[MyOEBB] FW: OEBB Approves Plans, Designs and Rates for 2012-13

Fri Apr 27 11:49:47 PDT 2012

From: HALL Denise * OEBB 
Sent: Friday, April 27, 2012 11:49 AM
To: 'OEBBSUPERINFO at listsmart.osl.state.or.us';
'OEBBBUSMAN at listsmart.osl.state.or.us'
Cc: OEBB.board at state.or.us
Subject: OEBB Approves Plans, Designs and Rates for 2012-13

Dear Superintendents, Business Managers and Benefit Representatives:

At its April 26th 2012 Board meeting, the OEBB board voted on plan
design and rate renewals for the upcoming 2012-13 plan year.  We wanted
to share the information with you as soon as possible to allow you to
consider the changes and rates in your budget and collective bargaining
discussions.

The estimated overall increase for medical plan rates for the 2012-13
plan year is 7.1 percent.  Rates for ODS medical plans 3, 5, 6, 7, 8 and
9 will each increase by about 7.49 percent and ODS medical plan 4 will
increase by 3.99 percent.  Kaiser plan 1 rates will see an increase of
5.94 percent, while Kaiser plan 1A will increase by only 4.70 percent.

As of October 1, 2012, Providence Health Plan plans 2 and 2A will no
longer be available under the OEBB benefits program.  As you may know,
the two Providence medical plans have experienced significant rate
increases in each of the past three years.  The Providence plans have
offered rich benefit designs and have experienced higher than
anticipated utilization during each of the four plans years. Providence
did not believe, and OEBB agreed, that continuing to offer these two
plans was in the best interest of OEBB members and felt that the plans
did not represent sustainable options.  Providence has been an excellent
partner and has brought a lot of value to the OEBB benefits program.
Employees and early retirees who are enrolled in one of the two
Providence medical plans at this time will need to select another
medical plan option during the 2012 open enrollment period, but will be
able to continue care with their current providers if selecting one of
the ODS medical plan options.

Another change that was approved for ODS medical plans 3 through 8 is to
attach the same pharmacy option to all plans.  In the past, employee
groups could select from three pharmacy plan options.  As of October 1,
2012, all ODS plans other than plan 9 will offer the pharmacy benefits
available under the current plan B option.  The Board also approved the
addition of a "value tier" on the pharmacy coverage under ODS Medical
Plan 9.  This will help those enrolled in Plan 9 who have certain
chronic conditions to receive a benefit toward medications used to
manage those chronic conditions prior to meeting the deductible under
this high-deductible, consumer-driven health plan.  All other
medications will be handled the same way as they are today.

Rates for the ODS vision plans will increase by 7.49 percent.  Kaiser
will not increase the rate for the Kaiser vision plan offering.  There
are no plan design changes to any of the vision plans.

OEBB moved to include orthodontia coverage under all but one ODS dental
plan offering beginning October 1, 2012.  The decision to include
orthodontia coverage in the dental plans was due in part to an earlier
Board decision to remove limitations on the number of plans each
employee group will now be able to offer.  The Board understands that
allowing more choice at the employee level could be an additional
administrative burden on entities as well as employees trying to make
the right choices.  In addition, allowing an individual to decide
whether to enroll in an orthodontia plan without regard to the dental
plan coverage would have resulted in adverse selection and unsustainable
rates for an orthodontia benefit.  OEBB will still offer one dental plan
without orthodontia coverage for those employees who do not wish to have
orthodontia coverage and/or who want a lower-cost option that still
provides preventive dental care and a comprehensive level of coverage
for themselves and their families.

Even with the move to include orthodontia coverage in most of the dental
plans, under the ODS dental plans, the largest increase will be just
under 7.5 percent with many employees realizing a decrease of around
0.50 percent.  Employees currently under ODS Dental Plan 6 with
orthodontia who have no need for orthodontia coverage and remain on Plan
6 will see a decrease in premiums of nearly 10.90 percent.  

Another change under the dental program is that employees who want to
enroll in the Kaiser dental plan can do so without having a Kaiser
medical plan. This has been requested by employees in the past and the
Board took those requests into consideration when deciding to remove
that requirement.  Orthodontia coverage will be included in the Kaiser
dental plan beginning October 1, 2012, as well.  Kaiser dental plan
rates will actually decrease for the 2012-13 plan year by as much as
12.61 percent for those individuals currently on a Kaiser plan with
orthodontia coverage.  All other Kaiser dental plan enrollees will see a
decrease of 7 percent and have an orthodontia benefit available to them.

The Willamette Dental option has always included an orthodontia benefit
and will continue to do so.  There is no rate increase on the Willamette
Dental plan.

The Board also considered and approved the rate renewal proposed for
coverages available through The Standard.  The Basic Life Insurance
rates will increase by 5 percent on October 1, 2012, but will still
remain more than seven cents per $1,000 in coverage lower than the
average pre-OEBB rate for basic life coverage.  Optional employee,
spouse and child life rates will not change, nor with Basic and Optional
accidental death and dismemberment rates.  Rates for the short-term
disability options will increase by 2 percent, and the rates for the
long-term disability options will increase by 5 percent - both still
lower than the average pre-OEBB rates in 2008.

The OEBB administrative fee will increase slightly for the 2012-13 plan
year.  The Board had decreased its administrative fee from 0.95 percent
to 0.85 percent for the 2011-12 plan year.   The administrative fee is
based on the overall medical, dental and vision premiums collected
throughout the year.   With the larger than anticipated movement to
lower-cost medical plans for 2011-12 and the expectation that this trend
may continue, as of October 1, 2012, the fee will increase to 0.90
percent.  The OEBB administrative fee is authorized by ORS 243.880 and
may not exceed 2 percent.  It is the only revenue stream available to
fund the Board's operating expenses.

OEBB staff is working to translate the renewal increases into actual
premium rates at this time.  We anticipate posting the new rates on our
website on or around May 1 and will be prepared to talk about the plan
changes and rate renewals during the insurance committee meetings
scheduled for the month of May and into early June.

I hope this information is helpful to you and your coworkers and peers.
The document presented to the Board during the rate renewal discussion
is now posted on the OEBB website at:
http://www.oregon.gov/OHA/OEBB/docs/MeetingAttachments/2012/BoardHandout
A_042612.pdf.  We've also posted the criteria and details relating to
the addition of bariatric surgery as a covered benefit under both the
ODS and Kaiser medical plans effective October 1, 2012, at:  

http://www.oregon.gov/OHA/OEBB/docs/MeetingAttachments/2012/BariatricSur
geryCriteria.pdf
<http://www.oregon.gov/OHA/OEBB/docs/MeetingAttachments/2012/BariatricSu
rgeryCriteria.pdf> . 

If you have any questions, concerns, suggestions, or comments regarding
these Board decisions, please send them to:  OEBB.Board at state.or.us or
feel free to give me at call at 503-378-5133.  Thank you. 

Sincerely,

Denise L. Hall

Denise L. Hall, Deputy Administrator

Oregon Educators Benefit Board

http://egov.oregon.gov/OHA/OEBB <http://egov.oregon.gov/DAS/OEBB> 

(503) 378-5133

(503) 378-5832 FAX

OEBB encourages all members to stay healthy and be happy!!!!     Pass it
on.....  http://www.oregon.gov/OHA/OEBB/WellLinks.shtml
<http://www.oregon.gov/OHA/OEBB/WellLinks.shtml>     

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