2014-2015 Recommendations
• Increase District contribution from $225 to $260• Increase premiums by 15%• Enter Interlocal agreement with Region 4 ESC for:
• Online benefit enrollment• Dental plan administration• Supplemental disability plan administration• Basic life insurance administration• Supplemental life insurance administration• Vision plan administration• Supplemental cancer administration• Supplemental accident administration
District Contribution
• 2002 district contribution $225• 2004 district contribution $232• 2005 district contribution $240• 2006 district contribution $260 • 2011 district contribution $225• 2014 district contribution $260
District Contribution Comparisons
DISTRICT PLAN YEAR CONTRIBUTIONBridgeport ISD 2013-2014 $225.00
Eagle Mountain Saginaw ISD 2013 - 2014 $225.00
HEB ISD 2013 - 2014 $225.00
Denton ISD 2013 - 2014 $235.00
Birdville ISD 2013 - 2014 $240.00
Lake Dallas ISD 2013-2014 $245.00
Lewisville ISD - ActiveCare 1HD 2013 - 2014 $245.00
Argyle ISD 2013-2014 $250.00
Plano ISD 2013 - 2014 $259.00
Northwest ISD 2014-2015$260.00
Proposed
Carrollton-Farmers Branch ISD 2013 - 2014 $262.00
Lewisville ISD -ActiveCare 1 2013 - 2014 $266.00
Keller ISD 2013-2014 $275.00
Krum ISD 2013-2014 $275.00
Grapevine-Colleyville ISD 2013 - 2014 $285.00
Carroll ISD 2013 - 2014 $290.00
Garland ISD 2013 - 2014 $325.00
Irving ISD 2013 - 2014 $325.00
Decatur ISD 2013-2014 $337.00
Lewisville ISD - ActiveCare 2 2013 - 2014 $348.00
Lewisville ISD - ActiveCare 3 2013 - 2014 $356.00
Stop Loss Claims
• NISD pays the first $150,000 in claims
• Stop loss picks up after the individual exceeds $150,000
• Average 5 stop loss for past 3 years• Total plan loss $2.25 million dollars
Self-Insurance Fund Balance
• 2006 fund balance $536,000• 2011 fund balance $2,100,000• 2011 Clinic Opens• 2011 State budget cuts begin• 2014 fund balance $500,000
• Implementation of Affordable Care Act• Stop loss claims• Raising costs of benefits
Affordable Care Act impact on Self-Insurance Fund
• Unlimited Wellness• Elimination of pre-existing conditions for children under 19• Extension of dependent children coverage up to 26
regardless of marital status• Increase access to mental counseling and treatment• Shared Responsibility Mandate• Maintenance of efforts• Creation of plan that cost less than $110 per month and
pays 60% of the benefits• Federal Reporting Annually• Penalties for non compliance
Benefits of Health and Wellness Center
• Annual administration cost $1,030,021
• Annual plan savings $1,400,000• Overall health costs have increased• Wellness Center has allowed NISD’s
increase to grow at a much slower pace
Medical Plan Participation
• 65% of the employee population participate in the medical plan
• The majority of the participants carry employee only coverage
• There are 70 district couples who carry employee and family coverage
• Estimated cost to increase the district contribution is approximately $756,000
Proposed Premium Increases
• Increase premiums by 15%• $17 per month increase for employee only in the
Basic Plan• $147 per month increase for employee and family
in the Core Plan• Employees receive $25 per month PHA Incentive
for employee only or employee and child coverage• Employee receives $50 per month PHA Incentive if
employee and spouse participate in the PHA with employee and spouse or employee and family coverage
Premium RecommendationsProposed 2014-2015 Medical Premiums
Core Plan with PHA Participation Premium NISD
PHA Participation Incentive
Proposed Premimum
Monthly Increase
Annual Increase
EE 537.00 260.00 (25.00) 252.00 32.00 384.00 EE+SP 1,190.00 260.00 (50.00) 880.00 114.00 1,368.00 EE+CH 1,009.00 260.00 (25.00) 724.00 93.00 1,116.00 EE+FM 1,450.00 260.00 (50.00) 1,140.00 147.00 1,764.00
Basic Plan with PHA Participation
PHA Participation Incentive
Proposed Premimum
Monthly Increase
Annual Increase
EE 426.00 260.00 (25.00) 141.00 17.00 204.00 EE+SP 926.00 260.00 (50.00) 616.00 79.00 948.00 EE+CH 781.00 260.00 (25.00) 496.00 64.00 768.00 EE+FM 1125.00 260.00 (50.00) 815.00 105.00 1,260.00
Core Plan without PHA Participation
PHA Participation Incentive
Proposed Premium
Monthly Increase
Annual Increase
EE 537.00 260.00 0.00 277.00 57.00 684.00 EE+SP 1,190.00 260.00 0.00 930.00 164.00 1,968.00 EE+CH 1,009.00 260.00 0.00 749.00 118.00 1,416.00 EE+FM 1,450.00 260.00 0.00 1,190.00 197.00 2,364.00
Basic Plan without PHA Participation
PHA Participation Incentive
Proposed Premium
Monthly Increase
Annual Increase
EE 426.00 260.00 0.00 166.00 42.00 504.00 EE+SP 926.00 260.00 0.00 666.00 129.00 1,548.00 EE+CH 781.00 260.00 0.00 521.00 89.00 1,068.00 EE+FM 1125.00 260.00 0.00 865.00 155.00 1,860.00
NISD Comparability Plan to TRS Plan Benefit
Network Non-network Network Non-networkDeductible
Individual Family
Coinsurance(plan pays afterdeductible) 80% 60% 70% 50%
(employee pays after 20% 40% 30% 50%deductible)
Out of Pocket Maximum(in addition to deductible)
IndividualFamily
Prescription Drug
Lifetime Maximum
Office visit Primary/Specialist $20/$30 Deductible and
CoPay Coinsurance
Emergency Room
Hospital Admission
High Tech Radiology
Prescription Drugs *
Retail Short Term - 31 dayGeneric $15 $15* > of $5 or 30% > of $5 or 30%*
Preferred Brand $35 $35* > of $35 or 30% > of $35 or 30%*Non-Preferred Brand $60 $60* > of $35 or 30% > of $35 or 30%*
Specialty Drug $200 $125 N/A*plus over cost *plus over cost
Retail Maintenance - 31 dayGeneric $15 $15* $25 $15*
Preferred Brand $35 $35* $75 $35*Non-Preferred Brand $60 $60* $75 $60*
Specialty Drug $200 $125*plus over cost *plus over cost
Mail Order -90day
Generic $45 N/A $25 N/APreferred Brand $105 N/A $75 N/A
Non-Preferred Brand $180 N/A $75 N/ASpecialty Drug N/A N/A $125 N/A
Employee OnlyEmployee/Child(ren)Employee/SpouseEmployee/Family
$100 copay plusDeductible and
Unlimited
Coinsurance
Coinsurance
$150 copay plusDeductible and 20% Coinsurance
Coinsurance
$150 copay plusDeductible andCoinsurance
$100 plan year prescription deductible until met by any
combination of Network & Non-Network prescriptions plus
copay(s)
$512$984
$1,084$1,400
Proposed with PHA2014/2015
NISD Core Plan
N/AN/A
$8,000$2,000
Unlimited
$200 Copay & Coinsurance
Coinsurance(CT scan, MRI, nuclear medicine)
$1,810$1,990
$796$1,269
$75 plan year prescription deductible until met by any
combination of Network & Non-Network prescriptions plus
copay(s)
2013/2014Rates
N/A
$1,000 $4,000
$900
per person
$300
TRS ActiveCare 3
Premiums do not reflect district contribution
Creation of High Deductible Plan
High Deductible Plan with PHA Participation
Premium NISD Proposed Premium
PHA Fee
Proposed Premium
Employee 341.00 260.00
81.00 0.00 81.00
Employee + Spouse 745.00 260.00
485.00 0.00 485.00
Employee + Children 645.00 260.00
385.00 0.00 385.00
Employee + Family 914.00 260.00
654.00 0.00 654.00
High Deductible Plan without PHA Participation
Premium NISD Proposed Premium
PHA Fee
Proposed Premium
Employee 341.00 260.00
81.00 25.00 106.00
Employee + Spouse 745.00 260.00
485.00 50.00 535.00
Employee + Children 645.00 260.00
385.00 25.00 410.00
Employee + Family 914.00 260.00
654.00 50.00 704.00
NISD (ACA Compliance) vs TRS (ACA Compliance)Benefit
Network Non-networkDeductible
Individual Family
Coinsurance(plan pays afterdeductible) 80% 60% 80% 60%
(employee pays after 20% 40% 20% 40%deductible)
Out of Pocket Maximum(in addition to deductible)
IndividualFamily
Prescription Drug N/A
Lifetime Maximum Unlimited
Office visit Primary/Specialist Deductible and
CoPay Coinsurance
Emergency Room Deductible and Coinsurance
Hospital Admission Deductible andCoinsurance
High Tech Radiology Deductible andCoinsurance
Prescription Drugs *
Retail Short Term - 31 dayGeneric > of $5 or 20% > of $5 or 30%*
Preferred Brand > of $35 or 20% > of $35 or 30%*Non-Preferred Brand > of $35 or 20% > of $35 or 30%*
Specialty Drug $125 N/A*plus over cost
Retail Maintenance - 31 dayGeneric $25 N/A
Preferred Brand $75 N/ANon-Preferred Brand $75 N/A
Specialty Drug $125 N/A
Mail Order -90day
Generic $25 N/APreferred Brand $75 N/A
Non-Preferred Brand $75 N/ASpecialty Drug $125 N/A
Employee OnlyEmployee/Child(ren)Employee/SpouseEmployee/Family
$4,200$4,000$8,000
$341$645
$2,400$4,800
(Discount cardIncluded)
Medical Deductible
$2,200$4,400
(CT scan, MRI, nuclear medicine)
$3,850
$794$1,060
$745$914
$325$572
Rates 2013/2014
plus Coinsurance
Medical Deductible plus Coinsurance
plus Coinsurance(Discount card
Included)
Medical Deductible
NISD HD PlanTRS ActiveCare 1HD
Premiums do not reflect
district contribution
Plan cost can’t
exceed $110
Must pay 60% of benefits
Interlocal Agreement with Region 4 ESC
• Online Enrollment savings of $80,000• 403(b) Administration savings of
$5,500• Basic life insurance savings of
$15,000
Fully Insured Dental Plan
• Cigna Dental Providers• All benefits remain the same except
root canals paid at 80% instead of 50% 2014 -2015Dental High Plan
Premium increase2.5%
Employee $ 47
Employee + Spouse $ 88
Employee + Children $ 74
Employee + Family $ 120
Dental Low Plan
Employee $ 25
Employee + Spouse $ 45
Employee + Children $ 37
Employee + Family $ 58
Other Recommended Changes
• Supplemental long term disability all current employees guaranteed issue policies
• Supplemental life insurance guaranteed issue policies
• Vision insurance provider network will remain VSP with a change in administrator
• Supplemental Cancer and Accident Plans• Discontinue offering AFLAC plans. Current
participants can continue to have payroll deductions.