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1 2013 Member Meeting 2013 Member Meeting
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2013 Member 2013 Member MeetingMeeting
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Presented by:
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Welcome, Introductions & Announcements
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About Today’s Webinar Presentation
All phone lines will be muted Questions can be submitted in writing
during the webcast A Question & Answer session will be held
at the end of the webinar A hard copy of the presentation provided
via email for your reference
THANK YOU FOR ATTENDING!
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Today’s Agenda Doug Jensen: Welcome and Introductions
NAMIC Insurance Solutions Team
• Service Tools and Administration• Financial Update & FSA Overview• Benefits Service Center
Gibson 2014 Strategies & Renewals
• Ancillary Benefits• Medical Plan Changes• Pre-65 Retirees• Extend Health: Post-65 Retiree Exchange• Health Care Reform
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Today’s Agenda
Benefit Service/Administration • New benefit administration• Benelogic Control
Open Enrollment 2014• Dates and expectations
2014: Looking Forward The Value of ICSO
Q & A
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ICSO H&W Named Fiduciaries Doug Jensen, Chair (12/2014), Illinois FAIR Plan
Association
Dane Austin (12/2014), New York Property Insurance
Anneliese Jivan (12/2016), California FAIR Plan
Ron Cassesso (12/2016), PIPSO
Jerry Warner (12/2015), New Jersey Insurance UW Association
Serving Without Compensation or Expense Reimbursement
Have a Personal Stake in the Success of the Program
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Key PartnersICSO H&W Named Fiduciaries
Provide Oversight
NAMIC Insurance Solutions (NIS) Benefit Administration and Finance
Management
Benelogic Control Benefit System
Connect Your Care FSA Services
Gibson Insurance Broker/Consultant
Extend Health Post 65 Retiree
Health Markets Insurance Agency (Insphere) Pre-65 Retiree
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ICSO H&W Named FiduciariesDuties and Responsibilities
Ensure availability of desired benefits for plan participants and employers
Maintain responsibility for signing off on various programs, policies and procedures
Explore opportunities for improvements in programs and/or process
Assure financial integrity of program and compliance with various regulations 9
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ICSO Health & Welfare Participants
42 Participating Employers
Total Number of Lives 1,464• 625 Active Employee Lives• 528 Dependent Lives• 311 Retiree Lives
Health Ins - 27 Employers
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Offering Quality Benefit Plan Accessibility and
Stability in a Constantly Changing Environment
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2013 ICSO H&W Impediments Unknowns created by Healthcare Reform (ACA)
ADP weak link in administrative chain
ICSO H&W temporary cash flow challenges
High premiums paid for SBR medical coverage
High long-term cost of post-65 retiree medical coverage
Aetna decision to non-renew master medical plan
covering • non-SBR actives and • pre-65 retirees
High cost of ancillary coverages
Challenges in simplifying processes of benefit handling
and procurement for employers
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2013 ICSO H&W Enhancements
Many Enhancements Were Transparent and Some are Ongoing
Continued implementation of plan adjustments required by Healthcare Reform (ACA)
Effective 8/1/2013: Terminated benefit administration services of ADP• Administration services transferred to the NAMIC Insurance
Solutions team• Benefit administration system moved to the Benelogic
Control System, along with COBRA services• FSA management moved to Connect Your Care
Successful marketing of SBR medical programs for various employers
Improved pricing for ancillary coverages
Successful implementation of Extend Health for post-65 retiree
coverage
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2013 ICSO H&W Enhancements (cont’d)
Response to loss of Aetna Master Medical plan• No impact on Aetna SBR plans or non-Aetna plans• Extensive but unsuccessful market research for full
replacement plan option• Identified private solution for pre-65’s, similar to the post-
65 Extend Health– Health Markets Insurance Agency (formerly Insphere)
introduced as pre-65 retiree solution• Options identified for the Aetna master group plans
impacted
Updated Participation Agreement• Important for
– Single 5500 filing– Clarify terms, conditions, expectations– Clear documentation of common agreement as an employer
group and a Trust
Continued expansion of ICSO website
Updating of the ICSO Benefit Guide, Manual and Grid
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Service, Tools & Administration
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ICSO H&W Eligibility Grid
Great resource tool for eligibility requirements
Unable to address every circumstance
Summary Plan Description prevails
Updates in progress
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ICSO H&W Eligibility Grid
• Continued updates being made to ensure it remains• Relative• Accurate
• Most current copies found posted on the Benelogic website through your HR Portal
• We encourage you to reference this if you are not already using this tool!
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Benefit Manual & Administration Guide
ICSO H&W provides members with detailed procedural guides
– Compilation of information and tools each member group will need for ongoing oversight and service
Updates in progress
Current copies posted through your HR portal
www.icsohrp.benelogic.com
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NAMIC Insurance Solutions (NIS)
Overview
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ICSO: A Full Service SolutionNIS, Gibson, Benelogic Roles
Named Fiduciaries
Participating Employers
Plan Participants
Your ICSO H&W Circle of Strength for Service
Strategic Consulting
H&W Vendor Management
Carrier Issue Resolution
Renewal Management
New Business
Technical Benefit Support
Health Care Reform
Represent the NFs
Customer Service
Billing
FSA Financial Administration
Member/Employer Issue Resolution
Record Keeping
Cash Flow Management
Financial Reporting
Non-carrier Dispute Resolution
Online Enrollment
Carrier Connections
Salary Changes and Updates
COBRA Management
FSA Link (to Connect YourCare)
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NAMIC Insurance Solutions Team
Gregg Dykstra – COO and General Counsel. Areas of responsibility include NAMIC Insurance Services
David Middleton – ICSO H&W Plan Administrative Executive. Areas of responsibility include insurance services and financial management.
Gigi Houston – Employee Benefits Specialist, and Human Resources expert. Areas of responsibility include ICSO H&W benefit management and invoicing.
Andy Knoblauch – Sr Accountant. Areas of responsibility include financial management support for ICSO H&W members.
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NIS Contact Information P. O. Box 68700
3601 Vincennes Road Indianapolis, IN 46268
Phone: (317) 875-5250
NAMIC Insurance SolutionsGigi Houston, SPHR / ICSO H&W Benefit Specialist
•email – [email protected]•call center phone: (855) 656-4276
David Middleton / ICSO H&W Plan Admin Executive •email - [email protected]
Andy Knoblauch – Senior Accountant •email – [email protected]
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Site Administrator Website
ICSO H&W Benefit Service Website: https://icsohrp.benelogic.com
Access benefits information and:• Census and Enrollment Data• Summary Plan Documents, Benefit Summaries and • Summary of Benefits and Coverage (SBCs)• Member Communications• ICSO H&W Benefit Manual & Administration Guide• ICSO H&W Eligibility Grid
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Site Administrator Tools
www.icso-hw.orgBasic information on Programs, Members,
Named Fiduciaries, FAQ and contact information
New services coming soon!
Currently preparing the ICSO H&W website to
allow ICSO site administrators secure access.
This will provide an easy and secure solution for
file sharing with NAMIC Insurance Solutions.
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Financial Review
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Statements of Net Assets Available for Benefits 2011/2012
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Statement of Changes in Net Assets Available for Benefits Year End 12/31/12
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Statement of Net Assets 9/30/13
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Statement of Changes in Net Assets Available for Benefits9/30/13
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ICSO: A Full Service SolutionNIS, Gibson, Benelogic Roles
Named Fiduciaries
Participating Employers
Plan Participants
Your ICSO H&W Circle of Strength for Service
Strategic Consulting
H&W Vendor Management
Carrier Issue Resolution
Renewal Management
New Business
Technical Benefit Support
Health Care Reform
Represent the NFs
Customer Service
Billing
FSA Financial Administration
Member/Employer Issue Resolution
Record Keeping
Cash Flow Management
Financial Reporting
Non-carrier Dispute Resolution
Online Enrollment
Carrier Connections
Salary Changes and Updates
COBRA Management
FSA Link (to Connect YourCare)
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Gibson Team/Key ICSO Members
Tim Leman, CEO and Principal Lead consultant on Gibson Team for ICSO H&W
[email protected] (574) 245-3512
Jan Phifer, Employee Benefits Practice Responsible for all benefit plan management for the ICSO H&W, including all medical, ancillary and retiree medical
[email protected] (574) 245-3503
DeAnna Kinyon, Employee Benefits Practice Responsible for successful Extend Health roll-out in 2013,
and is in the role of back-up service for the Gibson [email protected] (574) 245-
3585
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2014 Strategies
and Renewals
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Aetna Master Medical Plan Termination
Impacted by many changes in the administration of
employee benefits, including the Affordable Care Act
(ACA), effective 1/1/2014 the Aetna Master Health Plans
for the ICSO Health and Welfare plans will be terminated.
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Aetna Master Medical Plan Termination
Extensive market research was performed to seek out an alternative master medical plan
• No carrier willing to do a full replacement• For many reasons, primarily the uncertainty of how
the regulations under ACA will impact these plans going forward
The solution is in 2 parts
• Part 1: Group medical – working independently with the employers whose active group medical is impacted
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Aetna Master Medical Plan Termination
• Part 2: Pre-65 retirees – implemented a retiree HRA solution through Health Insurance Market Agency (formerly Insphere)
Guarantee issue coverage – no pre-existing condition limitations
Employer funds their portion of the PREMIUM ONLY through the HRA
Different from the post-65 retirees - pre-65 retirees cannot access these funds for any medical expense reimbursement
Annual fee for managing the HRA
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Ancillary Benefits Life, STD, LTD and Voluntary Life with Lincoln Financial
Group• Benefits second to none!• Large guarantee issue and benefit maximums• Managed LTD option available with 90 day waiting
period• AM Best Rating: A+ Superior
Dental with MetLife• Broad, national network • Plan design improvements over prior carrier• Reduced out of network costs• 2014 minimal increase of 6%• AM Best Rating: A+ Superior
Vision with VSP • No change in benefits• No increase for 2014• AM Best Rating: A Excellent
The move to the new Ancillary Benefit Providers was a Success!!
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Post-65 Retirees – ExtendHealth and the HRAs
Roll-out of the ExtendHealth = A Success!• Worked as promised• Rave Reviews
Enrollment stats
October 1st enrollment count• 195 eligible participants• 181 made elections• 8 chose not to participate• 6 unreachable (not contacted)
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Post-65 Retirees – ExtendHealth and the HRAsOf the 181 participants
107 Unique Plans Selected
17 different carriers
Top Plan Carriers:• AARP MS• Aetna• American Continental Insurance Company (An Aetna Co)• Humana• Anthem Blue Cross of California
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Post-65 Retirees – ExtendHealth and the HRAs
Key points about the move to ExtendHealth Only available to employers with 150+ retirees
• Membership in the ICSO H&W qualifies access • Retirees use HRAs to purchase individual plans,
– HRA funds can be available to pay for out-of-pocket expenses*
Individual counseling services Substantially reduced financial and administrative burden on
the employers A “getting started” introduction for active or retired
employees/spouses turning 65 is included in the “Turning 65 Checklist” on the ICSO website (www.icso-hw.org)
*Unlike pre-65’s whose HRA dollars are for Premiums Only
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Flexible Spending Accounts
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FSA – Encourage Participation
Terrific benefit – underutilized
Communication with staff about benefits of FSA to encourage participation
Pre-Tax means tax savings to participants
More staff (non-highly compensated employee) participation increases chances of passing compliance testing
Additional information on ICSO website
ACA continues to limit the healthcare FSA to a maximum of $2,500 in 2014
Participation can minimize employer testing issues
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FSAReminders Employers must pass compliance testing
Two primary tests• Eligibility • Ratio Highly Compensated
Employers must remit funds within 90 day window
Employees can submit claims for current year through the 1st quarter of next year
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FSAEarly Testing can identify potential issues for 2014
Reminders to participating employers including updates on eligibility and utilization rules
Manual review to identify potential issues
Begin 2014 testing earlier in first quarter
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ConnectYourCare FSA Services
Several Service Enhancements
Healthcare Payment (Debit) Card Accounts easily accessed through healthcare payment card
Online Account Access Participant Portal provides real-time account balances,
claims and reimbursement requests
RapidRequest Claims Processing State-of-the-art claims processing enables automated,
paperless claims handling Reduces processing time for speedy turnaround of
reimbursements
Customer Service Customer Service representatives are available to assist via
phone or email
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Health Care Reform (ACA)
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Continued Opportunities and Challenges for Employee Benefits
Next to payroll, medical benefits are the largest expense for most ICSO H&W employers
On behalf of ICSO H&W, Gibson continues to work with each employer group individually
–To develop a best practices framework for plan design, cost control and wellness
–Health benefit design strategies that will be key for the long term
–Manage compliance with Healthcare Reform
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Additional challenges for 2014
Continued implementation of the Affordable Care Act
Small employers (up to 50 eligible employees) moving to Community Rating (age-rated structure for employees & dependents) – at first renewal on or after January 1, 2014
Gibson team will continue to provide ongoing communication to the ICSO H&W members as the law and mandates become more clearly defined
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Health Care Reform Impact Model Notices
Notification to employees of their right to seek coverage on the ExchangesContinued monitoring of HCR developments for upcoming guidance on the notice requirement
Summary of Benefits and Coverage (SBC)•Document must be provided to all existing employees
• during the Open Enrollment, • 60 days prior to a mid-year benefit plan change; • to new hires with their benefit enrollment packets
•SBCs can be copied in B&W
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Health Care Reform Impact (cont’d)
For plan years beginning on or after January 1, 2014:
Non-discrimination for fully-insured plans• The federal non-discrimination rules related to
compensation will be applied to health insurance plans• Prohibit discrimination in favor of highly-compensated
employees
Patient Centered Outcomes Research Institute fees (PCORI)• For fully insured medical plans – the insurance company
is responsible for paying this fee• Excluded: HSAs, health FSAs, and stand-alone dental and
vision coverage
This list not all inclusive
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Health Care Reform Impact (cont’d)
Gibson Client Bulletins
• Timely updates and notices of provisions of ACA evolve and mandates are enacted
To receive these Client Bulletins, contact Jan Phifer [email protected]
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New and Improved Benefit Administration
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ICSO: A Full Service SolutionNIS, Gibson, Benelogic Roles
Named Fiduciaries
Participating Employers
Plan Participants
Your ICSO H&W Circle of Strength for Service
Strategic Consulting
H&W Vendor Management
Carrier Issue Resolution
Renewal Management
New Business
Technical Benefit Support
Health Care Reform
Represent the NFs
Customer Service
Billing
FSA Financial Administration
Member/Employer Issue Resolution
Record Keeping
Cash Flow Management
Financial Reporting
Non-carrier Dispute Resolution
Online Enrollment
Carrier Connections
Salary Changes and Updates
COBRA Management
FSA Link (to Connect YourCare)
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NIS Administration Services
ICSO H&W Employee Benefit Specialist– Gigi Houston, SPHR– [email protected]– (855) 656-4276
Hours of operation: 8:30 am to 5:00 pm CTAssistance with
– Benefit service issues– Employee record management– Communication with insurance providers– Claim resolution – Monthly invoicing
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NISThe Benelogic Control™ System
https://icsohrp.benelogic.comThe Benelogic database administration allows
Site Administrators have access to all employee data – Secure login permissions can be put in place to limit
access to sensitive data for various Site administrators
Allows “paperless” administration with employee and HR records
Ad Hoc report writer– allows employers to data sort employee records for
reporting purposes
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HR Portal for ICSO H&W
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Mailbox: [email protected] Phone: 1.888.898.1310 Hours of operation: 7:30 am – 4:00 pm Central
Time (Voicemail after hours)
Responsibilities Maintaining the system Special imported data error corrections Coding for Open Enrollment – New carriers,
new members Rate changes Salary increase data entry
Benelogic Service Center
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Access to Documents Global
– Life Insurance Certificates– Evidence of Insurability Form– Conversion Option Pamphlet
Site Specific – STD Claim Forms– Summaries of Benefits and Coverages– Carrier Website Links
Site Administrator AccessBenelogic Service Center
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Reports• Pre-Packaged Reports
– Employee Data– Census– Enrollments
• Ad-hoc Report Writer– Employee Information –Ex: Employee ID’s– Dependent Information– Plans– Costs (Annual/Monthly/Per Pay)
Site Administrator AccessBenelogic Service Center
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Salary Changes and Updates– Email salary change information to both:
• [email protected]• [email protected]
Life Event Changes (adding new hires, retirees, etc)– 2 steps:
• Input Life Event information into the Benelogic system www.icsohrp.benelogic.com
• Email [email protected] for notification that a Life Event has occurred
Site Administrator AccessBenelogic Service Center
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Open Enrollment
2014
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November 18th through
December 8th
Open Enrollment Dates
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Open Enrollment (OE) Access– Employee access via www.icsohrp.benelogic.com after Open
Enrollment begins– Employee User ID– Temporary Password – same as ID
Open Enrollment Tips– Employees not required to complete enrollment at one time– Enrollments not finalized until “Submit” is selected– Even if submitted, elections can be changed until OE closes
Confirmations– Employees may print an Enrollment Summary
• use new plan year effective date for new year’s benefit elections
Employee Self-ServiceBenelogic Service Center
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Beneficiary Designations– All employees need to access the employee self-
service to enter beneficiary designations
www.icsohrp.benelogic.comMedical FSA
ACTIVE ENROLLMENT– Eligible Employees must re-enroll if they chose to
participate in the 2014 Medical FSA– Each Participant will need to enter their annual
pledge amount.
Ancillary Benefits (Dental, Vision, Supplemental Life)– Employees need to access the employee self-service
to make a change to their current benefit enrollments
OPEN ENROLLMENT 2014
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Annual enrollment for Medical Benefits
For the SBRs working with GibsonThose who are “early renewing” on December 1st
– Employees will NOT use the Benelogic system for these updates/changes
– Gibson will be managing the changes to be uploaded into the Benelogic system
Those remaining with the 1/1/14 renewal date– Election choices should be completed before December 15th to
ensure updated information is complete with the carrier
Benelogic Service CenterOPEN ENROLLMENT 2014
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Annual enrollment for Medical BenefitsFor the Non-SBRs working with Gibson for your medical
Your plan changes and options have been presented to youOnce your plan designs have been decided upon
– Employees will use the Benelogic system to apply for their enrollment elections• Selecting a carrier and plan of benefits• Making any election updates or changes
OPEN ENROLLMENT DATESThe Benelogic system will be open from
November 18th through December 8th
OPEN ENROLLMENT 2014
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Annual enrollment for Medical Benefits
For group medical plans not working with Gibson for your medical
Once you and your broker have completed your renewal review
– Send all updated enrollment, premium and plan changes to [email protected]
– If possible, provide this information prior to December 15th to ensure the Benelogic system is updated for the January invoicing
Benelogic Service CenterOPEN ENROLLMENT 2014
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Looking Forward
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ICSO H&W Long Term Objectives
Availability of comprehensive and affordable health & welfare products fulfilling employers’ commitments to employees and retirees
Health & welfare options that allow employees and employers to select products that best suit their individual needs
Mutually successful long term relationship with NAMIC, Gibson, Benelogic and other vendor partners
Consistently satisfactory service in an ever-changing environment
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ICSO H&W Long Term Objectives
Necessary resources and communications available to assure employer and employee understanding of benefits
Effective handling of administrative issues as they arise
Expansion in number of participating employers and employees
Satisfactory management of Healthcare Reform (ACA) impact over time
Continued research for plan and benefit options to enhance the ICSO H&W benefit portfolio
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2014 Hot Buttons Continued review and potential marketing of SBR
healthcare coverages
Design, review and marketing of non-SBR healthcare coverages
Prepare for ACA changes in 2014 and beyond• Work to ensure compliance
Implementation of ExtendHealth for pre 65 retirees
Growth in membership and membership value
Equitable administrative costs
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The Value of ICSO
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Growing Membership
This year we welcome Kentucky to the ICSO H&W!
Message: “ICSO offers quality benefit plan accessibility and stability in a constantly changing environment”
Marketing initiative continues – GOAL: to increase ICSO membership
Who do you know that could benefit from membership in ICSO?
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Employers that fit the ICSO H&W model
Employers that want to:
Attract and retain qualified employees
Provide a high level of employee benefits at a reasonable cost
Increase efficiency – “Do more with less”
Focus on their business not their benefits
Make informed benefit decisions for employees and retirees
– Leverage knowledge of employer best practices– Increase bargaining power by joining a larger pool – Obtain administrative/consultative support with
benefits issues
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How ICSO stands apart Providing coverage options for different
populations– Active employees– Pre-65 retirees– Post-65 Medicare retirees – Eligible dependents
Meeting the critical needs of small & large employers
Regulatory compliance
Shared administrative cost and services
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How ICSO stands apart
Offering the comprehensive suite of health & welfare options that have been reviewed today:Active MedicalRetiree Medical HRA for qualified pre and post-65 retireesDentalVisionHealth Care Flexible Spending Account (HC FSA) Basic Life and AD&D Insurance; Supplemental Life InsuranceShort-term Advice to Pay and Long-term Disability InsuranceContinuation/Conversion of Coverage
– Life insurance Continuation or Conversion – COBRA or State Continuation for medical coverage on disabled
employees surviving spouses or dependents
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ICSO Health & Welfare Trust Competitively priced and unique
benefits not available outside the group
Reducing administrative costs and burdens
Remaining fresh and relevant Confidence in programs going forward
in a rapidly changing environment
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Your Full Service Solution!
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Your Service Team
David MiddletonICSO Plan Administrator
Gregg DykstraNAMIC COO & Gen’l Counsel
Tim Leman, Presidentand CEO, Gibson
Gigi Houston SPHREmployee Benefits Spclst
Andy KnoblauchSenior Accountant
Jan PhiferBenefits Practice, Gibson
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Open Discussion
Questions
Comments
Feedback?1
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Thank You!
