FY 2024 Approved Meeting Minutes

DRAFT FRIC Meeting Minutes
TENTATIVE AGENDA
March 1, 2024
Zoom Meeting
1130 AM

Members present: Julie Urmie*, John Laverty*, Josey Bathke+, Mary Charlton, George Hospodarsky, Daniel Katz, Cormac O’Sullivan, Richard Peter, Angela Speers, Sarah Tallman, Anand Vijh, Michael Weaver, Chuck Wieland

*Co-chairs; +Minutes

Members absent: Anya Prince

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Audra Haddy, Kate Klefstad, Erin Litton, Britt Marcussen, Cheryl Reardon, Julie Sexton, William Silverman, Cheri Smith, Dana Stafford, Melissa Twait, Jessica Wade, Kara Wright, Megan Threlkeld

  1. Introductions– Urmie and Laverty
    • Meeting called to order at 11:32AM
  2. Approval of February meeting minutes – Urmie and Laverty
  • Chuck Wieland moved to approved
  • Dan Katz seconded the motion
  • No discussion
  • February minutes were approved unanimously
  1. Investment Management Consultant selection – Troester
    • Captrust selected by RFIC to be investment management consultant
    • Timeframe reviewed w/anticipated beginning in Q2 of 2024
    • Initial goals discussed for the 3 plans
  2. Update on Mercy IC Transition – Troester
    • Health Plan Covered Lives - UI Self-Funded Employer Plans
      1. Enrollment as of 2/23/24 was:  666 total with 368 in UI Choice and 298 in UI Select
      2. Final enrollment numbers will be shared at FRIC’s April Meeting
    • Level One vs Level Two Coverage
      1. Draft communication to FRIC members on 2/29/24
        1. Mercy/UIHC Downtown is a Level One facility with Level One providers
        2. Other locations (like Solon, etc.) are also Level One facilities
        3. Independent providers at Mercy/UIHC Downtown are considered Level Two
      2. Message will be finalized and sent to all employees the week of 3/4/24
      3. All employee questions on this should be sent to Wellmark or UI Benefits websites
  3. Review/Discussion of Recommended Dental Plan Change – Olson/Troester
    • OPTION:  Annual Deductible for Premier and Non-Par Networks (recommended by Benefits staff)
      1. Current is $0 deductible
      2. Proposed change:   $15 annual deductible when using Premier and Non-Par Networks
      3. Estimated $405K plan savings because approximately 27K members (53% of members @ $15)
      4. Peer comparison:  ISU similar plan charges $50 annual deductible
      5. Additional Info requested:
        1. Dentists in the PPO network = 5
          1. Can this be expanded?  Can we ask Delta to expand this network?
          2. UI Benefits will go back to Delta and ask
        2. UI College of Dentistry Wait Times
          1. Endodontics & Periodontics – Feb openings
          2. Operative – March openings
          3. Pediatric – April openings
        3. Members using each network
          1. PPO = 33%
          2. Premier = 64%
          3. Out of Network = 3%
      6. Discussion:
        1. This option will only cover approx. half of the $1M deficit
        2. Providers and size of network reviewed
        3. $15 vs larger deductible? 
      7. Chuck Weiland moved to approve
      8. Cormac O’Sullivan seconded the motion
      9. No additional conversation held
      10. Motion approved unanimously
  4. Review/Discussion of Recommended OPM change for Rx – Olson/Troester
    • Previously discussed both medical and pharmacy OPM but this conversation is now focused on Pharmacy OPM only
    • Proposal:  change to RX OPM
      1. UICHOICE today single is $1,600 increase to $2,100; today family is $3,200 increase to $4,200
      2. UISELECT today single is $2,000 increase to $2,900 ; today family is $4,000 increase to $5,800
      3. Annual savings of $1.5M for UI Choice and $157K for UI Select
      4. Members impacted for UI Choice are 2,008 and UI Select are 141
      5. More discussions to be held next month
  5. Discuss Wght Mgt. Rx strategy and pilot program for GLP-1 coverage – Troester
    • Last month FRIC expressed support for a pilot program
    • Proposed pilot utilizes a step therapy/prior authorization approach as we develop an approach and refine
    • Best practice is still evolving related to treatment and coverage
    • Proposed Pilot Structure:
      1. 2 year pilot program for employee members only in UI Choice and UI Select 
        1. Y1 2025 – up to 500 enrollees
        2. Y2 2026 – additional enrollees TBD; dependent on year one
      2. Utilize step therapy approach and prior authorization
      3. Multidisciplinary Advisory Group to be created to advise on admin, eval and outcomes
        1. Benefits Administration
        2. Campus Health Officer
        3. Medical Providers
        4. Pharmacist
        5. Possibly a researcher
    • Chuck Weiland motioned to support the proposed pilot program as presented
    • Cormac O’Sullivan seconded the motion
    • No additional discussion held
    • The motion was unanimously approved
  6. PBM RFQL Update – Troester
    • 13 bids received, 6 viable after review
    • April 2024 – Committee reviews top candidates; select candidates to proceed
    • May 2024 – Candidate presentations end with committee; choose top candidate
    • May 2024 – Negotiations begin
    • June 2024 – Negotiations completed
  7. Access Metrics – Troester
    • January 2024 access metrics reviewed 
    • Specialty Care trending up; not yet at 80% 
    • Troester noted that it is still too early in the Mercy acquisition to know how/if the additional members will impact access 
    • There are educational opportunities related to how/if members should use Downtown campus ER

Next FRIC Meeting

April 5th from 11:30 a.m. to 1:00 p.m.

Via Zoom

 

DRAFT FRIC Meeting Minutes
February 2, 2024
Zoom Meeting
11:30 AM – 1:00 PM

Members present: Julie Urmie*, John Laverty*, Josey Bathke, George Hospodarsky, Daniel Katz, Cormac O’Sullivan, Richard Peter, Anya Prince, Angela Speers, Sarah Tallman, Anand Vijh, Michael Weaver+, Chuck Wieland

*Co-chairs; +Minutes

Members absent: Mary Charlton

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Audra Haddy, Kate Klefstad, Erin Litton, Julie Sexton, William Silverman, Cheri Smith, Dana Stafford, Jessica Wade, Britt Marcussen, Melissa Twait

  1. Introductions – Urmie and Laverty
    • Meeting called to order at 11:32 AM
    • An additional meeting has been added for April 19, 2024 (if needed)
  2. Approval of November meeting minutes – Urmie and Laverty
    • Chuck Wieland moved to approve.
    • Angela Speers seconded the motion.
      • No discussion.
    • December minutes were approved unanimously.
  3. Final Results of Open Enrollment – Olson
    • Open enrollment ended on Wednesday, November 15.
    • UI Select enrollment increased by 120 elections.
    • UI Choice decreased by 323 elections.
    • 81% elected UI Choice while 19% elected UI Select compared with 82%/18% respectively in 2023.
    • Mercy employees transitioning to the University of Iowa will continue to enroll through the end of February. These numbers will be reported at the March FRIC meeting.
  4. Investment Management Consultant Selection - Troester
    • The Retirement Fund Investment Committee (RFIC) has made its selection from two final-ists; both firms were excellent options.
    • Contract is anticipated to begin in Q2 of 2024.
  5. Update regarding Mercy Hospital transition – Troester
    • Day one of operation under UI Healthcare was January 31, 2024.
    • The facility is now a level one provider along with other affiliated clinics located outside of the Iowa City area (Williamsburg, West Liberty, Tipton, etc.).
    • WellMark has been provided with the updated information; communication to members will come later in February or early March.
    • Several independent practices continue to operate in the Market Street facility. Those will likely continue to operate independently as level two providers.
    • The addition of Mercy will bring approximately 800-900 contracts to the UI health plan. UHR is looking at the health profile of the new contracts to understand the effect this will have on future rates.
    • UHR is working with shared governance to understand how these new employees will be incorporated into UI Shared Governance and the Charter Committee system including FRIC.
    • New employees have until the end of February to enroll in a health plan and until the end of March to enroll in a retirement plan.
  6. Review/Discussion of Recommended Dental Plan Changes – Olson/Troester
    • UI dental plan is comparatively robust and the cost to the employee is low. Changes to the plan design have not been made in seven years. Going forward, the dental plan will be reviewed more frequently.
    • Proposed change is to include a $15 annual deductible per member when using Premier and non-participating providers (PPO network would maintain a $0 deductible).
    • Iowa State University’s plan includes a $50 deductible for non-PPO providers and $25 for in-network providers. UI’s plan continues to benchmark positively against geographical peers.
    • UHR will gather data on how many current providers are in and out of network prior to March vote on the recommendation.
    • Other options to eliminate the deficit include reducing coverage for periodontic maintenance therapy or high-cost services such as dentures, crowns, and bridges. The committee felt the deductible option was more equitable.
  7. Review/Discussion of Recommended OPM changes for Medical and Rx – Olson/Troester
    • Consider increasing out-of-pocket maximum (OPM) levels for medical and prescription drugs to limit increases to overall premiums.
    • Two years ago, Medical OPMs increased by $300 for single plans and $600 for family plans for level 1 & 2 providers, and by $500 and $1,000 respectively for level 3 providers (same increases for both UI Choice and UI Select plans). Proposal is for a similar increase in 2025.
    • Medical OPM increase would affect approximately 764 UI Choice members and 56 UISelect members.
    • Two options were provided for Rx plans for both UISelect and UIChoice, which would affect approximately 1,950-2,100 UIChoice members and 140-145 UISelect members.
    • More data will be provided in March regarding how these numbers break down between single and family plans.
    • UIs OPMs would continue to compare very favorably with average WellMark PPO and HMO plans.
    • Increased OPMs do not factor in cost of adding coverage for GLP-1 (weight loss drugs).
    • New Pharmacy Benefit Manager, once in place, may be able to offset some of these increases with more favorable contract, drug rebates, etc.
  8. Information/Discussion on Weight Mgt. Rx strategy and coverage – Troester 
    • Landscape around GLP-1 drugs continues to change.
    • UHR is proposing a pilot program to offer coverage to approximately 500 employee members in 2025.
    • Drug coverage for 500 employees could cost up to $7M (estimate only).
    • FRIC showed initial support for the pilot program.
    • UHR will engage with an outside vendor to determine the scope and scalability going forward.
  9. Pharmacy Benefit Manager (PBM) RFQL Update – Troester
    • 13 bids have been received and are currently under review.
    • Committee will meet in March to select finalists to proceed.
    • Candidate presentations will take place in April, followed by the selection of a top candidate.
  10. Access Metrics – Troester
    • Remained steady with a slightly positive trend in specialty care.

Meeting adjourned

  • Motion to end meeting moved by Chuck Wieland
  • Seconded by Richard Peter
  • No discussion
  • Committee agreed to adjourn unanimously at 12:57 PM

Next Meeting: March 1, 2024 via Zoom 

DRAFT FRIC Meeting Minutes

December 1, 2023

Zoom Meeting

11:30 AM – 1:00 PM

Members present: Julie Urmie*, John Laverty*, Josey Bathke, Mary Charlton, George Hospodarsky, Daniel Katz, Cormac O’Sullivan, Richard Peter+, Anya Prince, Angela Speers, Sarah Tallman, Anand Vijh, Michael Weaver, Chuck Wieland

*Co-chairs; +Minutes

Members absent: none

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Marcelo Correia, Audra Haddy, Leon Jons, Kate Klefstad, Erin Litton, Cheryl Reardon, Katie Robinson, Julie Sexton, William Silverman, Cheri Smith, Dana Stafford, Megan Threl­keld, Jessica Wade, Kara Wright

  1. Introductions – Urmie and Laverty
  2. Approval of November meeting minutes – Urmie and Laverty
    • Chuck Wieland moved a motion to approve
    • Anand Vijh seconded
    • No discussion
    • November minutes were approved unanimously
  3. Open Enrollment Update – Olson
    • Open enrollment ended on Wednesday, November 15
    • Similar participation levels as in previous years (»60%)
    • 80/20 split between UIChoice and UISelect
    • Annual year-end benefits reminder email sent out 1st week of December
  4. WellMark Plan Modernization Follow-up – Olson
    • myWellmark prompted members to update Primary Care Provider (PCP)
    • Letter mailings will be sent to members about PCP assigned by Wellmark after January 1
    • University Benefits will send a targeted email to members during first week of December for background and to clarify expectations
  5. Update regarding Mercy Hospital transition – Troester 
    • Mercy will come under the same tax ID as UIHC
    • Mercy on Market Street will be Level 1 starting Jan 31; communication after holidays
    • Billing of Mercy providers currently discussed
    • Suggestion of dedicated website to inform public about process
  6. Aon Information: Marketplace and Employer Planning: Weight Loss Rx Coverage – Troester 
    • Broad spectrum for how employers address GLP-1 coverage for obesity
    • Unrestricted (very few employers), minimal restrictions (few employers), restrictive and no coverage (many employers)
    • Dynamic environment with many employers reconsidering coverage in both directions (i.e., expanding coverage or reducing coverage)
    • Restrictive coverage requires prior authorization and evidence of behavior modifications prior to Rx refill 
    • Creates risk of rebate loss on drugs because rebate is gained when following FDA guidelines for prescription
    • Rebate loss would be absorbed by plan (rebates help keep premiums at lower rate)
    • Joni will investigate rebate loss in more detail during spring semester
    • Common to have prior authorization criteria that are stricter than FDA recommendation 
    • Weight Mgt. Rx strategy should be reassessed year-to-year
    • Considerations in the Weight Mgt. Rx strategy: formulary placement, clinical criteria for coverage, plan design & member cost share, prescriber network, member engagement, reporting, metrics for success, behavior modification 
    • Level for GLP-1 medication can be different than when used for diabetes (level can serve as lever) 
    • Weight Mgt. drug pipeline keeps expanding (CagriSema, Orforglipron, Retatrutide); FRIC will continue to monitor 
    • Current supply chain issues with Ozempic and Wegovy will be monitored by FRIC throughout 2024
  7. Weight Loss Rx Presentation – Dr. Leon Jons: UIHC Weight Management Providers (also present: Marcelo Correia, Katie Robinson)
    • Use of behavioral intervention prior to medication
      • Evaluation of causes of weight gain and barriers to weight loss 
      • Behavioral intervention as first step, followed by pharmacotherapy, followed by surgery
      • Behavioral intervention should always be used before other means and should always be part of any other approach
      • Can be required for people to be considered for pharmacotherapy; e.g., 6-month program before prescription (MOVE program at VA)
      • Documented effectiveness of behavioral intervention in prevention or delay of type 2 diabetes (article)
    • Use of medication around bariatric surgery outcomes
      • Different examples (liraglutide/semaglutide, phentermine/topiramate)
      • Use of medication around bariatric surgery has positive effects
    • New research
      • Cardiovascular outcome trial (SELECT trial, article)
      • Multicenter, double-blind, randomized, placebo-controlled trial
      • 17,600 patients, age 45 or older, preexisting cardiovascular disease, BMI of 27 or greater, no history of diabetes
      • Once-weekly subcutaneous semaglutide (2.4 mg) or placebo
      • 20% reduction in death from cardiovascular disease, non-fatal myocardial infarction or nonfatal stroke at mean follow-up of 40 months
      • Some patients discontinued trial for side effects (16% semaglutide, 8% placebo)
      • Likely different benefits of the drug
      • Surmount 1 trial (article)
      • Phase 3 double-blind, randomized, controlled trial
      • 2,539 adults, BMI of 30 or more, or 27 or more and at least one weight-related complication, excluding diabetes
      • Once-weekly subcutaneous tirzepatide (5mg, 10 mg, or 15 mg) or placebo
      • Mean weight loss at week 72 was 20.9% for 15 mg dose
      • 85% of patients receiving tirzepatide had weight loss of at least 5%
    • Narrow provider network
      • Small number of providers who are board-certified in obesity medicine
      • Limited capacity to take on patients
    • Outcomes in patients with higher BMIs
      • BMI not a good measure but often used
      • Discussed metabolic complications (e.g., diabetes, fatty liver disease), mechanical problems (e.g., hyperventilation, disability), psychological/psychosocial problems (e.g., stigma)
      • Lowering BMI typically improves other issues as well
      • Weight loss also reduces cancer risk (referrals from oncology)
    • Economic impact of obesity in Iowa estimated at $725m annually
    • Recommendations for employers
      • Offer insurance coverage and wellness programs for obesity care at parity with other chronic diseases
      • Foster a culture of support and inclusion
      • Provide education and resources
    • Landscape of obesity pharmacology
      • Insurance coverage: Federal government, VA, Tricare, Iowa City Public Schools, Waterloo Public Schools
      • Dropping insurance coverage in 2024 due to financial commitment: State of Iowa, Iowa State University
    • Models of care: MOVE program at VA, requiring behavioral interventions, narrow prescriber network, limiting access to higher BMIs and patients with comorbidities, weight loss requirements to continue medication, monitor potential future FDA approval of semaglutide for cardiovascular risk reduction
    • Discussion
      • BMI or weight-loss targets for certain types of surgeries or prevention 
      • Effect of Ozempic on A1C levels
  8. Pharmacy Benefit Manager (PBM) RFQL Update – Troester
    • Timelines are being met
    • Draft guiding principles 
      • Promote choice, flexibility, accessibility and inclusiveness for employees and their families
      • Emphasis on quality and value in plan design
      • Promote positive behaviors by employees
      • Ease of use by employees, ease of administration by University
      • Recognize and balance the role of University as employer, provider of health services and educational institution for health professionals
      • Strive to minimize disruption to plan members due to new formulary
      • Focus on a PBM relationship which is sustainable
      • Balance PBM standardization and UI customization requests
      • Ensure access to de-identified data and reporting to guide decision making
    • At least 5 year time horizon for new PBM relationship
  9. New Business: Draft Discussion Schedule for Spring 2024 Semester – Troester
    • Following proposal:
      • February: final result of open enrollment, update on Mercy, dental plan changes, OPM changes for medical and Rx, discussion on Weight Mgt. Rx strategy and coverage
      • March: finalize dental plan changes and OPM changes for Med/Rx motion and vote; continued discussion on Weight Mgt. Rx strategy
      • April: ID draft recommendations for Weight Mgt. Rx coverage, specialty Rx presentation
      • May: voluntary benefits survey results, final recommendation for Weight Mgt. Rx coverage, motion and vote
    • Possibility to schedule additional meeting and cancel if not needed
    • Will know from PBM RFQL how exactly prior authorization can be tailored when discussing Weight Mgt. Rx strategy and coverage
    • Weight Mgt. Rx strategy as pilot for initial years due to dynamic nature of weight loss drug environment; continuous reevaluation 
  10. Access Metrics – Troester

  • Meeting adjourned

  • Motion to end meeting moved by Chuck Wieland

  • Seconded by Cormac O’Sullivan

  • No discussion

  • Unanimously agreed

Next Meeting: February 2, 2024 on Zoom 

DRAFT FRIC Meeting Minutes

November 3, 2023

ZOOM Meeting

11:30 am

Members present: Julie Urmie*, Anya Prince, Chuck Wieland, George Hospodarsky, Richard Peter, Daniel Katz, Cormac O’Sullivan+, Sarah Tallman, Mike Weaver, Anand Vijh, Angela Speers, Mary Charlton, Josey Bathke

*Co-chairs; +Minutes

Members absent: John Laverty

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Cheri Smith, Dana Stafford, Julie Sexton, Kara Wright, Jessica Wade, Cheryl Reardon, Audra Haddy, Shelly Kurtz, Erin Litton, Melissa Twait, Megan Threlkeld, Lisa Mascardo, Kayla Godfrey, William Silverman

  1. Introductions and Roll Call

  1. Approval of October meeting minutes
    1. Chuck Wieland moved to approve the minutes of that meeting.
    2. Richard Peters seconded.
    3. Motion was approved unanimously.

  1. Open Enrollment Plans
    1. Rebecca Olson presented information about open enrollment which commenced on November 1 and runs until November 15, 2023. Discussed various changes to the benefits package and communications to faculty and staff. Will continue to have the dedicated open enrollment mailbox. It was well-utilized when it was rolled out. Campus building TV slides will run an open enrollment slide. Informational handouts and videos available in English, Spanish, and French. Healthcare interpretation services available as needed and HealthEquity has interpreters available for FSA questions.
    2. Enrollment tracking with similar numbers to previous years. Reminders will be sent next week to those who have not finalized and again one day prior to the end of open enrollment.
    3. Preliminary results will be available at December meeting and final enrollment numbers will be available at February, 2024 FRIC meeting.
    4. Retiree benefits: Medicare open enrollment is slightly different timeline, so they got a letter from the benefits department last week in September to align with the Medicare open enrollment timeline running October 15 through December 7, 2023

  1. Wellmark Plan Modernization Follow-up
    1. Rebecca Olson gave an update to the Wellmark Plan Modernization topic.
    2. Benefits met with UIHC and both had similar questions about the Wellmark update.  UIHC sent provider specific questions to Wellmark provider relations area. They are waiting on response.
    3. Wellmark has assured UIHC and Benefits that the “assigned” primary care provider will NOT function as a gatekeeper and will not impact the ability to see the PCP of your choice. However, if a PCP is not selected by the enrollee, one will be assigned by Wellmark. There is no ability to opt-out of this PCP requirement.  
    4. Reminder: If a PCP is assigned by Wellmark, they will send a letter notification which lists the assigned PCP for contract holder and their dependents. The letter will also include information about how the contract holder may update their PCP. These letters will be sent sometime after January 1st.
    5. As more information is known, updates will be shared in the December meeting.

  1. Weight Loss Rx Presentation
    1. Reminder this is an ongoing discussion throughout the year.
    2. Lisa Mascardo and Kayla Godfrey from UI Healthcare Pharmaceutical Care shared information on GLP medications being used for weight loss.
    3. They covered general information about the pharmaceutics of the various available medications, prescription patterns being seen at UIHC and statewide, availability of medications, and cost were shared with the committee.
      1. Wegovy and Saxenda are currently approved for weight loss and being prescribed for such around the country and in Iowa.
      2. There is a significant shortage of both medications which is predicted to last through 2024.
      3. UIHC is currently limiting dispensing of these medications to diabetic patients due to the supply shortage.
      4. The shortage has created a side supply chain of a compounded salt version of the medications which is NOT approved for human use and does not appear to work as well.
      5. Lisa and Kayla indicated the medications are lifelong administration and if patients come off the medications, they may likely regain much of the weight they lost especially if strong behavior modification skills aren’t in place.
      6. In their experience, very few patients come off the medications due to potential weight gain.  
      7. A major hurdle at present is the supply chain and unavailability of the medications. Especially the starting doses needed to begin treatment which are not available at present time.
      8. Cost is also a concern per the UIHC pharmacy specialists.
      9. Providers from UI Weight management clinic will present to FRIC in December.
      10. Materials being added to FRIC shared drive as they become available.

  1. Survey Regarding voluntary benefits
    1. Rebecca Olson shared information on Yr 2 Strategic Plan initiative to assess UI employees desire for additional “voluntary” benefits. These include things like vision insurance, pet insurance, legal services, etc. A subcommittee will form and survey a random sample of UI staff about their wants and needs. If an external entity offers a commonly requested service, benefits office will ask for RFP and the subcommittee will determine if possible to offer to UI staff.
    2. For “voluntary” benefits, the UI Benefits acts as a payroll deduction remitter by deducting the money from the employee’s paycheck and sending it to the vendor of the service. UI does not manage voluntary benefits.
    3. Anyone wishing to be on the subcommittee on voluntary benefits can contact Rebecca. 

  1. PBM RFQL Update
    1. Joni Troester reported that the PBM RFQL process is on track. A key goal for the new PBM is to allow UI to tailor some pharmacy benefits to meet UI needs. PBM Committee will start reviewing top bids in February/March 2024. PBM change will be January 1, 2025.

  1. Investment Management Consultant for Retirement Plans
    1. Joni Troester gave an update for the investment management consultant. Presentations by the four finalists being scheduled. The new contract is anticipated to be in place in early 2024. Updates in December and February FRIC meetings.
  2. Access Metrics
    1. Joni Troester presented the access metrics for October 2023. Meeting with UIHC patient access center to discuss continued difficulty to meet access goals within specialty care and general internal medicine. Efforts are ongoing to improve these statistics.
    2. No information on Mercy, Iowa City at the time of this meeting.
  3. New Business
    1. Dental plans will be reviewed in February 2024
    2. Out-of-pocket (OPM) medical and pharmacy will be reviewed in spring 2024
    3. Continued discussion about the impact of weight loss reduction medications and other potential changes on the OPM’s and overall plan costs. Request for information about total plan costs, OPMs, other changes to be presented in total cost package for discussions.
    4. Plan design changes will need to be voted on by the May FRIC meeting in order to process through the UI administrative system to President Wilson for submission to the Board of Regents in time for implementation in 2025.

Motion to adjourn: Weiland; Seconded Speers; approved unanimously.

DRAFT FRIC Meeting Minutes

October 6, 2023

ZOOM Meeting

11:30 am

Members present: Julie Urmie*, John Laverty*, Anya Prince+, Chuck Wieland, George Hospodarsky, Richard Peter, Daniel Katz, Cormac O’Sullivan, Sarah Tallman, Mike Weaver, Angela Speers, Mary Charlton

*Co-chairs; +Minutes

Members absent: Josey Bathke, Anand Vijh

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Cheri Smith, Dana Stafford, Julie Sexton, Cheryl Reardon, Audra Haddy, Shelly Kurtz, Erin Litton, Jessica Wade, Melissa Twait, Megan Threlkeld, Kate Klefstad

  1. Introductions and Roll Call

  1. Approval of September meeting minutes
    1. Chuck Wieland moved a proposal to approve the minutes of that meeting.
    2. Mike Weaver seconded.
    3. Motion was approved unanimously.

  1. Open Enrollment Plans
    1. Rebecca Olson presented information about open enrollment which runs November 1 until November 15th. Discussed FSA dollar amount increase and communications to faculty and staff. Will continue to have the dedicated open enrollment mailbox. It was well-utilized when it was rolled out. Campus building TV slides will be shown around campus.
    2. Retirees: Medicare open enrollment is slightly different timeline, so they got a letter from the benefits department last week to align with the Medicare open enrollment timeline.
    3. Interpretation: Written materials available in English, Spanish, and French. Benefits office utilizes healthcare interpretation services if needed and HealthEquity has interpreters available for FSA questions.

  1. HealthEquity Six Month Update
    1. Rebecca Olson shared 6 month stats with HealthEquity as well as feedback heard from employees, which is overwhelmingly positive.
    2. Will share similar statistics in the February 2024 FRIC meeting.

  1. Wellmark Plan Modernization Follow-up
    1. Rebecca Olson gave an update to the Wellmark Plan Modernization. This was discussed in the September Meeting, where the new platform would have a designated primary care provider listed. As discussed last month, this does not impact the ability to see the PCP or your choice or obtain plan benefits.
    2. The new information for October: A letter will be sent to enrollees that lists their PCP for themselves and their dependents. It gives information about updating the PCP listed. These letters will be sent after January.
    3. There will be more information available in November.
    4. Rebecca Olson discussed how Wellmark requires this new field designation, so it can’t be left blank and there is no ability to opt-out.
    5. Discussion:
      1. There were questions about how the Wellmark system will designate a PCP when there isn’t one. If Wellmark designates a PCP, then will the PCP know that they have a new patient? Will that PCP have capacity to actually take that person? The current understanding is that there is no communication between the Wellmark payment system and the healthcare side.
        1. There are ongoing talks with UIHC providers and Wellmark to discuss these concerns.
      2. There was a question about whether Iowa should also send a letter to clarify what the Wellmark letter means for them. (i.e. that they don’t have to have a PCP to see a provider). Iowa is planning to send out communication prior to Wellmark’s letter.

  1. Weight Loss Rx Discussion
    1. Reminder that this is an ongoing discussion throughout the year.
    2. Joni Troester presented updates on this ongoing discussion. Joni Troester met in September with physicians who presented to FRIC in the Spring explaining the decision to not cover weight loss rx for 1/1/24, but continuing to discuss and research this area.
    3. Updates on peer benchmarks: Iowa State University was covering the medication through ExpressScripts, but as of 9/1/23 they are no longer covering this. There is not yet clarity on the reasoning for these changes.
    4. Materials in shared drive: Joni Troester discussed a variety of new resources that have been uploaded to the FRIC Shared Drive of materials.
    5. Questions for the committee over the year will be what some restrictions on any coverage would be: i.e. who prescribes, what behavioral interventions may need to be paired, what BMI level, etc. We can’t put these restrictions with our current PBM, but we can put that in the request in the PBM RFQL in the spring to be able to tailor the prior authorization.
    6. Please send helpful articles and resources to Joni and Rebecca and they will put in the shared drive.
    7. Joni Troester shared the presentation schedule:
      1. November 2023 – Lisa Mascardo from UIHC Pharmacy will present on observations on prescribing weight loss  rx patterns and supply
      2. December 2023 – Weight Management Clinic Physicians will discuss possibilities for narrow eligibility criteria, as well as how these prescriptions interact with bariatric surgery.
        1. Member requested information on how a referral system might work. Or the steps in a step program. The referral system could potentially be included in a discussion in February 2024. Joni will request the physicians to cover the step program in December.

  1. PBM RFQL Update
    1. Joni Troester presented the timeline for the PBM RFQL process. Purchasing will post in November. PBM Committee will start reviewing top bids in February, 2024. PBM change will be January 1, 2025.

  1. Investment Management Consultant for Retirement Plans
    1. Joni Troester gave an update for the investment management consultant. Nine firms responded to RFQL and four have been chosen for finalist presentations. The new contract is anticipated to be in place in early 2024.

  1. Access Metrics
    1. Joni Troester presented the access metrics for August 2023. Continued difficulty to meet access goals within specialty care. Efforts are ongoing to improve these statistics.
    2. Discussion about how the potential Mercy purchase could impact access and people’s perceptions over which providers will now be Level I providers.

Motion to adjourn: Chuck Wieland; Seconded Cormac O’Sullivan; approved unanimously.

To be approved at Oct. 06, 2023 meeting

Draft FRIC Meeting Minutes
August 1, 2023
ZOOM Meeting
11:30am

Members present: Julie Urmie*, John Laverty*, Josey Bathke, Anya Prince, Angela Speers+, Sarah Tallman, Chuck Wieland, Richard Peter, Mary Charlton, Cormac O’Sullivan, Mike Weaver, George Hospodarsky, Anand Vijh, Daniel Katz

*Co-chairs; +Minutes

Members absent: none

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Cheri Smith, Dana Stafford, Jessica Wade, Kara Wright, Julie Sexton, Cheryl Reardon, Audra Haddy, Britt Marcussen, Erin Litton, Jessica Wade, Bernard Sorofman, David Fitzgerald

  1. Introductions– Urmie and Laverty
  • John Laverty is the new staff co-chair for the FRIC committee

  1. Welcome New Staff Members
    1. Mike Weaver
    2. George Hospodarsky

  1. Approval of May meeting minutes – Urmie and Laverty
  • Motion to approve:  Chuck Wieland
  • Seconded:  Mary Charlton
  • No discussion
  • Unanimously agreed
  • Opposed: None

  1. CY2024 Retiree Health Rates – Information Only

Industry Trends

  • Aon 7.4% Medical; 11.0% Rx
  • Wellmark 6.75% Medical; 13.0% Rx

Monthly premiums

  • UIChoice Single $1018 (increase 1%)
  • UISelect Single $916 (1% increase)
  • Note: $288 per month subsidy for eligible retiree continues for CY2024

  1. CY2024 Dental Rates – Discussion
  • Recommended 3% increase across all family status for 2024
  • Reminder- no rate increases 2018-2022: 3% increase for 2023

  • Approval
  • Motion to approve:  Chuck Wieland
  • Seconded:  Josie Bathke
  • No discussion
  • Approval: unanimous
  • Opposed: none

  1. CY2024 Health Rates – Discussion
  • Plan Change Adjustment: Change in relative value due to changes in plan design per Aon Modeling
  • PPO Cost Factor: used in setting the rate ratio between the two plans
  • Tier Ratio: The ratio between the Employee Only premium and the other Family Status assuming the Employee only premium is 1

  • Industry Trends
    • Aon 7.4% Medical; 11.0% Rx
    • Wellmark 6.75% Medical; 13.0% Rx

  • Projected Trends:
    • Use 7.4% for Medical; 11.0% for Rx (majority due to specialty Rx)

% Change in Premiums for 2024

    • UIChoice 5.75%
    • UISelect 1.7%

  • Approval
  • Motion to approve:  John Laverty
  • Seconded:  Sarah Tallman
  • No discussion
  • Approval: unanimous
  • Opposed: none

  1. Tentative Timeline – Troester
  • August 1- FRIC Discussion and Recommendation
  • August 9- Meeting with President Wilson to Review Recommendations
  • By August 28- Information provided by September Board Meeting Docket
  • By August 28- benefits website updated with CY2024 information with header “Pending Board of Regents Approval”
  • September 27, 28- Board of Regents

  1. Meeting Adjourned
  • Motion to end meeting moved by Chuck Wieland
  • Seconded by Richard Peter
  • No discussion
  • Unanimously agreed
  • Opposed: None

Next Meeting

September 1st from 11:30 a.m. – 1:00 p.m. via Zoom