SOUTHERN NEW JERSEY REGIONAL EMPLOYEE BENEFITS FUND OPEN MINUTES JANUARY 27, 2014 BERLIN BOROUGH 6:15 PM

Transcription

1 SOUTHERN NEW JERSEY REGIONAL EMPLOYEE BENEFITS FUND OPEN MINUTES JANUARY 27, 2014 BERLIN BOROUGH 6:15 PM Meeting of Executive Committee called to order by Michael Mevoli. Open Public Meetings notice read into record. PLEDGE OF ALLEGIANCE AND MOMENT OF SILENCE ROLL CALL OF 2012 EXECUTIVE COMMITTEE: Michael Mevoli, Chairman Borough of Brooklawn Present M. Joseph Wolk, Secretary Borough of Mt. Ephraim Present Richard Michielli Borough of Magnolia Present Louis Di Angelo Borough of Bellmawr Present Terry Shannon Borough of Barrington Present Jack Lipsett Gloucester City Present Neal Rochford Haddonfield Present EXECUTIVE COMMITTEE ALTERNATES: Joseph Collins Delsea Regional BOE Absent Gene Mercoli Cumberland Cty Tech Ed Present APPOINTED PROFESSIONALS PRESENT: Executive Director/Adm. PERMA Risk Management Services Paul Laracy Emily Koval Program Manager Attorney Medical TPA Aetna Medical TPA Amerihealth Conner Strong & Buckelew Brandon Lodics Jason Edelman J. Kenneth Harris, Esq. Kim Ward Lisa DiDio Dental TPA Delta Dental Prescription TPA Express Scripts Treasurer Fund Coordinator (Coastal group) Richard Schwab Rick Alessandrini Gerry Cowen (1) SOUTHERN NEW JERSEY REGIONAL

2 PRESENT FUND COMMISSIONERS: William Dunn, Mt. Holly MUA Eleanor Kelly, Borough of Runnemede Terry Osborne, Winslow Fire District ALSO PRESENT Joseph Rizzuot, Mount Holly MUA Jeff Keen, The Lance Group Joseph Linker, PERMA Joe Madera, Hardenberg Chuck Grande, ICG Karen Corey, ICG APPROVAL OF MINUTES: November 26, 2012 Open MOTION TO APPROVE OPEN MINUTES OF NOVEMBER 25, 2013: Commissioner Wolk Commissioner Michielli Unanimous CORRESPONDENCE None ADJOURN SINE DIE MEETING: Commissioner DiAngelo Commissioner Shannon Unanimous MEETING OF FUND COMMISSIONERS CALLED TO ORDER Roll Call of 2014 Fund Commissioners. (2) SOUTHERN NEW JERSEY REGIONAL

3 (3) SOUTHERN NEW JERSEY REGIONAL

4 In addition to the Commissioners present, nomination ballots were sent to all Commissioners. Ballots were received and counted as a vote Nominating Committee report was included. Number of Commissioner present did not represent a quorum to re-organize, however the ballots received in the office of the Executive Director did quantify for a quorum. Majority vote represented the nomination of the 2014 Executive Committee and alternates as presented on the ballot. The ballot of Executive Committee and Alternates was read by Commissioner Michielli as follows: Michael Mevoli Chairman Borough of Brooklawn Mayor Joseph Wolk Secretary Borough of Mt. Ephraim Richard Michielli Executive Committee Borough of Magnolia Louis DiAngelo Executive Committee Borough of Bellmawr Terry Shannon Executive Committee Borough of Barrington Jack Lipsett Executive Committee Gloucester City Neal Rochford Executive Committee Borough of Haddonfield Joseph Collins Executive Committee Delsea Regional BOE 1st Alternate Gene Mercoli Executive Committee Cumberland Co. Vo Tech Ed 2ndAlternate A ballot submitted by Clearview Township BOE included a vote for Mr. Joseph Collins as Chair and Gene Mercoli as Secretary. No second was made to that motion. ELECTION OF OFFICERS, EXECUTIVE COMMITTEE & ALTERNATES AS SUBMITTED: Commissioner Michelli Commissioner DiAngelo 32 Ayes, 1 Nays Fund Attorney swore in the Executive Committee Commissioners. EXECUTIVE DIRECTOR/ADMINISTRATOR: REORGANIZATION RESOLUTIONS- PROFESSIONAL SERVICES AGREEMENT- Executive Director said that the professionals were all given a 2% from 2013, as per the budget adopted in November. In addition, The Lance Group has requested to become a subgroup coordinator, much like the Allens Associates in the Coastal Fund. The broker fees were split to allow the coordinator fee to become $19.30 pepm, in addition to a broker fee decided by their accounts, which did not include an additional fee for the member or the Fund. He said that this broker has a substantial membership which makes sense to allow for this arrangement. (4) SOUTHERN NEW JERSEY REGIONAL

5 MOTION TO ADOPT RESOLUTION 1-14 APPOINTING FUND PROFESSIONALS FOR FUND YEAR Commissioner Lipsett Commissioner Michielli 7 Ayes, 0 Nays REORGANIZATION RESOLUTIONS - Chairman Mevoli reviewed resolutions 2-14 through Resolution 7-14 continued with the same signatories as In addition, Resolution #10-14 included Commissioner Wolk and Commissioner Shannon as Fund Commissioner and Alternate, respectively, to the MRHIF. MOTION TO ADOPT RESOLUTIONS , AS DISCUSSED. Commissioner Michielli Commissioner Wolk 7 Ayes, 0 Nays FINANCES PRO FORMA REPORTS Fast Track Financial Reports as of November 30, 2013 o Historical Income Statement o Consolidated Balance Sheet o Indices and Ratios Report Executive Director reviewed the Financial Fast Track which showed a $370,000 gain in November, which included changes to the suspension of the Terminal Liability in the amount of $1.2 million. The Fund is continuing to perform strongly, which is evidenced in preliminary numbers for December, as well. FINANCIAL DEVELOPMENTS - At our last meeting, the Executive Committee cancelled the 2012 terminal liability declaration. As a result of this action, the Fund s financial statements have been adjusted to reflect payables to former members as follows: 2012 Terminal Liability Refund Cherry Hill Fire District $ 102,457 Vineland City $ 679,820 Alloway Twp. BOE $ 44,184 Hainesport BOE $ 38,382 West Deptford BOE $ 344,777 $ 1,209,620 These payments are scheduled take place on or about 7/1/2014 although timing is subject to continued positive performance by the Fund. The Coastal 2011 fund year s position has also improved allowing for a refund to Vineland from that account of $191,206 and this payment would also be made on or about 7/1/2014. (5) SOUTHERN NEW JERSEY REGIONAL

6 Several current members are paying their share of the 2012 $6 million supplemental assessment in monthly installments. Due to positive performance of the 2013 fund year, it may be possible to offset this liability with surplus from 2013 and terminate these payments also by 7/1/2014. We will continue to monitor the feasibility of this concept and a recommendation to proceed in this direction is possible if positive financial results are confirmed over the next several months. SCHOOL BOARD COMMITTEE RENEWAL MEETING - We are in the process of gathering and summarizing claims experience through 12/31/2013. This data will be shared with the Fund actuaries and used to project rates for 7/1/2014 and hope to have projected renewal rates by mid February for adoption at the February 24 th meeting. To further discuss the renewal, we are inviting all School Board Fund Commissioners to a School Board Committee meeting on March 4 at the Tavistock Country Club. ASSET MANAGEMENT CONTRACT - We are currently using an investment brokerage firm for term investments. We can reduce transaction costs and obtain greater contractual protections by using a professional asset manager for this function. Alternatives available under the MEL joint purchasing contract are: 1. TD Bank, 8 basis points fee, $8,000 per year if $10 M is invested 2. Wells Fargo Bank, 15 basis points, $15,000 if $10 M is invested. The former asset manager for the MEL, Fernando Garip, now of Willmington Trust, can also perform the function of 10 basis points or about $10,000 per year. TD has been handling the Camden JIF for many years and is recommended for this assignment. MOTION TO AWARD TD BANK AS ASSET MANAGER AT A COST OF 10 BASIS POINTS NOT TO EXCEED $10,000 A YEAR. Motion: Commissioner Wolk Commissioner DiAngelo 7 Ayes, 0 Nays ADMINISTRATION COMMITTEE APPOINTMENTS - Each year the Fund Chair makes appointment to the Fund s standing committees. A report of the proposed 2014 committees is included in the agenda LEGISLATIVE UPDATE - The Fund has yet to receive a response from the letter we sent to the congressional delegation at the end of last year regard the Affordable Care Act. PERMA is working with the Fund Lobbyist; KZG, to set up a meeting with Congressman Frank Pallone to discuss the impact the ACA will potentially have on the Fund, in particular the 2018 Cadillac Tax. For your information, a power point presentation including key points of the impact of this tax was included in the distribution of the agenda. In addition, recent decisions are revealing that volunteer firefighters and other emergency personnel will most likely not be counted under the Affordable Care Act, which should be relief for many members. (6) SOUTHERN NEW JERSEY REGIONAL

7 MUNICIPAL REINSURANCE HEALTH INSURANCE FUND - The Municipal Reinsurance Health Insurance Fund met on December 11, 2013 at 2 pm at the Saddle River Borough Hall. The MRHIF held its annual public hearing and adopted the 2014 budget in the amount of $9,705,102. Commissioner Wolk s report is included. In response to Commissioner Shannon, Executive Director said that the Fund could consider a 1 or 2 year contract with the PBM, but the process can be disruptive and better investments are seen with longer contract terms MEL & MR HIF EDUCATIONAL SEMINAR - The 3 rd annual seminar is scheduled for Friday, April 11 th, beginning at 9:00 AM at the National Conference Center, Holiday Inn, NJ Turnpike Exit 8, East Windsor, NJ. The seminar qualifies for an extensive list of Continuing Educational Credits including CFO/CMFO, Public Works, Clerks, Insurance Producers and Purchasing Agents. There is no fee for employees and insurance producers associated with MEL and MR HIF members as well as personnel who work for service companies that are engaged by MEL member JIFs and MR HIF member HIFs. Attached is the enrollment form. INCLEMENT WEATHER REPORT - A procedure has been instituted for Commissioners to confirm whether a meeting has been cancelled. The Executive Director will talk to the Chair to determine if a meeting should be cancelled. In the case of an early morning or evening meeting, PERMA will leave a message, which can be obtained by dialing the Fund s main number of (201) and on the Fund website. BENEFITS OPERATIONS PRO FORMA REPORTS Client Activity Report - as of December 2013 Claim Appeals none ENROLLMENTS - All enrollment and billing questions should be directed to our dedicated enrollment team. The SNJREBF enrollment team may be contacted via at southernenrollments@permainc.com or by facsimile at Open Enrollment: All enrollment forms that were received for members who elected to make changes during open enrollment have been processed and changes have been updated with the carriers. Online Enrollment Training: PERMA is planning upcoming training session for the online enrollment system. Save the date notifications will be coming out in the next few weeks. UTILIZATION MANAGEMENT- JANUARY In the past year, radiology costs per member for traditional footprint SNJ members dropped by 9.7%, from $243 to $220. For Coastal subgroup members, where new providers were recruited and a communications campaign organized, the drop was 48.9%, from $533 per member to $272. Based on a claims comparison between 2012 and 2013, Triad Chiropractic review, has produced an estimated savings of 43%, $6.00 per employee per month, for traditional footprint SNJ members and 57%, $10.60 per employee per month, for Coastal subgroup members. (7) SOUTHERN NEW JERSEY REGIONAL

8 EXPRESS SCRIPTS FORMULARY UPDATE - On Friday, December 20 th, PERMA sent out the below to all Benefit Administrators and SNJREBF Commissioners with Express Scripts prescription coverage. If you or your group s representative has not received this communication, please reach out to me (blodics@permainc.com / ) and I will make sure it is forwarded in its entirety. Within the next couple of weeks affected members will begin receiving notifications from Express Scripts, of any impacted prescription they may be filling/have filled. Sample letters are attached for your reference. The following plan update has been scheduled for implementation on April 1, 2014: Physicians of affected members may call to request a clinical exception. Clinical exceptions will be reviewed and considered by Express Scripts clinical staff. Attached please see the 2014 Express Scripts Formulary Member Communications: Over the next several weeks, members who have or are currently utilizing one or more of the affected medications will be receiving a letter from Express Scripts. This letter will provide a detailed list of all medications that are affected by this formulary update, as well as the recommended alternatives. We recommend that all patient s who receive a letter, share it with their treating physicians to guarantee a smooth transition on and after April 1 st EXPRESS SCRIPTS SYSTEM INTEGRATION APOLOGY LETTER - Pharmacies and members that had claim processing issues due to the system integration received letters of apology from Express Scripts. A separate communication was sent to Pharmacies and members. Communications are attached for your reference. HEALTHCARE REFORM COMPLIANCE - As of January 1, 2014 the Patient Protection and Affordable Care Act (PPACA), require that all group health plans include an in-network out of pocket maximum, no greater that $6350 Individual and $12,700 Family. In order to comply with this, all SNJREBF plans that currently do not have in-network out of pocket maximum, or have an in network out of pocket maximum greater than $6350/$12,700. These out of pocket maximums will be inclusive of any in network medical copays, deductibles or coinsurance that a member may experience in a calendar year. Both carriers have confirmed, plans have been updated in the claims adjudication system. We are working on a plan to update all Plan Documents accordingly, for groups this applies to. In order to comply with PPACA, all plan change requests must be submitted no less than 90 days in advance of the desired effective date. CENSUS - In compliance with Health Care Reform and the Pay or Play mandate the HIF Service Team and Risk Managers will be reaching out to all groups for a census of all employees with a listing of hours they work per week. MEDICARE ADVANTAGE 2014 UPDATES - As of January 1, 2014, original Medicare (CMS) made an update to GYN benefits. Medicare s clinical team has deemed 1 routine cervical screening per 24 months as medically necessary. In 2013 one routine screening annually was allowed. This plan update has been made to Medicare s plan nationally and is affecting all Medicare enrollees, including the SNJREBF Medicare Advantage Plan. When advised of this change by CMS, AETNA requested an exemption to this policy, but was declined by CMS. Please be assured that additional screenings are available to patients in situations of medical necessity, (8) SOUTHERN NEW JERSEY REGIONAL

9 including but not limited to: high risk of cervical or pelvic cancer, history of cancer, and women who may have received an abnormal pap smear within the previous 3 years. In January 2014 PERMA enrollments will run a report that identifies all retirees and spouses who will reach 65 during the year. Medicare Advantage enrollment materials will be mailed to all newly eligible retirees and spouses 60 days prior to their 65 th birthday. DEPENDENT AUDIT UPDATE - The following groups participated in the first round of dependent eligibility and Coordination of Benefit Audits for medical and prescription plans. Berlin Borough BOE Borough of Barrington/Mt. Ephraim Borough of Brooklawn Borough of Gibbsboro Borough of Magnolia Borough of Merchantville Borough of Pitman EIRC Logan Twp BOE Lower Alloway BOE The following groups participated in the second round of dependent eligibility and Coordination of Benefits Audits for medical and prescription plans. Borough of Paulsboro Borough of Runnemede Borough of Somerdale Borough of Westville Chesilhurst Borough Clayton BOE Mt Holly MUA Riverside Twp BOE Southampton Twp BOE Township of Bordentown Through this exercise we were able to terminate dependents that did not meet the definition of an eligible dependent and identify employees who have other insurance. We have worked with the carriers to terminate coverage for the dependents that were identified as ineligible and update all coordination of benefit information that employees provided. This will ensure that financial resources are being spent appropriately. We are working with the groups to follow up with the employees on any missing or incomplete forms. The third round of audit will start in February. The following list of groups have been selected for the next round. Burlington Township BOE Collingswood BOE Delsea Regional BOE Cinnaminson BOE (9) SOUTHERN NEW JERSEY REGIONAL

10 We will follow the same process as the other two audits. We will be reaching out to each group to explain the process and address any questions or concerns. Chairman Mevoli asked if the Fund will be prosecuting those who were found to be inaccurately covered. Fund Attorney said it is the plan sponsor s responsibility to gather the eligibility information. Chairman Mevoli suggested making this audit an annual event. TREASURER'S REPORT Mr. Schwab reviewed his report including the December 2013, January 2014 bills list, confirmation of claims paid and transfers and the delinquent payment schedule. He said the number of members with delinquent balances is getting fewer. Confirmation of Payment December 2013 December TOTAL 2012 $1,750 TOTAL 2013 $1,271, TOTAL $1,273, Resolution 12-14: Payment of January 2014 Bills 2013 $1, $1,308, TOTAL 2011 $ 1,309, MOTION TO APPROVE RESOLUTIONS JANUARY BILLS LIST FOR THE SOUTHERN NEW JERSEY REGIONAL EMPLOYEE BENEFITS FUND BILLS LIST AND APPROVE THE CASH RECONCILIATION REPORT AND CASH TRANSACTION REPORT. Motion: Commissioner Lipsett Commissioner Wolk 7 Ayes, 0 Nays AETNA: Ms. Ward reviewed the Aetna reports which covered claims paid and large claimants through November She said the claims are one of the lowest for the whole year. In addition, the large claims case management program has been working well and she will bring some success stories to the next meeting. AMERIHEALTH Ms. Didio reviewed the Amerihealth claims paid report and high dollar claims report. She said in November and October Amerihealth Administrator claims which were slightly high. There was one high claimant. She reviewed claims in the Amerihealth NJ claims, which showed October to be a higher month, as well. She will be reviewing the large case management program with PERMA. FUND ATTORNEY: No report (10) SOUTHERN NEW JERSEY REGIONAL

11 OLD BUSINESS: none NEW BUSINESS: none PUBLIC COMMENT: none MOTION TO ENTER EXECUTIVE SESSION: Commissioner Michielli Commissioner Lipsett Unanimous MOTION TO ADJOURN: Commissioner Michielli Commissioner Wolk Unanimous MEETING ADJOURNED: 7:55 PM NEXT MEETING: February 24, 2014 Emily Koval, Assisting Secretary for JOSEPH WOLK, SECRETARY (11) SOUTHERN NEW JERSEY REGIONAL