FY22 Meeting Minutes

FRIC Meeting Minutes

April 1, 2022

Zoom Meeting

1130 AM


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

  1. Approval of March meeting minutes – Schueller and Urmie
    1. Chuck Wieland moved to approve
    2. Nancy Davin second
    3. March minutes approved unanimously

  1. 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.

  1. 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.

  1. 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

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


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


  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.


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
         


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


 

  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

    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

  

  1. 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.

 

  1. 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.

 

  1. 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.

 

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

 

Recorder: John Laverty

Enrollment Management

FRIC Meeting Minutes
December 3, 2021

Zoom Meeting

1130 AM

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


  1. Introductions– Garfinkel and Schueller
    1. Roll call taken

  1. 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

  1. Announcement that FRIC meetings will continue with virtual format through spring semester

  1. 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

    1. 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

    1. 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

  1. 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 

  1. 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

  1. 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. Access Reports - not available yet

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

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


Next Meeting

February 4, 2022

Zoom Meeting

FRIC Meeting Minutes
November 5, 2021

Zoom Meeting

1130 AM

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


  1. Introductions– Garfinkel and Schueller
    1. Roll call taken

  1. Approval of October meeting minutes – Garfinkel and Schueller
    1. Nancy Davin moved to approve
    2. John Laverty second
    3. October minutes approved unanimously

  1. 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.

  1. Open Enrollment Update – Olson
    1. Open enrollment is from Nov 1st – 15th
    2. Reminders will be emailed on 9th and 12th
    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.

  1. 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.

  1. 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.

  1. 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.
  2. Other Updates – Troester/Olson
    1. Access Reports
      1. Access Dashboard shared with committee on performance of assess for UI beneficiaries.

  1. New Business (AY 2021 - 2022)
    1. My Chart Presentation – December meeting
    2. UIHC – North Liberty Facility - TBD
    3. Mental Health Coverage.

  1. Meeting adjourned


Next Meeting

December 3, 2021

Zoom Meeting

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

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.

  1. 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.

  1. 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.  

  1. 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.

  1. 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.

  1. 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 that includes many generics, to $150 for Tier 5 that 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 the November, the committee will continue debating the pros and cons of copay and coinsurance.

  1. 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.

  1. Adjournment: Nicole Nisly made a motion to adjourn. Nancy Davin seconded. Committee approved unanimously.


Recorder: Anand M. Vijh

Tippie College of Business

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


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


  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.


Next Meeting
October 1, 2021
Zoom Meeting