Employees 5,698 Average Number of Covered Members 10,315 Employee Average Age 45.6 % of Population over 40 years old 47% % of Population with Chronic Condition 35% Preventive Care Utilization 47% % of Population Completing Health Assessment 87% Average Spend By Relationship Per Month Employee $610 Spouse $648 Dependent $247

Source: FBISD Finance & CIGNA

Benefits Overview

Medical Plan Metrics

Cost per Member per Month

Observations •Plan spend was 6.3% below the Education norm. •FBISD has more large claimants than other educational institutions, and the severity of the catastrophic medical events are more acute. •Preventive Care utilization and Well Visit completions are above the norm.

OAP Plan accounts for 77% of gross medical plan costs and

includes 57% of total membership.

Source: FBISD Finance & CIGNA

Benefits Overview

Medical Plan Metrics Chronic Condition Management • Top chronic conditions are: weight complications, diabetes, depression, lower back pain, and

asthma. •Chronic conditions are a significant driver of medical cost and often cause reduced productivity. •Of those identified, 15% are engaged in ongoing coaching to better manage their condition.

Only 14.4% of those with weight complications and 19.5% of those with diabetes are participating in health coaching.

Identified Engaged

Source: FBISD Finance & CIGNA

Benefits Overview

Medical Plan: RFP Bids Received Name of Company Submitting Bid Date of Delivery

Aetna 5/23/2014

United HealthCare 5/23/2014

Cigna 5/24/2014

Mercer 5/26/2014

HealthFirst 5/26/2014

Blue Cross Blue Shield 5/26/2014

Benefits Overview

Assessment of RFP Responses Volunteers for RFP subcommittee Teachers - Sharon Meyer & Jody Stiver

Paraprofessionals - Skip Hampton Auxiliary - Julie Torres Administration – Steve Bassett & Sonja Curtis

MHBT – Jared Moss, Kasey Salmela & Tiffany Parker Purchasing - Robert Langston

Benefits Overview

Carrier Options - Client Meetings

Cigna Blue Cross Blue Shield United Healthcare The Health Care Partnership Group

Benefits Overview

UHC San Antonio Customer Care Center • Experienced leadership since 1990 • <30 seconds average speed to answer • <2% call abandonment rate • 97.3% call quality site score • 95.4% first call resolution score

Benefits Overview

Notes: - Discussion on BCBS 2015

Claims Projection

Fort Bend ISDFinal Review for 2015

COVERED EMPLOYEES BASED ON:

OAP Plan 3,040

Local Plus 1,399

1,404

5,843

HRA

Total

CIGNA UHC BCBS

Claims Administration 21.89$ 27.43$ 31.33$

Onsite Wellness (2) Included Included Included

SL Contract Terms Paid 24/12 18/12 (1 laser)

Stop Loss Premium 20.86$ 22.69$ 17.86$

Total 42.75$ 50.12$ 49.19$

CIGNA UHC BCBS

Annual Fixed Cost 2,997,459$ 3,514,214$ 3,449,006$

Run-Off Admin NA 181,000$ 608,000$

2015 Fixed Cost Projection 2,997,459$ 3,695,214$ 4,057,006$

2015 Claims Projection 52,960,555$ 46,811,471$ 47,749,000$

Total Expected Cost 55,958,014$ 50,506,685$ 51,806,006$

Wellness Dollars 250,000$ 150,000$ 100,000$

Transparency Tool Included Included 2.50$

Onsite Rep 2.09$ 1.71$ 1.07$

UHC Fees include the following: - Nurseline - Enhanced Behavioral

Utilization Management - HRA Administration - Rx Administration - Fiduciary Liability

Benefits Overview

Fort Bend ISD Network Analysis Providers

Open Access Plus Network

CIGNA - OAP Network

BCBS - BlueCard

PPO Network

UHC - United HealthCare

Choice Plus

Gained Under UHC Network

1106

Total # 7799 # of In-Network 6322 7276 7428

# of Out-of-Network 1477 523 371 % of In-Network 81% 93% 95%

% of Out-of-Network 19% 7% 5%

Benefits Overview

UHC Plan Options • The Open Access Plus and Choice Fund HRA

benefits would remain the same (with larger networks)

• The Local Plus would be replaced with new UHC Methodist and Tier 1/Tier 2 specialist network which is expected to produce significant savings to members and district

Benefits Overview

UHC SUGGESTED PLAN DESIGN TO REPLACE LOCALPLUS Tier 1 & 2 Premium Providers Tier 1 Benefits Methodist Tier 2 Benefits

LocalPlus Hospital System and All Other Choice Plus Premium Physicians Providers

Deductible Deductible Deductible $750 Individual / $1,500 Family $750 Individual / $1,500 Family $1,500 Individual / $3,000 Family

80% Coinsurance 80% Coinsurance 60% Coinsurance

OOP (includes deductible) OOP (includes deductible) OOP (includes deductible) $3,750 Individual / $7,500 Family $3,750 Individual / $7,500 Family $6,500 Individual / $13,000 Family

Preventive Care 100% Preventive Care 100% Preventive Care 100%

$25 PCP Copay $25 PCP Copay $45 PCP Copay

$35 Specialist Copay $35 Specialist Copay $55 Specialist Copay

Emergency Emergency Emergency $250 Copay + Ded. & Coinsurance $250 Copay + Ded. & Coinsurance $250 Copay + Ded. & Coinsurance

$75 Urgent Care Copay $75 Urgent Care Copay $75 Urgent Care Copay

N/A N/A

$250 Inpatient Hospital Copay (per admission)

Prescription Coinsurance remains the same at: 30% / 40% / 50% Note: Out-of-Network providers are not covered. Visit myuhc.com, Click “Find a Physician” for a list of Choice Plus Providers.

Benefits Overview

Recommendation Switch from Cigna to United Health Care Keep premiums the same for 2015 The Open Access Plus and Choice Fund HRA benefits would remain the same The Local Plus would be replaced with new UHC Methodist and Tier 1/Tier 2 option Add 3 additional FTE’s to assist with ongoing plan education, network utilization and wellness

Benefits Overview

Timeline Medical marketing bid takes place for January 1, 2015

Evaluation, Interviews Benefits Committee Award Date Implementation Annual Enrollment Effective Date

June-July July 29, 2014 August 18,2014 BOT Mtg August - September October January 1, 2015

Source: FBISD Finance

Benefits Overview

Fort Bend Independent School District

Benefits Overview

Monthly Business Meetings: Date

August 13th

September 8th

October 21st

November 10th

January 14th

February 9th

March 2nd

April 7th

May 19th

Time (AM) 7:30 - 9:00

7:30 - 9:00

7:30 - 9:00

7:30 - 9:00

7:30 - 9:00

7:30 - 9:00

7:30 - 9:00

7:30 - 9:00

7:30 - 9:00