What is the group benefits program?

1. FROM INFORMATION TO ACTIONState Worksite Wellness Conference Ann S. Fuelberg, Employees Retirement System of TexasOctober 12-13, 2009

2. What is thegroup benefits program? 2009 State Worksite Wellness Conference

3. One advantage of joining a large self-funded plan like the GBP is that each member of the group shares the risk for the plan’s health claims equally. Managing health care effectively for the entire “group” is how ERS can offer employees and retirees a range of high quality, affordable benefits at a uniform rate. The GBP covers 1 in 46 Texans through its health plans GBP = “GROUP” Benefits Program527,792 Participants 2009 State Worksite Wellness Conference

4. How much does the gbp cost and who pays for it? 2009 State Worksite Wellness Conference

5. The State of Texas Pays Most of the Cost59 cents of every dollar State Contribution59¢ Member Copays and Coinsurance 19¢ Other Sources (such as the Reserve Fund) 9¢ Member Contributions13¢ 2009 State Worksite Wellness Conference

6. Potential Funding Gap Based on Emerging 9% Cost Trend Contributions will pay 6.5% of the increase Reserve fund may pay $179 million of the increased cost Contributions will pay 6.8% of the increase Potential funding gap is $154 million or 6.5% of the total plan expenses Smaller reserve fund can only cover $97 million of increased cost 2009 State Worksite Wellness Conference

7. What drives costs in the gbp? 2009 State Worksite Wellness Conference

8. COST DRIVER: Aging healthy members adds 1.9% to the annual health cost trend 50 and over 50 and over Under 50 Under 50 2009 State Worksite Wellness Conference

9. COST DRIVER: Hospital expenditures are rising faster than any other HealthSelect category (HealthSelect expenditures over time, as a percentage of total plan costs) 2009 State Worksite Wellness Conference

10. HealthSelect paid the most for these 5 types of hospital inpatient stays (Active and Retirees) Millions Source: Major Diagnostic Category Summary for All Claims, HealthSelect Annual Statistical Report, 2008 2009 State Worksite Wellness Conference

11. COST DRIVER: Prescription drug trend - GBP spends more than $1.5 million/every day on drugs Source: Texas Employees GBP FY2009 HealthSelect PDP Experience, Rudd & Wisdom 2009 State Worksite Wellness Conference

12. COST DRIVER: Name brand drugs increase costs The GBP and its members could save $5.3 million/year if four recently approved generic drugs were used rather than the brand-name drugs 2009 State Worksite Wellness Conference

13. COST DRIVER: Percent of members suffering from top 5 chronic conditions 18% 15% 16% 15% 12% Percent of HealthSelect Participants with condition 9% 6% 5% 4% 3% 2% 0% Diabetes and High Cholesterol Hypertension Asthma Degenerative Back Disorder Heart Disease Source: BlueCross BlueShield Texas, Expense Report, FY2009 2009 State Worksite Wellness Conference

14. What are the current wellness offerings with the gbp? 2009 State Worksite Wellness Conference

15. GBP participants have access to: Health Risk Assessments Coaching programs for tobacco cessation and weight loss Disease management programs for those with chronic conditions Mother and baby programs for pre- and post-natal care A 24-hour Nurseline Personal Health Manager Discounts to gyms, eyewear, etc. Flu Shots and Health Screening Reminders Youth Fitness Program HealthSelect participants can earn up to $600 per year for using the Personal Health Manager. GBP Wellness Benefits for State Employees 2009 State Worksite Wellness Conference

16. Your personal health information is always protected HIPAA ensures that your personal health information is always protected Personal health information will not be released to anyone (including your employer ) without your written consent. HRA results may not be used to discriminate against you when applying for health insurance or for another job if you leave state employment. HRA results are only used for outreach for Blue Care Connection® programs, which are designed to assist you with managing chronic conditions or helping participants achieve a healthy lifestyle. 2009 State Worksite Wellness Conference

17. Help us promote wellness participationStatewide participation rates are very low 2009 State Worksite Wellness Conference

18. Moving AGENCies into action:Resources to help you promote WELLNESS 2009 State Worksite Wellness Conference

19. NEW online at ERS.STATE.TX.US Now you can go to the ERS website to analyze HealthSelect data specific to 8 regions of the state Total number of active state employees and their dependents per region Regional Health Indicators Map 2009 State Worksite Wellness Conference

20. View the top conditions in your region Link to BCBS Wellness presentations about that condition Coming soon are participation rates in disease management programs for each region Regional Health Indicators Map 2009 State Worksite Wellness Conference

21. BlueResource materials 2009 State Worksite Wellness Conference

22. Click here:New HealthSelect Wellness Icon 2009 State Worksite Wellness Conference

23. New HealthSelect Wellness website 2009 State Worksite Wellness Conference

24. Resources for you and your employees Regional Health Indicator Map Shows you top chronic conditions for your region with links to… Wellness Presentations Aimed at Top 5 Chronic Conditions ready for you to use New HealthSelect Wellness Logofor you to add to your website that takes your employees directly to… Blue Care Connectionoffering a full suite of wellness and disease prevention programs 2009 State Worksite Wellness Conference

25. Thank Youwww.ers.state.tx.us 2009 State Worksite Wellness Conference