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Rappahannock Community Services Board Board Meeting

Detailed summary of Anthem projection increases, enrollment data, claimant analysis, demographic info, and plan recommendations for RACSB Board Meeting.

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Rappahannock Community Services Board Board Meeting

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  1. Rappahannock Community Services BoardBoard Meeting Matt Davis, SVP Heather Marr, Account Executive Jessica Loving, Account Manager McGriff Insurance Services

  2. Executive Summary Medical • Anthem is projecting an approximate 8.68% increase from the current expected funding rates and 30.18% increase from current funding rates • Anthem is proposing no change in cost to the Aggregate or Specific Stop Loss Insurance • Enrollment has increased 2.6% on a contract basis and 5.5% on a member basis • Current period had 2 claimants exceeded the specific stop loss for an excess claims discount of $166,699. • Prior period had 3 claimant exceeded the specific stop loss for an excess claims discount of $543,698 • Of the 533 members who filed claims for the current period, 314 (58.9%) utilized less than $1,000 in claims and 92 members did not have any claims filed. • Paid Claims by Relationship: • Employee/self: 79.4% • Spouse/partner: 5.6% • Child/other dependent: 15.0% • Demographic information: • Subscriber (employee) average age is 42.0, lower than Anthem’s benchmark of 44.7 • Member average age is 35.3, higher than Anthem’s benchmark of 34.8 • 69.7% of members are female, 30.3% male • Anthem has provided RACSB the option to migrate to their Essential Formulary; projected annual approximate 1.5% reduction in claims cost

  3. 2019 Plan Recommendations Medical • Product changes to migrate closer to benchmark • Funding at expected vs. below expected • Changing Specific Stop Loss to 125,000 vs. 80,000 • Maintain a flat rate for employees on the base program • Migrate to the Essential Formulary

  4. 2018 Benchmark: Medical Plans – All Plans Combined

  5. Current Medical Benefits

  6. Recommended Benefit Changes

  7. Reinsurance Changes RACSB would have to incur 6 claims over the 125K spec to offset the savings for the change in Reinsurance amount.

  8. Recommended Funding

  9. Bringing Rates to Expected • Current funding being below expected • Claims increased early in 2018 -19 • Projected to exhaust surplus at the end of current plan year • Recommend to increase funding to ‘Expected Liability’ at renewal and consider funding between current and ‘Expected Liability’ • Reviewing employee tier options and contribution strategies.

  10. Contribution Strategy

  11. In Conclusion Recommended changes for Medical include: • Implementing to the new benefit platform including the following plans • HK POS 30 1000/20%/4500 • HK POS 25 500/20%/4000 • HK POS 15/20%/3500 • KC Plus 15/20%/3500 • Benefit changes include moving to the Essential Formulary • Increase the Specific Stop Loss to $125K from $80K. • Increasing the funding to Anthem’s projected Expected Liability. Questions!

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