Cape Girardeau Public School District No. 63 November 1, 2010 Presented by:

1. Cape Girardeau Public School District No. 63 November 1, 2010 Presented by: David J. Johnson, CEBS, Senior Benefits Consultant CBIZ Benefits & Insurance Services, Inc.

2. CBIZ is: • One of the nation’s leading providers of outsourced business services • Offices in most major cities in the U.S. • 9th largest Accounting Firm • 13th largest Business Insurance Firm • 2nd largest Benefits Specialist in the U.S.

3. Cape Girardeau Public School District #63has contracted with CBIZ to provide: • Long Range Planning • Ongoing Consulting Activities • Plan Design and Rate Negotiations • Ongoing Administrative Services • Employee Communications • Benefits Technology • Health and Productivity Management • Legal and Regulatory Affairs

4. Cape Girardeau Public School District #63Annual Healthcare Premium Per Employee (includes retirees) *Hewitt Associates

5. Health Insurance Realities • The rates for a group of your size are determined by your claims or “loss ratio”. • Loss ratio is the percentage of premium dollars used to pay for claims. The loss ratio doesnot include the costs for administration, pooling, reserve adjustment or trend.

6. Sample Medical Plan RatingEffective January 1, 2011

7. What Research Tells Us • 15% of a plan’s members incur 85% of paid claims • 5% of a plan’s members incur 45% of paid claims • 85% of members use the plan sparingly Cape Girardeau Public School District #63 Claims History • Eighteen claims over $50,000 • Six claims over $100,000 • Those eighteen claims total $1,806,318 or 34% of all claims on less than 2% of membership

8. Large Claims

9. Current Plan (Effective January 1, 2010) *Out-of-pocket Includes Deductible. 9

10. Current Rates (Effective January 1, 2010) 10

11. Proposed Plan Changes Effective January 1, 2010 Base PPO Plan • Change Office Visit Copay from $30 to $30/$50 • Increase Rx Copays from $10/$30/$60 to $15/$40/$60 • Increase Deductible to $2,500 • Increase Out of Pocket to $5,000 • Change ER copay to $200 then 20% and Urgent Care to $75 Resulting Increase: +10.00% (Credit of – 9.79%) Buy-Up PPO Plan • Leave as Current Resulting increase: +19.79% QHDHCP • Increase Deductible to $3,000 Resulting Increase: +9%

12. Proposed Rates (Effective January 1, 2011) 12

13. Health Care Reform If preceding changes are made, the Cape Girardeau School District’s Health Plans will no longer be grandfathered for healthcare reform purposes. As such, the following changes will occur effective January 1, 2011: • Ban on pre-existing condition exclusions for children under age 19. (already receive credit for other coverage) • Dependent Age limit raised to 26 • Ban on lifetime or annual limits (already in place) • 100% coverage for preventive services • Ban on discrimination based on salary Please also note, the IRS has determined that the reporting of the cost of employer sponsored health plans on W-2’s will be voluntary in 2011.

14. Questions / Discussion Thank You!!