2021 Annual Enrollment Webinar #2 - CPG · Finished! Review your offering Rates Election 25. Plan...
Transcript of 2021 Annual Enrollment Webinar #2 - CPG · Finished! Review your offering Rates Election 25. Plan...
Andrew Brown, Business Analyst, Benefits Policy
Tak Lam, Associate Business Analyst, Benefits Policy
Damon Tutein, Assistant Business Analyst, Benefits Policy
Wednesday, August 19, 2020
2021 Annual Enrollment Webinar Series
2021 Annual Enrollment Webinar #2
The Journey from Planning to Annual Enrollment
Today’s Agenda
Annual Enrollment Planning
Pricing and 2021 Renewals
• Pricing and Trends
• Annual Renewals
• Active and Retiree Health Plans
Disability Plan Selection and Member Enrollment Process
Reflections, Questions, and Discussion
2
Annual Enrollment Planning
3
The Journey from Planning to Enrollment
Policy
& Design
Plan
SelectionPricing
4
Overview of Our Seamless Annual Process
5
• Benchmarking
• Industry trends
• Client feedback
• Evolving needs
of the Church
Policy & Design
• Detailed analysis
of group experience
and industry trends
• Final plan pricing for
the coming year
Pricing
• Groups select plans
that will be offered
to employees
Plan Selection
• Employees and
their families
review their
choices and
enroll or make
changes for 2021
2021 Plan Selection and Annual Enrollment Timeline
Major Categories
• Plan array process
• Pricing
• Renewals
• Renewal
supporting
materials
• Member
communications
January
to July
• Plan Selection
Release Date: 08/26
• Group plan
selections: 08/26–10/07
• MLPS system
preparation
• Member
communication
mailings
August
• Group plan
selections continue to 10/07
• Active AE dates
– 1st Session: 10/12–10/30
– 2nd Session: 10/28–11/18
• Retiree AE dates: 10/15–12/07
• Pre-65 Retiree dates: 10/28–11/18
• Vendor / member account set-up
October
• CPG conducts a
Quality review of
AE transactions
• Member ID card
production and
mailing
December
to January
6
2021 Administrator Education Opportunities
Member Education Opportunities
• IBAMS education sessions (by request)• Health plan care management programs (for current enrollees)
• Enrollment support via Health Advocate
Renewal and AE Webinars for Administrators(June–September)
2020 CPG Summer Sessions Virtual Conference(July 15 and 23)
Virtual Episcopal Benefits Administrators Conference(September 29 and October 1)
7
2021 Member Education Opportunities
Health plan care management programs
(for current enrollees)
Enrollment support via
Health Advocate
IBAMS education sessions
(by request)
Opportunity 01
Opportunity 02
Opportunity 03
8
2021 Annual Enrollment Planning
Communicating to your Related Entities and Employees
9
Mail Date: September 28
Session 1:
Oct. 12 to Oct. 30
August 21
Dependent Aging Out Letter
September 4
Notice of Creditable Coverage (NOCC)
August 26
In Your Renewal Package
• Letter Template for Administrators
• Plan Comparison Chart
• Annual Enrollment Guide
• Summaries of Benefits and Coverage (SBCs) posted to CPG.org
Mail Date: October 14
Session 2:
Oct. 28 to Nov. 18
2021 Active Member AE Timeline
2021 Annual Enrollment Planning
10
Mail Date: September 28
Session 1:
Oct. 12 to Oct. 30
Mail Date: October 14
Session 2:
Oct. 28 to Nov. 18
2021 Active Member AE TimelinePlans Going Away
• Should you elect to no longer offer a plan
in 2021 that you offer in 2020
• Annual Enrollment requires action
by employee
• MLPS tools and reports to help you manage
When Members Change Networks or Plan
Types
• Resources available to provide information
• Ensuring continuity of care for those in
treatment
Pricing and 2021 Renewals
11
Plan Selection and
Annual Enrollment Timeline
Pricing and Trends
12
Pricing: Overview—Key Factors
13
Overall Group Specific
Actual versus expected
• Large claims
Projected
• Cost trend assumptions
• Known/expected changes
• Stress testing
Relative positioning
• Medical Trust average
• National rate – Denominational
Health Plan groups
Group-specifics
• Demographics/geographic factors
• Experience
• Prior rate actions
Pricing: Focus on Cost Trend Assumptions
Projected percentage increase in the cost to treat patients from
one year to the next, assuming that benefits remain the same
What is medical and pharmacy cost trend?
14
Cost trend influencers:
• Unit cost inflation of medical products and services
• Per capita utilization or changes in the number or
intensity of service usage
Cost trends used to estimate what the same health
plan design will cost from year to year
Consolidation of healthcare providers
Aging of the coveredpopulation
Changes in federal or state legislation
Cost shifting from public payers (Medicare)to private plans
Impactof fixed deductibles and copays
Healthcare service utilization
Variations in provider treatment patterns
Medical technology and drug therapies
Changing health of the covered population
Price inflationor deflation
Pricing: Focus on Cost Trend Assumptions
What are some factors that can affect healthcare trends?
15
Pricing: Focus on Cost Trend Assumptions
What do the current trend studies show for 2021?
2021 medical cost projection could range from 4% to 10% —
uncertainty due to impact of COVID-19
Prices remain primary driver; growing at faster rate than utilization
Inflators: COVID-19 mental health impact, specialty drug spending,
chronic disease prevalence
Deflators: telehealth goes mainstream, narrow networks, worksite
clinics, lower-cost sites of care, increase in benefits communication
and navigation tools
Sources: PwC’s Health Research Institute – Medical cost trend: Behind the numbers 2021 16
Pricing: Focus on Cost Trend Assumptions
Medical Trust trend assumptions for 2021 pricing
17
Medical &
Behavioral
Health
(5.7%)
Prescription
Drug
(8.2%)
2021 Overall Average Preliminary Rates
Active Health
18
Composite Trend +7.10%
Prior Experience 1.00%
Demo/Geo Risk Profile 0.10%
Benefit Changes 0.80%
Cost Containment Strategy/Economies of Scale - 1.5%
Surplus - 2.10%
+ 5.44%
2021 Dental Rates—Actives
The average Dental Rate increase for 2020 is < 1%
19
Some groups may see a modest rate increase
based on their claims experience.
0.91%
Basic Dental /
Dental and
Orthodontia
1.90%
Preventive
Dental
Plan Selection and
Annual Enrollment Timeline
Annual Renewals
20
Health Plans Offered for 2021
• PPO 100
• PPO 90
• PPO 80
• PPO 70
• CDHP 15
• CDHP 20
• CDHP 40
• EPO High
• EPO 80
• CDHP 20
7 Plan Options with Anthem and Cigna 3 Plan Options with Kaiser
21
Renewal Supporting Materials
Renewal Package
• Alerts master administrator to
go to MLPS for the
Group’s Plan offering
and selections
• Provides a link to instructions
for how to access information
22
Renewal Email
• Medical Trust Renewal Letter
• Participating Group Agreement
• Administrative Policy Manual
• Medical Trust Compass Report
and how to use it
• AE Timeline and Letter Templates
for Administrators
• Healthcare Compliance Notices
• Summaries of Benefits and
Coverage (SBCs) on CPG.org
• Health Plan Comparison Chart
2021 Active Renewals
• Review and share accordingly
with your key stakeholders
• IBAMS resources available to
assist you with questions
• Determine your 2021 Plan
offering and make elections
in MLPS
August 26 — Available in MLPS
• Plan Selection Deadline:
October 7
Plan Selection Timing
23
MLPS—Plan Selection Page
Navigate to Plan Selections when it opens in the MLPS site
20xx_Billing_Schedule_for_Episcopal_Church_Medical_Trust.pdf
20xx_AE_Timeline_for_Administrators.pdf
1. Log into CPG as an administrator and select MLPS.
2. Click the Plan Selections Link.
24
Plan Selection Page: Making Selections
To complete
Plan Selections:
1. Click Accept or
Decline next to
each plan (do
not leave any
blank radials)
2. Click Submit
3. Finished!
Review your offering
Rates Rates Election
25
Plan Selection Page: Additional Option Requests
To request an
Additional Option:
1. Leave radial buttons blank
2. Click check mark in
Additional Option
Requested box
3. Enter comments in the
Plan Request box
4. Click Submit
Submitting a request for additional options
Rates Rates Election
✓ Additional Option Requested
26
Plan Selection Page: Additional Option Requests
If you request a multiple Tier and/or Rx pricing, upon receiving notice
that your additional request is ready you will need to review your new
offering
Viewing Tier and Rx Changes
1. Adjust values for Rate Tiers /
Rx Options to changes
2. Click View Plans (to
complete use previous
instructions)
3. Finished!
Rates
27
Plan Selection and
Annual Enrollment Timeline
Active and Retiree Health Plans
28
Enhanced Hearing Aid Benefits for 2021
Active Benefit Allowance
Active Health Plan Current Benefit 2021 Benefit
All Self-Insured Active
Health Plans
Hearing aid device
discount only
Maximum benefit of $1,500
per ear, every three years
29
The Episcopal Church Medical Trust Designs and
Administers Retiree Medical and Dental Benefits
Health
• Medical Supplies and Services,
including Preventive Care
• Behavioral Health
• Pharmacy
• Vision
• Employee Assistance Program
• Health Advocate
• Hearing (discount and benefit)
• Global Travel (assistance and benefit)
• SilverSneakers™ (gym benefit)
Dental
30
Comprehensive Plus Premium
Monthly Premium Rates (PMPM)
2021 $400 $520 $605
2020 $380 $505 $590
2021 Increase (versus 2020)
Dollar Amount $20 $15 $15
Medical Trust 2021 Medicare Supplement Plan Rates
31
Specialty drugs and future changes to Medicare and Part D subsidies
represent main pricing risks.
Plans with Rx
Comprehensive
(no Rx)
Plus
(no Rx)
Premium
(no Rx)
Monthly Premium Rates (PMPM)
2021 $215 $250 $300
2020 $210 $245 $295
2021 Increase (versus 2020)
Dollar Amount $5 $5 $5
Medical Trust 2021 Medicare Supplement Plan Rates
32
Plans without Rx
Retiree Enhanced Hearing Aid Benefits for 2021
Retiree Benefit Allowance and Hearing Aid Device Discount
Medicare Supplement Current Benefit 2021 Benefit
Comprehensive and
Plus Plans
$1,000 per ear,
every five
years
Maximum benefit of $1,500
per ear, every three years, plus
hearing aid device discount
33
Retiree Enhanced Hearing Aid Benefits for 2021
Retiree Benefit Allowance and Hearing Aid Device Discount
Medicare Supplement Current Benefit 2021 Benefit
Premium Plan $2,000 per ear,
every five
years
Maximum benefit of $2,000
per ear, every three years, plus
hearing aid device discount
34
2021 Dental Rates—Retirees
No Dental Rate increase for 2021!
35
Dental and Orthodontia
Basic Dental
Preventive Dental0%
2021 Retiree Member AE Timeline
2021 Retiree Annual Enrollment
36
October 15 to December 7
Disability Plan Selection and
Member Enrollment Process
37
2021 Fully-Insured Disability Enrollment Timeline
Employer- and Employee-paid Disability Plans
• Monitor plan performance
and vendor management
• Employer and member
communication production
January
to July
• Disability Plan Selection Release Date: 08/26
• Employers select employer-paid or employee-paid
disability offerings: 08/26–10/07
• No action is required for 2021 if employers are
satisfied with their current plan selection
• Disability enrollment dates: 10/12–11/18
• Administrators review employee compensation
records in ER and update as needed
• Enrollment process and system preparation
• Zurich / member account set-up
August
to November
• Medical
underwriting and
enrollment
approval
(Employee-paid
plans only.
Applicable to
employees who
previously declined
coverage and want
to enroll for 2021.)
December
to January
38
Have your client ID ready when completing the survey. You can
find your client ID in ER or on your Medical Trust invoice.
2021 Fully-Insured Disability Plan Selection
Three-step Plan Selection Process
Employer- and Employee-paid Disability Plans
39
1 • Receive email with a link to the plan selection survey
– Satisfied with current plans, no action is required for 2021
– Your plan options will roll over to 2021
2 • Want to change plans, complete and submit the survey to make
your 2021 plan selections
– A step-by-step guide to completing each screen of the survey
is located on ARC, along with a link to the survey
3 • Save the submission screen as confirmation of your changes
2021 Fully-Insured Disability Plan Selection Enrollment Process
Employers offering new employer-paid or employee-paid disability
coverage for the first time, in 2021
40
1 • Contact your IBAMS representative (if applicable)
or Client Services at (866) 802-6333
2• Complete the STD and LTD Employer Plan Selection Form located on
cpg.org under Forms and Publications, and return the form to CPG at
3• Enroll employees in MLPS, or fill out the Employer- or Employee-Paid
Enrollment Form for each employee, located on cpg.org under
Forms and Publications, and return the forms to CPG at
– For employee-paid coverage, enrollment can be completed in
MLPS, but a paper form must be returned for each enrollee
Reflections, Questions, and Discussion
41
42
For your participation and feedback.
Thank you!
Important Disclosures
This material is provided for informational purposes only and should not be viewed as investment, tax, or
other advice. It does not constitute a contract or an offer for any products or services. In the event of a
conflict between this material and the official plan documents or insurance policies, any official plan
documents or insurance policies will govern. The Church Pension Fund (“CPF”) and its affiliates
(collectively, “CPG”) retain the right to amend, terminate, or modify the terms of any benefit plan and/or
insurance policy described in this material at any time, for any reason, and, unless otherwise required by
applicable law, without notice.
Short-term disability and long-term disability insurance products and services are offered by Zurich
American Life Insurance Company, NAIC No. 90557, a New York domestic life insurance company. The
information provided here is a summary of the group disability income insurance coverage and is for
illustrative purposes only. A certificate with more complete policy information is available upon request.
Please refer to the certificate or the group policy for a complete description of coverage, terms,
conditions, exclusions, and limitations. If any conflict exists between the certificate and/or policy and the
information described here, the terms of the certificate and policy will govern. Other self-funded disability
benefits may be provided by The Church Pension Fund.
44