Transition Update

Indiana StatewideGroup Insurance Trust

Aaron Curtis & Dan Bond

Capstone Benefit Advisors

Carrier Selection

Considerations:

• Provider Discounts

• Market Share

• Trust Experience & Capabilities

• Future Consolidation

Carrier Selection

Why Not NRECA?

• No Separate Plan for Indiana Co-ops

• SBC Offered Lower Rates in Recent Years

• Only Rental Provider Networks in Indiana

Discovery

Process:

• Information Exchange

• Questionnaire

• Q & A

Discovery

Network Analysis:

• Provider Disruption for Members

• Provider Discounts

Trustee Decision

• Report/Analysis from Capstone

• Final Interview With Trustees

• Carrier Selection Goal: No Later Than April 30, 2011

• Final Rate Determination Goal: No Later Than September 30, 2011

Transition

Transition to New Carrier Completed By:

January 1, 2012

What To Expect

• Business as Usual

• Same Principal Contacts

• Continue Using Benefit Solver

• Look for Updates as Progress is Made

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www.isabenefitsblog.com

Questions ??

Health Care Reform: 1/1/2011

SBC Plans Will Be

Non-Grandfathered

Health Care Reform: 1/1/2011

Dependent Coverage to Age 26

• Other Eligibility Criteria Does Not Apply– Marital Status, Student Status, Dependency,

Residency, Other Coverage

• Tax Exempt To Age 27

• Notice Distribution Required

Health Care Reform: 1/1/2011

Lifetime / Annual Limits

• Lifetime/Annual Limits Eliminated

• Applies to Essential Benefits

• Notice Distribution Required

Health Care Reform: 1/1/2011

No Pre-Ex for Under Age 19

• Pre-Existing Condition Exclusions Currently Only Apply to Late Enrollees

– This is Now Eliminated for Anyone Who Has Not Reached Age 19

Health Care Reform: 1/1/2011

Preventive Care Services

• No Cost Sharing for Many Preventive Care Services and Immunizations

• For a Complete List, Go To:

www.HealthCare.gov/center/regulations/prevention.html

Health Care Reform: 1/1/2011

External Review Process

• Member Initiated

• Claim Decision Review

• Independent Organization

– Not Associated with the Carrier

Health Care Reform: 1/1/2011

Nondiscrimination–Problem Areas

• Different Benefits for Exec/Exempt Employees

• Shorter Waiting Periods for Exec/Exempt Employees

• Larger Contributions for Exec/Exempt Employees

Health Care Reform: 1/1/2011

FSA Limitation

• No Longer Cover OTC Drugs

• Requires Prescription

• Insulin is an Exception

• Master Cafeteria Plan has been Updated

CONTACTS

Aaron Curtis, Capstone Benefits Group

317-328-7880, ext. 145

acurtis@capstonebenefits.com

Dan Bond, Capstone Benefits Group

317-328-7880, ext. 147

dbond@capstonebenefits.com

Questions ??

THANK YOU!