FRIC Meeting Minutes
May 6, 2022
Zoom Meeting
1130 AM

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Members present:  Michael Schueller*, Julie Urmie*, John Laverty, Nancy Davin, Cathy Koebrick, Dan Katz⁺, Nicole Nisly, Cormac O’Sullivan, Angela Speers, Chuck Wieland, Anya Prince, Sarah Tallman, Richard Peter

*Co-chairs; ⁺Minutes

Members absent: Anand Vijh

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Kevin Zihlman, Jessica Wade, Dana Stafford, Cheryl Reardon, Audra Haddy, Britt Marcussen, Jill Valde

1. ---

   Introductions – Schueller and Urmie

2. Approval of April meeting minutes – Urmie and Schueller
   1. Chuck Wieland moved to approve
   2. Nicole Nisly second
   3. April minutes approved unanimously

3. Plan Design Review: Co-Pay/Co-Insurance/OPM rate increase proposals

The plan elements were reviewed, discussed and voted upon individually with discussion and consideration for total and percentage increases relative to current copay levels and between group comparisons for UIChoice and UISelect. Several recurring comments or themes emerged through the discussions. These included:

0. 1. 1. The need to address changes to co-pay and OPM rates on a more regular basis to avoid large absolute or percentage changes in one year.
      2. For multiple line items the possibility of introducing predetermined incremental changes was considered, but in the end the committee decided to make its best judgment for the necessary increase for this year alone and readdress possible changes in subsequent meetings/years.
1. Proposal: Increase Quick Care copay from $5 to $10

Discussion involved consideration of deterring Quick Care utilization due to a copay increase. Following discussion motion was made to accept the proposal as written (increase from $5 to $10).

Motion: By Nisly, to accept proposed changes as written

Second: Tallman

Vote: Unanimous

2. Proposal: Increase ER copay from $100 to $150

Discussion: Three main concerns about raising ER copay were raised. The first was that patients do not totally control where they are directed for care. Therefore, a patient may desire a visit with outpatient services and have intentions of utilizing healthcare resources in the most responsible way; however, their medical issue may be too serious for primary or outpatient care. Therefore, the copay cannot impact their decision-making in the way it was intended. Second, it was raised that the copay increase may affect families with children who require frequent emergency care. The group had sympathy for this point as it would affect young families, possibly already with heavy medical expenses, where the employee is toward the entry level of the pay scale. The third concern involved a possible unfairness in that for patients who are admitted the copay is waived. However, some patients may complete an “inpatient stay” entirely in the ER if the hospital is too full and therefore be subject to the copay. A final consideration was raised that it was difficult to have ER fees increase when there has not been an improvement in ER services over time. It was countered that the copay increase may, by design, divert unneeded ER visits to more appropriate venues, thereby improving ER access.   

It was proposed that the Medical and Pharmacy Out of Pocket Maximum discussion would further inform the conversation about the ER copay decision, and it was proposed and subsequently entertained by the Chairs that further discussion on the ER copay be considered later in the meeting. For the purpose of organizing the minutes, this note taker has taken the liberty of including below the results of the conclusion of the ER discussion when it occurred later in the meeting after the Medical and Rx OPMs were considered.

It was further discussed that it would be consistent with plan design to have differentiation in the plans as reflected by differences in ER copay amounts.

Motion: Nisly, that the Choice ER copay increase to $125 and Select copay increase to $150.

Second: Speers

Vote: 8 in favor, 4 against, 1 abstention

3. Proposal: Increase Urgent Care copay as follows:
   1. 1. UIChoice increase from $10/$25 to $15/$30, s/f respectively
      2. UISelect increase from $10/$35 to $15/$40, and $20/$50 to $25/$55; levels I and II, s/f, respectively

Motion: By Nisly, to accept proposal as written

Second: Laverty

Vote: Unanimously in favor of the motion

4. Proposal: Increase Inpatient Deductibles for UIChoice and UISelect per the table below.

Discussion: Concern was raised over the larger dollar amount increase in deductible particularly in the Select family status. It was further discussed that as a percent increase it was the same or lower across statuses compared with the proposed Choice increases and that it was important to plan design to maintain a distinction in the plans.

Motion: By Laverty, to accept proposal as written

Second: Tallman

Vote: Unanimously in favor of the motion

5. The Committee had previously requested data about peer benchmarking in order to frame the Medical and Pharmacy Out of Pocket Maximum Discussion. This was then presented in a table comparing the 2022 single and family plans of 14 peer institutions. A comparison of the 2022 family plans shows a range of the combined medical and prescription OPMs from $5500 to $17,400. For comparison, as of 2022, the University of Iowa combined (medical + Rx) family OPMs was $5600 (for both Choice and Select plans). The proposed changes continue to position the combined medical plus prescription OPMs for Select ($8000) and Choice ($7200) plans at the lower end of the 2022 range.

6. Medical and Pharmacy Out of Pocket Maximum

Proposed changes are summarized in the table below. The percentages and cost increase comparison, although not supplied in the table presented at the meeting, were added by this note taker as they factored in some aspects of the discussion. At the prior meeting an analysis of projected members affected by the cost increases was requested and this is provided to the group and is included in the tables below.

Discussion: It was decided to discuss and vote upon the medical and pharmacy OPMs separately.

1. Medical OPMs. There was a discussion about the impact of the cost increases, and particularly about the relative impact to UISelect members. Proposals about lower percent increases and phased increases were made and followed by debate. It was ultimately decided that as the percent increases were similar between the plans, and as there had not been an increase to the OPM since the plan inception in 2008, that with acknowledged rises in health care costs, and to maintain a distinction between the plans, to accept the changes as proposed.

Motion: by Laverty, to approve changes as proposed.

Second: Wieland

Vote: Unanimously in favor of the motion

*Note: 42,000 members across both plans

2. Pharmacy OPMs. Debate on the pharmacy OPM proposal centered on the potential impact of the relatively large cost increases in the Select plan (see below table). It was pointed out that the current plan does not reflect a plan differentiation between the Select and Choice plans. It was suggested that it would be best to phase in the Select cost increases to allow members to plan and blunt the effect of a large single year increase. After more discussion, a consensus emerged that phased plans would be problematic as it is difficult to predict the needs in future years and, that as the committee has a rotation membership, the knowledge of the intent to raise rates at a certain point might be lost. After more discussion of several straw recommendations, it was proposed to increase the UI Select single and family prescription OPMs to $1800 and $3600, respectively ($200 and $400 less than the proposed changes, respectively).

Motion: By Nisly, to accept UIChoice Rx OPMs as written and increase UISelect single and family Rx OPMs to $1800 and $3600.

Second: O’Sullivan

Vote: 5 in favor, 8 opposed

Further discussion ensued and was followed by a motion to accept the proposed changes as written.

Motion: By Wieland, to accept proposed pharmacy OPM increases as written

Second: Tallman

Vote: 11 in favor, 2 opposed

7. Aon/PBM Review

An update will be provided at the September meeting.

8. FSA Vendor Report

A vendor has been selected. The vendor’s website and cellphone app are user friendly and are anticipated to be an improvement over the existing process.

1. Adoption Assistance Pilot Program

The Board of Regents approved an adoption assistance pilot program. The University of Iowa will sponsor the program which will assist employees with adoption expenses incurred while finalizing an adoption. The eligible employee will have the opportunity to request reimbursement for qualified adoption expenses.  There will be limitations concerning what is considered an eligible expense, as well as the maximum benefit (reimbursement) available. 

Adjournment

Motion to adjourn by Nisly; second by Laverty. Meeting adjourned.

FRIC Meeting Minutes

April 1, 2022

Zoom Meeting

1130 AM

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Members present:  Michael Schueller*, Julie Urmie*, John Laverty, Nancy Davin, Cathy Koebrick⁺, Dan Katz, Nicole Nisly, Cormac O’Sullivan, Angela Speers, Chuck Wieland, Anand Vijh

*Co-chairs; ⁺Minutes

Members absent: Anya Prince, Sarah Tallman, Richard Peter

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Jessica Wade, Kara Wright, Dana Stafford, Cheryl Reardon, Audra Haddy, Britt Marcussen, Megan Hammes, Jill Valde, Siroos Shirazi, Michael Brownlee, Alex Mersch, Megan Threlkeld

1. Introductions – Schueller and Urmie
   1. Roll call taken
2. Approval of March meeting minutes – Schueller and Urmie
   1. Chuck Wieland moved to approve
   2. Nancy Davin second
   3. March minutes approved unanimously
3. UIHC Specialty Pharmacy

Mike Brownlee and Alex Mersch from UIHC Specialty Pharmacy Services presented an overview, data and other information regarding our specialty pharmacy program.  The program began in 2019 and is the required specialty pharmacy for our employee and retiree health plans.

A number of trends related to specialty pharmacy were shared, such as a shift of more meds to specialty which drives an increase in drug spend while potentially reducing the overall cost of total care due to increased quality of care.  Some factors that drive or mitigate drug spend were noted as well.

Specialty Pharmacy implications for our health plan include increase in specialty claims and members on therapy, rather large increase in claims for non-UI pharmacies, and total allowed amount also going up.  A review of data for UIChoice and UISelect shows an increase in dispenses of autoinflammatory therapeutic group from 2020 to 2021, and a very slight decrease in neurology claims.

Brownlee highlighted a number of service differentiators of UIHC Specialty Pharmacy Services:

• Pharmacist physically in the clinic and available to meet with patient (in person education).
• More streamlined and collaboration with other providers due to that physical presence.
• High touch member experience. Live person answers within 10 seconds typically.
• Identifying issues to Wellmark that disrupt patient care.
• Continuing to advocate for member access

Some data and metrics were shared.  Recently Trellis, a consulting company, released benchmark data on pharmacy performance. UIHC outperformed the benchmark (90) with a score of 93.  It was noted UIHC’s score also improved from last year (92). Other data shared included the average turnround time for a new Rx fill – 1.5 days for UIHC compared to other pharmacies at >5 days.   UIHC’s Specialty Pharmacy is currently licensed in 10 states.

Looking ahead, goals and plans include continuation of exemplary service / member experience, financial copay assistance access, evolving and expanding services, advocacy in the specialty market, and remaining a vested partner with the UI and Wellmark.  Also noted they are watching for and anticipate a shift of oncology meds going from specialty to generic.

Discussion and questions in response to the presentation included clarification that the UIHC discharge pharmacy provides 24/7/365 service.   It was noted that 20-30% of UI members get copay assistance related to specialty pharmacy. Also noted that members traveling or living in areas not currently licensed are covered via partnerships and collaborations with external pharmacies in those areas to ensure continuity of care.

4. Updates
   1. Troester provided an update on pharmacy benefit manager exploration for which AON has been engaged. Currently in phase 1 to see if it would be advantageous – nondisclosure agreement was just signed. Anticipate May meeting will have initial report from AON to share.
   2. Olson provided update on flexible spending account vendor search.  Interviews are now complete with the top 3 candidates.  Selection committee includes Laverty from FRIC plus key HR staff.  Selection committee will be meeting in April to review/rank candidates and provide an overall recommendation to leadership. Hope to choose by end of April so can present to FRIC at May meeting.

5. Health Plan Design Review

This was a continuation of March discussion, led by Olson.  Troester noted if there are changes for 2023, those will need to happen at May meeting to be in place for 2023.  Since last meeting, data has been collected related to employee/member cost share.

Overall trend information was shared.  UIChoice employee cost share dropped from 6.8% to 5.8% over the last 4 calendar years.  UISelect cost share dropped from 12.6% to 11.7% over the 2 years since the plan was implemented.

The Plan Provision modeling was updated to include total estimated plan savings if all proposed changes were made. 

The itemized dollar and percentage changes for UI Choice and UI Select plan modeling were reviewed:

• Quick care copay change from $5 to $10 for both plans (100% change); reminder that doc on Demand is available at no charge. Some discussion about whether this small financial impact is worth making the change.
• ER copays increase from $100 to $150 for both plans (50% change). Reminder that if member is admitted, ER copay is waived.  Also reminder that urgent care option is available. Some discussion around what is the cost (or other element) break point that causes someone to choose urgent care vs ER since a reason for this proposed change is to change behavior and encourage people to use urgent care vs ER. Also some discussion on waiver of copay due to admission vs appropriate use of ER services.  Comments regarding the importance of educating employees/members.
• Other copays increase by $5 (these copay differ by plan in some cases currently and will continue to.
• Inpatient deductible (UIChoice only) increase by 25%. Note this is a nonstandard benefit.
• Deductible (UISelect only) increase 25% or 18.75% depending on coverage.
• Medical OPM increases (vary by plan, individual/family, and provider tier – min 15%; max 25%);  Question about ISU OPM which is the same as what is proposed ($2000/$4000).  Some concerns that the significance of the increase for an employee’s OPM is too much.
• Pharmacy OPM increase 45.5% for UIChoice and 81.8% for UISelect.  

Troester provided a reminder that the intent of this benefit plan design review was no change to methodology of UIChoice – higher premium with lower out of pocket; UISelect lower premium with higher OOP.  It was noted that some organizations have a cost share design based on employee salary for premiums. 

The following were requests for additional data at May meeting

• How many members meet OPM on medical/Rx/both (understanding who is impacted the most). 
• Benchmark OPMs from BigTen.  
• Benchmarks from BigTen and any institutions that are doing salary-based cost share.

Adjournment

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Motion to adjourn by Wieland; second by Davin. Meeting adjourned 1:03pm

Funded Retirement and Insurance Committee (FRIC) Meeting Minutes
March 4, 2022
via Zoom at 11:30 AM

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Members present: Michael Schueller*, Julie Urmie*, John Laverty, Nancy Davin, Cathy Koebrick, Dan Katz, Anya Prince, Cormac O’Sullivan+, Sarah Tallman, Angela Speers, Chuck Wieland, Anand Vijh, Richard Peter

*Co-chairs; ⁺Minutes

Members absent: Nicole Nisly

Administrative staff present: Joni Troester, Rebecca Olson 

Visitors present: Cheri Smith, Jessica Wade, Dana Stafford, Julie Sexton, Cheryl Reardon, Audra Haddy, Britt Marcussen

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1. Roll Call/Introductions: Joni Troester completed roll call.
2. Approval of February Meeting Minutes: A motion to approve the minutes was made by Chuck Wieland, seconded by John Laverty, approved unanimously

3. Updates:

   1. Aon/Pharmacy Benefit Manager (PBM) exploration – Joni Troester

      1. Continuing to gather data for presentation on feasibility of creating direct PBM program. On track for report at May FRIC meeting. 

      2. Flexible Spending Account (FSA) Vendor Selection – Rebecca Olson

         • A committee of key UHR staff members, a data systems expert, and a FRIC member have reviewed FSA vendor proposals.  Three vendors have been selected for further interviews. Planning for selection of final vendor Spring 2022. 

      3. UIHC Access Reports – Joni Troester

         • UIHC is reaching targets for access by university plan beneficiaries in primary, specialty, and tertiary care.

      4. Quarterly Metrics – Rebecca Olson

         • Four quarters of plan metrics reviewed for both UI Choice and UI Select health plans

         • Roughly 85% of UI employees are enrolled in UI Choice and 15% in UI Select with enrollment in UI Select increasing over the previous year

         • UI Select began enrolling UI employees in calendar year 2020

         • Per-member-per-month costs for UI Choice members are roughly twice the cost for UI Select members for a variety of reasons

4.  Health Insurance Plan Design Review: Co-Pay, Co-Insurance, OPM – Joni Troester & Rebecca Olson

   1. Reviewed the Updated draft Guiding Principles:

      • Maintain quality health plan

      • Review annually, as an industry best practice

      • Drive utilization to cost-effective, quality solution

      • Standardize plan provisions, as much as possible

      • Provide ongoing communication and education to plan members

      • Prioritize plan member accessibility to quality health care

      • Balance employer and employee cost sharing arrangements

      • A plan review has not been conducted since the Health Benefit Review was conducted in 2018/2019. Several plan provisions within UIChoice have not been changed since 2008. 

      • Projected 2022 health claim costs by AON and Wellmark were presented to the committee

        • AON predicting a 5% medical, 7% pharmacy increase over 2021

        • Wellmark predicting a 7.25% medical and 11% pharmacy increase over 2021

   2. ​​​​​​​Summary of committee discussion: Lengthy discussion about guiding principles for the review of the health plans including overall plan design, inclusivity, quality, services offered, accessibility, cost-sharing, out-of-pocket payments, co-pays, and overall cost to beneficiaries and the institution. 

5. Rate setting is completed across the entire population, not by plan or by family status.

6. Discussion on whether to increase cost share for individual aspects of health plan and cost impact on plan members

7. Impact of Co-pays versus Co-insurance

8. Review of ER co-pay.   Other options available for care like Telehealth, Doc-on-Demand, QuickCare, UrgentCare vs. Emergency Room

   • Educate and incentivize use of best and most cost-effective care options given specific situations

9. Other various co-pays

   1. Mental health co-pays (no changes)

10. Inpatient versus Outpatient deductibles (differences between UIChoice and UISelect)

11. Differences in cost structures of UIChoice versus UISelect

    1. UIChoice is more expensive premium cost on a monthly basis but has lower co-pays and co-insurance requirements for some services when accessed

    2. UISelect is less expensive premium cost on a monthly basis but has slightly higher co-pays and co-insurance requirements for some services when accessed

    3. How to balance the differential cost structure versus employee choice for plans

    4. Discussion on out-of-pocket maximums (OPM) for individual plans and differences between OPM for medical care and OPM for pharmaceutical care.

    5. Should there be separate OPM for Medical and Pharmaceutical or one “global health care” OPM?

    6. Further discussion, informed by additional data, will happen at our April meeting.

• Final Points for future discussion:
  • Need for market corrective increases to both health plans. Distributing the increases over 1-2 years or more versus a large cost increase in a single year.
  • Maintaining the cost differential structure between the UIChoice and UISelect plans
  • Need for an annual review to prevent large increases in the future

Adjournment: The meeting adjourned at 1:00 PM after a motion by Chuck Wieland and seconded by Cathy Koebrick, and approved unanimously.

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Recorder: Cormac O’Sullivan

College of Nursing and UIHC Dept. Of Anesthesia

Funded Retirement and Insurance Committee (FRIC) Meeting Minutes
February 4, 2022
via Zoom at 11:30 AM         

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Members present: Michael Schueller*, Julie Urmie*, John Laverty+, Nancy Davin, Cathy Koebrick, Dan Katz, Nicole Nisly, Anya Prince, Cormac O’Sullivan, Sarah Tallman, Angela Speers, Chuck Wieland, Anand Vijh, Richard Peter

*Co-chairs; +Minutes

Members absent: none

Administrative staff present: Joni Troester, Rebecca Olson 

Visitors present: Cheri Smith, Kara Wright, Jessica Wade, Dana Stafford, Julie Sexton, Megan Hammes, Cheryl Reardon, Audra Haddy, Teresa Marshall, Britt Marcussen, Jill Valde, Kevin Zihlman, Brian Cassady, Keri Semrau, Phil Roudabush, Melissa Twait, Megan Threlkeld

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1. Roll Call/Introductions: Joni Troester completed roll call. Michael Schueller introduced new FRIC member Richard Peter from Tippie College of Business who is replacing Jon Garfinkel on the committee.

2. Approval of December Meeting Minutes: A motion to approve the minutes was made by Chuck Wieland, seconded by Nancy Davin, approved unanimously.

3. MyChart Presentation:  Brian Cassady, lead application developer for MyChart, began the presentation showing the variety of “community connection” sites across Iowa maintained by his team along with the main UIHC MyChart site. Patient engagement is key and MyChart makes it easy. Engaged patients are more likely to have healthier behaviors and use preventative health care options. Volumes of users of the platform have increased dramatically over the past two years, from 269,131 total users in October 2019 to 421,062 total users in October 2021. Much of this can be attributed to the pandemic. The Institutional Activation Rate in 2017 was 39.5%; in 2021 that number jumped to 66.6% with some age demographics up to 80%. Two new methods of activation include “Auto-Instant Activation” and “Instant Activation” triggered from messages sent to patients for new appointments who are not already using MyChart. Keri Semrau, Director of the UIHC Patient Access Center, then explained all the functions available to patients in MyChart, including: scheduling, reminders, Fast Pass Wait List offers, eCheck-in, video visits, visit information, provider messaging, and bill pay. Direct scheduling is available for known patients in many clinics as wells as “Open scheduling” to some clinics/sites for those who have not been seen before. Automated reminder messages have a Spanish translation option along with 20 other languages. Keri confirmed that patients with one of the UI health care plans (UIChoice & UISelect) are offered priority in Fast Pass Wait List and for scheduling appointments. Philip Roudabush discussed the MyChart Bill Pay feature and explained this has greatly increased paperless statements and payments. FRIC members asked questions related to “preferred name” in communication to patients, how accounts for children and “parent proxy” works, and several other questions answered in the presentation.

4. Updates

   1. COVID – Joni Troester

      • UI health insurance plans cover OTC COVID test kits effective Jan 15, 2022

      • Information about test kit coverage is available on the UHR website at https://hr.uiowa.edu/benefits/health-insurance/wellmark-health-plan-updates

   2. Fee Leveling – Joni Troester

      • Fee leveling across all UI retirement plans went into effect January 2022

      • Same administrative fees charged across all retirement plans now

      • No questions or concerns raised by participants so far; notices went out in November 2021

   3. Fund Line-up Change – Retirement Plans – Joni Troester

      • Upon recommendation of the UI Retirement Fund Investment Committee (RFIC), the Royce Premier fund will be frozen; new contributions will be mapped to Vanguard Small Cap fund effective 3/31/2022

   4. Savi – Student Loan Assistance – Rebecca Olson

      • Upon request at the last FRIC meeting, Rebecca Olson discussed resources offered by Savi [https://www.bysavi.com/] with UI General Counsel and the UI Office of Student Financial Aid. She confirmed that neither have any concerns about offering the availability of Savi resources to UI employees

      • College student loan borrowers may be able to reduce their overall loan fees, identify the best loan repayment options, and in some cases identify loan forgiveness programs

      • UNI and ISU offer Savi resources to their employees

      • An announcement will be made to UI employees in an upcoming Iowa Now this spring

   5. Aon/Pharmacy Benefit Manager (PBM) exploration – Joni Troester

      • Aon is completing a market check review of our pharmacy plan including current contract terms.

      • Currently Aon is in the “data gathering phase” which will include looking at costs vs. benefits

      • A report-out is anticipated at the May FRIC meeting if all goes as expected

   6. Flexible Spending Account (FSA) Vendor Selection – Rebecca Olson

      • University HR staff currently manage FSA claims and reimbursements

      • A committee of key UHR staff members, a data systems expert, and a FRIC member was created to review FSA vendor proposals

      • 12 proposals were received; the committee is narrowing the list down and is planning to do vendor interviews of the finalists in late February and March with a goal to have the new FSA vended service begin on January 1, 2023

      • Three primary criteria include: 1) the employee/customer experience, 2) data/systems/reporting, and 3) plan administration and compliance, including data privacy

      • A question was asked about cost savings. Joni reiterated  that cost savings was not the only driver (although it should be cost-neutral at minimum), but also to improve our employee experience, and the efficiency of the process. Another question asked about security of personal data; Rebecca said data privacy and security is of primary concern and specific questions about this have been asked of the vendors

      • The new FSA service should greatly improve turnaround times for reimbursement (most vendors indicate 2–4 day typical turnaround), provide a user-friendly interface and dashboards, have multiple options for how to submit claims, and likely offer an FSA Debit Card feature for point-of-sale direct payment from the FSA account for covered items and services

  

5. Open Enrollment—Final Results: Rebecca Olson shared a table indicating continued movement towards the UISelect plan (440 more enrolled in 2022; 2,883 total) vs. UIChoice (695 fewer enrolled in 2022; 15,216 total).  The increase in UISelect was especially noticeable in the “Employee Only” and “Double Spouse Family” categories because of the zero employee premium cost, although there was increased movement across all employee classifications and family statuses.

6. Health Insurance Plan Design Review: Co-Pay, Co-Insurance, OPM – Joni Troester & Rebecca Olson

   • This is an introductory conversation to get input from FRIC about considerations and guiding principles to consider during such a targeted review

   • We have not reviewed our plan design since 2018; aomw of the UIChoice plan provisions have been in place since 2008. Best practice is to review every year

   • Both UIChoice and UISelect will be reviewed. Joni shared a copy of the UIChoice-UISelect plan comparison as of Jan 1, 2022

   • DRAFT Guiding Principles were shared for consideration, including:

     • Maintain quality health plan

     • Review annually, as an industry best practice

     • Drive utilization to cost-effective, quality solution

     • Standardize plan provisions, as much as possible

     • Balance employer and employee cost sharing arrangements

   • Continuum of Care – where to go for care, i.e. Doctor-on-Demand/Telehealth, Quick Care, Urgent Care, Primary/Specialty Care, Emergency Room

     • Need to consider educating and incentivizing use of best and most cost-effective care options given specific situations

   • FRIC committee members had several suggestions and comments about guiding principles for consideration in this review. These included:

     • Survey employees about their views of our health care plans; Joni indicated that may not be feasible yet this spring but could consider in the future

     • Continue to educate and communicate about health care resources and coverage to ensure employees better understand and comprehend their options

     • Employee access to quality health care is key

   • Rebecca previewed a potential scenario for UI Choice for discussion. This would include “smaller changes” and standardize to the Wellmark book of business more closely

   • Joni reminded the committee that rate setting is across the entire population, not by plan or by family status.

   • Under “Projected Financial Impact” the question was asked if it could show % of change?

   • It was confirmed the Rx OOP max. and Medical OOP max. are separate, so the two maximums would be added together to see what an employee could potentially pay in total OOP

   • Rationale for looking at increased efficiencies is that increased efficiencies are used to keep premium increases at a minimum year over year.

   • Further discussion by committee members asked about how these potential increases are related to what UI employees are seeing in their salary increases? Also, the importance of health insurance and other UI benefits as part of employee recruitment and retention efforts.

   • Further discussion about this, including review of additional options, will be brought to our March meeting.

7. Note of Thanks: Before adjourning, Mike Schueller wanted to take a moment to thank Jon Garfinkel for his service on FRIC over the years and encouraged other committee members to thank Jon as well. Jon’s insight and leadership on the committee will be missed.

8. Adjournment: The meeting adjourned at 1:04 PM after a motion by Chuck Wieland and seconded by Nancy Davin, was approved unanimously.

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Recorder: John Laverty

Enrollment Management

FRIC Meeting Minutes
December 3, 2021
Zoom Meeting
1130 AM

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Members present:  Jon Garfinkel*, Michael Schueller*, John Laverty, Nancy Davin, Cathy Koebrick, Dan Katz, Nicole Nisly, Cormac O’Sullivan, Sarah Tallman⁺, Angela Speers, Julie Urmie, Chuck Wieland, Anand Vijh

*Co-chairs; ⁺Minutes

Members absent: Anya Prince

Administrative staff present: Joni Troester, Rebecca Olson

Visitors present: Cheri Smith, Kara Wright, Jessica Wade, Dana Stafford, Cheryl Reardon, Teresa Marshall, Britt Marcussen, Jill Valde, Kevin Zihlman

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1. Introductions– Garfinkel and Schueller
   1. Roll call taken
2. Approval of November meeting minutes – Garfinkel and Schueller
   1. Minor typo to be corrected
   2. Chuck Wieland moved to approve; John Laverty second
   3. November minutes approved unanimously
3. Announcement that FRIC meetings will continue with virtual format through spring semester
4. Benefits Updates
   1. COVID – Troester

• Boosters approved for all ages; available in the community & UIHC
• Pharmaceuticals to treat COVID not yet approved by FDA
• Vaccine mandate being reviewed by UI. Will be managed by departments/orgs with federal contract requirement.  On hold until mid-January due to court injunction
• Special health plan provision for COVID inpatient coverage with no member cost will sunset on December 31. Health plan coverage will revert back to standard plan coverage on January 1.

 ​Open Enrollment – Olson

• Ran very smoothly this year; No negative feedback from employees regarding health premium increase
• Overall, our plans are viewed very favorably by our new employees
• During the 2 week open enrollment (Nov 1 to Nov 15), 11k employees completed enrollment and all other employees’ 2021 elections were rolled over to 2022, except FSA where employees must re-enroll each year
• Preliminary results indicate 14% enrolled in UI Select for 2022; last year it was 12%
• New hires (upwards to 40%) are selecting UI Select option when choosing single or double spouse ($0 premium cost to employee)
• Final open enrollment stats will be shared in the February FRIC meeting
• 3. Student Loan Program – Olson
• UHR to roll-out availability of the SAVI student loan program in 2022
• Program provides access to resources where employees find options for new repayment plans or qualify for loan forgiveness over time
• To be eligible, employee must work at least 30 hrs/week and earning W2 wages, plus their (undergrad and grad) loans must be through the Federal Direct Loan program; dependents of UI employees not eligible
• No cost to employees to use the SAVI website (do it yourself method) or employee may pay $60 annual fee and documentation handled by SAVI
• UNI & ISU implemented SAVI in 2021
• Follow-up questions for Benefits to research before implementation and communication occurs
• 4. ACO 2020 Results – Troester
• Accountable Care Organization (ACO) and Shared Savings Agreement with UIHC has been in place since 2016
• Approximately 26,000 UI health plan members are attributed to UIHC
• 2020 very abnormal year due to COVID and the delay of care & decrease in services provided; no shared savings for 2020

5. Discussion on Pharmacy Benefits – Troester/Olson

• Continued discussion from November meeting with review of pharmacy plan modeling, including focus on insulin coverage and costs for our members
• Reviewed projections to move from coinsurance to copays
• Projected range of additional costs if we move to copay approach would be $9 to $28/month over approximately 11,000 members
• Olson notified the committee that the Wellmark Pharmacy Committee completed annual review of the formulary. The committee approved several formulary changes for 2022, including some of the insulins on our plans. Given the formulary changes, our review and analysis from this year is impacted.  
• Troester re-introduced Pharmacy Benefit topic discussed in February/March of 2020; this project was placed on hold due to COVID
• UI will reengage with AON consulting to complete market check review of pharmacy plan arrangement
• Expect project will be completed spring of 2022 with results before the last FRIC meeting of the year
• Update will be provided in February meeting 

6. Preview of Plan Design Review: Co-Pay/Co-Insurance/OPM – Olson

• We have not reviewed plan design since 2018; reviews should be completed every year (best practice)
• UI Choice started 1/1/2008; UI Select started 1/1/2020
• Minor changes to UIChoice Quick Care & Office Copays in 2018; no changes to out of pocket max since plan inception in 2008
• For February meeting, model three different plan design scenarios; with each approach, obtain the projected financial impact to members
• Projections will look at small and moderate changes, plus Wellmark book of business
• During the review, committee will consider impact on recruitment/retention

7. Other Updates – Troester/Olson
   1. Metrics – UIChoice and UISelect plan results

• Reviewed first three quarters of 2021
• Average 16k employees in UIChoice; 2700 in UISelect
• Closer to end of year, more members obtain services
• UISelect has lower cost per member; UIChoice is twice as much

1. 2. Access Reports - not available yet

Meeting adjourned – Nicole Nisly moved that the meeting close & Mike Schueller seconded motion

8. New Business (AY 2021 - 2022)
   1. MyChart Presentation – February 2022
   2. UIHC – North Liberty Facility - TBD
   3. Mental Health Coverage

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Next Meeting

February 4, 2022

Zoom Meeting

FRIC Meeting Minutes
November 5, 2021
Zoom Meeting
1130 AM

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Members present: Jon Garfinkel*, Michael Schueller*, John Laverty, Nancy Davin, Anya Prince, Cathy Koebrick, Dan Katz, Cormac O’Sullivan, Sarah Tallman, Angela Speers, Julie Urmie, Chuck Wieland⁺, Anand Vijh, Nicole Nisly

*Co-chairs; ⁺Minutes

Administrative staff present: Joni Troester, Rebecca Olson 

Visitors present: Cheri Smith, Kara Wright, Jessica Wade, Dana Stafford, Megan Hammes, Audra Haddy, Cheryl Reardon, Siroos Shirazi, Teresa Marshall, Britt Marcussen

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1. Introductions– Garfinkel and Schueller
   1. Roll call taken
2. Approval of October meeting minutes – Garfinkel and Schueller
   1. Nancy Davin moved to approve
   2. John Laverty second
   3. October minutes approved unanimously
3. COVID Updates – Troester
   1. All vaccine boosters are available to eligible employees along with newly approved children ages 5-11.
   2. Executive Order mandates COVID vaccine for federal employee contractors.   Regents reviewing and will be coming out with future guidance in the coming weeks.
4. Open Enrollment Update – Olson
   1. Open enrollment is from Nov 1^st – 15^th. 
   2. Reminders will be emailed on 9^th and 12^th. 
   3. Benefits website has helpful resources to guide employees how to complete their forms.
   4. For the new open enrollment feature “You Ask, We Answer” contact form, Benefits will have personnel dedicated to answer questions from 8am-5pm M-F.
   5. Confirmation statements will be sent after the enrollment period has ended.
5. Regulatory Update - Olson
   1. Transparency in Coverage Rule and Consolidated Appropriations Act effective January 1, 2022
      1. Transparency in ID Cards
         1. ID cards will include in and out of network deductibles, out-of-pocket maximums, and how to find network providers.
      2. Provider Directory
         1. Requires online directory update every 90 days.
      3. Continuity of Care
         1. For certain patients, opportunity to continue care if their provider is no longer in the network.
      4. No Surprise Billings
         1. Establishes new claim payment requirements for patient liability/balance billing if ER services obtained from OON provider.
      5.  Information will be sent to policy holders by end of year.
6. Farmland Update from 10/27 Meeting – Troester/Garfinkel/Schueller
   1. Meeting with Sustainability Committee and Selected Faculty along with shared governance and FRIC representatives with TIAA and its Nuveen Executive Leaders
   2. TIAA has updated website to provide more transparent information about the concerning issues.
   3. Updates will be provided to the FRIC committee annually in the future.
7. Discussion on Pharmacy Benefits – Troester/Olson
   1. Continued discussion from October meeting.
   2. Assume change would be cost neutral to the plan.
   3. Proposed changes to Copays (Tier 2 & 3 only)
      1. 71.5% would see no change due to $0 generic co pay.
      2. 7.3% members would pay less.
      3. 21.1% members would pay more.
      4. Fewer individuals would reach their out-of-pocket maximum.
   4. Under the Wellmark book of business, there would be a copay for generic drugs.
      1. 91.4% would pay more in pharmaceuticals.
      2. This approach would be a huge dissatisfier for members.
   5. Discussion will continue as more requested information is provided.
8. Other Updates – Troester/Olson
   1. Access Reports
      1. Access Dashboard shared with committee on performance of assess for UI beneficiaries.
9. New Business (AY 2021 - 2022)
   1. My Chart Presentation – December meeting
   2. UIHC – North Liberty Facility - TBD
   3. Mental Health Coverage.
10. Meeting adjourned

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Next Meeting

December 3, 2021

Zoom Meeting

Funded Retirement and Insurance Committee (FRIC) Meeting
October 1, 2021
via zoom

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Members present:

Jon Garfinkel, Michael Schueller, John Laverty, Nancy Davin, Cathy Koebrick, Dan Katz, Nicole Nisly, Angela Speers, Julie Urmie, Sarah Tallman, Anand Vijh

Members absent:

Anaya Prince, Cormac O’Sullivan, Chuck Wieland

Administrative staff present:

Joni Troester, Rebecca Olson

Visitors present:

Cheri Smith, Kara Wright, Jessica Wade, Dana Stafford, Julie Sexton, Cheryl Reardon, Britt Marcussen, Audra Haddy, Teresa Marshall, Kevin Zihlman, Siroos Shirazi

---

1. Preliminaries: Meeting started on time. Joni Troester did the roll call. Committee reviewed the September meeting minutes.  Cathy Koebrick motioned to approve the minutes, Nancy Davin seconded, and the rest of the committee approved the minutes with a unanimous vote.
2. Rate approval: Joni Troester informed the committee that President Wilson approved the new health-care plan rates for 2022.  There is no increase in dental plan rates for 2022.
3. COVID updates: Rebecca Olson and Joni Troester (the administrators) provided updates on COVID-19 cases and coverage. Several points came up as follows:
   1. Following CDC approval, UEHC (University Employee Health Clinic) will soon be giving booster shots to employees meeting certain criteria (such as those over 65 years of age, or those having certain underlying health conditions). UEHC will be sending emails to eligible employees.
   2. The booster shot is approved for those who received the Pfizer vaccine in the first place. As of now, there is no similar approval for those who received Moderna or Johnson and Johnson vaccination.
   3. Recently President Biden released an executive order which mandates COVID vaccinations for employees who work for federal contractors employing more than one hundred employees. The university is working with the Board of Regents to determine next steps.
   4. Among approximately 44,000 employees and dependents on our health plans, there were 39 admissions to UIHC hospital for COVID in 2020. There were 11 admissions to UIHC hospital during first eight months this year. These statistics compare favorably with national averages.
   5. There continues to be no copay for COVID tests during the national public health emergency.  Members also have no cost share for inpatient, in-network treatment of COVID.  Starting 2022, coverage will revert back to standard plan coverage for inpatient, in-network treatment of COVID.  
4. Fee leveling: The Retirement Fund Investment Committee approved a change to the administrative fee structure for UI retirement plans at TIAA. The intent of the change is to provide a consistent or “level” fee across all fund investments.  Currently, administrative fees vary among fund investments. As of January 1, 2022, an annual fee of 2.3 basis points will be charged to all fund investments. All plan participants will receive a letter in November 2021 informing them of this change.
5. Open enrollment for 2022 benefits: Following a long-time practice from before the COVID pandemic, the open enrollment period will be November 1 to 15. This is the once-a-year opportunity for employees to make changes to their insurance benefits, outside of a qualifying life event (such as marriage or birth).  The administrators are making a strong effort to educate employees about the available benefits package at the university.  There will be YouTube videos of an overview of 2022 benefits and how to complete your enrollment in Employee Self Service. There will be both English and Spanish versions of the open enrollment benefits guide. There will also be a new online resource where employees can ask open enrollment questions that will be answered by a dedicated benefits staff member in the University Benefits Office.
6. Pharmacy benefits: In May 2021, the committee had voted to investigate the pros and cons of moving to a copay approach of sharing the cost of prescription medicines as an alternative to the current coinsurance approach. The committee requested financial modeling of a change to copays. Under copay system, members pay a fixed dollar cost per prescription rather than a percentage of the total prescription cost.
   1. Wellmark modeled the financial impact of a change from coinsurance to copays, keeping the plan as financially neutral as possible. Another criterion was to keep Tier 1 copay to be zero as under the current plan design.
   2. Under the proposal, the copay would range from $0 for Tier 1 which includes many generics, to $150 for Tier 5 which includes non-preferred specialty drugs. Some members would pay the same cost as under the existing coinsurance plan, some 11,000 members will pay more, and some 4,000 members would pay less. Our plans have a $1,100 out-of-pocket maximum for drugs, which means that the likely financial impact on employees will be limited.
   3. The committee asked that the modeling be re-run to keep both preferred and non-preferred specialty tiers charging a coinsurance and also look at tier copay/co-insurance for Wellmark book of business. For November, the committee will continue debating the pros and cons of copay and coinsurance.
7. Access report: The administrators shared statistics on health plan member access to primary care, specialty care, tertiary care, etc., at UIHC hospital. As usual, these statistics provided by UIHC look good. Data shows that 98%, 82%, and 70% of members looking for primary, secondary, and tertiary care are seen within 10 days.
8. Adjournment: Nicole Nisly made a motion to adjourn. Nancy Davin seconded. Committee approved unanimously.

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Recorder: Anand M. Vijh

Tippie College of Business

Funded Retirement and Insurance Committee (FRIC) Minutes
September 3, 2021
Zoom
11:30 – 1:00 pm

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Members Present:

Nancy Davin, Jon Garfinkel, Co-Chair, Dan Katz, Cathy Koebrick, John Laverty, Nicole Nisly, Cormac O’Sullivan, Anya Prince, Sarah Tallman, Mike Schueller, Co-Chair, Angela Speers, Minute Taker, Julie Urmie, Anand Vijh, Chuck Wieland

Admin. Liaisons:

Rebecca Olson, Joni Troester

Guests:

Audra Haddy, Megan Hammes, Cheryl Reardon, Dana Stafford, Jessica Wade, Kara Wright, Brit Marcussen, Jill Valde, Cheri Smith, Teresa Marshall

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1. Introductions/Role call – Garfinkel and Schueller
   1. Sarah Tallman has joined the FRIC committee this year.
2. Approval of May meeting minutes – Garfinkel and Schueller
   1. Corrections to spelling and date were noted. A motion to approve was made by Chuck Wieland, seconded by Nicole Nisly, approved unanimously.
3. Quarterly Report – Olson
   1. Rebecca Olson presented UIChoice and UISelect dashboard metrics which included costs and utilizations for 1st and 2nd quarter 2021.
4. Rate Setting for CY2022 – Troester
   1. Dental - Proposed 0% increase in dental premiums based on cost and utilization across all family statuses.
   2. UIChoice and UISelect - No change to premium cost share for UIChoice and UISelect.
      1. UIChoice EE and Dual Spouse Family premium cost share remain at 10% for 2022.  UIChoice all other family status premium cost share remain at 20% for 2022.
      2. UISelect EE and Dual Spouse Family premium cost share remain at 0% for 2022.  UISelect all other family status premium cost share remain at 20% for 2022.
   3. Rate setting process discussed. Assumptions and data used in rate setting shared.  Given COVID and the unique past year of plan utilization, University Benefits worked with AON to model projections.  To account for irregular utilization during the pandemic, AON used two years of claims data and adjusted claims using COVID factors to account for suppressed claims during 2020 and future COVID related costs.  Projections also include increased Wellmark administrative fees for CY2022.
   4. UIChoice will be increasing 7.1% for CY22 and UISelect will be increasing 2.9% for CY22
   5. The CY22 Open Enrollment guide will be available in Spanish for employees during this fall
   6. A motion to approve the CY2022 dental and health rates was made by Chuck Wieland, seconded by Nicole Nisly, approved unanimously.
   7. A motion to cancel the September 10th FRIC meeting was made by Chuck Wieland, seconded by Nicole Nisly, approved unanimously.
   8. For the Medicare carve-out retiree health plans, CY2022 rates are:
      1. UIChoice Single increasing by 6.6%
      2. UISelect Single increasing by 6.5%
5. Farmland Update – Troester
   1. Joni Troester shared an update on Farmland.  Faculty Senate approved a resolution in April 2021 and Staff Council approved a resolution July 2021 urging FRIC and RFIC to ask TIAA to address transparency and sustainability issues.  Next steps are a campus meeting with TIAA Nuveen Leadership of Responsible Investing on October 27, 2021. TIAA will meet with Sustainability Charter Committee, Shared Governance Leadership, and RFIC. Joni Troester will provide a follow-up at our November FRIC meeting.
6. COVID Updates – Troester/Olson
   1. Joni Troester provided an update on vaccination planning.  There will be a 3rd dose for select populations, currently by appointment at UEHC.  Also, a booster is approved for 8 months out from second dose beginning September 20th, 2021.
   2. Rebecca Olson provided an update on COVID related health plan provisions.
      1. Plan members currently have no cost sharing for COVID testing and related services during the national public health emergency. Members also have no-cost share for inpatient, in-network treatment of COVID-19 through December 31, 2021. Coverage will revert back to standard plan coverage for inpatient, in-network treatment of COVID-19 starting January 1st, 2022.
7. WellMark Changes for CY2022 – Olson
   1. Rebecca Olson shared the following health plan changes. Bereavement and family counseling will be covered as of January 1st, 2022. Family counseling includes marriage counseling, but group counseling is excluded. Dental treatment for accidental injury needing repair increased to 24 months as of January 1st, 2022.  Surgical Removal of Impacted Teeth is covered only with concurrent medical needs as of January 1st, 2022.
8. Announcement
   1. Flexible Spending Account (FSA) will be transitioned to a FSA administrator for 2023.  Numerous advantages to having a FSA administrator process claims versus in-house, manual claim processing: Debit card, Faster claim processing, Ability to quickly respond to any federal changes to FSA rules.  This will result in an improved employee experience and greater efficiency to the plan. Timeline for transition: Recommended- Fall 2021; Vendor Selected- Spring 2022; Implemented- January 1, 2023.
9. Other Updates – Troester/Olson
   1. Access Reports
   2. Board of Regent Review

Chuck Wieland made motion to adjourn. Cathy Koebrick seconded. Unanimous approval.

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Next Meeting
October 1, 2021
Zoom Meeting

FRIC MINUTES
Friday, May 7, 2021
Zoom
11:30 – 1:00 pm

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Members Present:
Nancy Davin, Minute Taker, Jon Garfinkel, Co-Chair, Dan Katz, Cathy Koebrick, John Laverty, Nicole Nisly, Cormac O’Sullivan, Anya Prince, Ben Rogers, Mike Schueller, Co-Chair, Angela Speers, Julie Urmie, Anand Vijh, Chuck Wieland

Admin. Liaisons:
Rebecca Olson, Joni Troester

Guests:
Audra Haddy, Megan Hammes, Cheryl Reardon, Richard Saunders, Julie Sexton, Dana Stafford, Jessica Wade, Kara Wright, Siroos Shirazi, Jill Valde, Cheri Smith, Heather Mineart, Jennifer Vermeer

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1. Introductions/Roll Call.  Complete.
2. Approval of April meeting minutes. The motion was made by O’Sullivan and seconded by Laverty to approve the minutes. Approved unanimously.

3. Digital Evaluation and Management (E&M) Coverage. Jennifer Vermeer presented on behalf of the UI Health Care team regarding a proposal for plan coverage of asynchronous medical management communications between the patient and provider via MyChart proposed to begin in January 2022.

4. For coverage of digital E&M codes, medical care or decision-making must be provided, i.e., not a prescription refill request. Medicare has defined the terms regarding reimbursement. It is a lower-cost option in lieu of an in-person exam and Wellmark is not currently covering. The fee is less than in-person and is based on time.  This option is only available for established patients.  A $0 copay is proposed for the first-year pilot. If approved, it should not have an abundant financial impact on the plan.

5. A motion was made by Nisly to recommend approval of coverage for digital evaluation and management code beginning January 2022 at $0 copay for a one-year pilot and seconded by Weiland. The motion passed unanimously with one abstention by Katz noted for conflict of interest. Benefits will report back 6-9 months into the pilot.

6. COVID Updates. No cost-share for covid testing and related services to diagnose or detect covid 19 continues through the end of the national public health emergency. Members have zero cost-share for inpatient, in-network treatment of COVID-19 through June 30, 2021, with a chance of extension as there has been in the past.  Whether renewed or not, there will be communication to employees.

7. Vaccination Plans. Supply is no longer an issue. On April 5, the Governor opened all Iowans’ eligibility. Fac/staff can receive vaccinations through the University Employee Health Clinic (UEHC) or from a local community provider. Over the summer, there will be conversations with UEHC and UIHC regarding how to incorporate any potential booster vaccine into our annual influenza campaign if feasible. Our healthcare plans cover the vaccines at no charge.

8. Blue Cross/Blue Shield Class Action Lawsuit. There was a recent nationwide mailing from BC/BS discussing a settlement in a class-action lawsuit where the plaintiff alleged that the national offices violated anti-trust laws because they do not agree to compete amongst themselves. The mailing indicated that the recipient may be considered eligible. The UI General Counsel is discussing with the Board of Regent Office and the Iowa Attorney General to determine UI eligibility. The Attorney General has contacted BC/BS to seek clarification. If members wish to file a claim, they may.

9. Other Updates

   1. The Quarterly Report for the period 1/1/21 - 3/31/21 was shared.

   2. The March Access Reports for Primary, Specialty, and Tertiary Care all revealed meeting or exceeding their targets except Specialty care at 78.88%, which will be monitored.

   3. Board of Regent Review. The review was approved to send to the presidents of the Regents institutions as part of the Consent Agenda at February 2021 meeting. Incoming president Barbara Wilson begins in July, after which there may be additional information for the committee on this issue.

10. Initial discussion on Pharmacy Benefits
    The committee began its discussion of pharmacy benefits within the health insurance plans. Rebecca Olson provided an overview of current Rx benefit coverage for UIChoice and UISelect. Committee member, Julie Urmie, provided a summary of potential plan change options regarding specific drug coverage, and the overall structure of copay vs coinsurance of drug coverage. Discussion will continue in Fall 2021 regarding options presented, including impact to the plans overall and impact to plan members.

11. New Business (AY 2021 - 2022)

    1. Farmland Investments

    2. Mental Health Coverage​​​​​​​

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Next Meeting
September 3 and 10, 2021
Zoom Meeting

Funded Retirement and Insurance Committee (FRIC)

Meeting Minutes for April 2, 2021
Meeting was via Zoom

1130 AM

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Members Present: Jon Garfinkel (co-chair), Michael Schueller (co-chair), Nancy Davin, Cathy Koebrick, John Laverty, Nicole Nisly, Cormac O’Sullivan, Anya Prince, Ben Rodgers, Angela Speers, Julie Urmie Anand Vijh, Chuck Wieland.

Administrative Liaisons: Joni Troester, Rebecca Olson

Guests: Audra Haddy,  Cheryl Reardon, Richard Saunders, Julie Sexton, Dana Stafford, Jessica Wade, Kara Wright, Mike Brownlee, Lisa Mascardo, Alex Mersch, Kevin Zihlman, Cheri Smith, Jill Valde, Mike Weaver

Members Absent: Dan Katz

1. ---

   Introductions– Jon Garfinkel and Michael Schueller
   1. Completed for members and guests.
2. Approval of March meeting minutes – Garfinkel and Schueller
   1. Motion to approve the minutes by John Laverty, second by Cathy Koebrick. The motion passed unanimously.
3. Annual Specialty Pharmacy Presentation by Mike Brownlee, Lisa Mascardo, and Alex Mersch – UI Health Care Pharmaceutical Services
   1. Alex Mersch and Mike Brownlee gave a Powerpoint presentation on outcomes from the specialty drug partnership between UIHC and UI Benefits and answered questions about the program. High satisfaction with the specialty pharmacy services and good patient adherence were reported. The vast majority of UI Plan participants’ specialty drugs are filled at UIHC.

 

4. COVID Updates – Troester/Olson
   1. Rebecca Olson provided an update on cost-sharing for COVID diagnosis and treatment.
      • ​​​​​​​No member cost for COVID 19 testing & related services to diagnose or detect during the public health emergency.
      • No member cost for COVID 19 in-patient, in-network treatment was extended to June 30, 2021.
      • The university is preparing to begin vaccinating students and employees. The ReadySet survey for employees to indicate interest opens April 2 and UI starts the vaccination process for faculty and staff on April 5
5. 2022 Plan Design Discussion – Olson/Troester
   1. Rebecca Olson presented data on member impact and peer comparisons related to the proposed change in level 1 copays. There was a discussion of the pros and cons of the proposed change.
      • Current coverage:  Apply one co-pay per date of service.
      • Proposed change:  Apply one co-pay per provider, per date of service.
      • Motion to approve the change by Nicole Nisly, second by Chuck Wieland. The motion passed with 12 members in favor and 1 member (O’Sullivan) opposed.
6. Prioritization of May Agenda Items for Discussion - Garfinkel
   1. Three short presentations were given in order to prioritize a topic for discussion at the May 7, 2021 FRIC meeting.
      • Nicole Nisly presented on the issue of Farmland Investments in the retirement plan.
      • Julie Urmie presented on the issue of coinsurance in the pharmacy Benefits.
      • There was a pre-recorded video presentation from Dan Katz on the Mental Health Co-Pay Structure.
   2. A poll will be sent to FRIC members to have them select the topic they feel is the highest priority for presentation at the May meeting. The topics not selected for presentation at the May meeting will be discussed at a later meeting
      • ​​​​​​​Updated poll results (7) members prioritizing Pharmacy Benefits (5) member prioritizing mental health benefits and (1) member prioritizing Farmland investment for discussion at May 2021 meeting

Motion by Nicole Nisly to adjourn the meeting, second by Nancy Davin.  Motion passed and the meeting was adjourned at 1:00 p.m. 

Meeting minutes submitted by Julie Urmie

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​​​​​​​Next Meeting

May 7, 2021

Zoom Meeting

Funded Retirement and Insurance Committee (FRIC)
Meeting Minutes
Via Zoom
March 5, 2021

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1. Role Call/Introductions
   1. Members Present:
      1. Jon Garfinkel*, Michael Schueller*, John Laverty, Nancy Davin, Anya Prince, Cathy Koebrick, Dan Katz, Nicole Nisly, Cormac O’Sullivan, Angela Speers, Julie Urmie, Chuck Wieland⁺, Anand Vijh
   2. Members Absent:
      1. Ben Rogers
   3. Administrative Staff Present:
      1. Joni Troester, Rebecca Olson
   4. Visitors Present:
      1. Cheri Smith, Megan Hammes, Audra Haddy, Cheryl Reardon, Richard Saunders, Dana Stafford, Jessica Wade, Kara Wright, Teresa Marshall, Dan Fick, Heather Mineart
2. Approval of February meeting minutes – Garfinkel/Schueller 
   1. Motion to approve by Wieland; Second Davin. Unanimous approval.
3. COVID Updates – Troester/Olson
   1. Health Plans
      1. No member cost for COVID 19 testing & related services to diagnose or detect during the public health emergency.
      2. No member cost for COVID 19 in-patient, in-network treatment has been extended to June 30, 2021.
   2. Vaccination Plans
      1. Still following IDPH guidelines for COVID 19 vaccinations.
      2. Faculty/staff eligible for vaccine based and age and/or medical condition priority system as administered through health provider.
      3. Vaccines may also be obtained through pharmacies based on IDPH guidelines.
4. Retirement Plans – Troester/Garfinkel
   1. Update – New IRS guidelines regarding loan provisions and plan administration
      1. TIAA implemented new loan system to comply with new IRS guidelines.
      2. University converts to new system March 30.
      3. New limit on number of loans is 3.
      4. One time administration fees ($75-$125 processing fee and $25 annual fee).
      5. Current loans are grandfathered on existing loan system.
      6. Communication sent to plan participants in February.
   2. Update – 4/1, 5/1, and 7/1 Fund line-up changes
      1. Retirement Fund Investment Committee (RFIC) regularly reviews retirement funds available to UI employees and recommends the following:
         1. 4/1 - Freeze Invesco Oppenheimer Senior Floating Rate fund due to performance; map new contributions to most age appropriate fund within  Lifecycle funds for each participant
         2. 5/1 - Freeze Lazard Emerging Markets fund due to performance; map new contributions to TIAA-CREF Emerging Market Fund Index
         3. 7/1 - Freeze Templeton Global Bond fund due to performance; map new contributions to Western Asset Plus
5. 3. Update - Natural Disaster Distribution
      1. Federal government to allow participants to take a special natural disaster distribution of individual retirement plan monies.
      2. Participant must have suffered a financial loss in 2020 due to a natural disaster such as the derecho.
      3. UI employees must contact TIAA to determine eligibility and make a request for a distribution of their VRSP funds.
   4. Farmland Investments
      1. Discussion on topic will occur on March 9^th during scheduled presentation at the Faculty Council meeting.  Update will be given to the FRIC members during the April meeting.
6. 2022 Plan Design Discussion – Olson/Troester
   1. Hearing Aid Coverage
      1. Current coverage is 20% coinsurance with a $2,000 limit every 5 years.
      2. Proposed changed to applicable level of co-insurance with a $1,500 limit every 36 months.
      3. Motion to approve (Wieland) second (Garfinkel). Unanimous approval
   2. UI Choice Level 1 Co-pay
      1. Current coverage:  Apply one co-pay per date of service.
      2. Proposed change:  Apply one co-pay per provider, per date of service.
      3. Discussion on the pros and cons of the proposal.
      4. Additional information to be provided to the committee at April meeting. 
7. Updates – Troester/Olson
   1. Access Reports
      1. Employee patient access reports shared with committee.
         1. Reviewed all measurable goals in each category, UIHC exceeded each category.
   2. Quarterly Metrics
      1. PowerPoint slide provided to the committee which included 4 quarters of 2020 costs and utilization for UIChoice and UISelect.
   3. Board of Regent Review
      1. Board of Regents consent agenda (hyperlink provided)
         1. Consent agenda was approved by BOR
         2. Updates will be provided as issues/resolutions arise.
8. New Business
   1. April– Specialty Pharmacy Annual Presentation
   2. UIHC North Liberty Project – on hold

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Next Meeting

April 2, 2021

Zoom Meeting

Funded Retirement and Insurance Committee (FRIC) Meeting

February 5, 2021, via zoom       

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Members present: Jon Garfinkel*, Michael Schueller*, John Laverty⁺, Nancy Davin, Anya Prince, Dan Katz, Nicole Nisly, Cormac O’Sullivan, Ben Rogers, Angela Speers, Julie Urmie, Chuck Wieland, Anand Vijh

*Co-chairs; ⁺Minutes

Members absent: Cathy Koebrick

Administrative staff present: Joni Troester, Rebecca Olson 

Visitors present: Megan Hammes, Audra Haddy, Cheryl Reardon, Richard Saunders, Julie Sexton, Dana Stafford, Jessica Wade, Kara Wright, Cheri, Smith, Siroos Shirazi, Jennifer Vermeer, Jody Felderman, Michelle Havinga, Teresa Marshall, Heather Mineart

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1. Roll Call/Introductions: Joni Troester completed roll call.
2. Approval of December Meeting Minutes: A motion to approve the minutes was made by Nancy Davin, seconded by Chuck Wieland, approved unanimously.
3. UIHC Population Health Presentation: Jennifer Vermeer and Michelle Havinga from UIHC presented to the committee. They explained what an Accountable Care Organization (ACO) is and common contract features. Specifics of the internal MOU UIHC/UI Benefits were discussed. It was noted there is an emphasis on quality first and then potential savings secondarily. Wellmark quality targets as defined by the “Value Index Scores” (VIS) were elaborated on as well as types of medical visits and tracking of those visits. UIHC’s key projects, including the Wellmark PCP Visit Project, ED Discharge Follow-Up Project, Population Health Provider Dashboard, and the Primary Care Provider Incentive Plan were explained. It was emphasized there is a several month lag in data reported for the ACO agreement due to claims run-out period and then data analysis. At the September 2021 meeting there will be a report of CY2020 outcomes for the ACO that includes attributed members from UI Choice and UI Select.
4. Open Enrollment—Final Results: Rebecca Olson shared a table indicating some movement towards the UI Select plan (13%) vs. UI Choice (87%). There was movement in all family status categories to UI Select, but it was highest from the “Employee Only” status, accounting for about 80% of the overall migration. A discussion ensued of what trends may look like in the coming year which is hard to predict, although it was noted enrollment in the UI Select plan is approaching the original estimate when the plan was implemented.
5. COVID Updates: The University health care plans have no cost-share for COVID testing and related services to diagnose or detect COVID-19. Coverage is in place during the public health emergency. There is no cost-share for in-patient, in-network treatment of COVID-19 through March 31, 2021 (which has been in place since last spring).
   
   Joni Troester co-chairs the UI Vaccination Distribution Group (VDG) with Dr. Dan Fick as part of the UI Critical Incident Management Team (CIMT). The VDG has developed an integrated campus plan and is currently working through the Iowa Department of Public Health (IDPH) guidance regarding priority of eligible populations based on UI employment categories. Staff in “critical roles” are being notified by their collegiate/division leaders; those 65 and older can show interest for receiving the vaccine via UIHC MyChart or working with another community provider. There has been advocacy for people working in higher education to be prioritized for the vaccine.
   
   The Johnson & Johnson 1-dose shot will greatly increase supply and accessibility once it’s approved. A question was asked about CIMT putting out a communication to campus about what Fall semester will look like; Cheryl Reardon replied it is too early to communicate those details right now.
6. Retirement Plan Updates: Joni Troester explained recommendation from the RFIC that UI pursue pro rata fee leveling for retirement plan funds with TIAA as the recordkeeper. These funds include our 403B mandatory retirement accounts as well as the voluntary individual plans. These are asset-based fees charged as a percentage of the fund assets; the percentage is relatively small at 3bps (1 bps = 1/100 of 1%); the fee covers recordkeeping and tracking data within the funds; and those with similar account balances pay similar fees. There are life cycle funds right now that are not paying a fee which creates inequity. The tentative timeline includes further discussion in February and March 2021, with expected implementation during CY2021 with an effective date of 1/1/2022. A motion to support the RFIC fee-leveling recommendation from their January 4, 2021 meeting was made by Dan Katz and seconded by Chuck Wieland; approved unanimously.
7. With the meeting time running out, Joni suggested we table the other items on the committee agenda (including additional retirement plan updates, 2022 plan design discussion, UIHC care patient access report update, and new business) until our next meeting in March; all agreed. Joni also noted there is a meeting with the Faculty Council and RFIC members on March 9 to further discuss the Farmland Investments. Dan Katz strongly suggested Liz Tovar as UI’s Chief Diversity Officer be included in that meeting.
8. Adjournment: The meeting adjourned at 1:00 p.m. after a motion to do so was approved unanimously.

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Recorder: John Laverty

Enrollment Management

Funded Retirement and Insurance Committee (FRIC) Minutes
December 4, 2020, 11:30 am – 1:00 pm
Conducted via Zoom

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Members present: Jon Garfinkel*, Michael Schueller*, Nancy Davin, Dan Katz, Nicole Nisly, Anya Prince, Cormac O’Sullivan, Angela Speers, Anand Vijh ⁺, Chuck Weiland

*Co-chairs; ⁺Minutes

Members absent: Cathy Koebrick, John Laverty, Ben Rogers, Julie Urmie

Administrative liaisons present:  Rebecca Olson, Joni Troester

Visitors present: Teresa Marshall, Cheryl Reardon, Cheri Smith, Julie Sexton, Dana Stafford, Jessica Wade, Kara Wright, Megan Hammes, Siroos Shirazi

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1. Roll Call/Introductions: Joni Troester completed roll call.

2. Approval of November Meeting Minutes: A motion to approve the minutes was made by Nancy Davin, seconded by Cormac O’Sullivan, approved unanimously.

3. Open Enrollment Preliminary Results: Rebecca Olson informed the committee that approximately 11,000 UI employees completed benefits enrollment by the scheduled end date of November 13, 2020. Regarding health plans, approximately 12% of the enrolled employees chose UISelect and the rest chose UIChoice. A significantly higher number of employees chose UISelect plan compared to last year when it was first offered.  Final stats will be shared with FRIC in February.

4. Board of Regents Review: The Board established an advisory group to identify possible administrative and academic collaborations and efficiencies across the Regent institutions. The Board had their first meeting on this topic in November 2020 and a second meeting is scheduled in February 2021. Some of the collaborations and efficiencies involve insurance benefits. Updates on the Board review will be shared with FRIC.

5. Affordable Care Act Update: A court case currently filed with the Supreme Court questions the constitutionality of ACA in view of the repeal of individual mandate. The Supreme Court will release their decision in spring or early summer. The benefits department will monitor developments and inform FRIC periodically.
   
   The Supreme Court decision is not likely to impact the University health care plans. UI provides health insurance coverage to regular faculty and staff employees working at least 50% time which is more generous than ACA requirements.

6. COVID Update: The University health care plans provide excellent coverage of COVID related health problems. There is no member cost for COVID testing during the national pandemic. There is no member cost share for in-patient, in-network treatment of COVID-related health problems through March 31, 2021. COVID vaccines will not require a cost share from members. In addition, through December 30, 2020, retirement plan participants may withdraw money from their retirement plan without a tax penalty if they have a COVID-related financial hardship.
   
   UI Hospitals are geared up for delivering COVID vaccine that they expect to receive. Iowa River Landing facility of UI Hospitals has purchased six super-cold freezers to store the vaccine. Cormac O’Sullivan informed the committee that both Pharmacy and Nursing students at UI are planning to help with delivering the vaccine.

7. Farmland Investments: Faculty Council received a proposed resolution to divest from farmland investments held by TIAA. An initial conversation occurred during the November Faculty Council meeting. A follow-up discussion will occur in their January meeting where TIAA is scheduled to present on this topic. Jon Garfinkel, Cathy Zaharis and Joni Troester will attend the meeting and provide FRIC with an update.

8. Other Updates: Joni Troester updated the committee on the timing of access reporting from UIHC and open questions concerning prior authorizations and return visits. Committee to expect access reporting and answers to open questions for February meeting.

9. New Business: Joni Troester reviewed the status of new business items.  UIHC will provide the committee with an update on the North Liberty project in the spring. UIHC population Health will provide an update to the committee during our February meeting. Mike Brownlee and Lisa Mascardo from UIHC Specialty Pharmacy will provide an update of 2020 results during our April meeting. Joni also shared the committee will discuss plan design changes during the February meeting.

Adjournment: The meeting adjourned early after a motion to do so was approved unanimously.
 

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Recorder: Anand M. Vijh
Tippie College of Business
Next Meeting: Feb. 5, 2021; 11:30am-1:00pm; via Zoom

Funded Retirement and Insurance Committee (FRIC) Minutes
November 6, 2020, 11:30 am – 1:00 pm
Conducted via Zoom

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Members present: Jon Garfinkel*, Michael Schueller*, Nancy Davin, Dan Katz, Cathy Koebrick, John Laverty, Nicole Nisly⁺, Anya Prince, Cormac O’Sullivan, Ben Rogers, Angela Speers, Julie Urmie, Anand Vijh, Chuck Weiland

*Co-chairs; ⁺Minutes

Members absent: none

Administrative liaisons present:  Rebecca Olson, Joni Troester

Guests:  Charles Anderson, Katherine Imborek, Susan Klatt, Teresa Marshall, Heather Mineart, Cheryl Reardon, Keri Semrau,  Cheri Smith, Sonia Slevinski, Julie Sexton, Dana Stafford, Jennifer Vermeer, Jessica Wade, Mike Weaver, Kara Wright

1. ---

   Roll Call/Introductions. Joni Troester completed roll call.
2. Approval of October meeting Minutes.  A motion to approve was made by Chuck Weiland, seconded by Nicole Nisly, approved unanimously.
3. UIHC COVID-19 Response.  Jennifer Vermeer, Katherine Imborek, Keri Semrau presented an overview of UIHC’s response to the COVID-19 since the pandemic was announced in March. The committee agreed UIHC’s response to the pandemic is very impressive.
4. Open Enrollment Update. Rebecca Olson provided an update on open enrollment which is currently underway. The virtual open enrollment is going very well. Final day for open enrollment is Friday, November 13^th.  She will share preliminary results at the December FRIC meeting.  
5. Benefits at Termination of Employment.  Rebecca Olson reviewed what occurs with insurance benefit coverage when faculty and staff leave employment at the university.
6. UIHC Patient Access Reports.  Joni Troester presented UIHC patient access reporting thru September, 2020.  UIHC continues to meet goals in this area.   A question was posed by committee member regarding prior authorization requirement for UI Choice or UI Select members to schedule with a specialist.  No authorization is required.  Joni Troester to follow-up with Patient Access Center. Additional question posed by committee member regarding access for return visits.  Joni Troester to follow-up with UIHC to determine if this data is currently captured and could be shared with the committee.
7. Quarterly Metrics. Rebecca Olson shared quarterly health plan stats thru 3^rd quarter 2020. A side-by-side comparison of data from both plans (UI CHOICE and UI SELECT) was reviewed. Given the COVID-19 pandemic, there has been irregular utilization  which makes data analysis difficult to interpret.       
8. New Business Topics. Joni Troester reviewed the status of three new business items.  UIHC North Liberty project was placed on hold due to COVID but should be resurrected in early 2021. We will have something to share with the committee in the spring. UIHC Population Health will provide update to the committee during our February meeting. Mike Brownlee and Lisa Mascardo from UIHC Specialty Pharmacy will provide an update of 2020 results during our April meeting.

Motion to adjourn by Michael Schuller, second by Cormac O’Sullivan; approved unanimously.

Funded Retirement and Insurance Committee (FRIC) Minutes
October 2, 2020, 11:30 am – 1:00 pm
Conducted via Zoom

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Members present: Jon Garfinkel*, Michael Schueller*, Nancy Davin, Dan Katz, Cathy Koebrick, John Laverty, Nicole Nisly, Anya Prince, Cormac O’Sullivan, Ben Rogers⁺, Angela Speers, Julie Urmie, Anand Vijh, Chuck Weiland

*Co-chairs; ⁺Minutes

Members absent: none

Administrative liaisons present:  Rebecca Olson, Joni Troester

Guests:  Dan Fick, Megan Hammes, Susan Klatt, Teresa Marshall, Cheryl Reardon, Richard Saunders, Cheri Smith, Julie Sexton, Jill Valde, Jessica Wade, Mike Weaver

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1. Introductions.  Michael Schueller introduced the members and guests present for today’s meeting. Joni Troester welcomed new committee member, Anya Prince, who replaced Brian Kaske.
2. Approval of September meeting Minutes. A motion to approve was made by Chuck Weiland, seconded by Nicole Nisly, approved unanimously.
3. COVID-19 Updates. Rebecca Olson shared that COVID 19 retirement plan loans which allowed increased loan limits expired September 22, 2020.
4. Open Enrollment Plans. Rebecca Olson provided an update on Open Enrollment plans. Open Enrollment for 2021 benefits runs Oct 22 - Nov 13. This year is an expanded open enrollment period due to COVID-19. The enrollment will be fully virtual this year, including several online resources, including an interactive enrollment guide, daily live Q & A sessions, real world examples of costs under our health plans, and informational videos. Open Enrollment communication to campus started September 30^th and will continue until the end of the Open Enrollment period. Rebecca fielded questions from the Committee. She confirmed a side-by-side comparison of health plans would be available for employees to use during the enrollment period.
   
   Committee members asked how flexible spending accounts (FSAs) work. Rebecca stated that the FSA funds in one’s account on December 31^st must be used, otherwise they are forfeited. The list of eligible medical expenses has been expanded to cover certain over-the-counter items without a prescription. Both masks and face shields purchased during the COVID are considered eligible medical expenses on the health FSA.
   
   Committee member asked if our FSA plan allowed a "grace period" option of 2.5 months and the option to carry a small amount over to the next year. The UI does not administer the plan this way, as the administration of such a plan is challenging; no other discussions on this topic.
   
   In past years, open enrollment closed on a Sunday, but this year it is a Friday. The decision to close on Friday is due to an absence of staff in ITS and University Benefits over the weekend should the employee encounter a system problem. This year, the enrollment period was extended by one week to include a three-week time period.
   
   A question was raised regarding translation for employees for whom English is not their spoken language. If employees wish assistance translating our materials to their native language, University Benefits will secure a translator on campus.
5. Retirement Plan: Fund Line-up change. Joni Troester communicated the recommendation from the Retirement Fund Investment Review Committee to eliminate Invesco Oppenheimer Senior Floating Rate Fund due to underperformance. Assets within this fund will be mapped to the most age appropriate fund with the Lifecycle target funds for each participant.
6. CY2019 ACO Shared Savings Results. Joni Troester provided an update on the CY2019 ACO through UIHC. UIHC exceeded the Quality Indicator score, and received 30% of the annual savings attributed to the ACO (per the shared savings agreement). Total savings were $1.8 million for calendar year 2019 with $550k was transferred to UIHC. Discussion: There was request from the committee for more information about the ACO in general, and population health. Joni will follow-up with UIHC regarding a future presentation on this topic.
7. UIHC Patient Access Report. Joni Troester presented patient access reports thru August, 2020. UIHC continues to meet goals in this area.   
8. Financial Challenges in the Coming Months. Joni Troester indicated if there are any benefits related issues relative to institutional financial challenges there may be a need for a special meeting prior to November 6th.    
9. New Business Topics. UIHC North Liberty project was put on hold due to COVID. UIHC will try to have something to share with the committee in Spring 2021. For the November FRIC meeting, UIHC will come to the meeting and discuss their COVID response.
10. Final comments. Dan Katz shared he is concerned that there are people in our community that are losing their jobs. Could we extend our benefits after layoffs of University employees? This will be added to the agenda for November.   

Motion to adjourn by Jon Garfinkel, second by Michael Schueller.

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Next Meeting:

Dec. 04, 2020

Zoom Meeting 11:30am - 1:00 pm

Funded Retirement and Insurance Committee (FRIC) Minutes
September 4 and 11, 2020, 11:30 am – 1:00 pm
Conducted via Zoom

September 4 Meeting Minutes

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Members present: Jon Garfinkel*, Michael Schueller*, Nancy Davin⁺, Dan Katz, Cathy Koebrick, John Laverty, Cormac O’Sullivan, Ben Rogers, Angela Speers, Julie Urmie, Anand Vijh, Chuck Weiland

*Co-chairs; ⁺Minutes

Members absent: Brian Kaskie, Nicole Nisly

Administrative liaisons present:  Rebecca Olson, Joni Troester

Guests:  Dan Fick, Megan Hammes, Susan Klatt, Teresa Marshall, Cheryl Reardon, Richard Saunders, Cheri Smith, Julie Sexton, Jill Valde, Jessica Wade, Mike Weaver, Kara Wright, Dana Stafford

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1. Introductions.  Jon Garfinkel  introduced everyone.
2. Approval of May meeting Minutes. A motion to approve was made by Cormac O’Sullivan, seconded by Chuck Wieland, approved unanimously.
3. COVID-19 Updates. This will be a standard agenda item for the foreseeable future. Rebecca Olson discussed the changes that were made to the health plans as discussed at our May FRIC meeting. There is $0 cost-share for COVID-19 testing and related services during the public health emergency, and $0 cost-share for in-network, inpatient COVID-19 treatment through December 31, 2020. As of September 1, we will revert to the standard health plan provisions for virtual visits and accidental dental benefits. UI Choice and Select plans provide coverage for virtual visits and will now be considered an office visit where a co-pay would apply unless seeking mental health services on UI Choice; $0 copay. Accidental dental benefits must be treated within 12 months from the injury. Finally, special mid-year health plan changes where IRS allowed COVID-19 exception for employees to add to or drop health insurance coverage ended August 31, 2020. When a COVID-19 vaccine is developed and distributed, it will be covered with no co-pay since it is part of the preventative plan.
   
   The IRS released clarification of COVID-19 related provisions which included expansion of “qualified individuals” definition giving members access to COVID 19 retirement fund distributions up to the lower of their plan balance or $100,000 with no penalty before December 31, 2020. COVID 19 retirement plan loan limits were increased to the lower of their plan balance or $100,000 and are available before September 23, 2020. A communication regarding this will be distributed.
4. CY2021 Premium Rate Discussion. 
   1. Plan comparisons are listed on the website.
   2. Dental II Premiums. UI Benefits recommends 0% increase across all family statuses. 
   3. UI Choice. 
      1. Employee premium cost share for Employee and Dual Spouse Family is 10% for CY2021.
      2. Employee+Spouse and Employee+Child and Family status remain at an employee premium cost share of 20%.
   4. UI Select.
      1. Employee premium cost share for Employee and Dual Spouse Family statuses remains at 0%.
      2. Employee Spouse, Employee+Child and Family Statuses have a cost share of 20%.
      3. Joni Troester  reviewed the design features of the UI Select Health Plan.
5. CY2021 Premium Rate Setting.
   1. Rate setting process discussed; assumptions and data used in rate setting shared.
   2. Proposed rates were presented with a 5% increase for both UI Choice and UI Select plans and across all family status. (less than CY2020 @ 10%)
6. CY2021 Retiree Health Insurance Rates.
   1. Rate setting process discussed; assumptions and data used in rate setting shard.
   2. Proposed rate increase for Medicare Carve-out Retiree Health Plan is  8.9%. (slightly less than 10.6% for CY20)
7. Motion to approve rates for CY2021. Following discussion and time for questions, a motion was made by Nancy Davin, which was seconded by John Laverty to approve the rates as proposed. The motion was passed unanimously. 
8. Anand Vijh asked that Zoom roll call votes be alternated in alpha and reverse alpha order. 
9. We will have an additional September meeting next Friday, September 11, 11:30 a.m. Outlook invitations are on calendars with the Zoom link included.  We have a proposal from UIHC on which Jennifer Vermeer – from UIHC-  would like FRIC feedback. 
10. Chuck Wieland made a motion to adjourn, seconded by Ben Rogers. Motion passed.

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September 11 Meeting Minutes

Members present: Jon Garfinkel*, Michael Schueller*, Nancy Davin⁺, Dan Katz, Cathy Koebrick, John Laverty, Nicole Nisly, Cormac O’Sullivan, Ben Rogers, Angela Speers, Julie Urmie, Anand Vijh, Chuck Weiland

*Co-chairs; ⁺Minutes

Members absent: Brian Kaskie

Administrative liaisons present:  Rebecca Olson, Joni Troester

Guests:  Teresa Marshall, Heather Mineart, Richard Saunders, Katie Schier, Cheri Smith, Julie Sexton, Dana Stafford, Jennifer Vermeer, Jessica Wade, Kara Wright

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1. eConsults.  Jennifer Vermeer and Katie Schier from UIHC presented on behalf of UIHC regarding adding eConsults to the UI Choice and UI Select plans for 2021. Presentation included a definition of e-consults, benefits to the plan and patient, and results from a previous pilot program with Medicare.
   Time was allowed for questions and discussion. A motion was made by Nicole Nisly, seconded by Ben Rogers. All present voted in support of adding eConsult to the plan except Dan Katz who abstained due to the fact that a decision would present a conflict of interest.
2. 2020 Metrics. Rebecca Olson shared the metrics for July 2018 through June 2020. There has been irregular utilization due to the COVID-19 pandemic, making data analysis difficult to interpret at this point. FRIC members requested a side-by-side comparison of data from both plans (UI CHOICE and UI SELECT) in the future, especially when meeting virtually.   

Following open enrollment FRIC members will receive an update on plan migration.

3. UI Health Care Patient Access Report. Patient access targets continue to be met in a timely manner. The PAC has done an excellent job facilitating access. Nicole Nisly asked if eConsults will counted in the access numbers.  Joni Troester will let the committee know in November whether eConsults will be tracked.
4. New Business. Scheduled for spring 2021 is an update from UIHC on the North Liberty project (rehab facility). At the October 2020 meeting an update will be provided on the open enrollment plan.

The next meeting is October 2, 11:30 am – 1:00 pm.

FRIC Meeting Minutes: May 1, 2020

FRIC
MEETING MINUTES
May 1, 2020
Meeting conducted via Zoom 11:30 am to 1:00 pm

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Members present: Jon Garfinkel*, Nancy Davin*, Chuck Wieland, Mike Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Nicole Nisly, Dan Katz†, Steve Bernholtz, John Laverty, Ben Rogers, Cormac O’Sullivan

*co-chairs, †minutes

Members absent: Brian Kaskie

Administrative liaisons present: Rebecca Olson, Joni Troester

Guests: Jessica Wade, Joe Yockey, Kara Wright, Dana Stafford, Cheryl Reardon, Cheri Smith, Julie Sexton, Michael Brownlee, Lisa Mascardo, Alex Mersch, Jill Valde, Susan Klatt

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1. Introductions – Garfinkel and Davin
2. Approval of February 2020 FRIC meeting minutes: moved by Nisly; second by Wieland
3. Number of meetings in September for Premium Rate Setting Discussion
   • September 4 only or add September 11
   • Discussion, followed by Roger’s motion to schedule 2 meetings and cancel second if possible; seconded by Wieland; Vote: approved
4. Specialty Pharmacy Presentation – Michael Brownlee, Chief Pharmacy Officer; with Lisa Mascardo and Alex Mersch
   • Partnership between UI pharmacy and UI Benefits started in 2019. Gives members more high touch service, offers more robust copay assistance program, goal to improve overall pharmacy experience.
   • UI pharmacists are part of the larger health care team and take an active role in the complicated process of health care administration for often complex patients.
   • The specialty pharmacy quality and adherence metrics are very high and exceed those of outside pharmacies.
   • UI pharmacists ask: Is the drug really working? They feel that they do a better job of assessing medication compliance and outcomes relative to the results expected from a particular therapy. One thing that helps produce these results is that UI pharmacists track the labs and make more nimble medication adjustments.
   • 30% of pts take advantage of copay or grant assistance which translates into beneficiary savings of up to $750-800/month.
   • Satisfaction surveys are administered quarterly to the specialty med patients and most patients agree that they are very satisfied. Patients frequently comment that they like getting a live person on the phone.
   • Drug cost trends: specialty pharmacy meds are expensive and outpace the rate of rise of non-specialty medicine inflation. A 7% or more year-over-year increase in specialty pharmacy revenues is expected. 42% of pharmacy industry revenue in 2021 is expected to be accounted for by specialty meds versus 17% in 2011.
   • Approval process for specialty meds is faster: taking about 10 mo v 2 yrs previously, meaning that more meds are entering use at a faster pace.
   • Contributing to overall healthcare costs is that the services that go along with the specialty meds are also more complex and expensive. For example, the meds are not just oral but also may require i.v. administration: at home with home nurse or at i.v. infusion center.
   • 30% of total pharmacy benefits are consumed by just 5 disease categories: Inflammatory diseases like rheumatoid arthritis and inflammatory bowel disease, multiple sclerosis, oncology, Hepatitis C, and HIV. 1-2% of patients can drive 50% of specialty drug costs
   • There are unpredictable cost increases leading to difficulties in forecasting.
   • A priority is to monitor outcomes versus value.
   • Volume of UI specialty pharmacy care increased in 2019 with expanded membership, higher risk pts, and new treatment options.
   • A gray area in the way Wellmark categorized certain meds as pharmacy versus medically related and associated copays was clarified and should no longer be an issue.
   • Lessons learned from member feedback: members like more technology, want to leverage My Chart, improve packaging, and gain access to limited distribution drugs.
   • Questions
     1. Q: How many pts receive copay assistance that weren’t receiving it before? A: no exact data, no answer on change, pharmacy will look into.
     2. Q: Can a reduction in other areas of care be shown as a result of specialty med use (i.e. does the treatment of Hepatitis C lead to lower long-term Hepatitis C related medical costs?) A: Hard to show reduction in other areas of care (mitigation) as a result of use of more specialty meds. More time needed.
5. COVID-19 Response – Troester
   • New employee orientation: New employee orientation being done via YouTube. The Benefits Office has quickly adapted to the remote environment
   • Dependent eligibility verification: strict enforcement on hold until resolution of acute COVID phase
   • Telehealth: telehealth visits covered at no charge in both UI (Choice and Select) plans; 2900 visits via UIHC’s COVID telehealth screening service  on all plans so far. COVID  testing is free and COVID vaccines will be free. UI opted in to have no copays related to treatment for COVID.
   • CARES Act – Retirement Plan Provisions (details available on https//hr.uiowa.edu/benefits/retirement-plans/cares-act-provision-and-your-retirement-plans)
     1. Penalties and withholding are waived for qualified distributions from retirement plan accounts
     2. Retirement plan loan limits have been increased
     3. Optional suspension of required minimum distributions (RMDs) for 2020

Discussion on COVID response:

• Discussed tele access depending on patients’ location and continuity of care.
• Q: How will the suspension of elective surgeries affect costs/revenue? A: Will we have the info in Sept when we start talking about setting rates.
• Q: How many patients have contacted TIAA to take advantage of the COVID provisions?A:70-80
• Q: Do we have furloughed employees and what’s happening to their retirement or benefits vis a vis COVID? A: No furloughs yet as result of COVID. All employees are in pay status until the end of the semester. New pay practices starting 5/16/20 will be released.

6. Active Employee Death Benefits – Olson
   • Health and dental insurance: Continuation for spouse and dependent child (up to age 26), premiums are the same as for retirees
   • University paid group life insurance: 2 x salary up to $400,000 max, some employees may have opted for different coverages
   • Accumulated vacation time payout
   • Accumulated sick leave payout (For employees 55 and older $2,000k max, per State of Iowa guidelines).
   • One month base pay
   • EAP (employee assistance program) service for spouse and children up to 90 days
7. Updates on metrics
   • Steady to slightly increased ER and outpatient visits compared with Q1 2019
   • Increase in pharmacy and outpatient clinic costs
   • Difficult to assess metrics due to unknown affect of COVID on access.
8. Possible extra FRIC meeting in May or June related to measures that may need to be taken in response COVID induced losses or costs.

 

Motion to adjourn: Wieland; second: Nisly

FRIC Meeting Minutes: Mar. 06, 2020

FRIC

MEETING MINUTES
March 6, 2020
302 University Services Building
1130 AM

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Members Present: Steve Bernholz, Nancy Davin, Jon Garfinkel, Daniel Katz, John Laverty, Nicole Nisley, Ben Rogers, Michael Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Chuck Wieland

Members Absent: Brian Kaskie, Cormac O’Sullivan

Administrative liaisons:  Rebecca Olson, Joni Troester

Guests:  Megan Hammes, Richard Saunders, Dana Stafford, Kara Wright, Joe Yockey, George Johnson

 

1. Introductions– Garfinkel and Davin

2. Approval of February meeting minutes – Motion to approve by Wieland; second by Davin.  Unanimous approval. 

3. Follow-up on Open Enrollment Demographics – Provided by Rebecca Olson
   • Shared UIChoice and UISelect Health Plan enrollment data as of January 1, 2020.
   • Chuck asked about information by income bands; others on the committee suggested waiting until UISelect grows (i.e. above 10%)
   • UIHR will add this to the enrollment report template next year
4. Provider/Network Access Reports – Provided by Joni Troester
   • Feb. 2020 report reviewed (in binder)
   • Health care providers are meeting expectations based upon predetermined metrics.
   • We can expect some variance from month-to-month; in February 2020, slightly higher for primary care, a little lower for specialty care, and a slight increase for tertiary care.
   • Feedback from Dr. Nicole Nisly indicates that UIHC is working to hire more 1^st level Neurology care providers at IRL. Also increasing e-consultations between primary and specialty care providers to increase options for primary providers to help patients in their offices.
   • UIHC is not quite ready to publicly discuss planning for the new North Liberty facility. FRIC will have a report from UIHC in Spring 2021.
   • New UIHC patients not willing to take “first-available” appointments are not included in the patient access reports. Patients with already established relationships with a care provider at UIHC are also not included, as they already have priority for on-going appointments.
   • General discussion ensued regarding Coronavirus (COVID-19) and what is being done at UI to prepare and respond. It was recommended to refer to the UI website for Campus Coronavirus Updates at https://coronavirus.uiowa.edu/.

5. Pharmacy Benefit Manager Update – Provided by Joni Troester
   • Finalizing scope of work with Aon to conduct market check review. They will provide UI initial information this summer and have a formal report in the fall.
   • Phase II would be an RFP if the data suggests it would be beneficial to move forward with that option.
   • It was suggested that even if we don’t do an RFP, that we still look into the pharmaceutical rebate issue and value based opportunities; what we could do to benefit those enrolled in our health insurance plans.
6. Preliminary Discussion: Potential Use of Health Plan Savings – Garfinkel
   • Just under  $4 million in projected institutional savings (not new revenue) from premium cost structure changes with UI Choice single and UI Choice dual spouse family now having a 5% premium cost share
   • Prior discussions (by the Health Insurance Stakeholder Advisory Committee) have suggested the savings should benefit employees who participate in the health insurance plans (this could be considered a “guiding principal”)
   • A few suggestions from FRIC committee members included:
     • Develop a mechanism to provide grants from the savings for pilot programs in health care that would directly benefit patients or provide preventative care
     • Create an “endowment” to offset unexpected costs in the Plans (i.e. outliers of super high-priced drugs)
     • Create an employee assistance fund for those who are unable to pay for out-of-pocket expenses
     • Determine some free medications that are essential and of high benefit and/or could reduce health care expenses later (i.e. HIV prevention drugs, insulin, etc.)
     • Reduce premium prices and/or out-of-pocket costs
     • Reduce fringe rates to UI departments to help provide more competitive salaries in targeted job categories.
     • Support preventative and well-being services; outside gym and other wellness membership costs (it was mentioned that Wellmark already provides some of this benefit to us; it’s just not advertised widely because of relationship with UI Recreation Services)
     • FRIC co-chairs will reach out to UI Staff Council president – Mike Weaver and UI Faculty Senate V.P. – Joe Yockey to discuss their participation (or by designees from those two shared governance groups) regarding options for the estimated $4 million savings. Mike Weaver convened a group already last year, so may have a list already developed and ready to share.

7. Level One Providers - Urmie
   • 2019 vs. 2020 data provided
   • Julie Urmie told of some UI staff who work in other parts of the state and don’t have direct access to Level I providers unless they travel back to the Iowa City area. These are mostly health care residents.
   • Joni Troester reminded the committee that UI staff not only work across Iowa but also across the US.
   • There was a discussion about those who are required to live elsewhere because of their job at UI vs. those who choose to work remotely.
   • Discussion continued about the fairness of those remote employees having to pay higher rates (Level II). Chuck Wieland commented that in either case, the maximum out-of-pocket limits are the same. Also, our Level II is more similar to most other employers’ Level I coverage.
   • Mike Schueller said this issue has been discussed before during his tenure on FRIC and because of the complexities of the issue and good coverage provided, no accommodations have ever been made for those working remotely.
   • A question was asked by Jon Garfinkel about how making accommodations for staff working remotely to receive Level I benefits would be different than exceptions being made for certain pharmaceuticals or procedures we make now?
   • A discussion ensued about considering just health care residents working remotely in Iowa because of their relatively low salaries and how paying Level II out-of-pocket could affect them more. Others asked then to consider reviewing all employees at or below certain salary levels. UIHR staff explained the difficulty and complexity of looking at just salary levels of individual staff.
   • Julie Urmie will consider suggesting to out-of-region health care clinics to increase their agreements with UI so that UI staff working in those areas could use Level I benefits. Many of these locations already have some level of agreement with UI.
8. Old Business
   1. UI Health Care ER – Discussion
9. New Business
   1. April Meeting – Specialty Pharmacy presentation
   2. Spring 2021 meeting – UI HC North Liberty project

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Next Meeting
April 3^rd from 11:30 a.m. – 1:00 p.m. at 302 USB (Meeting was canceled)

Minutes taken by John Laverty

FRIC Meeting Minutes: Feb. 07, 2020

FRIC
Meeting Minutes
February 7, 2020
302 University Services Building
1130 AM

Members Present: Jon Garfinkel (co-chair), Nancy Davin (co-chair), John Laverty, Nicole, Nisly, Ben Rodgers, Mike Schueller, Sarah Tallman, Anand Vijh, Julie Urmie, Chuck Wieland,

Administrative Liaisons: Joni Troester, Rebecca Olson

Guests: Richard Saunders, Jessica Wade, Julie Sexton, Dana Stafford, Megan Hammes, Cheryl Reardon, Kara Wright, Jill Valde, Theresa Marshall,

Members Absent: Brian Kaskie, Steve Bernholz, Dan Katz, Cormac O’Sullivan

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1.  Introductions– Garfinkel and Davin

2.  Approval of December meeting minutes – Wieland motion; Davin second

Moved and Approved Unanimously

3.  Open Enrollment Update – Olson

• Shared final open enrollment update from 2019. Only modest changes in terms of UIChoice vs. UISelect population mix since last update.
• 1323 UI select & 16918 UIChoice - 7% overall migrated to UI Select.
• Expecting more migration to UI Select next year - particularly as premium on UIChoice increases for employee only and UI dual spouse family
• FRIC requested more information about age and faculty/P&S/merit demographics in relation to migration to UI Select.
• Next fall we will have more information that will allow us to make more informed decisions regarding rate setting structure; actual utilization of the new plan
• Committee member provided personal experience with UI Select.
  • UI Select has been a learning experience. 
  • When you have kids in college you have to communicate regarding out of state and in state when people move back and forth under the Guest Membership program
  • Finding providers on UI Select is not that easy. Opportunity to improve the communications and website.
• Anecdotal feedback discussed about why staff did not move to UI Select.
  • Feedback that decision is being driven for many by the out of state differences between the plans.
  • Feedback that many are waiting for word of mouth from peers.
  • Differential cost between the plans was not big enough to drive some people to change.

A reminder was provided that UI allows people to move back and forth between plans each year at open enrollment

• Projected institutional savings projected at just under $4 million this year from the premium cost structure changes (UI Choice single and UI Choice Dual Spouse Family now having a 5% premium cost share)

4.  Retirement Plan – Pre-2009 withdrawals – Olson

• We currently have an unusual provision that allows withdrawal of pre-2009 employer contributions from the mandatory retirement plan. No other TIAA plans (nationwide) have a similar provision. Proposal is to sunset this provision Jan 1, 2021.
• Only 14 employees have requested this in the last 10 years but experiencing increasing interest in this provision.
• Philosophically the university provides contributions for retirement. This clause allows withdrawal of funds in such a way that they could be used for non-retirement. Discussion ensued about the fact that this part of employee compensation and employees should have some discretion about how their compensation is used.
• Discussion arose about whether the implementation window should be shortened to July 1, 2020.
• Motion to approve and seconded to accept proposal but change implementation date to July 1, 2020.
• Significant discussion ensued. Points discussed:
  • Discussion that this is the employer money.
  • This only affects the individual who makes the decision to withdrawal.
  • There are administrative fees associated with these withdrawals and they are error prone due to complexity of calculating the amounts but not a significant impact to plan viability.
  • This is going to be viewed as taking away yet another benefit/reducing the University benefits even if very few use it.
  • This is moving the University back to the standard given that no one else in the nation does this.
  • No history is available about why this was introduced in 2009. And this is not allowed for contributions after 2009.
• Motion amended after discussion and seconded to accept original proposal with Jan 1, 2021 implementation date. Motion carried with 7 aye and 3 nay

5.  Provider/Network Access Reports/Follow-up – Troester

• Access for primary care expectations are being met. Individuals who are requesting very specific times/physicians not counted in this number.
• Specialty care – Expectations met in January.. Some areas such as dermatology and neurology remain challenging.
• Questions from FRIC members
  • Where there are national shortages, should we be considering level 1 for other providers? Could be explored but would want to do this in partnership with UIHC.
  • Dermatology may not be getting credit for e-consults. We will need to investigate this. These are appointments that are being brought through PAC. Are there non-appointment items like this that need to be considered in our metrics.
  • Where does mental health fall within this information. Psychiatry can be difficult to get into. Level 1 for both plans are community plus UI Healthcare. As such this is different. We also have EAP and can do four free visits before referral to community 
• Tertiary care metrics are being exceeded and met across all sub-specialties.

UIHC has been a very good partner and is working hard to expand access and meet the access metrics.

6.  Quarterly Metrics – Olson

• 8 quarters of statistics now available with the Faculty, P&S, and Merit population under same benefits plans.
• As expected Q4 was the busiest.
• Number of employees and members has grown modestly.
• Utilization and costs are up.
• Seeing about 6% annual cost increases. National is 6-7%.
• Specialty drugs are growing at the most rapid rate, and we will discuss more in April.

7.  Pharmacy Benefit Manager Update - Troester

• Finishing up work with Aon on statement of work to examine what financial gain that may be available by leveraging a direct PBM contract.
• Summary of this analysis will hopefully brought forward to FRIC in September 2020 timeframe
• If analysis is promising, then UI would consider moving forward to an RFQ.

8.  Old Business

• UI Health Care ER – Discussion.  March or April agenda.
• Request to invite UIHC to discuss North Liberty expansion plans in March/April.

Motion to Adjourn approved at 12:48PM

9.  New Business

• April Meeting - Specialty Pharmacy Presentation

Minutes taken by Ben Rogers.

FRIC Meeting Minutes: Dec. 06, 2019

FRIC
Meeting Minutes
December 6, 2019
302 University Services Building
1130 AM

Members Present: Jon Garfinkel (co-chair), Nancy Davin (co-chair), Steve Bernholz, Dan Katz, John Laverty, Nicole, Nisly, Cormac O’Sullivan, Ben Rodgers, Mike Schueller, Sarah Tallman, Anand Vijh, Julie Urmie, Chuck Wieland,

Administrative Liaisons: Joni Troester, Rebecca Olson

Guests: Richard Saunders, Jessica Wade, Julie Sexton, Dana Stafford, Megan Hammes, Rhonda Fruhling, Chris Thompson, Mary Ann Allan, Susan Klatt

Members Absent: Brian Kaske

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1. Introductions– Jon Garfinkel and Nancy Davin

• Completed for members and guests.

2. Approval of November meeting minutes – Jon Garfinkel and Nancy Davin

• Motion by Mike Schueller to approve the November meeting minutes, second by Chuck Wieland. Motion passed unanimously.

3. Diabetes Pilot Update – Presentation by Rhonda Fruhling and Chris Thompson, UI Health Care

• A total of 42 patients have participated in the diabetes pilot program: 21 are considered active, 13 disengaged and 8 graduated from the program. Over the 12 month period, Hemoglobin A1C improved, diabetes self-control improved, and QoL improved. Cost data was confounded by outliers. Future goals are to increase access by engaging new providers and to develop new guidelines for patient progress through the program and what constitutes engagement. 

• The committee is interested in additional data on costs and a comparison of outcomes for active vs disengaged participants.

4. Open Enrollment Update – Rebecca Olson

• Benefits office staff provided extensive educational materials to assist with open enrollment and also conducted in person and zoom informational sessions. About 750 people attended the in person sessions and about 150 people attended the zoom sessions. They are still finalizing enrollment statistics, but approximately 7% of employees enrolled in UISelect. 

• There is a new voluntary 457b deferred compensation plan beginning in January 2020.  Employees may enroll beginning mid-December.  Employee only contributions will be made to the plan.
• Late December, Benefits is mailing a letter to the homes of employees and retirees who chose UISelect to confirm their enrollment and provide a recap of the plan provisions and drug formulary, including the process for obtaining a guest membership through the UISelect Plan

5. Quarterly Metrics – Rebecca Olson

• Quarterly utilization and cost metrics were presented. Utilization and costs generally were up relative to last year.

6. Provider/Network Access Reports/Follow-up – Joni Troester

• Provider network access reports will be begin to be sent monthly, but eventually will transition to quarterly reports. An escalation protocol for the patient access center has been formalized.  There still are anecdotal reports of access issues - it is important to report these issues to the UI Benefits Office so that they can follow-up. Plan to put notification on benefits website that employees should identify themselves as UI Choice or UI Select members when they call UI Health Care for appointments.

7. Old Business

• As a follow-up to last meeting’s discussion about emergency department (ED) wait times, Dan Katz proposed that employees should be able to go elsewhere and have equivalent coverage if wait times are longer than 2 hours. Dan will summarize the proposal in an email and send to the committee chairs. Additional data from the UI ED will be requested.

Motion by Mike Schueller to adjourn the meeting, second by Nicole Nisly. Meeting adjourned at 1:00 p.m. 

Meeting minutes submitted by Julie Urmie

FRIC Meeting Minutes: Nov. 01, 2019

Funded Retirement and Insurance Committee (FRIC) Meeting
November 1, 2019,
302 USB

Introduction and roll call of members:  Nancy Davin, Daniel Katz, John Laverty, Nicole Nisly, Cormac O’Sullivan, Ben Rogers, Michael Schueller, Sarah Tallman, Julie Urmie, Chuck Wieland, Steve Bernholtz

Introduction and roll of administrative liaisons: Joni Troester, Rebecca Olson

Absent (members): Brian Kaskie, Jon Garfinkel, Anand Vijh

Visitors: Richard Saunders, Julie Sexton, Dana Stafford, Kara Wright, Andrew Nugent, Jennifer Vermeer, Dan Fick, Jessica Wade, Keri Semaru, Theresa Marshall

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1. Approval of October 2019 minutes: Motion to approve O’Sullivan, 2nd Rogers.  Unanimous approval
2. UIHC Emergency Room Access/Capacity presentation: Andy Nugent (Medical Director for the ED at UIHC) provided information on the Emergency Department access and capacity. 
   • ER volume has decrease by approx. 5000 visits in the past few years.
   • 40% of ER patients are admitted. The national average is 15%. 
   • Quick Care & Urgent Care are an option.
   • Discussion around education on when to use Quick Care or Urgent Care rather than going to the ER.
   • The Crisis Stabilization Unit has helped provide mental health care relieving the ER.
   • Dan Katz suggested having a Kiosk in the ER lobby to help patients decide if they should wait in the ER or go to Quick/Urgent Care instead. 
   • There is a need for a Pediatric ER to see these patients in a less stressful/scary environment. 
   • UIHC census is often over capacity at 98% full. Optimum capacity is 85%. This often can create back log in the ED for patients that need to be admitted.
3. Open Enrollment Update: Rebecca Olson informed the group that Open Enrollment is going well.
   • There have been 32 training sessions, 18 off site & office hours all over campus to educate staff on their health insurance options.
   • In the first nine days, of those who have completed enrollment for 2020 benefits, 84% chose UIChoice & 10% chose UISelect. 35% migration was predicted. 
   • Open Enrollment goes until November 15th. Historically, many wait until the last week to enroll. 
   • Staff will receive a confirmation & have until November 25th to make any final changes.
4. Access Targets for 2020:  Jennifer Vermeer provided an update on UIHC access for 2020.
   • The dashboard report she provided is new. There was discussion about primary care physicians and wait times for appointments. 
   • Additionally, there was some question on primary care providers that were accepting new patients. 
   • The new dashboard will be updated and shared with FRIC in 2020.
5. Retirement Plan Investment Review:
   • Joni Troester informed the committee that the wording used for the upcoming review was changed based on feedback from FRIC. 
   • Review will focus on areas in both the mandatory and voluntary plan related to fund line-up and plan architecture. 
   • Phase 2 for the review will explore options for additional flexibility in plan design. 
   • Next steps will be to go to the Shared Governance committees for review.

Wieland motion; Schueller second; Unanimous approval to adjourn.

Adjournment: Meeting adjourned at 12:50 p.m.

Submitted by Sarah Tallman

FRIC Meeting Minutes: Oct. 04, 2019

Funded Retirement and Insurance Committee (FRIC) Meeting

October 4, 2019, 302 USB

Introduction and roll call of members:  Nancy Davin, Jon Garfinkel, Daniel Katz, John Laverty, Nicole Nisly, Cormac O’Sullivan, Ben Rogers, Michael Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Chuck Wieland

Introduction and roll of administrative liaisons: Joni Troester, Rebecca Olson

Absent (members): Steve Bernholtz, Brian Kaskie

Visitors: Megan Hammes, Cheryl Reardon, Richard Saunders, Julie Sexton, Dana Stafford, Jill Valde,  Kara Wright, Mary Ann Allen

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1. Approval of September 2019 minutes: Motion to approve Wieland, 2nd Rogers. Unanimous approval
2. Catastrophic leave policy: Joni Troester provided an update on proposed changes to the Catastrophic leave policy which would allow eligibility for 9-month faculty and staff to receive donations.
3. Changes in medical plans and open enrollment: Following extensive deliberations of FRIC and approval by the Board of Regents, University of Iowa will offer two health plans during calendar year 2020: UIChoice (existing) and UISelect (new). UISelect plan has been designed to accommodate the needs of employees who want lower monthly premiums in exchange for increased copay and deductibles. Additional differences include Level Three providers by exception only and a change in the Rx Formulary. The UI Benefits department intends to hold extensive informational sessions and one-on-one office hours to educate employees on the two plans. This effort starts next week with mailing out the information packet for open enrollment that begins on October 23 and closes on November 15, 2019.
   • Other changes include an increase to the Healthcare Flexible Spending Account limit to $2,700 for calendar year 2020.
4. Mandatory retirement plan fund line-up changes:  The Retirement Fund Investment Review Committee has recommended fund line-up changes to the mandatory 403(b) retirement plan.
   • Two funds will be changed to a share class with lower fees. These are as follows:
     • T. Rowe Price Growth Stock Fund will be changed from the retail share class to institutional share class
     • Columbia Small Cap Value Fund will be changed from the retail share class to the institutional share class.
   • Two funds will be closed with assets and balances mapped to the identified funds. This is due to low performance and higher fees of the funds that will be closed. These include:
     • TIAA CREF International Equity (TIIEX) MAPPED TO TIAA CREF International Equity Index Fund (TCIEX)
     • Victory Munder Mid Cap Growth Fund (MGOYX) MAPPED TO TIAA-CREF Mid-Cap Growth Fund (TRPWX)
5. Offering a 457(b) retirement saving plan: Effective January 1, 2020, University of Iowa will offer a voluntary 457(b) plan that enables employees to make contributions for retirement savings. Contributions can be on a pre-tax or post-tax basis. 2019 IRS limits allow $19,000 as a maximum contribution. This is in addition to the 403(b) voluntary plan limits. Campus communication will occur mid-December 2019 with contributions starting 1/1/20.
6. Updates on LiveWELL program: Megan Hammes, Senior Director of UI LiveWELL program provided an update on LiveWELL, specifically LiveWELL 2020 and planned changes. In 2019, LiveWell went through an external review. Recommendations from this review formed the basis for liveWELL 2020. Changes include alignment of liveWELL mission with UI mission, expansion of programming and services focused on campus engagement and well-being culture, expansion of one staff member, and discontinuing the one-time annually Personal Health Assessment incentive with reallocation of funds to support the expanded programming and staff.
7. Retirement Plan Investment Reviews:  The Retirement Fund Investment Review Committee is the committee with fiduciary responsibility for all employee retirement plans provided by UI. As part of this fiduciary responsibility, the Committee is considering a review of the retirement plans by an outside consultant to make sure plan design, funds, and fees are in alignment with best practice and meet all compliance standards. More discussion will occur with FRIC on this issue.

Adjournment: Meeting adjourned at 1 p.m.

Submitted by Anand M. Vijh