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COMMITTEE REPORTS

CLASSIFIED EMPLOYEE PERSONNEL ADVISORY COMMITTEE

BENEFITS COMMITTEE REPORTS
IUBC Reports Offered Here (in italics)

(for years prior to FY05, please see Staff Senate meeting Minutes)

Your CEPAC-nominated representatives on this committee:
Ron Brekke rbrekke@montana.edu Shari Curtis sharon.curtis1@montana.edu and Carol Shannon

From Staff Senate Minutes, 9/24/08 - Ron Brekke reported that the Well Award sign up (for the possibility of receiving $100 for wellness activity) closes September 30th. Ron will follow up on Staff Senate's concerns, today, that health-oriented activities as described by Well Award but not conducted through the Wellness Program, don't qualify for credit towards the $100. Deb Harrison was asked about Wellness participation for remote staff, and she confirmed that the program provides Well Check events etc at remote locations.

Ron reported on the $1500 dental maximum, which some staff members had raised as being adequate. Ron had consulted the chair of MSU's benefits committee as well as the director of benefits for the Office of the Commissioner of Higher Education. No plans currently exist to alter the benefit for reasons including: any increase in coverage must be funded by increased premiums. Only 4% of people covered by the MUS dental plan exceeded or hit the $1500 maximum last year. There is currently no deductible applied to the MUS dental insurance policy. Ron said that the Benefits Department would be happy to present further information to Staff Senate/MSU (it was mentioned at today's Senate meeting, that Faculty Senate are looking into arranging something like this).

Ron also mentioned that IUBC meets October 2-3.

September 4, 2008
Attending: Young, Johnston, Brekke, Crow, Shannon, Coffey, Haynes, Wheeler, Hapner, Alt, Spinelli, McKenzie, Mathre

Sherry Todd is leaving MSU and a replacement is needed. Doug will contact Sara France. Fall schedule was reviewed (see last item below).
Ken Hapner reviewed WalMart’s drug program, which offers certain drugs for $4 for 30 days and $10 for 90 days. A doctor’s prescription is required, even for non-prescription drugs. Prescription dosages may differ from WalMart offer, eg doctor says 20 mg and WalMart offers 10 mg. Avenues for informing our members (on this and other drug pricing issues) were discussed. Jerry Coffey will bring in a Consumer Reports article on buying drugs.
Barb Wheeler discussed the Well Awards program for active employees and their spouses. The most important thing for people to do at this time is to register at www.montana.edu/wellness. with a deadline of Sept. 30th. WellAwards allows participants to receive $100 by earning 15 credits for participating in health-related activities between May 1, 2008 and April 30, 2009.
The first, new combined Wellness/Choices newsletter is at the printer and will be mailed home. It will be printed 4 times per year. Topics will be determined by questions from the members. Members expressed continuing concern at the loss of Choices.
Several additional (>65) retirees have dropped MUS insurance, either at reenrollment or later. There seem to be several reasons, including migration to a spouse’s plan. The committee would like to know to what extent cost is the issue. Also, do retirees consider more than the premium cost, eg the deductibles and the richness of the benefits? Is the plan simply too expensive for some, leaving them exposed to all expenses not covered by Medicare? Could a follow-up questionnaire for those dropping shed light on these issues?
The committee reviewed the information with regard to replacing the Pharmacy Benefit Manager (PBM) with a self administrated program—Pharmacy Benefit Administrator (PBA). This would be a huge undertaking which would include—employing some in-house staff, contracting for products and services, incorporating a culture of education/health/prevention, building consumerism into all components, involving the pharmacy school at UM , purchasing a formulary.
Several members will be attending the IUBC (Inter-Units Benefit Committee) meeting in Helena from October 2-3.
The committee will meet again in 272 SUB at 8 AM: Oct. 9, Nov. 13, Dec. 4

(At Staff Senate, August 20th) Ron Brekke reported that enrollment details and full information about the Well Award program have been mailed - sign up during September. Ron also invited input to take to the MSU Benefits Committee meeting, September 4, and to Inter Units Benefits Committee on October 2. Ron was reminded of outreach feedback that the $1500 annual maximum benefit on the premium dental plan was found to be insufficient by some employees.

July 23, 2008 (at Staff Senate meeting) Ron Brekke spoke about the WellAward program in which participants (faculty, staff, and spouses) can earn $100 for participating in health-related activities. Details will be circulated in September.

Also HR/Personnel & Payroll's recent announcement of the Benefits Calculator was discussed, and the feature applauded. The concept originated with Staff Senate at a Board of Regents meeting in 2006 and Staff Senate is delighted to see it come to fruition.

May 21, 2008 the Montana Chamber of Commerce sponsored a 2-hour Wellness Program presentation for Montana businesses. The presentation was provided by David Hunnicutt, PhD, the President of WELCOA (Wellness Council of America). WELCOA’s membership includes over 2,500 companies and over 700 Well Workplaces. Dr. Hunnicutt is widely recognized as a national wellness advocate, consulting with hundreds of organizations each year

Wellness is: Process of being aware of and actively working towards better health.
Wellness Programs are something we do for people, not to them.
Unhealthy lifestyles—People value their health more when they start to loose it. Pharmaceutical solutions offer assistance but sometimes have side effects.
Healthy Lifestyle---
- Walking 30 to 35 minutes every day can insure a longer and healthier lifestyle by 10 to 12 years
- Eat 100 fewer calories per day than you are currently eating
- Four Major Points
- Health Care is Expensive—We spend more on health care than any other industrialized nation.
- The situation will get worse unless something is done
- Many current health problems can be prevented—80% of citizens are sedentary. More physical activity increases heath but you should start slowly if haven’t been active.
- Well-Designed Worksite Wellness Programs Save Money—Cost/benefit analysis from 10 studies showed that there was $3.93 savings for each $1.00 invested.

May 1, 2008
Attending: Young, Johnston, Brekke, Marx, Crow, Todd, Shannon, Coffey, Haynes, Wheeler (brought the Bagels!),

The 3-year terms of Debbie Haynes and Doug Young as faculty representatives on the MSU Benefits Committee are expiring. Both are interested in continuing. In addition, Rachel Rockafellow is interested. Doug forwarded all three names to Faculty Senate, which is responsible for sending a slate of candidates to the President for selection. Update: Faculty Senate forwarded all three names to the President.
Carol Shannon has been reappointed to a new 3-year term. Welcome back, Carol.
Reenrollment for FY09 health and other benefits is proceeding. Some members find the on-line process cumbersome. Ideally: Should be as easy as buying a camcorder on Amazon.com. Reality:
1. Difficulty finding initially.
2. Difficulty navigating – sometimes circular.
3. Some links are very small at the bottom of the page.
4. After choosing a new plan (eg switch from New West to Allegiance A), user must still separately go through and remove each dependent from the old plan.
5. Dates on flex plan are incorrect. Some of these issues seem to be dictated by Banner (eg dates). But it isn’t apparent why the user has to be exposed to Banner’s anomalies. Amazon has very complex software operations occurring in the background, but the customer isn’t exposed to them. HR/PP personnel have conducted numerous help sessions to deal with these problems. Some members of the benefits committee suggested that the Chair contact the relevant folk in ITC.
Paul Bogumill has suggested a review of the structure of our pharmacy offerings, with the aim of encouraging people to use the least cost drugs and sources. The issue arose this year with Proton Pump Inhibitors such as Nexium and Prevacid, and will arise as other drugs go off patent or generic “equivalents” come on the market (ala Prilosec OTC). Deb Haynes reminded the committee that financially strapped people may fail to take appropriate drugs and/or dosages, with cost consequences for the plan at a later date. A “carrot” approach may be more effective than “sticks” in getting people to get their meds in a cost-effective manner. The following people agreed to meet over the summer to look at this issue: Young, Haynes, Wheeler, Brekke, Coffey. They may begin with a conference call with Paul Bogumill.
The committee suggested that several issues will be important next year, many of which involve Communication with Members:
1. The Choices Newsletter has been an effective way to communicate complex information. The committee remains concerned that the Newsletter has been interrupted.
2. Wellness will begin its Well Awards program in September. Members (and spouses) can earn up to $100 by certifying various behaviors, including exercise, blood draw, etc.
3. A survey of members regarding problems/complaints/satisfaction may provide useful information. A blog could be established and/or a Frequently Asked Questions site. Existing members could be encouraged to attend New Employee orientations (even if long-standing employees), because health and other benefit options are extensively discussed.
4. Will SPDs on the web be accurate July 1? For what period? Will managed care SPDs change Jan 1? Can the web site clearly indicate the applicable period for the SPDs that are posted? Also, SPDs are sometimes unreadable if they span across two pages (as the workbook does), but only one page will fit on the screen.
5. There is little or no information on the web regarding retirement plans. RFPs are overdue, and MUS could provide comparative info on expense ratios, as well as discussions of investment issues, eg diversification.
The committee tentatively scheduled its first meeting of the fall for Sep 4.

April 11, 2008 The pod cast for CHOICES 2008/09 is up and running at http://www.mus.edu/choices/

April 3, 2008
Attending: Young, Johnston, Brekke, Alt, Marx, Tanner, Shannon, Hapner, Mathre, Coffey, Haynes, Wheeler

Ken Hapner introduced the Medicare Advantage plan to be tried on a pilot basis in Missoula and Billings this fall. (Bozeman retirees are not eligible this year.)
1. The new plan offers premium savings estimated to be $116-135 per month to retirees on Medicare, because of a subsidy from the federal government.
2. The new plan shifts GASB liability away from MUS.
3. Caution: The drug formulary is somewhat different (required by Medicare), so it’s important for retirees to check whether it suits their needs.
4. The pilot is optional and participants may switch back to normal MUS health plans the following year.
5. The new plan has the potential to save MUS money as well, because retiree costs > premiums (no state contribution).
6. However, MUS must watch for “adverse selection” – if relatively healthy members leave for Medicare Advantage, while relatively unhealthy (and thus expensive) members stay with MUS.
The MUS letter to current users of Proton Pump Inhibitors was distributed. Prilosec OTC and Omeprazole will be available over the counter. Other PPIs (Nexium, Aciphex, etc.) will be available from retail pharmacy, but not from mail order. These other PPIs are “chemically equivalent,” but some users report differences in effectiveness or side effects.
1. Costs will increase substantially for people who use retail pharmacy.
2. Costs will increase even for people who use the over the counter drugs, but these costs can be mitigated through the use of the flex plan.
3. Costs are expected to decrease substantially for the plan.
Alternate IDs: Several committee members urged everyone to use alternate ID numbers (rather than social security numbers) for their medical plans. Alternate ID numbers can be requested on a HR/PP form available at: http://www.montana.edu/wwwpn/HealthBenefits/Alternate%20ID%20Form.pdf
On Friday, Apr 4 at 3PM in 276 EPS, Paul Bogumill will record his Choices talk for podcast. Committee members are encouraged to attend.
Points for Doug to cover in his Choices talks Monday April 7 at 10 and 11:30 in 276 SUB.
1. Self-insured
2. Reserves => Rates
3. PPIs
4. Blood lab via Wellness
5. Flex advantage with example
6. Reenrollment: Active-Online only; Retiree-Paper only
7. Alternate ID procedure
8. Contacts for Complaints, Clarification and Cuss words: MSU Benefits Committee members (list), HR/PP, COHE
The Choices newsletter has been abruptly suspended. The MSU committee expressed strong support for Choices, saying that it is widely read by faculty, staff and especially retirees. It plays an important role in providing information to our members on benefits issues, including the health plans and retirement. The committee would like to see the problems resolved so that Choices can be continued.
The MSU Benefits committee will meet May 1 in 274 SUB.

February 28 & 29, 2008 IUBC met in Helena. Please see additional handout from MSU Benefits Committee meeting.

The InterUnits Benefits Committee (IUBC) made final decisions on plan changes and premium rates for the upcoming plan year (FY 09). The hard decisions and major decisions we made last year to our indemnity plans and the adoption of our new vision and dental plans have had their desired effects. Claims costs so far this year have been reduced due to the plan changes and a significant number of our members switching to our more cost efficient managed care plans.
There was some extensive analysis conducted which indicate that our reserve funds are becoming more than was needed to pay claims already incurred and to provide a adequate cushion for inevitable claims fluctuations that always occur. As a result the IUBC made the decision to spend-down these excess reserves by lowering premiums for this coming plan year (FY 09). The rates for Actives will be reduced an average of 7% with a range of +2% to a -11% in the various categories (Employee only, Employee + spouse, etc). Retiree rates will remain the same overall for the next year with adjustments of +1% to a -2% in these various categories. The premiums for the vision and the dental plans will remain basically the same for all members for FY 09. It must be noted and remembered that these reductions are likely a one-time only occurrence due to the extra work, diligence and continuous monitoring by our benefits team in Helena. Medical inflation will continue and members should anticipate at least modest increases in future years.
Unlike last year, the plan changes for next year consist of minor changes rather than major restructurings. More complete details will be offered in the next Choices Newsletter which should be available before the enrollment begins on April 21st. Both Actives and Retirees will also be receiving an Enrollment Workbook that will outline the complete rates for next year and the various plan choices.
Our pharmacy provider (CVS/Caremark) will be making available to our members an ExtraCare Health card which will provide an opportunity to reduce health care costs and improve employee health. Card holders will receive a 20 percent discount on regular, non-sale priced CVS/pharmacy brand health-related items at CVS pharmacies nationwide. There are currently 8 CVS stores in Montana, with plans to nearly double that amount over the next couple years. Specifically important to our MUS plan, the ExtraCare Card provides an opportunity to assist in reducing drug expenses by increasing access to over-the-counter (OTC) products. Card-holders can utilize the card for more than 1,300 eligible health-related CVS/pharmacy and exclusive brand products. More information will be made available when this ExtraCare Health card becomes available.
A pilot WellAwards Program was initiated for three months (September to November 2007) at Flathead Valley Community College. It provided cash incentives to encourage healthy activities and life styles. A participant earned credits by completing various activities. These activities included---Chemistry screen, blood pressure check, teeth cleaning, eye exam, bone density exam, weight management, strength training, aerobic exercise, flexibility exercise and many others. A participant earned one credit for each activity. At the completion of the program each participant who had earned 5 credits received $50.00. This WellAwards Program will be introduced and implemented on other campuses this fall. It will be for 8 months and more credits will be required to complete the program but the cash incentive will be $100.00.
Schedule for 2008 CHOICES Meetings in Bozeman on April 14th
- Retirees---8:30 at Wingate Inn, 2305 Cantron St
- Actives---11:30 in Reid 101
- Actives--- 1:30 in Reid 105
The Chairman of our campus benefits committee (Douglas Young Phd Professor of Economics) will also be providing information for the CHOICES benefits (2008 to 2009) on April 7th at 10-11 and 11:30-12:30 in SUB 276
Items of interest
1. Blood chemistry screenings which are provided at WellCheck or the Wellness program are submitted to a lab which provides results that are as acceptable and as good quality as any lab your physician may recommend. Your doctor should be able to review and utilize these lab tests without requiring similar screenings from his/her recommended lab.
2. In 1977 the Montana University System (MUS) received $30.00 per month for each employee from the state, which was equivalent to an average of 2% of an employee’s wages. For 2007-2008 the monthly employer contribution is $590.00 for each employee which is equivalent to about 20% of an employee’s wages.

*Paragraphs A & B have been obtained from a report Jerry Coffey provided to the Benefits Committee on March 6th.

February 14, 2008

Retirement: Ken Hapner introduced us to three educational references at various websites which would be helpful for all employees to read and, as appropriate, initiate action to benefit their retirement years.
1. Shopping for a Long-Term Care Policy, Tom Lauricella, Feb 3, 2008, Wall Street Journal, http://online.wsj.com/article/SB120200860508738543.html
2. Long Term Care Insurance, AARP: http://www.aarp.org/money/financial_planning/sessionfive/longterm_care_insurance.html
3. How Will You Pay for Old Age? Consumer Reports, pages 35-50, October, 1997.
EAP (Employee Assistance Program) The university will be contracting with a new EAP Provider
We reviewed the IUBC (Inter Units Benefit Committee) agenda which will be presented and discussed February 28th to 29th in Helena. About 5 to 6 members from MSU will be attending. A more detailed report will be provided after the meeting. Some of the items to be discussed include:
1. Financials
2. MUS Risk Management
3. Rx plan changes
4. Dental plan changes
5. Medical plan changes and prevention coverage
6. Vision plan update
7. WellAwards pilot outcome
8. Rates and Reserves
9. Year in review

Plan Change Sub Committee meeting February 7, 2008 This report is a brief explanation of the items discussed at the meeting

Delta Dental
1. The plan is breaking even (for claims under the new plan design) as of now, so the plan will continue as is and see how it develops. The “run in” dental claims expense (claims with dates of service prior to July 1 but paid this benefit year) are large – which was expected.
2. Utilization of our dental plan is as expected and normal. There have been very few complaints. Delta Dental has been working with us very well.
3. It is possible to look at different categories (preventative, restoration, diagnostic etc) and review planned vs actual expenses.
Pharmacy
1. Pharmacy expenses have been increasing and the trend in the industry is for members to pay more of the cost. The MUS goal is to have 75%/25% (benefit plan pays 75%/member pays 25%). The most recent 12-month period has about 78%/22%.
  1. Various scenarios being considered: are increasing the copays (example $10/$20/$30 to $10/$25/$40) and/or increasing the retail Pharmacy deductible (from $200 per family/year to $300 per family/year) and /or increasing the benefit year out-of-pocket maximum (from $800/$1,600 to $1,200/$2,400). These changes would have members paying 23% to 27%.
  2. There are also plans being developed to inform, promote and encourage members to purchase OTC (Over the Counter) medications whenever possible. Zyrtec is one example of medication now being offered OTC.
  3. There will also be a program to review certain medications which may be over-utilized—sleep aids, heartburn
2. A lot of effort and time has been put forth over the past year reviewing the pharmacy plan design and negotiating with PBMs (Pharmacy Benefit Manager). It was discovered that some significant rebates from the pharmacy companies had not been paid to the MUS benefits program per contract agreements.
EAP (Employee Assistance Program) /Wellness
1. We are in the process of choosing a new EAP Provider.
2. The EAP program is currently underutilized by employees
3. The new EAP program will offer more online tools and training in addition to legal and financial advice.
4. A spring tour by members of the Benefits team will be promoting and informing employees of EAP services.
WellAward Program
1. This is a healthy lifestyle and disease prevention program for insured faculty, staff and their insured spouses. Flathead valley Community College was selected to participate in the WellAwards Pilot Program.
2. This is an incentive-based wellness program linked to a $50 cash reward through achievement of wellness criteria, which is based upon earning credits. Various program categories and Wellness activities earn 1 or more credits. A minimum of 5 credits must be earned. More information will be provided as this WellAward Program is expanded.
Federal GASB regulations This was presented and discussed at the MSU January 17th benefits meeting and was included in that monthly report.
Final Preventative Benefit Language
1. A summary of the preventative benefits available (for MUS 2008-2009) in Traditional, Managed Care In Network and Out of Network were listed. This summary is similar to the list which was in a previous report from the Plan Change committee meeting on December 3, 2007. There was a request that the ‘Preventative Medical Exam” paragraph provide a more detailed explanation of the procedures and tests which are included in this exam. A list of suggested procedures and tests for the “Preventative Medical Exam” was included in the original Preventative Services recommendations.
2. The template for helping to develop the Preventative Benefits was provided by the benefits team from the MSU campus.
FLEX Plan Beginning July 1, 2008 the administration fee will be zero cost to the participant.

The IUBC (Inter University Benefits Committee) meeting will be held February 28 & 29 in Helena. The above items will be presented and discussed.

January 17, 2008
As an introduction to the Benefits committee meeting here are some comments of an email from Paul Bogumill (Director of Benefits):

We are looking at eliminating the employee’s admin fee for flex accounts – to better promote the use of this benefit. We will focus some upcoming newsletters and presentation on how best to use these accounts.
The Pharmacy (Prescription Drugs Program) benefit needs a lot of attention – a very high trend. To fix it we are trying to get better unit costs from the PBM (Pharmacy Benefits Manager) and we need to evaluate the member share on RX . The member share component is very important for you folks to understand – presently we have fallen into an 80 / 20, meaning at the end of the day the plan is paying 80% of the total rx spend and the members 20%. Our “goal” is to maintain at least a 75% / 25% split – so we will be making rx plan design changes to support this shift – thus copays and deductibles will be going up.
Also – with in the RX plan changes we are looking to introduce a program on PPI meds that will read as follows…….
As many of you may already know, once a drug becomes available to purchase over-the-counter, it can no longer be claimed under the prescription drug plan. Recently the medication Prilosec (and it’s generic Omeprazole), which is a Proton Pump Inhibitor, became available without a doctor’s prescription.
There are other Proton Pump Inhibitor medications that are prescribed by doctors such as Aciphex, Nexium, Prevacid, and Protonix. These prescription drugs are still a benefit under the State’s prescription drug program as long as they are filled at a retail pharmacy. Because of the availability of an over-the-counter alternative and other cost considerations, these drugs will not be available through the mail order facilities.

There were a couple questions from the meeting regarding the Prescriptions Drugs Program which Paul answered via email:

If the admin fee for the flex accounts is eliminated then where will the money come from to pay the admin fee?-----From the forfeited money
Has an RFP (for Prescription Drug Program) been issued? Yes-responses have been evaluated and currently the final contract negotiations on the new contract are in progress. This is being done through the purchasing association of the large employers as one group, which allows for better pricing.
When will the new Prescription Drug Program be implemented? July 1, 2008 and it will be seamless to the members for the most part.

Benefits Committee Meeting Notes

Benefits Committee membership: Ken Hapner brought it to our attention that there were two (slightly different) lists of members--Benefits Committee list and OPA (Office Planning and Analysis) list of members. He will develop one correct list. There is one vacancy for a classified rep. Previous Chair of the Benefits Committee will be added as an ex-officio member.
Plan Change Committee: Ron Brekke reported…..As mentioned above the Prescription Drug Program has a goal of 75%/25% pay plan. Since this is not being met there is a proposal to increase the co-pays and deductibles for retail and mail order, to be similar to the state’s plan. This includes the following brief example:

Type of Drug	Local Pharmacy Costs	Mail Order Pharmacy Costs
	You Pay / Current / Proposed	You Pay / Current / Proposed
Generic	The greater of $10 or 20% / 20% with $10 minimum	$20 / $20
Brand formulary	Thegreater of $20 or 30% / 30% with $25 minimum	$40 / $50
Brand non-formulary	The greater of $30 or 40% / 40% with $40 minimum	$60 / $80

3. Eyemed has increased the out-of-network benefits for members living more than 50 miles from a network provider.

4. Wellness Subcommittee: Barb Wheeler reported

A RFP has been issued for our EAP (Employee Assistance Program) and Wellness services.
EAP includes issues related to life and work, legal and financial counseling, short term mental health counseling. Employees are encouraged to utilize this assistance program as the services can be very helpful and beneficial. Favorable comments have been made regarding these services.

5. Retiree Task Force: Ken Hapner reported….

Federal GASB (Government Accounting Standards Board) may require accountability for all unfunded liabilities within our Health Plan. This could result in large increases in premiums for the retirees and Medicare eligible active employees in order to cover unfunded liabilities). An insured product such as an MA (Medical Advantage) plan for these members would remove the unfunded liability…hence the request to New West to propose a MA plan to address this issue.
403b Plan Modifications Federal guidelines require upgraded regulations and oversight of 403b tax-deferred savings plan by January 1, 2009. The various 403b plans within the MUS system need to be refined and standardized within a single “umbrella” plan document.

Plan Change Committee meeting Dec 3, 2007
This report is a brief explanation of the items discussed at the meeting.

A. The IUBC (Inter University Benefits Committee) is reviewing vendors for our MUS (Montana University System) RX (Prescription Drugs) program. The present contract has been in place for 7 years, and in accordance with Montana law a new bid process must be completed. This bid process “forces” us to research the present market to be sure we are getting the best deal available. Our present PBM has been absorbed by CareMark – and CareMark is one of the companies being considered. As the incumbent, we are looking at RX plan changes as we would do any year. They gave a presentation which included the following information and services they could provide:
1. A confidential personal health record that can be accessed by designated advisors.
2. Specific advice from their pharmacist about their medications and health plan
3. Access to lifestyle and biometric screening and the tools (blood pressure monitors, pedometers, diabetic testing equipment , etc.) to monitor and maintain health.
4. Company Profile: 6,200 retail and specialty stores, 170,000 employees including 20,000 pharmacists, 16% share of U.S. retail prescriptions, 8 pharmacies in Montana
5. A team contact list for the MUS account
6. A Plan Design Summary which basically listed the current MUS program One item which was briefly discussed—Out of Pocket max (retail only): $800 individual $1,600 family. It appears that when this max is reached then the member may not be as cost conscious when purchasing the prescription drugs since he/she will not be incurring any expenses on future purchases. The state has a max of $1,400 individual $2,800 family.
7. Programs to inform and encourage members to buy generic and order by mail
8. An analysis of MUS prescription expenses included the following data from January 1, 2007 to September 30, 2007
  1. Total net cost paid by plan--$11, 527,719 up about 14% (taking into account an increase in membership) This is a SIGNIFICANT increase and steps need to be taken to reduce these expenses.
  2. Total member cost--$3,341645 which is 22.5% of total net cost
  3. Generic substitution rate—93.5%
SPD Review
There were various paragraphs within the benefits booklet which were reviewed as to whether words should be deleted or remain the same. These subjects included: Pre-existing conditions, Continuation of Coverage, Retiree coverage eligibility, Open enrollment
Preventative Schedule of Benefits
A spreadsheet displaying preventative benefits for Traditional and Managed Care plans was presented. A brief summary is listed below.
1. Traditional Plan
  Preventative services, Adult Exams and Tests Mammogram, gynecologic exam, Pap test, clinical breast exam, preventative medical visit (includes physical exam, personal and family history, urinalysis, screening for high risk behaviors and obesity), bone density, sigmoidoscopy, colonoscopy, blood analysis.
  - Immunizations and pneumonia and flu shots EXCLUDES immunizations recommended due to types of employment or travel (ie. Malaria, yellow fever etc)
  - Child checkups through age 7
  - Physical exam visits are covered at the following approximate ages:
  - *Newborn who did not receive exam in hospital or birthing facility or was discharged in less than 36 hours
  - *1, 2, 4, 6, 9, 12, 15, 18, 24 months
  - *One per year thereafter through the 7th year
2. MC (Managed Care) in Network
  1. Mammogram-age 40+ one/year (no deductible, no coinsurance), Ages 35-39 one baseline mammogram (no deductible no coinsurance)
  2. Gynecolocic exam and pap test one/year (included in office co-pay)
  3. Preventative Medical Visit age 8-39 one every two years $15 co-pay, age 40+ one/yr $15 co-pay
  4. PSA test for males (included in office visit co-pay)
  5. Bone density screen once every 5 years for females age 60+ an males age 70+ subject to deductible and 25% coinsurance)
  6. Blood analysis (included in office visit co-pay)
  7. Stool occult blood colorectal screening ages 40+ (include in office visit co-pay)
  8. Flexible sigmoidoscopy and double contrast barium enema every five years for members age 50+ (subject to deductible and 25% coinsurance)
  9. Colonoscopy once every ten years age 50+ (subject to deductible and 25% coinsurance)
  10. Immunizations and pneumonia and flu shots $15/visit without office visit 25% coinsurance (no deductible)
  11. Child checkups through age 7 (same schedule as proposed for traditional) $15 co-pay per visit
3. Proposed Plan (Developed by MSU Benefits Committee)
  1. Mammogram one/year for female members age 40+ (no deductible, no coinsurance)
  2. Gynecologic exam, pap test, clinical breast exam one/yr for female members age 19+ ( no deductible, no coinsurance)
  3. #Preventative Medical visit-one visit every 2 years for age 19+ (no deductible: $15 copay) #See note below
  4. Bone density (DEXA) screen once every 5 years for females age 60+ and males 65+ (deductible and coinsurance apply)
  5. Ultrasound heel scan for bone density every 5 years for members+ (Obtain from MUS Wellness at Wellcheck, $10 copay)
  6. Blood analysis (Obtain from MUS Wellness-chemistry screen with lipid analysis $20 copay; complete blood count $16 copay; for male members PSA screening
  7. Stool occult blood screening-once per year age 50+ ( obtain free from MUS Wellness)
  8. Flexible sigmoidoscopy every 5 years OR
  9. Colonoscopy every 10 years for members age 50+ (deductible and coinsurance apply)
  10. Children 0-7: Included in office visit copayment. If no office visit, subject to coinsurance up to a $10 max (no deductible).
    - 8-18: No deductible up to max. Max=$250/yr
    - 19+: $75/yr
  Comments: Most of the Proposed Plan items are being offered in the MC and Traditional or offered at Wellness Check (items e, f, g, h). Some of the preventative services in Traditional and MC could have a more thorough explanation. The bone density (DEXA) is not included in Traditional or MC as presented in the Proposed Plan but it may be covered under Medicare?
  An item under further consideration and to be discussed at next plan change committee meeting is a baseline medical visit within 1 year of employment by MUS for persons 19+ including adult dependents. Visit will include physical exam, personal and family history, urinalysis and screening for high risk behaviors and obesity. No deductible; $15 copay Obtain blood analysis from MUS Wellness in advance.
4. Vision Plan update—Enhanced Out of Network benefits
  Since the Eyemed vision network has not been able to sign-up providers in all areas then it has enhanced some out-of-network allowances if there are no in-network providers within 50 miles. This includes:
  1. a. Exam with dilation as necessary-up to $85 instead of $45
  2. Frames: $100 instead of $47
    An additional benefit--Providers out of the network are being more flexible and offering lower prices to our members to compete against Eyemed.
November 9, 2007 Present: Barb Wheeler, Sherry Garner, Lisa Crow, Ron Brekke, Jim Mitchell, Susan Alt, Kathy Tanner, Jerry Coffey, Bob Johnston, Don Mathre, Doug Young
Doug passed on Paul Bogumill’s comments on SPD issues:
The law specifies that major changes have to be up within 30 days and minor changes within 90 days. Most of our changes are regarded as minor - hence the 90 day window.
The managed care plans are a group purchase with the other members of MAHCP - something that I didn't know - and they have various starting dates. The State begins Jan 1 I believe.
General policy has been: If a change is an improvement for employee, implement Jan 1 and advertise July 1. If a change is not better, implement (and advertise) July 1.
The issue of New West not having the up to date spd's has arisen before and "they are working on it." (My quotes - not Paul's) Other managed care providers have specialty teams for MUS, but New West doesn't. MUS continues to address this issue with New West.
Committee members noted an additional problem: The plan documents are extremely hard to read, because they read across two pages on the paper copies, but the pdf’s on the web don’t line up that way.
Ron Brekke stated that he will attend a meeting of the Plan Change Subcommittee of IUBC in a few weeks. The Preventive proposal developed at MSU last summer and presented at IUBC this fall is not on the agenda of the email he received.
Committee members have heard numerous complaints about Delta Dental’s claims processing, including denying claims. Approximately 20 complaints have been forwarded to the Commissioner’s office.
One committee member expressed concern about the continued use of social security numbers for insurance identification. MSU was able to make an alternative numbering system work for students across diverse computing environments.
Jerry Coffey will present pre-retirement workshops November 9 at 12 and 4 in Ballroom D.
Anyone considering rolling over a 403(b) should be extremely cautious as the tax situation is unclear.
Don Mathre offered an article from Business Week describing employer policies to adjust insurance premiums based on risk factors such as cholesterol, BMI, and/or Blood Pressure. http://www.businessweek.com/magazine/content/07_45/b4057083.htm Discussion suggested that positive incentives (lower premiums for low risk) meet less employee resistance than negative incentives (higher premiums for high risk). Positive incentives may be more likely to be legal. Incentives must be targeted at risk factors that people can control – or at least influence – through their behavior, in order to have a positive incentive effect. Other considerations are the costs and benefits to the plan, as opposed to costs and benefits to Medicare. Also, human costs and benefits as opposed to strictly financial costs to insurance plans, and costs to employers and employees of ill health through lost productivity.
October 3-5, 2007 IUBC Retreat:
MSU attendees: Ron Brekke, Ken Hapner, Jerry Coffey, Barb Wheeler, and Doug Young
This is a summary of the IUBC topics which were presented and discussed at the annual 3-day retreat.
1. Financial Report
  1. For all medical and dental plans combined, revenues exceeded expenses by 1.2% for FY 2007. IN FY 2006, the excess of revenue over expenses was 8.6%.
  2. The dental plan experienced a deficit while the medical plan experienced a positive cash flow.
  3. Actives have a current Funding Loss Ratio of 93.0% while the retirees are running at 137.4%.
  4. Pharmacy expenses have increased significantly……8.2% when 06/07 Medicare Part 2 subsides are taken into account. Without these subsides the trend would be 16.5%
  If current expense growth continues, then an adverse financial situation will result. With projected funding increases of 6% and projected expense increases of 10% medical & 13% Rx, then expenses will exceed revenue. There were several detailed and historical charts showing and comparing medical categories and plans.
2. MUS (Montana University System) Account Report
  1. There were charts which showed the number of members (percentage) by age group in each plan for two years. It was noted that members were moving into the managed care plans.
  2. The claims (policies) which have been filed were separated into the following categories: Medical: 70%
    Pharmacy: 20%
    Dental: 10%
3. Balance Sheet
  This report is ‘snapshot’ once a week comparing total assets to liabilities. An industry standard is 3-6 months of assets greater than liabilities. The MUS group insurance figure is about 5.4 months, down from 5.7 months a year ago.
4. CDHP Consumer Driven Health Plan
  These type plans consist of:
  1. HSA (Health Saving Account) which have tax advantages and can be used to help pay health expenses.
  2. High deductibles with the insurer paying expenses up to an amount of the deductibles and then the health insurer starts to contribute.
  A survey letter was sent to 3,500 MUS employees with 20% responding. The survey asked several questions regarding CDHP and an individual’s involvement in his/her financial decisions. The initial results indicated that there was some interest in these types of health plans.
5. Preventative Benefits
  This report has been previously presented.
6. Diabetes Management Program
  This presentation included the following information:
  1. In 2004 diabetes was the 6th leading cause of death
  2. People with diabetes are at increased risk for Hypertension, heart disease, heart attack, congestive heart failure, amputation of lower limbs.
  3. Type II diabetes is an acquired life –long disease marked by high levels of sugar in the blood.
  4. Obesity is the most powerful predictor of who will have Type II
  5. Treatment includes: dietary modification, drug therapy, Increased physical, weigh loss
  A pilot program of 69 participants showed improvements, relating to diabetic complications, moving from extreme risk level to high or moderate levels. In addition to living a healthier life these reduced risk levels also decrease medical costs.
7. Vision Plan
  This presentation was from our EyeMed provider
  1. Benefits of an eye exam can help identify: diabetes, hypertension, multiple sclerosis
  2. An explanation of the MUS vision was provided
  3. EyeMed has been finding it challenging to develop their network, so there have been some changes due to Montana’s rural environment. This includes a higher out-of-network allowance for some services and material in rural areas. Out of network benefits may be increased in urban areas next plan year – under discussion.
8. Pharmacy
  The pharmacy expenses of the MUS insurance plan have been increasing significantly. The pricing of the prescriptions drugs is sometimes rather complicated. An audit was conducted which revealed that the MUS insurance plan had not received $500,,000 in rebates per our contract. Another audit discovered that we were receiving a 55% discount vs 62% per the contract. The Benefits department will continue to conduct their own audits to discover any discrepancies regarding pricing and how rebate checks are calculated. Consultants have been retained to assist in writing a new pharmacy RFP that will include third party audits and other improvements.
9. Allegiance
  1. Allegiance has a pilot program utilizing Comprehensive Enrollment Wizard (CEW) which allows members to access their benefits online.
  2. Allegiance also showed several charts relating to the level of service they were providing our members and how they had met or exceeding those targets. Standards for service provision are a new feature of the current contract.
10. Dental
  This presentation was given by Delta Dental representatives
  1. Features and highlights of the Premium and Basic Plan
  2. Online service with www.WeKeeepYouSmiling.com/MUS This website allows an enrollee to view benefits, eligibility, claim status and dental health information. It also includes a dental fee finder which shows the customary cost for a procedure by zip code and a directory of providers.
11. Working Families Tax Relief Act (WFTRA)
  Employees of the Montana University system who are enrolled in our health insurance will receive an explanation (and form) of the new tax regulations regarding payroll health insurance deductions. Some people who are eligible dependents from the perspective of our plan are not dependents from the perspective of the IRS. Therefore, premiums for those dependents must be taken out on an after tax basis.
12. Next Steps
  Various task forces and subcommittees of the IUBC will meet this fall and winter to work on a number of issues:
  WFTRA
  Pension Admin
  Wellness
  403(b) RFP
  Pharmacy RFP
  The full IUBC will meet again in late February to decide plan changes and premiums for FY 2008-09. Tentative meeting date is Feb 28-29.
September 6, 2007 - The first meeting for this school year of the MSU Benefits Committee was held September 6, 2007. Present: Kerri Marx, Lisa Crow, Jerry Coffey, Ron Brekke, Deb Haynes, Don Mathre, Ken Hapner, Barb Wheeler, Carol Shannon, Jim Mitchell, Susan Alt and Doug Young. The items discussed included:
1. Preventative services
  - During the summer several members of the benefits Committee held meetings to develop a Proposed Preventative Services Program. Some of the changes were mandated by the last legislature (ages 0-7). It recommended doctor’s visits depending on age (0 to over 50) to include: physical examination, immunization, urinalysis, lab tests, blood analysis, screening for high risk & obesity, mammogram, gynecological exam, Pap test, Ultrasound heel scan for bone density, colorectal cancer screening, PSA screening, personal & family history.
  - A more detailed explanation by age group is attached.
  - A very thorough cost analysis spreadsheet was also presented and attached .
    These are proposed preventative services. If any of the CEPAC members have any additional recommendations then feel free to contact me.
2. IUBC Meeting
  - The IUBC annual meeting will be October 3-5
  - Topics will include: Financial condition of the plan(s), Preventative Benefits, Diabetes Management, Depression Management, Metabolic Syndrome Program, Vision Update, Pharmacy Industry, Traditional Plan Update, Dental Update, Subcommittee Reports (Admin, Plan Change, Appeals), Task Force Committee Reports (Compliance, Wellness, Retiree), Old business, New business.
  - If any of the CEPAC members has a specific question regarding one of the above topics or would like a topic not listed to be presented then feel free to contact me before October 3, 2007.
3. Other items presented which will be discussed in future meetings
  - A booklet or notebook for families to keep their own records and history of doctor’s visits
  - A concern about codes used by doctors and insurance companies which may be too general and not as detailed or specific enough to describe the various reasons for a doctor visit.
  - An awareness that the IRS and the MSU medical plan have slightly different qualifications for individuals being classified as dependents. For example, our health plans allow children to be covered up to the age of 25 (if they are not married and not covered in another job). The premiums for these dependents are taken out of employees' paychecks on a pre-tax basis, but the IRS only allows them to be pre-tax if the children are claimed as dependents on the income tax returns.
  - Concerns about the complexity of the health plans, and what can be done to more effectively communicate with members .
Fall, 2007 - Ron Brekke appointed to the committee. His first meeting will be during Fall semester. November 9, 2006 - Present: Barb Wheeler, Heather Barnaby, Lisa Crow, Kerri Marx, Dori Fuentes-Sanchez, Jerry Coffey, Robert McKenzie, Don Mathre, Deborah Haynes, Doug Young, Jodie DeLay
1. Barb Wheeler reported that numbers were down for the fall wellcheck, probably because flu shots were not offered at the same time. Wellness performs about 1400 blood screens annually, reaching about 25% of participants.
  Flu shots will be available Monday, Nov 13, Thursday, Nov 16, and Monday, Nov 27. Shots are free to participants. There are currently no plans to seek reimbursement from Medicare: Discuss with Paul.
2. We discussed the EyeMed plan that will be an option July 1, 2007. Their network is still very weak here: For zip code 59715, EyeMed lists two national retailers (one in bozeman and one in helena) and 6 private practitioners (2 in bozeman, 2 in butte and 2 in helena). Hopefully the state contract will pave the way for us.Coffey recommended a recent article in Consumer Reports and will seek permission to post it to the Choices web site.
3. We continue to be concerned about participants making poor choices, and what this costs them and the plans. What about a "pocket guide" that people could consult when an issue arises? the guide could list questions to ask in various situations: Prescriptions drugs: Is a generic available? Is this maintenance/Could I get this from mail order? When should I consult a case manager? Whom do I call? For surgeries and other non-emergency events: What will the be the charges, including facilities, labs, physicians, anesthesiologists, assistant surgeons, etc? Are each of the providers in my network or out of network? If not, could something be done differently? Is an assistant surgeon really necessary?
There was also discussion of additional ways that participants could be better informed about choosing which plan to participate in. The Choices booklet is already available, the plan reps come to campus, and HR puts on Reenrollment help sessions, but these are lightly attended.
Doug was directed to contact Paul with regard to these issues.
September 7, 2006 - Attended by: Susan Alt, Barbara Wheeler, Deborah Haynes, Don Mathre, Doug Young, Gail Weidenaar, Jodie Delay, Heather Barnaby, Kerri Marx, Norma Tatarka, and Robert Johnston.
From CEPAC 5/10/06 unapproved Minutes - Carol Shannon reported on some errors in the overview section of the CHOICES workbook. Carol recommended that staff check service details with their plan administrator.
Carol was then asked various health benefit questions:
- Shouldn't the income ceilings used to determine eligibility for, for instance, the health insurance premium waiver for dependent children, be re-examined every year? (It was suggested that salary increases might unreasonably render employees ineligible for the program). Carol will raise the question with the MSU Benefits Committee. Since Carol's term on the committee ends this month, Sara France undertook to alert Jodie DeLay and Gil Weidenaar to the question.
  
  April 6, 2006 - Carol Shannon submits this report:
  
  The new Director of Benefits for MUS is Paul Bogumill
  There are new lower premiums for retirees who are 65+. These will appear in the Choices packets that will be distributed in mid-April.
  The next Choices newsletter will explain the change in premiums in detail. The newsletter will also explain the new Managed Care option for retirees.
  Allegiance will now offer a Managed Care option (in addition to the Traditional Indemnity Plan).
  A letter will be sent to all active employees and retirees describing the changes for FY 07 and listing the help sessions that will be available.
  The survey results will be posted on MSU Today in the near future. The results will include data from both active employees and retirees. Disclaimers will be included to help people better interpret the results.
  The Dependent Waiver report for this first year was consistent with expectations for costs and intentions.
  Allegiance and New West now have local anesthesiologists in their networks and BCBS now has a local allergist in its network.
  Under the indemnity plans, there are no deductibles on annual mammograms, gynecological and prostrate exams and they are covered up to the maximum allowable amounts.
  Under both the indemnity and managed care plans, it is usually a good idea to get a prescription for the mammogram at the same time as the gynecological exam, in order to avoid a possible charge for another office visit.
  The next MSU Benefits meeting will be 5/2/2006.
  
  March 8, 2006 (from CEPAC Minutes) - Carol Shannon reported on the last meeting of the MSU Bozeman Benefits Committee (notes to follow). Three issues will be voted upon at IUBC tomorrow:
  next year's proposed premium structure
  managed care options for retirees
  debit cards for flex accounts
  Recent public forums indicate the staff are in agreement with adoption of these items (some logistical issues were discussed).
  Carol also reported on the progress of the recent CHOICES survey. Results will be offered to CEPAC for publication on the web, but preliminary findings have been sent to IUBC. Carol intimated there are no startling outcomes from the survey.
  Jodie DeLay reported that, barring any last minute events, she will vote in favor of the three issues, as Carol just described, at IUBC tomorrow. In other IUBC business, Jodie reproted that Glen Leavitt is retiring at the end of the month and IUBC has requested to be involved in hiring his replacement. Further, the RFP process to receive bids on the third party administration of the MUS health care plan is due to begin again (the current contract with Allegiance expires summer, 2007. Finally, Jodie mentioned wanting input into how to promote under-utilized mail-in prescription opportunities, and she will ask for CEPAC's feedback in due course.
  IUBC Meeting February 2, 2006
  Submitted by: Jodie DeLay, MPEA Representative from Bozeman.
  Note: This is my first meeting so I've done my best to capture the highlights. There is a huge volume of information and a major learning curve, so understand that these notes are from a rooky perspective!
  Glenn Leavitt announced that he will be retiring at the end of March.
  PHARMACY REPORT: Tammy Tarzynski (Pharmacare) reported to the committee. Written report was also submitted. Highlights include: MUS is doing a good job of using mail-order pharmacy and generic prescriptions (better than average). This keeps costs down for the plan. The Specialty Pharmacy option is underutilized at this point. Discussion followed as to how to increase participation. Three of the top 25 Rx's used by MUS employees will become generic in 2006 - this will reduce costs for our plan. There was a spike in expenses to the plan in July (likely due to consumer response to changing from Blue Cross to Allegiance as administrator) and in October (no absolute explanation, but will continue to track). Pharmacare recommends that we consider opportunities to continue to encourage people to use the mail order pharmacy and specialty pharmacy, that we add coverage for Prilosec OTC at zero copay (much cheaper than the RX form of the drug) and that we consider tablet splitting for appropriate drugs.
  AFLAC sent a request letter defining their service and looking for MUS participation. The committee, by voice vote, elected not to follow-up.
  Dependent Fee Waiver Summary for UM campuses was presented. Based on initial data the program seems to be a success - more children are being insured. Indications are that MSU data is similar.
  New colonoscopy benefit: Between July and January, 52 screening colonoscopies were completed. Through seven months the cost to the plan is around $14,000. Expect that this is more than what will be typical because of the newness of the benefit, should taper off somewhat. Cost is within what was projected.
  PLAN CHANGE DISCUSSION - Items to be discussed at campus meetings and then voted on at the next meeting:
  Items sent back to committee for further discussion:
  Mental Health benefits were discussed rather extensively. Proposal to change outpatient coverage to 25% copay and max of 40 visits with Employee Assistance Program referral and 50% copay and max 20 visits without EAP referral.
  Preventative Benefit - discussion to cap adult preventative services at $300.00 per person per year was discussed.
  Retiree Part D Subsidy: Not sure yet whether we'll qualify, will have a plan ready by March 1st. Would likely cost plan around $150,000 - $200,000. Would receive around $1million from federal government. Premiums for medicare/retirees would be reduced by approximately $64/month.
  Dental plan for retirees and increased benefit for children - committee looked at potential costs for a number of combinations and coverages. Decided the information was too broad and that the committee should limit potential options before putting before campuses.
  The IUBC will meet again in March.
  January 12, 2006 - Carol Shannon reports, at CEPAC meeting February 8, on the January 12 Benefits meeting
  MPEA Representative: Susan notified Quint Nyman that there is a vacancy on the committee and will follow-up with him to make sure there is someone on board to attend the Inter-units Benefits Committee (IUBC) meeting in February.
  VEBA: There has been some question as to whether employees who are on PERS can count sick leave in their High Average Salary (HAS) and VEBA or if they have to choose one or the other. Both MSU classified VEBA groups (one is union and one is not) were under the impression that they could count the sick leave in both places. The state of Montana has determined that employees must choose one or the other, and though the commissioner's office is still reviewing, it appears that our groups will likely have to reevaluate based on having to choose. If this turns out to be the case, personnel staff will go to both groups and let them know of the change. The state has tools which help people decide whether to count the sick leave in HAS or VEBA, and has promised to send these tools to Dawn. In addition, any of the VEBA groups can collectively, by vote, decide NOT to participate in the VEBA program. (The program is not voluntary for individuals, however, the group they are included in does vote on whether or not to participate. Individuals within the group must then go along with the vote.) Employees who are on TRS have been excluded from participating in VEBA. Employees who are on TIAA CREF may count sick leave in both HAS and VEBA.
  MSU currently has five VEBA groups:
- Union/classified - The teamsters union recently voted to opt out so they are excluded, but all other union employees who are over 55 are included.
- Non-union classified group - 55 years and older
- Extension employees - per their request, all are included regardless of age
- Faculty - 59 years and older (members of TRS excluded)
- Professional employees - 55 and older

Although the Commissioner's Office has mandated that the MUS participate in VEBA, MSU is the only campus that is participating at this time. All the other campuses have refused.

The following web page has some FAQ's about VEBA: http://www.montana.edu/staffsenate/veba%20faqs.html

SURVEY REGARDING HEALTH PLAN TRANSITION: Chris Fastnow attended to answer questions. She explained that the data is better if we have a high percentage of surveys returned from a stratified sample, than if we send the survey to every employee and get a low percentage returned. It is also more cost effective to do a stratified sample. The committee agreed using samples stratified by employee group (classified/prof/faculty/extension) as well as by the plan (Allegiance/Blue Cross Blue Shield HMO/New West HMO) would be fine. The question then came up whether we should include the other MSU campuses in the survey. Some of the personnel folks were meeting with representatives of the other campuses and agreed to discuss with them. The committee is fine with including the other campuses or not based on that meeting. This survey will be done now and we will do a larger survey late in the summer prior to the RFP being awarded for the new contract.

There was a question as to who would be on the RFP writing committee. No one knows but we will try to find out so that we can hopefully avoid some of the concerns that developed with the last RFP.

ALLEGIANCE EXPLANATION OF BENEFITS FORM: Some retirees have complained that the EOB is not as clear or easy to read as it was with Blue Cross/Blue Shield. Non-retirees don't seem to have the same concerns. The issue might relate to Medicare. We have a couple of committee members who will compare an old BCBS EOB with the new Allegiance EOB so that we can identify the specific problem and develop a solution.

Personnel and Payroll staff has worked hard to get Allegiance and BCBS together to work out issues with Medicare claims which have occurred since the transition. Last month there was a meeting with all parties which hopefully will resolve some of the problems and get the processing of Medicare claims back on track. KUDOS to Susan, Dawn, Kerri, Heather, Lisa and any others who assisted with this effort!

MAMMOGRAM UPDATE: The Hospital Board of Directors and the doctors of Advanced Imaging met on December 21st to discuss potential solutions which would allow our employees to continue the same type of mammogram program which was available prior to Advanced Imaging changing their name and getting their own facility outside of the hospital. More questions came from that meeting and no decisions were made. The group was getting together again January 11th. We have not been updated regarding any outcomes from that meeting. Beginning in February, Bozeman Deaconess will be able to do MRI mammograms (advanced diagnostic) rather than sending people to Billings.

WELLNESS UPDATE: Wellness subcommittee of IUBC has met twice -lots of response and discussion. They would like to begin doing some targeted messaging in the next fiscal year and will be asking for $12,000 to cover the costs of compiling data, mailing, etc. Targeted messaging is being used in many states and large companies to help improve overall health by changing lifestyles and offering direct options. Accomplishing this goal would require employees to sign a HYPPA agreement with re-enrollment to allow MAHCP and case managers access to personal information. At this time only the OCHE Director of Benefits and his staff have this information. We send data without personal info to MAHCP to compile statistics, but nothing can be linked to an individual. The Bozeman Benefits Committee had some very strong concerns about rushing something like this to try and get HYPPA language into the next enrollment period. We would like to take more time and do it correctly - have some research on how the state process is working and how this type of targeting has been met by others. Some companies offer lower premiums to people who participate - could we? Who would the letters come from? Would employees have the ability to "opt out"? Barb will try to get more information and share our concerns with the IUBC.

OTHER: Pharmacare - the online history only goes back six months rather than to the beginning of the year. Is there a reason? In the past this has been a great way to get information for tax purposes. Doug will look into this.

Retirement Subcommittee of IUBC: Mike Boysza (Chair), Norma Tatarka and Doug Young had a conference call with Glen Leavitt. They discussed: Medicare Part D: May have plan in place by July 1 or perhaps join with state of Montana and start Jan 1, 2007. Glen to bring options to retiree committee. Rebid 403(b) and ORP: Admin subcommittee to handle. Dental Plan for Retirees: Glen will approach consultants/providers and ask for quote. Voluntary plan more costly than mandatory. Adjusting premiums between large deductible and other plans for retirees: Glen to analyze/discuss with consultants and bring options to committee. Premiums originally set by estimating that large deductible plan was "worth" 85% of normal plan. Managed care options for retirees: State offers all types of plan to its retirees. Glen will bring options to retiree committee. Retiree appointee to IUBC: Glen notified UM who says "they will" have someone.

The next meeting will be February 9th at 8:00 a.m. in SUB 272.

December 5, 2005 - Jodie Delay reports
MAMO UPDATE - Barb: Barb, Doug and Bob McKenzie met with Don Majerus (Deaconess), and Tamar Bartz, Rich Wallace and ? of Advanced Medical Imaging. The MSU group expressed concerns about the changes that resulted in the loss of "one-stop" mamo + clinical. Advanced Medical Imaging are radiologists and won't be responsible for clinical exams. AMI and Deaconess are meeting later this month and will consider if they can better accommodate MSU.

Committee recommended that IUBC carefully consider and review the potential for adding an annual preventative screening for men and women under our plan. The screening could be age and gender specific but should include the preventative screens which are generally suggested by the medical establishment for basic wellness. Also, once it is clear which tests and office visits are acceptable with our plan (either as is or as amended), we would like to have Allegiance send a letter to all preferred providers that clarifies how screenings should be coded.

DOMESTIC PARTNER DECLARATION: Committee decided to ask the IUBC Administrative Sub-committee to review potential legal and procedural concerns.

SURVEY: Craig Roloff recommended that a survey be done to collect data on the satisfaction that people have with Allegiance, New West and the Blue Cross HMO. The Benefits Committee was asked to be included in the introduction of the survey. We agreed that we should be part of the survey, but thought since we have had very little time transitioning to the new administrator and PPO plans, it might be better to use the initial survey to identify any problems that there are or have been with the transition. A second survey could be done again later, before the RFP, to gauge the response to these problems and general satisfaction. Susan Alt will work with group to make changes to survey and circulate back to Benefits committee before it is completed. RETIREE DENTAL BENEFITS: Ken inquired about when/why dental benefits for retirees were dropped. No one could recall a time when retirees had dental benefits, so if there was ever such a thing it would have been more than twenty years ago. Discussed the possibility of adding the benefit. Concerns were raised about the potential cost of the program. It would likely have to be optional as even a marginal premium would be difficult for many retirees to handle. With fewer people enrolled the cost might be prohibitive. The question then came up about the possibility that we could "subsidize" dental insurance for retirees at roughly the same rate as the subsidy for health insurance ($.12/dollar). It was brought up that people do have the option to purchase COBRA for dental and health insurance for 18 months after they retire or leave MSU. This is new since Allegiance came on as our administrator.

There was discussion regarding the need to collect some data about why we are losing retirees from our plan. We assume that it is because of the cost of the premium, but don't have any data. The committee asked the representatives of the IUBC Retiree Subcommittee to take this to the next meeting for discussion.

CEPAC INITIATIVES: The Benefits Committee appreciated hearing about CEPACs thoughts on the Benefits Smorgasbord, etc. They will wait for CEPAC to define their plan and evaluate as more details are available. Please continue to keep the Benefits Committee in mind as work continues.

MPEA UNION REP.: Janae Heap has resigned from the committee so we need to find a new representative. Susan will ask Quint Nyman to put out a request to MPEA members to see if anyone is interested. The committee will think about colleagues who might be suitable. This person will also serve as a representative on the IUBC.

VEBA: Susan will ask someone to attend the next meeting to provide and update.

NEXT MEETING: The next meeting is tentatively scheduled for January 12th at 8:00a.m. in the SUB.

October 6, 2005 - Carol Shannon reports
IUBC report - Revenues exceeded expenditures this past FY and the same is expected for this FY. In FY 07 the state will pay an additional $50/month per employee. There will probably be no increase to out-of-pocket costs for employees for next FY 07. The premium for retirees will likely increase similar to the increased state contribution for employees.

The MUS has a registered nurse to assist employees in cases where there is a "serious diagnosis" (e.g. terminal diagnosis, problem pregnancy, etc.). She will help with negotiations for wheelchairs, air evacuation and general case management. There is no deductible and no co-pay. Call Personnel and Payroll Services for more information.

There is still no retiree representative on the MUS Benefits Committee.

Other items - There has been no response from the letters sent to the dermatologists and allergists in Bozeman, with the exception Dr. Brian Rogers. Dr. Rogers does not want to become a preferred provider with Allegiance because of the time and expense in handling claims. He currently does not balance bill and does accept BCBS allowables.

There have been some complaints about the slowness in turn around time for claims with Allegiance.

New West will be the carrier for Bozeman Deaconess Hospital as of July 1, 2006. At this time New West will not sign with the Surgery Center. As a result, the Bridger Orthopedic doctors who use the Surgery Center are currently unable to sign on with New West as preferred providers.

Currently, the MSU Benefits plan is a qualified substitute for the new Medicare prescription plan and creditable coverage letters will be mailed in November. The MUS plan does not, however, qualify for the federal subsidy that can be given to some plans that cover retirees on their prescription coverage. However, retiree coverage options will be researched for the next plan year (7/1/06) with the hope of being able to qualify for the subsidy. Right now, MUS individuals who qualify for Medicare are being encouraged to wait to sign up for a prescription drug plan until the MUS Benefits plan has been reorganized.

Advanced Imaging is the only place in Bozeman who performs mammograms. At the time of this meeting, they were not preferred providers with Allegiance and this was a concern since employees would be balanced billed for diagnostic mammograms (screening mammograms would be covered 100% but would cost our plan more). They did sign with Allegiance on October 11, 2006. Employees still need to see a physician for a breast exam and to get a prescription for a mammogram.

There is some confusion as to what benefits are considered "Wellness" benefits. The MSU Wellness director was not able to attend the meeting due to off-site Well Checks.

September 22, 2005 - information supplied by Personnel and Payroll Services, circulated by CEPAC via the classified listserv:
Faculty Council, Professional Council, and the Classified Employee Personnel Advisory Committee (CEPAC) have received some inquiries from their constituents about dealing with issues from the switch from Blue Cross Blue Shield to Allegiance and/or the new managed care plans (New West and Blue Cross Blue Shield). Here is a list of where you should go with questions.

Medical Claims Questions: Contact your plan administrator directly
Allegiance 1-877-778-8600
Blue Cross Blue Shield 1-800-820-1674
New West 1-888-500-3355

Dental Claims Questions: Contact Allegiance directly 1-877-778-8600

Insurance Card Replacement: Contact your plan provider directly
Allegiance 1-877-778-8600
Blue Cross Blue Shield 1-800-820-1674
New West 1-888-500-3355

If you have contacted your Medical plan administrator about an expense that has been covered in the past and now is not covered or some other unusual circumstance then contact
Kerri Marx (Beneifts Manager) kmarx@montana.edu or Heather Barnaby(Insurance Specialist) hbarnaby@montana.edu
Personnel and Payroll Services, 994-3651

Faculty and staff who have comments about the switch from BCBS to Allegiance and/or the new managed care plans (New West and BCBS) can contact members of the MSU Benefits Committee, including Douglas J. Young, Debbie Haynes, Robert Johnston, Carol Shannon and Jodie Delay. http://www.montana.edu/pps/NewEmployee/NEBO/MSUBenefitsCommitteeMembers.pdf

Claims decisions can be appealed to Commissioner's Office: Shelly Murphy Benefits Representative 444-0330 smurphy@oche.montana.edu

Upcoming health care sessions on campus:
-New West Health Services Representatives will be on campus to answer your questions: September 22, 2005 11am - noon Noon - 1pm 1 - 2pm SUB Ballroom D Can't attend a session? Contact New West at 1-888-500-3355

-Allegiance, BCBS, and New West will be on campus for the Wellness Fair which is scheduled for November 8th and 9th from 7am -11am in the SUB Ballrooms.

September 12, 2005 - Jodie DeLay reports:
ALLEGIANCE: Overall positive reports on transition. Staff has been responsive and easy to work with. Turnover time has been a little slow, but at this point, not a big issue as staff is working to address the situation. The benefits committee is sending a letter to five local physicians, mostly dermatologists, to ask them to either join the Allegiance network or to sign an agreement to not balance bill MSU employees.

BLUE CROSS HMO: There have been some significant problems to date including the very late mailing of benefits cards and, in some cases, doctors being listed as providers who were not. About 100 employees signed up for this option. Personnel is considering each complaint and working to find solutions.

NewWest HMO: No problems.

Immunization Benefit: MUS plan includes only $250 for immunizations from age 0-2 and providers charge significantly more than that. The County Health Department does these shots for $10.00 each - we need to better advertise/promote that option for people.

Change in mammogram benefit: Advanced Imagery will now be doing mammograms at their facility, located in the hospital complex, but not at the hospital itself. Because they do not have nursing liability, women will now need to see their physician for the clinical breast exam, get a prescription for their mammogram and then schedule the mammogram separately. Wellness is looking into this situation to see if there is a remedy. MSU is the only institution that previously had the one-stop mammogram benefit (women received a prescription from wellness and then reported to radiology at the hospital for a clinical breast exam and mammogram).

Medicare Reform Act: Glen Leavitt is hoping to set up a meeting to discuss the ramifications of this on our retirees/employees. For now we are recommending that people stay on our plan, and don't worry about making a hasty decision to meet the November 1st deadline. Because we are a qualifying plan, retirees will not suffer any penalty if they decide later to switch. However, once someone leaves our plan, they can not come back. We need to figure out how to get this info in front of people. We will look at including in the next Choices later and possibly a mailing to our retirees.

IUBC: We are continuing to work to get a retiree appointed to the IUBC. Cathy Conover has talked to Sheila Stearns and we will pursue.

TIAA CREF/PERS/TRS: Retirement benefits are also part of the Benefit Committee's charge. Currently TRS has an unfunded liability. The legislature, perhaps during the special session this winter, will need to find a solution to this situation. Employer contributions to TIAA CREF are less than to TRS/PERS already, in fact they are the lowest in the nation. Employer contributions to all the plans are low compared to other states. Is it time to lobby for more funding? How do we protect our employees from having the unfunded liability paid for by employees? We will ask Glen Leavitt to put this issue on the IUBC agenda and will continue to follow issue and hopefully be able to be proactive.

Well Check: Set for November 8 and 9. Anticipate having plenty of flu shots.

June 20, 2005 - Campus announcement:
2005-2006 CHOICES Re-Enrollment is wrapping up!

A letter from Personnel and Payroll Services confirming your CHOICES selections for the upcoming year will be arriving in campus mail next week. Read this confirmation letter - if you find an error contact Personnel and Payroll Services immediately at 994-3651 or email hbarnaby@montana.edu.

A "Welcome Packet" from Allegiance will be arriving at your home address next week in a Montana University System Envelope. If you turned your enrollment form in late you may receive your card later this month or after July 1st. In order to insure timely claims processing provide your doctors/dentists/pharmacists your new insurance card for any services rendered on or after July 1, 2005. Following is the Allegiance group number for our campus: 9500025. The Allegiance Customer Service toll-free number will be available for your use beginning July 1, 2005. (1-877-778-8600)

*Please note that if you have chosen medical coverage through New West Managed Care or Blue Cross Blue Shield Managed Care you will use your Allegiance card for dental appointments and prescription drug coverage and will be receiving a separate card from New West or Blue Cross Blue Shield for your medical Insurance coverage.

June 2, 2005 - Carol Shannon reports: the Benefits committee will have a special meeting in July since so many changes are taking place July 1. We haven't had a meeting since the last report.

May 3, 2005 BCBS Managed Care will be on campus to present two additional information sessions on Thursday, May 5 from 10am-11am and from noon – 1pm in the President’s Conference Room.

April 28, 2005 - Carol Shannon reports: the MSU Benefits committee had its meeting on April 28. (Carol and Jody in attendance)

If anyone at the meeting sees anything that needs to be corrected and/or added, please let me know.

SSNs will be sent to Allegiance for everyone at MSU except those individuals who already had generated IDs with BCBS (80+ individuals). These numbers are necessary for transferring data from BCBS to Allegiance. MSU employees will have the opportunity later to request a generated ID from Allegiance. ID numbers will not be printed on the ID cards since for the majority of the people it would mean their SSN.

There may be some tax implications for insuring domestic partner and /or children over 19 who are not attending school. More information about this to come later.

There are some issues with electronic submission of claims from Allegiance to Medicare. Allegiance did buy software to handle this but do not have it working yet.

There is some confusion with the BCBS HMO. Some people are thinking they have a choice of staying with BCBS for the traditional plan which is incorrect. BCBS is in the process of establishing a local network in Bozeman for their HMO. It was not in the Choices booklet since it was not available at the time the booklet was printed.

“Marriage Penalty” – Currently, when both spouses work at MSU there is not a “family” deductible. This will be presented to IUBC at their fall meeting.

“Marriage Benefit” – Currently, when both spouses work at MSU and there are 2 children attending college in the MUS, both children will get the dependent tuition waiver.

There are currently 3 VEBA groups designated at MSU: Faculty (60 years +), Extension (all individuals), and Classified Professional Union Exempt (55 years +). The committee received letter from an employee asking if the University System could follow the lead of the State and institute a “pre-retirement option” in addition to the sick leave for the VEBA. This will be presented to the IUBC at their fall meeting.

There is some confusion as to whether sick leave monies designated to go into a VEBA are eligible for retirement. This issue is being explored by Personnel and Payroll folks.

Barb Wheeler has been hired as the new Wellness Director. She will begin around June 1. Barb worked with the MSU Well Program for many years.

The MSU Benefits Committee does not usually meet in the summer but with so many changes taking place they are planning on meeting in July.

April 27, 2005 - click here to review frequently asked questions about VEBA

April 25, 2005 - announcement from Personnel and Payroll Services:
Attend an information session to find out more about which Bozeman doctors are members of New West Health Service, & details about the plan!

Wednesday, May 4th at 7 am, 8.30 am, 10.30 am, and noon. All sessions will be presented in SUB Ballroom B.

April 21, 2005 - CEPAC announcement:
CEPAC has received calls from staff with questions about the inclusion of managed care options (in the Bozeman area) as part of the CHOICES package. This is an important new option to consider and Personnel and Payroll Services is working hard to bring us information in this regard.

The two organizations offering managed care here are Blue Cross Blue Shield and New West. Both are coming to campus (BCBS on Thursday, April 28th 8 am and 10 am, President's Conference Room) and New West (time/date TBA) to give information and answer questions. Dates/times/venues of presentations will be announced via the President's Office listservs.

April 11, 2005 - President's Listserv announcement:
The Allegiance Website is live!

To check whether your provider is a member, check their website at www.abpmtpa.com/mus. Click on "Find A Doctor". For In-State providers, click on "Allegiance Multi-Provider Search". For Out-of-state providers click on "National Network.". If you discover that your provider is not a member, you can fill in or download a provider nomination form at http://www.abpmtpa.com/mus/providernominationform.pdf and Allegiance will attempt to obtain a contract with your doctor.

To learn more about the transition of third party administrator from Blue Cross Blue Shield to Allegiance Benefit Plan Management, please attend the CHOICES Insurance Update on Monday, April 18th, 9am-10am, in Roberts Hall Room 101. Other topics to be discussed are: Retiree Premium Changes, Colonoscopy Coverage and Dependent Premium Waiver. The update will be presented by Glen Leavitt, Director of Benefits, Commissioner of Higher Education's office, MUSBenefits@oche.montana.edu.

April 1, 2005 - Carol Shannon reports:
My understanding is that Allegiance isn’t prepared to handle generated id’s for the entire university system at this time. If employees at MSU wish to have a generated id used with Allegiance they need to contact Dawn Watkins in Personnel and Payroll. Personnel and Payroll will manually edit the file sent to Allegiance to change the ID number that is sent. Currently there are about 20 people at MSU who do not wish to have their SSN used for their id. SSN’s will not be printed on the id cards. Employees will receive their cards around 6/17.

Dawn Watkins (PPS) adds: we are working very hard on not using soc sec numbers for ID numbers concerning the medical insurance. For the time being there is a strong chance we will be using our generated ID numbers.

Announcement via the President's Listserv:

Allegiance Transition Task Force Update

The network of doctors in the Bozeman area is currently available at the following website: http://www.montana.edu/pps .
[Carol adds: The state and national networks will be provided later. The list of local doctors was available now. Our insurance plan will provide coverage for doctors outside of Bozeman, both statewide and nationwide]. If you live in the Bozeman area and do not see your doctor listed, please complete the nomination form also found at the above listed website. This nomination form should be returned to Allegiance so that they can contact your doctor and begin contract negotiations. The network listing of doctors outside of the Bozeman area is currently unavailable; you will be notified when it is available.

InterUnits Benefits Committee Update

The Spring Meeting was held on March 10, 2005. Following are changes to the plan effective July 1, 2005.
*Preventive Colonoscopies will be covered once every 10 years beginning July 1st for people age 50 and older
*The Dependent Premium Waiver was approved as a 2 year pilot program. Employees who make $25,000 or less and cover dependent children may apply during CHOICES re-enrollment to have their insurance premium for their children’s medical coverage waived.
*There will be no increase in employee premiums for the 2005-2006 plan year. Employees who elect to be covered on a Managed Care Plan will see a decrease in their premium. Retirees will see a 4% increase in their premiums.
*There will be a lifetime maximum of $2,000,000.
*Mammograms will no longer be on an age schedule - they will be available at any age as a preventive coverage
*Dependent Children will be eligible to remain on the plan until age 25 as long as they are an IRS definable dependent
*1 pair of glasses or contact lenses will be covered on the medical plan after cataract surgery

Upcoming CHOICES re-enrollment meetings

CHOICES Insurance Update: Monday, April 18th , Roberts Hall Room 101
?Transition of 3rd Party
Administrator from BCBS to Allegiance
?Retiree Premium Changes
?Colonoscopy Coverage
?Dependent Premium Waiver
Presented by Glen Leavitt, Director of Benefits, OCHE, MUSBenefits@oche.montana.edu
CHOICES Help Sessions: SUB room 106E, Monday, April 25th - noon to 1pm;
Tuesday, April 26th- 3:30pm - 4:30pm;
Friday, April 29th noon-1pm

March 10, 2005 - Don Mathre reports on the IUBC meeting:
It was a most interesting meeting. The vote to cover colonoscopies passed on a 10 to 9 vote. The folks voting against it were mainly interested in getting more economic information, but I voted for covering them since I felt we had enough info to go ahead for a trial period. The affordability measure passed easily but we reduced the maximum salary to $25,000 instead of $30,000 just to see how many folks would sign up and how much it would cost the system in the first year of operation. The other main thing that was passed was to institute a $2,000,000 life-time maximum on health insurance coverage. This was to make it comparable to the max allowed by the HMO's. I voted against it, but I also don't think it is that big a deal at the current time. Perhaps sometime in the future. Other than that we did approve the premium changes that Glen [Leavitt] suggested which were basically those that we received a month ago.

March 9, 2005 - updates discussed at CEPAC monthly meeting:
Third Party Administrator Task Force. Janae Heap, member of the Third Party Administrator Task Force, had sent an update, and Dawn Watkins spoke of continued meetings with Allegiance every other week. Hold ups in the selection of hospital network members has delayed the publication of the provider list on the OCHE web site. However, Personnel and Payroll Services will shortly publish the Bozeman provider list via its web site. A discussion took place regarding Allegiance's proposed continued use of SSN rather than GID. The SSN will not appear on the membership card, but will play a role in the claims process. Dawn has repeatedly questioned this practice and will follow up again, asking for a description of the security processes Allegiance has in place, and establishment of the reasons why a GID cannot be substituted.

Dependent Health Insurance Premium Fee Waiver. Janae Heap, member of IUBC, had sent an update and Dawn Watkins reported that IUBC will vote tomorrow on recommending the proposed two year pilot program to the Commissioner. If approved by IUBC and the Commissioner, the issue will progress to the Regents this month. The pilot provides for employees making less than $30,000 annually (MSU income only, and without reference to spousal earnings) to apply for a waiver of the premium to cover dependent children ($60-100 per head). Funding for this pilot comes from the benefits pool.

Health Insurance Premiums. Dawn Watkins reported no premium increase, other than 4% for retirees.

Colonoscopy. Janae Heal, member of IUBC, had sent an update and Dawn Watkins reported that discussion of a plan to cover colonoscopy is under way. Preliminary ideas include the first free colonoscopy at aged 50; the regularity of screening thereafter is still under review.

Common Law Health Coverage. Montana recognises common law partners, and yet the current MUS health insurance policy does not provide coverage to unmarried couples. Dawn Watkins spoke of a proposal, on which IUBC will vote tomorrow, under which employees could cover unrelated adults via their health insurance eligibility. It is possible, if passed, that this plan will be presented to the Regents as soon as this month.

February 9, 2005 - Jodie DeLay reports:

Report on IUBC meeting on Feb. 1: Our plan is in good financial shape with about a $6million reserve this year alone. IUBC supports no major changes in premium's etc. but would like input from campuses.
Report on Transition Task Force: Group is meeting bi-weekly (please see Janae's report). The OCHE web page is running a little behind schedule, largely due to the untimely death of Linda Ryckman who worked in Glen Leavitt's office and the legislative session ~ not Allegiance. They have made great strides in signing providers in Montana. The Benefits committee continues to have concerns about the nationwide provider network and is anxious to see the list. The committee also continues to feel that the design of the card will be critical to the service provided outside of Montana and looks forward to being briefed as the design is developed.
Consider final affordability proposal: This is the proposal to use funds from our plan to help supplement the cost of insurance for the children of low income employees. The IUBC will vote on adding this benefit at their March 9th meeting. The details are as follows: the program will be an expense to the plan (similar to the Wellness Program and annual admin costs), the IUBC will approve the expense annually as it does the other expenses, the program will be evaluated as a two-year pilot to determine the impact on eligible plan members and the cost to the plan, eligibility criteria include an annualized wage of $30,000 or less and an IRS definable/verifiable dependent enrolled in the plan. (coverage of spouse is not included), premium waiver granted to employees who actively select the waiver. The benefit would cover the additional expense of insuring dependents only. The benefits committee was supportive of the plan for several reasons. First, our plan has sufficient reserves at this time that this will not have a negative fiscal impact. Second, this would be a significant benefit to our lower-paid employees. We would wish to make sure that people are aware that this is a two-year pilot program and that depending on the actual cost to the plan, etc. it could change or be eliminated. As with other programs, even after the pilot-program it would be reviewed annually.
Consider premium changes for next year: There is no plan to make any change to the premiums of currently employed folks, assuming that the legislature passes the current bill which adds $46.00 contribution from the state. This will be voted on at the March 9th meeting. Those who switched to the HMO would actually see a decrease of $34 -$45. There is a proposal to increase the out-of-pocket premium for retirees by $11 - $23. This is smaller than was projected and is necessary because the state doesn't contribute to the retiree premium. Another caveat is that we do NOT go to the Medicaid pharmacy program. This will be discussed at the March 9th IUBC meeting. The committee felt that the Medicaid pharmacy program was not a good idea, based on various background knowledge, and hoped that it wouldn't be considered strongly. This is another area where solid and extensive data would be needed before recommending.
Consider a lifetime maximum benefit policy: Currently our plan has no cap on the amount of benefit that can be paid. There are some who think we should consider placing a cap. The rational is that hospitals etc. consider this cap when billing expenses and may charge less if there is a cap. The committee discussed the need to have significant data in hand before this was considered. There would need to be strong evidence that NOT having a cap is hurting the plan for it to be a positive change. Setting limits for no real purpose would not be a benefit for our plan or the individuals that use the plan. Data, data, data.
Consider a proposal to pay for colonoscopies as a screening program: Our plan already covers colonoscopies that are done for specific concerns or by doctor's suggestion. This proposal would have the plan pay for a colonoscopy for people 50 and older, for the purpose of screening. The proposal would be to pay for one every 5 - 10 years up to the age of 65, when Medicare covers the cost. The committee was strongly supportive of this as it could well save the plan costs, and lives. Again, the committee would like to see data - number of employees with colon cancer, cost of claims, etc.
Domestic partner policy: This is a Board of Regents issue. Glen Leavitt is drafting a policy to define who qualifies as domestic partners. We will wait to see what is developed.
Terms of office for committee members: Don Mathre will investigate the rules and bylaws of the committee to see who should be reappointed, whose terms are complete and who is eligible to be the chair person.
Spring Campus Meetings: We will have meetings on March 1st to discuss the affordability plan, proposal to not change premiums and proposal to offer colonoscopies. We will advertise via staff bulletin, listserv, and the personnel and payroll web site.

Reminders: The wellness fair will be held on March 22.

Update: The Ask an Expert trial has had great call volume. The experts are overloaded with emails and requests. We have no results, at this time, regarding customer satisfaction. There have been some complaints. Laci would recommend that we try to have experts from our own campus for this effort.

January 13, 2005 Jodie Delay reports: Lacy Hintzpeter gave an update on a number of activities within the wellness program.

Ranger Website - Security is very strong on our network. We use banner numbers rather than social security numbers and everyone signs a HYPPA agreement.

CHOICES - next edition will feature wellness

ASK an EXPERT - Four-month trial program will begin early in February on a first come, first serve basis. Benefit provides one-on-one consultation with a registered dietician (Food4you2@msn.com) or exercise specialist (jane.edlund@umontana.edu). For full detail, please visit http://www.montana.edu/wellness/event_asktheexpert.html.

Spring Wellness Fair - March 22, 2005
Fall Wellness Fair - November 8 and 9, 2005

In process of linking the Ranger database (wellness efforts) with the state claims database so that we can identify trends and be proactive with our wellness program.

Flu shot is covered 100% by our insurance (up to $75.00). It is part of our immunization benefit. The County Health Department has flu shots available, by appointment only, for $17.00. Call 406-582-3100 to make an appointment.

Affordability Task Force: Our committee's recommendations to the IBC after our last meeting were to annualize the salary when determining if a person is eligible and to require people to apply to receive the benefit. The IBC adopted both these suggestions and the proposal currently being discussed is to cover the additional insurance premium for children (not spouses) of low-income employees (currently being defined as having an annualized salary of less than $30,000) if they apply for the benefit. IUBC was told that $500,000 is the most it will cost the plan. The inter-units benefits committee will vote on whether to adopt this benefit at their meeting on February 1st.

New West Health Services HMO: About 25 people signed up during the enrollment session.

Liberty Mutual -we will not do payroll deductions

Senate Bill 72: a retirement incentive that would pay one year of health insurance for every five years worked for employees who retire within a small window. As drafted, the person must be eligible for retirement. Also, as drafted, the bill is unfunded and calls for vacancy savings to be used to cover the cost. The committee suggests that the university oppose this bill.

December 16, 2004 Carol Shannon reports:

New West Health Services (aka Managed Care Health Option, CHO Health, HMO)
Employees are currently able to sign up for this plan which will start January 1, 2005. I explained to Kerri Marx that there was quite a bit of confusion as to the email posting on the President's list serve because of the wording of the name. The suggestion was made to put all of the literature/information, that PPS is currently giving to employees who request more information, on the PPS website. Once that is done, another email should be sent out that clears up the name confusion and that provides a link to the information on the web.
VEBA (Voluntary Employee Benefit Account)
This is a new program that allows employees to put unused sick leave in a tax free VEBA when they retire or leave the university. This money can then be used for medical purposes. PPS is in the process of defining groups that will then vote on whether or not they wish to participate. Once the group is defined and votes, every member in that group has to follow the group's decision. You don't have the option as an individual to decide whether or not to participate. At this time there are no groups defined for classified employees. If you have questions, please contact Kerri Marx or Susan Alt.
Metlife
A letter from Glen Leavitt, Director of Benefits (OCHE), will be sent to all Metropolitan Life 403(b) participants stating that Randy Knowles has lost licensing for both insurance and securities in Montana and should not be meeting with employees on any MUS campus to service any 403(b) supplemental retirement programs. The names of the individuals who will be handling the Metlife accounts will be sent to MSU employees in the near future.
Transition Task Force
The Transition Task Force, which is handling the transition from BCBS to Allegiance, will now start meeting bi-weekly. As of yesterday the Allegiance contract had still not been signed but it should be signed very soon. At this point, 93% of the doctors in Bozeman have signed with Allegiance and all medical centers. Allegiance is now working on contacting and signing non-MD professionals. Allegiance has been successful in landing contracts with other large companies - D.A. Davidson, Northwestern Energy, Washington Mutual and Town Pump. As soon as the contract is signed, information will be available on the OCHE website. I requested that an email be sent to all employees providing a link to the website. I also requested that the website include a list of local doctors as well as the other networks that have been contracted so that employees can find out if their personal doctors (both in-state and out-of-state) have contracted with the Allegiance network.
Affordability Task Force
This task force is working on a plan to help lower income employees, with children as dependents, in getting monetary assistance with their health insurance costs. This money is budgeted out of the medical account (the same account that funds Wellness). The two recommendations from our committee today were 1) to adjust the salary by the FTE when determining whether an employee qualifies (e.g. if an employee makes $25,000 and works halftime - .5 FTE - then the salary used to determine qualification would be $50,000 for that employee) and 2) every employee who wishes to receive the benefit must fill out an application.
Search for new Wellness Director
The search committee has been selected and will start meeting in January.

November 10, 2004 Neither CEPAC representative could be present at the November 10th meeting. However Carol Shannon relayed a message from Benefits Committee Chair, Don Mathre in which he reported "most of the discussion [at the meeting] was what issues would need to be covered by the transition task force. That will also be our main topic of discussion at our next meeting". Jodie DeLay reported that the Benefits Committee is awaiting confirmation of the contract with Allegiance having been signed and, subsequently, the informational web site going live (possibly next week). Meanwhile, many employees' questions were addressed when Allegiance and the Director of Benefits, Office of the Commissioner of Higher Education, came to Bozeman on October 19 - a summary of which was circulated from the VP for Administration and Finance's office on October 22. Next Benefits Committee meeting will be December 16.

October, 13, 2004 Jodie DeLay reported that on September 29th at the Inter-Units Benefits Committee meeting, a list of MD's from the Bozeman Area was presented to Bozeman representatives. According to the list, which was compiled by the Commissioners Office, one provider shy of 90% had signed with Allegiance. 90% was required in order for a contract to ultimately be awarded. Other questions that the Bozeman Benefits Committee had raised were not addressed in writing. In addition, there was some concern regarding the meaning of "signed". Some area providers told representatives from the Bozeman Campus that they were not providers, when Allegiance indicated that they had signed contracts.

Three staff members from Allegiance, as well as Glen Leavitt and Cathy Swift from the Commissioners Office, met with the Bozeman Benefits Committee on Tuesday, October 12th. They responded to questions and provided information.

Glen indicated that the Commissioners Office was aware of the concern about whether contracts were in place and had asked for an audit of the list of MD's Allegiance had indicated had signed. The audit showed that a "memorandum of agreement" had been signed by all of the physicians that were listed as "signed". Allegiance stated that it would have detailed contracts in place with each provider listed as signed once they are awarded the Third Party Administrator Contract. Some of the providers have formally signed extensive contracts directly with Allegiance to serve other contracts they have with other employers.

Allegiance representatives indicated that they would do everything possible to sign as many ancillary service and specialty care providers as possible if they were awarded the contract. They offered to supply us with a list of these that are currently on board.

Allegiance representatives indicated that if they receive the contract, when an employee needs service out of state, the service provider can access the Allegiance website 24 hours a day for verification of benefits. Also, if the contract is signed with Allegiance, their web page will be updated for the MUS to show MUS providers in all areas and customer service representative would be well trained to answer any questions. Out of state employees will be provided with information regarding providers that are members of the network of third party administrators with whom Allegiance has contracts.

Allegiance representatives stated that they were testing their software which should provide a smooth claims process for Medicare patients and were comfortable that they would be in position to offer a smooth, simple process by the time the plan year started in July.

The question was asked, "what do we stand to gain from making this change?" and the response was that we would have improved service through a better web interface, have better flow of data from an administrator perspective and would have customer service representatives dedicated to the MUS contract.

Allegiance representatives indicated that providers within the network would continue to file patient claims, would enjoy claim processing times of around two weeks and would not balance bill. They indicated that they had a strong support network and generally had very positive responses from providers that they currently work with. In addition, they have taken over other plans from Blue Cross and Blue Shield and those transitions have been smooth. They agreed to work with us, if they receive the contract, to put together a FAQ and other information to help fully inform our employees of changes, enhancements, etc. They also agreed to have a regular presence in Bozeman, similar or better than that which Blue Cross Blue Shield currently has.

Allegiance representatives agreed to come back to Bozeman next week to meet with CEPAC and I agreed to compile a list of questions to send them in advance of that meeting.

To fully address the questions and concerns of classified employees, I look to CEPAC to take the pulse of our constituents to make sure that we have the opportunity to at least ask for information necessary to determining whether we, as the Bozeman Benefits Committee, should recommend that the contract with Allegiance be signed or not. Ultimately, however, the decision to sign the contract with Allegiance or to enter into a new RFP process belongs to Commissioner of Higher Education, Sheila Stearns and NOT the Benefits Committee.

If CEPAC can provide a list of questions, I will see to it that the questions are presented to Allegiance so they can respond at the meeting next week.

September 15, 2004 - Jodie DeLay reported that the MSU-Bozeman Benefits Committee met with President Gamble for an update on the status of the possible change from Blue Cross Blue Shield to Allegiance, 7/1/05. Since then the Commissioner's office has requested a written response and supporting documentation from Allegiance to address the concerns that the MSU-Bozeman Benefits Committee has over preserving the level and standard of coverage in such a switch. These responses are due to the Commissioners Office by the end of September, in time to give the Bozeman Benefits committee and the I.U.B.C. a chance to review before passing a recommendation to the Commissioner's Office by October 29. Jodie reported President Gamble to have expressed confidence that Allegiance is endeavoring to meet MSU-Bozeman's needs.

August 11, 2004 - Jodie DeLay and Carol Shannon gave an update to the May 12, 2004 report. Brief history: the administration of the university system's health insurance program was put out to bid for a new contract commencing July 1, 2004, as the previous contract was expiring. Allegiance received the most points in the RFP process and was recommended as the successful bid. Blue Cross Blue Shield submitted a counter bid and matched the costs offered by Allegiance. Due to concerns about Allegiance's coverage, including an insufficient network of providers in Bozeman, MSU requested confirmation of the contract be delayed. Blue Cross Blue Shield was given a one year contract extension at the lower bid price until June of 2005. The inter-units benefit committee has been asked to give a recommendation to Commissioner Stearns at the end of October as to whether Allegiance has built a satisfactory network in the Bozeman area and responded to other issues, or whether the contract should be re-bid. Jodie and Carol reported that meetings are scheduled to pursue complete and accurate communication around this issue, and to ensure MSU has opportunity to review the network documentation. Jodie and Carol will contact CEPAC officers when there are further updates and work with CEPAC to inform staff of any changes in the program's administration.

July 7, 2004 - no report.

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