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PfISD Benefits Committee Meeting

PfISD Benefits Committee Meeting. February 20, 2019. PfISD Demographics. Average Employee Age: 41.8 Membership by Gender: 34% Male 66% Female. PfISD Medical. PfISD Pharmacy. PfISD Medical & Rx Per Employee Per Year. EE Out of Pocket = 3.8% Increase since 2014.

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PfISD Benefits Committee Meeting

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  1. PfISD Benefits Committee Meeting February 20, 2019

  2. PfISDDemographics • Average Employee Age: 41.8 • Membership by Gender: • 34% Male • 66% Female

  3. PfISDMedical

  4. PfISDPharmacy

  5. PfISDMedical & Rx Per Employee Per Year EE Out of Pocket = 3.8% Increase since 2014

  6. PfISDTop 5 Conditions

  7. PfISDMedical Claims - Key Stats • Spouse Utilization • On average, spouse costs are 80% higher than average member costs • Emergency Room Utilization • Utilization of ERs remains high • 2018: 8.1% of claims / 2017: 9.3% of claims / 2016: 7.5% of claims • Top Shelf Medications • 67% of cost of pharmacy claims on high cost medication ($400+ per 30 day supply) from 13% of population • Total Claims Breakdown • 7.6% of membership is driving 65.3% of cost

  8. PfISDOpportunities & Next Steps • Consider adding a spousal surcharge • Promote the EAP & resources for mental health • Evaluate ways to steer to high value providers • Surgery Plus • BridgeHealth

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