Your Health Benefits for 2018 - UW State... · Your Health Benefits for 2018 –February 24, 2017 11 Sept. 2016 Vendor proposals due Nov. 2016 Board reviews results 2016 Timeline

Your Health Benefits for 2018 – February 24, 2017 1

Your Health Benefits for 2018Self-Insurance, Regionalization, Medicare, Next Steps

Lisa Ellinger, Director

Office of Strategic Health Policy


We want to ensure that you…

Understand the Group Insurance Board’s recent

decisions & the process involved

Understand how changes will impact you

Are aware of next steps and how you can stay informed

Know how to get health benefit information &

assistance


Agenda1. New eLearning

2. Understand changes: history, timeline, process

3. Next steps

4. How changes affect you

5. Stay connected

6. Q&A Discussion


Group Insurance Board ActionHistory, Timeline, Process


Group Insurance Board ActionFeb 8, 2017: Approved self-insured/regional program structure for 2018

https://youtu.be/kYESoIjQ4Gc


How did we get here?• Group Insurance Board has discussed

and considered self-insurance for past

five years


Oct.

2012

Deloitte Consulting

issued preliminary

report

Aug.

2013

Deloitte presented second

report with detailed analysis

Historical Timeline

Oct.

2013

Board

delayed

action

Jan.

2014

Board recommended hiring a

benefits consultant

Sept.

2014

Segal Consulting

awarded


Mar.

2015

Segal presented first

report to the Board

Aug.

2015

Segal issued a Request for

Information (RFI)

Historical Timeline

Nov.

2015

Segal presented second

report to the Board


How did we get here?• Two actuarial studies – Deloitte and

Segal – concluded:

• A Request for Proposals (RFP) was the

only way to determine cost impact

• Proposals are legally binding


Feb.

2016

Board directed

ETF to issue

an RFP

Jan.

2016RFP developed

2016 Timeline

May

2016

Public Request

for Comment

issued

Jul.

2016

Jun.

2016

Public Request for

Information issued

(draft RFP)

RFP issued


Sept.

2016Vendor proposals

due

Nov.

2016

Board reviews

results

2016 Timeline

Feb.

2017

Board decision to

move to

self-insurance/regions

Apr.

2017*

Contracts sent to Joint

Committee on Finance (JCF)

for 21-day passive review

Vendor contracts

negotiated

Feb.

2017

May

2017*JCF decision

* Estimated timing

Mar.2017*


RFP OverviewVendors required to:

• Bid on any of the four defined regions

and/or submit statewide/nationwide bid

• Complete a technical proposal

• Submit an administrative cost proposal

• Complete a claims repricing exercise

• Submit information about their proposed

network for 2018


Proposal Scoring

40%Response to

Technical Questions

20%Response to

General Questions

40%Cost / Access

Proposal


Board Decisions: 2/8/17• Self-insurance

• 4 regions

• 1 statewide/nationwide vendor

• 1-2 additional vendors in each region

• Effective January 1, 2018


Board Decisions: 2/8/17• Medicare 2018

• Medicare Supplement through new

statewide/nationwide vendor

• Medicare Advantage through current

vendor (Humana)

• Medicare 2019

• Options will be presented at May

2017 GIB meeting


Self-Insuring /Regions:Next Steps

• Contract Negotiations

• Legislative Approval

• Tiering/Premiums

• Communication/Outreach


Legislative Approval

MayJFC decision

February 9th

The board sent a letter to the Joint

Committee on Finance chairs to explain

decision & rationale

Not approved?

• The Board will reconvene

• We could maintain the current

program structure

Late March or Early April

ETF finishes contract negotiations

with vendors

21 Day Passive Review

Contracts sent to the Joint Committee

on Finance


Tiering / Premiums• Released at open enrollment

• No significant changes for 2018

• Goal: competitive statewide/nationwide

plan

Tier 1


Looking Forward2018 & Beyond…


How will this affect retirees?Pre-Medicare retiree program mirrors active employee program

Enhancements:

Improved

Provider Access

Improved

Quality & Value

Improved

Customer Service


Regions &

Vendors

WestHealthPartners

SouthDean

Quartz

EastAnthem

Network

NorthSecurity

Statewide/Nationwide

Vendor: Anthem


Provider Access

98% of Current Providers

Expected

Available Providers

We’ll provide info to help

you find which plans cover

your health care team


What’s changing for Medicare retirees?

It’s Your Choice Health Plan Medicare

It’s Your Choice Medicare

Advantage

It’s Your Choice Medicare Plus

Same 3 plan options available in 2018:


What’s changing for Medicare retirees?

Now

2018

It’s your Choice

Medicare Plus

Administered by:

WPS Insurance

Administered by:

Anthem Blue

Cross Blue Shield

It’s your Choice

Health Plan Medicare

County-specific service areas

Administered by 17 plans

Region-based

Administered by 6 plans

It’s your Choice

Medicare Advantage

Administered by:

Humana

Administered by:

Humana

Changes: who will administer & regional structure


Information about changeswill be sent to your home before open enrollment


Need Medicare Advice?• Medigap Helpline

1-800-242-1060

• ETF Ombudsperson Services

• Email: [email protected]

• 608-261-7947 or 1-877-533-5020

mailto:[email protected]


2019 & Beyond

Expand options

with lower monthly

premiums

Offer excellent

benefit packagesProvide choice

Deliver high quality,

high value services

ETF’s goals:

Likely focus on

expanding Medicare

Advantage


Stay Connectedetf_wi etf.wi.gov

608-266-32851-877-533-5020

ETF E-mail Updates

ETF will provide information prior to open enrollment.


Questions?


Q&A DiscussionIf you have questions after today’s session please send them to:

Millard Susman

[email protected]

Documents

Your Health Benefits for 2018 - UW State... · Your Health Benefits for 2018 –February 24, 2017 11 Sept. 2016 Vendor proposals due Nov. 2016 Board reviews results 2016 Timeline