May 6,  2016 Funded Retirement and Insurance Committee (FRIC) Minutes
302 University Services Building (USB)

Members present: Steve Bernholtz, Nancy Davin (co-chair), Nicholas Francisco, Jon Garfinkel (co-chair), Mary Greer, Brian Kaskie, Daniel Katz, Nicole Nisly, Michael Schueller, Katherine Tachau, Anand Vijh, Lynn Vining
Administrative officers present: Joni Troester, Debra Hughes
Members absent: Amber Seaton, Bernard Sorofman
Guests present: Megan Hammes, Suzanne Hilleman, Jessica Wade, Julie Sexton, Brad Archer, Victoria Lim, Rick Borchard, Kara Wright, Pat Clinton, Michael Brownlee, Lisa Mascardo, Eric Stevens, Pat Clinton, Kara Wright

1. Nancy Davin and Jon Garfinkel called the meeting to order at 11:30. Member and guest introductions were made.  Jon shared that President Harreld was unable to attend today’s meeting due to previously scheduled budget meetings.
2. The April 1, 2016 minutes were approved unanimously.
3. UIHC Specialty Drugs

Michael Brownlee, Chief Pharmacy Officer, assisted by Lisa Mascardo, Ambulatory Care Services Director, gave an informational overview of specialty medications and pharmacies. Highlights included:

1. Center of Medicare and Medicaid Services’ definition of specialty pharmacies
2. 51 billion dollars were spend in 2012 Specialty meds; projected to be 120 billion dollars in 2020
3. Benefits of UI Pharmacy services

Jon requested that committee members be prepared for further discussion regarding this topic by reviewing the drug prices article prior to attending the fall meeting.

4. Fall meeting schedule- deferred until the end of the meeting. Group discussed and agreed that an invitation would be extended to President Harreld to attend a meeting after September 2016.
5. Preliminary Discussion Premium Setting Process for 2017

Debra Hughes gave a brief overview of our rates since 2012. Highlights included:

1. UI is self-funded and the yearly goal is to net to zero (break even) in rate determination so that premiums cover claims incurred.
2. Are required by law to have a reserve to assure coverage
3. Paid claims have increased from 85 million dollars in 2012 to 119 million dollars in 2015
4. Historically committee and UI has looked at each family coverage option separately
5. Preliminary claims for present year (runs June 2015 through May 2016) are running approximately 7%, slightly higher than the 5% increase that was implemented.  Final numbers should be available for review at the September meeting for decision making.

6. Value Based Benefit Design- Guiding Principles
   Jon and the committee members thank Mary, Katherine, Nicole, and Bernard for their work in drafting revised guiding principles. It was requested that #8 be revised to read: Be patient-centered and value–driven in organizational health benefit design (e.g. generic drug program design).  The group unanimously approved the document and the requested revisions
7. Old Business:
   1. Delta Dental visit frequency
      Debra Hughes updated the group that employees who due to specific health conditions require more frequent visits than specified by the current guidelines can easily obtain services by having their dentist do a one-time call to authorize additional visits as needed.
   2. Transgender coverage
      Transgender coverage has been approved. Joni shared that the implementation date has not yet been finalized.
8. New Business:
   1.  Debra Hughes’ retirement
      Joni shared that Debra will be retiring. A search for her replacement is ongoing.  Joni and all thanked Debra for her invaluable service and also for her willingness to continue assist in the transition.
   2. Request for 2nd meeting in September
      Group discussed that additional time may be needed to discuss premium rates for CY2017.  Group discussed options of additional meeting versus extending the current Sept. 2nd meeting.  Members unanimously agreed to hold a second meeting on Sept 9th.
9.  Meeting was adjourned at 1:05 pm.

Respectfully submitted,

Lynn Vining

Funded Retirement and Insurance Committee (FRIC) Minutes from April 1, 2016

Meeting was called to order at 11:30 a.m. in 302 USB

Members present: Steve Bernholtz, Nancy Davin (co-chair), Nicholas Francisco, Jon Garfinkel (co-chair), Mary Greer, Brian Kaskie, Daniel Katz, Nicole Nisly, Michael Schueller, Bernard Sorofman, Katherine Tachau
Administrative officers present: Joni Troester, Debra Hughes
Members absent: Amber Seaton, Anand Vijh, Lynn Vining
Guests present: Megan Hammes, Suzanne Hilleman, Jessica Wade, Kevin Ward, Dianne Wasson, Brad Archer, Victoria Lim, Rick Borchard

1. Nancy Davin and Jon Garfinkel co-chaired the meeting.
2. Committee members, administration representatives, and guests introduced themselves.
3. The minutes of meeting from March 4, 2016, were approved unanimously.
4. UI CHOICE OUT OF AREA COVERAGE – HUGHES

In a prior meeting a proposal was made to offer guest membership to cover a gap in faculty and professional staff out-of-area coverage/out of network coverage. Currently, professional staff out-of-network claims are processed at level 3 for enrollees seeking out of network coverage. Non-emergency out-of-network medical care is reimbursed at level 3, requiring 40% co-insurance. For out-of-network care, deductibles and /or co-insurance apply to the separate level 3 out- of-pocket maximum of $2,000.00. In network care and care received from a provider participating in the Blue Cross and Blue Shield national network are applied at the level 1/2 out-of-pocket maximum amount of $1,700.00.  Guest membership would allow out- of-network services to be processed at level 1/2 but would only be available to those living outside of the area on a temporary basis of 90 days or more.  Those permanently residing outside of the area would not be eligible for a guest membership.  It was estimated that it would cost 2 million dollars per year to initiate a guest membership for participants. Previously the committee had requested additional information about the number of participants who would be potentially benefitted by a guest membership program in order to support a decision.

At this meeting Ms. Hughes provided the following additional data:

UI Choice Members reaching Out of Pocket Maximums for 2015

The committee then undertook a thoughtful discussion, interpreting the above data and balancing the estimated cost of the guest membership program against the number of potential beneficiaries. It was the consensus of the committee that the cost outweighed the potential benefit and no action was recommended to the chairs.

5. DENTAL PLAN FREQUENCY LIMITATIONS

At the prior meeting, benefits administration presented to the committee information provided by Delta Dental indicating that the dental plan could save approximately $500,000.00 per year by limiting dental care that currently exceeds recommended dental visit frequency guidelines. In order to facilitate decision making, the committee requested the number of participants who had exceeded dental visit frequency guidelines in 2015. At this meeting the following supporting information was provided by Ms. Hughes:

Dental membership exceeding the recommended frequency guidelines for 2015 were:

A discussion ensued in which the committee considered questions such as:
Do we need a better understanding of who the patients are and what leads some patients to seek care above recommended norms? Are there associated or underlying conditions that certain participants have that are causing them to seek extra care? This led to the thought that perhaps the guidelines were too stringent and perhaps there were segments of the dental population or diagnoses that could legitimately merit extra care, but were currently not considered. This in turn led to the thought that perhaps the guidelines may in fact need to be liberalized instead of restricted. An additional thought was that some care providers might be bolstering their reimbursements by recommending unnecessary care. It was also asked whether, in the long run, costs would actually increase as a result of having limited preventive maintenance if access were restricted.

After further discussion, three potential directions emerged: 1. Recommend no change to the current system, 2. Limit the frequency of covered visits to the number recommended in the guidelines, and 3. Limit the frequency of visits to the recommended number except when actively approved by the care provider.

The current guidelines were reviewed and the following motion was put forth and discussed:  Dental visit frequency should adhere to the current Delta Dental Guidelines. Exceptions justifying additional care beyond those outlined by the Frequency Guidelines will be made with the written authorization of the participant’s dental provider for specific medical conditions defined in Delta Dental of Iowa’s Enhanced Benefits Program.

It was proposed that this would allow us to study the actual need for the care without completely restricting it. The motion carried unanimously.

6. CADILLAC TAX – PRELIMINARY PREMIUM DISCUSSION

Ms. Hughes updated the group on the projected impact on employee coverage imposed by the Affordable Care Act (ACA) stipulated provisions that propose penalties on high cost benefit programs. Based on projections, the cost of Employee Only coverage may cross the threshold to be subject to the Cadillac tax in 2022. (This includes total cost of UIChoice single coverage, HCSA and dental). The cost threshold is much higher for family coverage, and it is estimated that our Family coverage would not reach that threshold until 2032.

Due to many uncertainties about the details of the tax, no action was recommended at this time. The committee appreciated the information and Ms. Hughes proposed future updates.

7. VALUE BASED BENEFIT DESIGN

In an ongoing discussion of this topic, the committee reached the realization that in order to properly approach a discussion on Value Based Design, the Committee’s Guiding Principles would first need to be reviewed. A discussion was then entertained by the chairs in which it emerged that there was great interest in revising portions of the Guiding Principles. The Chairs then directed the formation of a subcommittee to study the Guiding Principles and prepare a draft revision. The subcommittee members are:
Mary Greer, Katherine Tachau, Nicole Nisly and Bernard Sorofman.

8. Old Business: none

9. New Business: agenda planning for the May meeting

Meeting was adjourned at 1:05 pm

Respectfully submitted,

Daniel Katz, MD

Funded Retirement and Insurance Committee (FRIC) Minutes from March 4, 2016

Meeting was called to order at 11:30 a.m. in 302 USB.

Members present: Steve Bernholtz, Nancy Davin (co-chair), Nicholas Francisco, Mary Greer, Brian Kaskie, Daniel Katz, Nicole Nisly, Michael Schueller, Bernard Sorofman, Anand Vijh.

Administrative officers present: Joni Troester, Debra Hughes.

Members absent: Jon Garfinkel (co-chair), Amber Seaton, Katherine Tachau, Lynn Vining.

Guests present: Dan Fick, Megan Hammes, Suzanne Hilleman, Brad Archer, Julie Sexton, Jessica Wade, Kevin Ward, Kara Wright, Pat Clinton, Rick Borchard and others

1. Nancy Davin co-chaired the committee.
2. Committee members, administration representatives, and guests introduced themselves.
3. The minutes of meeting from February 5, 2016, were approved unanimously.
4. Reminder: President Harreld will attend the May 6, 2016 FRIC meeting.
5. Megan Hammes presented slide show on UI Livewell program / Comprehensive Well-being:
   1. Reviewed 10 years history of Livewell, VOI model, PHA participation percentage (73%).
   2. Reviewed Health Improvement Graphs, other Livewell services, and Strategic Opportunities for 2016.
6. Megan Hammes answered questions following presentation:
   1. Question from committee member about if Livewell offers mental health services. Question from guest about availability of Livewell services for retiree population.
   2. Brian Kaskie asked how the Livewell programs can be used for other campus opportunities. This led to many great questions about funding, balancing resources, and historical strategic changes to the program
7. Debra Hughes presented slide show on FRIC Value Based Benefit Design:
   1. Reviewed 10 year history of FRIC: free generic medication, strategic changes to life insurance, LTD, dental and health. What does FRIC want to do moving forward? Specific discussion about incentive for regular visits to primary care provider. How can Livewell play a role?
8. Committee agreed with suggestion to redistribute FRIC guiding principles to help lead discussion in the future.
9. Committee member asked for data on the UI E-care (UIeCare) program. How to measure success. Information will be provided in future meeting.
10. FRIC agenda items 4 – 7 were not covered in the meeting.
11. The meeting adjourned around 1 p.m. as scheduled.

Recorder: Nicholas Francisco

Funded Retirement and Insurance Committee (FRIC) Minutes from February 5, 2016

Meeting was called to order at 11:30 a.m. in 302 USB.

Members present: Steve Bernholtz, Nancy Davin (co-chair), Nicolas Francisco, Jon Garfinkel (co-chair), Daniel Katz, Michael Schueller, Amber Seaton, Bernard Sorofman, Anand Vijh, Lynn Vining.

Administrative officers present: Joni Troester, Debra Hughes.

Members absent: Mary Greer, Brian Kaskie, Nicole Nisly, Katherine Tachau.

Guests present: Dan Fick, Megan Hammes, Terri Hein, Suzanne Hilleman, Dan Schropp, Jessica Wade, Kevin Ward, Dianne Wasson, Pat Clinton, and others

1. Jon Garfinkel and Nancy Davin co-chaired the committee.
2. Committee members, administration representatives, and guests introduced themselves.
3. The minutes of meeting from December 4, 2015, were approved unanimously.
4. Examples of Value-based benefit design were discussed along with Value-based health insurance design opportunities to further explore:
   1. Diabetes care pilot project in which UIHC will actively pursue diabetic patients and manage their condition. This is an example of value-based health insurance program.
   2. Full coverage for generic medicines that cost a lot less than equivalent brand name medicines.  
   3. Bernard Sorofman pointed out that there is considerable academic literature on how to reduce healthcare costs. He will share some of this literature with committee members in future weeks.
   4. It is possible to design a better reimbursement system that incentivizes people to reduce healthcare costs. This may include different copayments, deductibles, and out-of-pocket maximums. For example, a patient who has reached out-of-pocket maximum for a given year has no incentive at all to reduce costs.
   5. Explore whether we can lower costs by negotiating with drug providers and/or pharmacies.
   6. Explore opportunities to direct patients to receive care from the highest quality providers.
   7. Explores incentives or surcharges for specific behaviors such as smoking or tobacco use.

The March meeting will feature a review of these types of programs offered at the UI.  Further discussion by the committee will be needed to determine various future opportunities to explore.

5. A continuing issue concerns out-of-area coverage under UI Choice. This issue is especially important for retirees who often move out of Iowa.  Under the present plan there is a higher copay and out-of-pocket maximum for out-of-area coverage, which is classified as Level 3 care. However, as pointed out above, once a member hits out-of-pocket maximum under any plan, there is no incentive for him or her to economize or to choose the cheaper Level 1 or 2 healthcare providers. The collective cost of adding a Guest Membership for out of area care is an increased cost estimated at $2 million per year. Debra Hughes presented some numbers on how many members hit out-of-pocket maximum, but more information is awaited. We may need to revisit the coverage of out-of-area care in view of its higher costs.
6. There has not been any significant progress to report on the status of transgender care since the last meeting. This will be tabled for future discussion until there are new developments.
7. At present the UI Benefits plan allows members to purchase dependent life insurance in the amount of $10,000 or $20,000 for a spouse/partner or $5,000 or $10,000 for a dependent child. This life insurance is taken by 5,600 employees at present. The committee voted unanimously to add a third option effective 1-1-17, of $40,000 term life coverage for a spouse/partner and $20,000 for term life coverage for dependent children, doubling the maximum coverage available.  Since spouse/dependent life insurance is fully paid by an employee, there is no cost impact to the benefits plan.
8. At present the Delta Dental plan has no limits on how many preventive care visits (cleanings, X-rays) a covered person makes in a year.  Delta Dental has recommended capping the number of preventive care visits to twice a year.  Placing limits will reduce plan costs by $500,000 a year.  Committee members asked the administrative officers to come back with answers to: 1. Is there any harm to limiting preventive care visits to twice a year? 2. How many members currently receive preventive care services exceeding typical benefit plan frequencies in a given year?
9. Jon Garfinkel informed the committee that President Bruce Harreld will visit the May 6, 2016, FRIC committee meeting.
10. The meeting adjourned around 1 p.m. as scheduled.

Recorder: Anand M. Vijh

Funded Retirement and Insurance Committee (FRIC) Minutes from December 4, 2015

Meeting was called to order at 11:32 a.m. in 302 USB

Members present: Steve Bernholtz, Nancy Davin (chair), Jon Garfinkel (chair), Mary Greer, Brian Kaskie, Nicole Nisly, Michael Schueller, Bernard Sorofman, Katherine Tachau, Anand Vijh, Lynn Vining.

Administration present: Joni Troester, Debra Hughes.

Members absent: Nicolas Francisco, Amber Seaton, Victoria Sharp

Guests present: Richard Borchard, Megan Hammes, Susan Klatt, Julie Sexton, Jessica Wade, Kevin Ward and others.

1. Introductions.

Committee members, administration representatives and guests introduced themselves.

2. Approval of Minutes from November 6, 2015 Meeting

Minutes were approved unanimously.

3. UIChoice Level 1 UI Health Alliance Update

The Committee was informed about changes in level 1 coverage.  The following UI Health Alliance partner providers were added to UIChoice Level 1:  McFarland Clinics, Iowa Health and Great River Medical.  Mercy, Des Moines will no longer be part of the UI Health Alliance as of 1-1-16.  Overall, the impact will be to those employees who get care further away from the Iowa City area.  Changes indicated small differences in coverage in some areas and positive additions in others. 

4. UI Choice Out of Area Coverage

The members of the committee continued a discussion started at the November meeting regarding the possibility of UIChoice Level 1 or Level 2 coverage in Level 3 (40% co-insurance) areas – called “guest memberships.” Guest memberships could be structured to reduce the financial burden on members.  Preliminary data were provided from Wellmark.  Of the 28,000 UI Choice members, based on home address currently reflected in the computer system 587 reside outside the State of Iowa.  It is unknown how many more have State of Iowa residences but live outside the State for a period of time.  A rough estimate of the costs of changing from 40% co-insurance to 10% or 20% was $2M. 

The committee felt this estimate was too rough and asked that the data be refined to get a better estimate and, if possible, a profile of who this might be (e.g., college students, faculty on sabbatical).  Additionally, the committee asked that data be provided that describes a general profile of out-of-state members who reach the deductible level vs. those who do not.  Finally, a policy question needs to be researched – Can we charge for guest memberships?  Or, more broadly, can we alter the current structure of insurance options for select or all beneficiaries having to use Level 3?  More information will be forthcoming.

5. Transgender Care Discussion Continued

The FRIC Chairs have had further discussions with University leadership regarding the Committee request to improve insurance coverage for transgender care.  A decision is still pending.

6. Dependent Life Insurance

The Committee revisited the November discussion on this topic.  For clarity from the November Meeting Minutes -- the amounts of coverage has not changed in many years, there are not many inquiries or dissatisfaction.  The question is do we consider adding additional coverage levels and addition proof of insurability to reduce costs.  This is an after-tax benefit and therefore the costs are borne by the individuals who purchase the coverage.  The committee received information on the costs are for those coverages, the cost of burial and enrollment patterns.  The committee made no decisions and requested information on what rates would be if we expanded the coverage levels. 

7. Dental Plan Frequency Discussions

In November, the committee learned that limiting specific covered services in the plan to accepted clinical dental guidelines could reduce costs to the plan by as much as $500,000.  The suggested limit was 2 examinations, 2 cleanings, 2 x-rays and 4 periodontal visits per year.  Further data were requested from Delta Dental on current utilization and dental clinical best practices recommendations. 

8. Value-based Health Insurance

The Committee began a brief introduction into what will be an ongoing discussion in the use of Value Based Benefit Designs.  A committee document and Flex Benefits System Guiding Principles approved in 2008 was distributed as a foundation for future discussions.  This topic will continue at the February 2016 meeting.

9. New Business

During the discussion of agenda topic #4 UIChoice Out Of Area Coverage, the committee recommended that it look at utilization trends / data in the spring of each year (rather than at the usual September meeting) and requested data showing the premiums and claim experience for different risk pools (i.e., single, family, etc.) over time – preferably 3 years. 

The meeting adjourned at 1:03 p.m.

Recorder: Bernard Sorofman

Funded Retirement and Insurance Committee (FRIC) Minutes from November 6, 2015

Meeting was called to order at 11:30 a.m. in 302 USB

Members present: Steve Bernholtz, Nancy Davin (chair), Nicolas Francisco, Jon Garfinkel (chair), Mary Greer, Brian Kaskie, Nicole Nisly, Michael Schueller, Victoria Sharp, Anand Vijh

Administration present: Joni Troester, Debra Hughes.

Members absent: Amber Seaton, Bernard Sorofman, Katherine Tachau, Lynn Vining

Guests present: Megan Hammes, Suzanne Hilleman, Susan Klatt, Jessica Wade, Kevin Ward, Dianne Wasson, Victoria Lim, and others

1) Committee members, administration representatives and guests introduced themselves.

2) Approval of Minutes from October 2, 2015 Meeting
Minutes were approved unanimously.

3) Transgender Care Discussion Continued
John Garfinkel and Nancy Davin met with Dr. Robillard. He is working with the BOR to move the transgender care issue at the University of Iowa forward towards approval. Updates will be presented by the co-chairs at succeeding FRIC meetings as more information becomes available for sharing with the Committee.

4)  TIAA/CREF VRSP Loans Discussion Continued
Debra Hughes clarified that the administrative impact on the cost of these loans to the plan is very small in scope. Many people taking loans from their plans are of such age that they could take dispersals from the plan. However, by taking the loan, participants are avoiding a tax liability at the time. TIAA-CREF mentioned that there has been some IRS scrutiny surrounding these loans and they suggested that UI cap the number of loans. The limited number recommendation would be 5 - 7 loans. To clarify, the limitation would be on the number of loans at any given time. There is no limit on the number of loans over the life time of the participant while having the VRSP.  There were 165 new loans in 2014 and 119 new loans to-date in 2015. Of the 192 people who have loans outstanding, 33 with multiple loans greater than 5 current loans. TIAA-CREF would provide counseling on how to manage the taking of loans if the number were to be limited in the future. Total dollar amount of loans cannot exceed 40% of the balance in the VRSP. After discussion, a motion to implement a limit of 6 loans was voted on and carried by a vote of 9-1.

5)  Life Insurance Changes
Evidence of Insurability; UI does not have evidence of insurability clause. Underwriter did not see issues with not having EOI for the Group Life insurance plan because the UI has capped the group life insurance benefit at a $400,000 maximum. Adding an evidence of insurability clause to the Supplemental Life Plan to reduce rates for employees was discussed.  Inconvenience to employees was a consideration, as well, and the cost benefit of adding the EOI was not worth the benefit of pursuing this change.

6)  Dependent Life Insurance
Debra Hughes distributed a handout on Spouse/Partner/Dependent life coverages. The amounts of coverage UI offers has not changed in many years, and was reviewed.  It does not appear that many inquires or dissatisfaction exists with this type of coverage. Some consideration for doubling the coverage, which would double the premiums. This is an after-tax benefit offered to employees. The committee requested information on what other Regents institutions are doing and what the costs are for those coverages, as well as the cost of burial for a dependent. The committee also requested an update on the number of employees enrolling in this coverage after the annual open enrollment is complete.

7)  UI Choice Out of Area Coverage
Members of the Committee have received several calls/communications regarding the out-of-area coverage (e.g. students) and a request to allow guest memberships. UI Choice out-of-area coverage has gotten better for standard care (Level 3, 40% co-pay and applies to out-of-pocket maximum). Emergencies are covered as in-state coverage. Discussion focused on additional data requested:

• How big is the population that pay the 40% co-pay but never hit the out-of-pocket maximum?
• How much use is outside of state?
• Impact of cost to UI
• Assessing use by various user groups (students, retirees, employees working out of state).

Many questions surround this issue, such as how many individuals would migrate to other plans if they could pay at a Level 1 or Level 2 rate. Also discussions about the impact of e-care on overall costs and coverages.

8)  Dental Plan Frequency Discussions
Debra Hughes distributed a handout of recommended frequency of use limitations of four types of dental procedures of Dental Plan.  Suggestions for frequency limitations to begin 1-1-2017. Limitations would save approximately $500,000 per year if UI went to the clinical guidelines as recommended by the Delta Dental of Iowa Clinical Director. Discussion included what scenarios fall under "more frequent use" but would not be covered under standard medical insurance? Dental benefit maximum does exist with plan; $2,000 per covered individual.  No action taken pending further future discussion. 

9)  Value-based Health Insurance
What does the Committee want to know to make more informed decisions on value-based health insurance? Prior to the next meeting, the committee would like to receive 1-2 articles outlining the basic principles of Value Based Benefit Design.

The meeting adjourned at 1 p.m.

Recorder: Michael Schueller

Funded Retirement and Insurance Committee (FRIC) Minutes from October 2, 2015

Meeting was called to order at 11:40 a.m. in 302 USB.

Members present: Steve Bernholtz, Nicolas Francisco, Jon Garfinkel (chair), Brian Kaskie, Michael Schueller, Bernard Sorofman, Katherine Tachau, Anand Vijh,

Administration present: Joni Troester, Debra Hughes.

Members absent: Nancy Davin (chair), Mary Greer, Nicole Nisly, Amber Seaton, Victoria Sharp, Lynn Vining

Guests present: Megan Hammes, Terri Hein, Julie Sexton, Jessica Wade, Kevin Ward, Michael Brownlee, Lisa Mascardo and others

1. Committee members, administration representatives, and guests introduced themselves.
2. The minutes of meeting from September 11, 2015, were approved unanimously.  Motion by Tachau / Sorofman.
3. Health and Dental Insurance Rates for 2016.  The Committee continued the discussion of Rates for 2016.  Hughes indicated that rate recommendations from FRIC were accepted by the administration in all cases except Employee/Child medical – these were not increased as much as recommended.  Rates will be released during the open enrollment period, November 1 through November 15, 2015.
4. 2016 HCSA Limit.  The current Health Care Spending Account limit is $2500.  Motion:  The committee recommends an increase to $2550.  Motion by Schueller / Francisco.  Approved unanimously. 
5. Transgender Care.  In 2014 the committee sent a letter to former President Mason recommending the provision of transgender care through the University health insurance plan.  Committee Chairs Garfinkel and Davin met with Interim President Robillard to discuss the letter.  The Committee reaffirmed its support of the original letter.
6. TIAA / CREF VRSP Loans.  TIAA submitted a recommendation to the University that additional limits be placed on borrowing funds from Voluntary Retirement Savings Plans.  Currently, one can take out a minimum of $1000 on each loan, totaling no more than 45% of one’s VRSP funds, with no limit on the number of loans.  Payments are automatic deductions and include interest.  Discussion included the impact on individuals and the University.  There is a small impact on the administrative fees charged to the plan.  No decision was made. The committee asked for more data. 
7. Specialty Drugs.  During the annual benefit plan review process, Wellmark made a recommendation to the University to move the administrative management of specialty drugs, various medications that usually have high costs, from the medical part of the plan to the pharmacy benefit.  Most institutions (~90%) have specialty drugs in the pharmacy benefit part of their plans.  The change is estimated to reduce the cost of specialty drugs by 3%. Additionally, there will be much better ability to track and manage costs.  Discussion was about out of pocket expenses.  However, with specialty drugs, beneficiaries reach their out of pocket maximums fairly quickly.  Motion:  The committee recommends changing the management of specialty drugs from the medical benefit to the pharmacy benefit.  Motion by Tachau / Bernholtz.  Approved unanimously. 
8. Life Insurance Changes.  The current rates for life insurance provided by the University plans are higher than other plans.  Some members of the University community requested we consider a change in rates/policy. The primary reason rates are higher is that there is no “evidence of insurability” (medical exam) required.  The committee requested more data in order to make a recommendation.
9. Dependent Life Insurance.  The evidence of insurability discussion also included dependent life insurance changes.  Dependent life insurance is fully funded by the employee after taxes.  Initial discussion on changes to coverage amounts.  More data was requested in order to make a recommendation.
10. Recommended as a new business item:  A discussion about value-based health insurance. 
11. The next committee meeting will be on November 6, 2015.
12. The meeting adjourned at 1:03 p.m.

Recorder: Bernard Sorofman

Funded Retirement and Insurance Committee (FRIC) Minutes from September 11, 2015

Meeting was called to order at 11:30 a.m. in 302 USB.

Members present: Steve Bernholtz, Nancy Davin (chair), Nicolas Francisco, Jon Garfinkel (chair), Mary Greer, Brian Kaskie, Nicole Nisly, Michael Schueller, Anand Vijh.

Administration present: Joni Troester, Debra Hughes.

Members absent: Amber Seaton, Victoria Sharp, Bernard Sorofman, Katherine Tachau, Lynn Vining.

Guests present: Rick Borchard, Terri Hein, Suzanne Hilleman, Christine Miller, Dan Schropp, Craig Syrop, Kevin Ward, Dianne Wasson, Megan Hammes, Jessica Wade and others.

1. Committee members, administration representatives, and guests introduced themselves.
2. The minutes of meeting from May 1, 2015, were approved unanimously.
3. Aim@Diabetes presented a pilot project that would be offered to UI employees with Type 1 & Type 2 Diabetes and who received care from a UIHC provider. There are potentially 700 people at the UI that could be in the project. The focus of Aim@Diabetes is on self-care, working with the patients so they can take better care of themselves. The savings of the project was estimated at $80,000. It should also help to reduce the burden of the disease through ease of testing. Team was asking that we waive the co-insurance for the meters and strips for those enrolled in the plan. After one year, the team would then look to explore replicating the model to support other costly chronic diseases.

The FRIC committee unanimously moved to waive the co-insurance for equipment and strips for those participating in the UIHC AIM@Diabetes pilot in the UI Choice health plan

4. Health Care premium rates at the UI in the UIChoice plan have not been increased for the last three years. The expenses from the past have come to a point where the rates needed to be adjusted.  The committee voted 8-1 to raise the health insurance rates for the next year.

Dental rates have a 0% increase recommended for 2016. 

5. Medically necessary Transgender Care coverage has been unanimously recommended by FRIC in the past.  Additional follow up will occur by the Committee co-chairs and other assigned members.
6. The next committee meeting will be on October 2, 2015.
7. The meeting adjourned at the regular time of 1 p.m.

Recorder: Steve Bernholtz

Funded Retirement and Insurance Committee (FRIC) Minutes from May 1, 2015

Meeting was called to order at 11:30 a.m. in 302 USB.

Members present: Steve Bernholtz, Nancy Davin (chair), Nicolas Francisco, Jon Garfinkel, Michael Schueller, Bernard Sorofman, Katherine Tachau, Anand Vijh.

Administrative officers present: Sue Buckley, Richard Saunders.

Members absent: Mary Greer, Sheldon Kurtz, Nicole Nisly, Amber Seaton, Victoria Sharp, Lynn Vining.

Guests present: Dan Fick, Suzanne Hilleman, Debra Hughes, Joni Troester, Dianne Wasson, others.

1. Nancy Davin chaired the committee.
2. Committee members, administration representatives, and guests introduced themselves.
3. The minutes of meeting from February 6, 2015, were approved unanimously.
4. The committee noted the very able services of Sheldon Kurtz as a committee member since 1991 and the chair of the committee for many of those years. His term is expiring this year and he has decided to not renew it. There was sincere appreciation of his service for so many years. The committee also appreciated his recent email as follows:

I will not be at the meeting Friday as I will be in China.  I’m sad to be missing my very last FRIC meeting, but wanted to take the opportunity to express my appreciation to Sue and Richard for all their efforts on behalf of the employees of the University and the respect they’ve shown this committee over so many years.  I also wish to thank my colleagues on this committee and particularly Nancy for their untiring efforts (yes, even devotion)  in making sure that UI has an excellent health insurance plan and in causing this  committee to be viewed as a model for appropriate faculty/staff governance. 

I also hope that a renewed push will be made to get transgender coverage under UI Care (if President Mason has not already approved it). 

Again, thanks to all.

5. Sue Buckley informed the committee that out of 1,400 UI employees eligible for the Early Retirement Incentive Plan (ERIP), 362 had applied. From this application pool, 197 cases were approved and 165 cases were denied. In each case the concerned department was asked if the planned retirement was in their best interest. Another 16 applications are still under review, so the final numbers may change. The Human Resources department projects cost savings of $28.9 million from this ERIP, out of which $16.6 million is from the General Education Fund (GEF). These cost savings exceed the $20 million estimate given to the Board of Regents before launching the plan.
6. Sue Buckley informed the committee that she will be retiring from her post as the UI Vice President for Human Resources on June 30, 2015. In addition, Richard Saunders will also be retiring from his post as the UI Assistant Vice President for Human Resources on June 12, 2015. In their places, we will find Joni Troester and Debra Hughes. We wish to thank the retiring officials for their dedicated service to the university over so many years.
7. Richard Saunders informed the committee that the Memo sent to President Sally Mason recommending the inclusion of Transgender Care as a part of health care benefits is still in her office. If it is not approved before her retirement as President, then the committee will re-submit this Memo to the Interim President Jean Robillard after he has settled in his new position.
8. Under a settlement reached between the State of Iowa and the Standard and Poors’ Corporation, $2.4 million will come back to the Regents retirement plans with TIAA-CREF in the near future. That is because the Corporation had overcharged its retirement plan participants for fees. This settlement will amount to $40 to $50 per active participant.
9. The committee discussed the coverage of fertility treatment under the health care plan. Many young women are choosing to store their eggs for future use. The surgical procedure for harvesting and storing eggs costs around $13,000 per cycle, and, on average, a woman may need to undergo two cycles. At present, Wellmark covers fertility treatment only if there is a medical need, but not for personal lifestyle reasons. As a result, many women who are denied first time because they were asking for it due to personal lifestyle reasons come back asking for it due to medical reasons. The question is whether the health plan should be expanded to cover fertility treatment for both medical and lifestyle reasons. There are likely to be about 20 cases per year in the lifestyle reasons category, and at $25,000 per person it means an extra cost of $500,000 to the health plan. The committee discussed the issue, but decided to table it for an indefinite period.
10. The next committee meeting will be on September 11, 2015, which is the second Friday of the month. Traditionally, the meetings are held on the first Friday, but in September we skip the first Friday that happens to be just before the Labor Day weekend.
11. The meeting adjourned earlier than the regular time of 1 p.m.

Recorder: Anand M. Vijh

FRIC Meeting
February 6, 2015
302 USB

Committee attending:  Bernholtz, Davin, Francisco, Garfinkel, Nisly, Schueller, Sharp, Sorofman, Tachau, Vining.

Committee absent:  Greer, Kurtz, Seaton, Vijh.

Administration Attending:  Buckley, Saunders

Guests:  Rick Borchard, Gary Gussin, Terri Hein, Suzanne Hilleman, Hughes, Debra, Joni Troester, Kevin Ward, Dianne Wasson.

Meeting started.

1.  Introductions.
   1. All in attendance introduced themselves and the constituencies which they represent.
2. Minutes.  Discussion of minutes for 10/3/14
   1. There weren’t enough members present at the beginning to approve the meeting notes.
   2. After about 30 minutes, the meeting notes were approved.
3. ERIP Update
   1. ERIP III has been approved and 1400 employees and staff have been notified that they are eligible for it. They must apply by 3/6/15 and it must be approved by their department. IF approved, they must be retired by 6/30/15.
   2. Those in UI Health Care and covered by SEIU are not eligible for ERIP III. 
4. CREF update
   1. CREF is changing their fee basis, similar to what happen with TIAA.
   2. Tier 1, where funds are less than $20 million in assets, will have their fees increase to cover costs.
   3. Tier 2, where fund are between $20 and $400 million in assets, will have their fees stay the same.
   4. Tier 3, where funds are greater than $400 million in assets and the UI sits, will have their funds decrease.
   5. Due to an overcharge in the S&P that several states attorney generals have sued the S&P, roughly $2.4 million will be coming back to the state of Iowa. Some of that will be coming back to the UI through the Board of Regents. It will be roughly $100/person for those that had those fees count against them in their CREF account.
5. Transgender Care
   1. A letter was created and sent to President Mason, but nothing has been heard about its response.
6. New Health Insurance Coverage.
   1. It was requested that a drug be covered by the UI Health Plan at a reduced cost, but it was later discovered that it was a Tier 2 drug since there is no Generic available. It can only be covered at 30%.  
   2. It was suggested that it could be possible to work out a payment plan with the business office, making the payments perhaps more affordable for the patient.
7. 2015 HCSA
   1. The group voted to keep the HCSA at a $2500 limit at this time, instead or raising it to $2550. It will be reviewed again for 2016.
8. Egg and Sperm Storage Update
   1. This topic was to be discussed more at a future meeting where more information would be provided about how providers document why it was done or what was wanted to be done.
9. Adjourned. 

FRIC Meeting
October 3, 2014
302 USB

Committee attending:  Davin, Francisco, Garfinkel, Greer, Nisly, Sharp, Sorofman, Vijh, Vining.

Committee absent:  Bernholtz, Kurtz, Schueller, Seaton, Tachau.

Administration Attending:  Buckley, Saunders

Guests:  Rick Borchard, Gary Gussin, Terri Hein, Susan Klatt, Joni Troester, Dianne Wasson.

Meeting started at 11:38am.

1.  Introductions.
   1.  All in attendance introduced themselves and the constituencies which they represent.
2. Minutes.  Discussion of minutes for
   1. May 2, 2014.  Minutes approved.
   2. September 5, 2014.  Minutes approved after minor corrections.
3. Deloitte Update
   1. It was brought to our attention that nothing at this time in the Deloitte review addresses the scope or purview of the FRIC committee.
4. Possible Early Retirement Incentive Program
   1. The University is considering a third Early Retirement Incentive Program, ERIP III.  The committee saw a draft proposal of a new ERIP that would closely mirror the ERIP II program.  ERIP II provided financial support for health insurance and contributions for retirement over a five year period.   No program has been approved and the specific details have yet to be finalized.  Depending on the final approved criteria for eligibility, there may be as many as 3000 employees eligible.
   2. The program will clearly define what benefits would be provided for the employee entering into ERIP III, the eligibility requirements for participation, and the timeframe for evaluation and decisions.  Any program must be approved by the Board of Regents. 
   3. Applicants for participation in ERIP III would be screened to determine if such a decision for early retirement is beneficial to both the employee, the employee’s university department and the University as a whole.
   4. The topic was informational and no decision was made by the FRIC committee.  There was substantial discussion on the program and its potential characteristics and impact on the university.
5. Transgender Care
   1. FRIC has agreed that members Kurtz, Davin, and Nisly would draft a letter to President Mason in support of transgender care through the University insurance program.  A letter is being created, but was not available at the time of the committee meeting.
6. Egg and Sperm Storage Update 3/15
   1. This came up briefly as a reminder that data is being collected for a discussion in March, 2015. 
7. Old Business
   1. Other than agenda item V. Transgender Care, none brought forward.
8. New Business
   1. Three issues were brought forward at the meeting as possible future topics for the committee.  The topics were discussed briefly and recommended for future committee discussion when data can be available to the FRIC committee.
      1. Facial Hair Removal for individuals with a medical necessity.  It is currently not covered.
      2. Pre-exposure prophylaxis treatment for individuals “who do not have HIV but are at substantial risk of getting it to prevent HIV infection…”(http://www.cdc.gov/hiv/prevention/research/prep/). New CDC guideline recommendations have been released.
      3. Medicare Advantage – What can be done with university benefits in association with this portion of Medicare.
9. Adjourned at 12:43 pm.  The next meeting will be November 7, 2014.

Funded Retirement and Insurance Committee (FRIC) Minutes from September 5, 2014

Meeting was called to order at 11:30 A.M. in 302 University Services Building

Members in Attendance:  Steve Bernholtz, Nancy Davin, Nicolas Francisco, Jon Garfinkel, Mary Greer, Sheldon Kurtz, Nicole Nisly, Michael Schueller, Amber Seaton, Victoria Sharp, Katherine Tachau, Anand Vijh

Members Absent:  Bernard Sorofman, Lynn Vining

Administrative Officer(s) Present:  Richard Saunders

Guests Present:  Rick Borchard, Suzanne Hilleman, Debra Hughes, Susan Klatt, Dan Schropp, Julie Sexton, Megan Hammes, Wendy Berger

1. Committee members, administrative representatives and guests introduced themselves.
2. Approval of minutes from the meeting on May 2, 2014 were not available and were deferred.
3. Meeting discussion opened with Richard Saunders providing a summary of items/issues reviewed and/or approved by FRIC in the 2013/2014 academic year. These included:
   1. Reduction in unlimited supplemental life insurance coverage to $1 million of coverage
   2. Changes to Delta Dental II coverage including changing the % on Orth care or the employee from 30 to 50%, adding a carryover of unused benefits in Parts B and C to a maximum of $4,000.00 of benefit in a single year and adding a Delta Dental of Iowa network of preferred providers.
   3. Addressing gender change coverage – currently in a holding pattern
   4. Addressing storage of harvested eggs and sperm by University Hospitals until late spring 2015.
4. Item of Business:  Health Insurance premium rates for Calendar Year 2015. A handout summarizing the financials for all the health plan options for Calendar Year 2014 and potential rates for 2015 was provided to the committee. Overall, premiums for the health care plans paced evenly with the expenses paid to cover participants. Individually, the Single, Employee and Spouse and Employee and Children plans were sustained through premium payments. The Employee and Family plan operated at a deficit, most specifically as a result of substantial payouts to providers for services to care for patients with unique circumstances that will not likely occur with any frequency. The committee discussed the pros and cons of both increasing health care premiums and maintaining the current rates for Calendar Year 2015. After substantial discussion a motion was made, and seconded, to leave the premium rates for all plans unchanged for 2015. The motion was voted on and carried by a vote of 8-4.
5. Item of Business:  Dental Insurance premium rates for Calendar Year 2015. A discussion of the Delta Dental of Iowa plan provided to University faculty and staff took place based on financial data for the plans for 2014 provided to the committee. All of the dental plans, with the exception of the Single plan are operating at a deficit for 2014. The current rates were set without the benefit of much financial data because of the previous Dental I and Dental II being combined into one plan for 2014. A brief discussion of the financials were discussed followed by a motion to accept suggested rates for 2015 provided in a handout from Human Resources Benefits for committee consideration.  The new rates were single-$42, spouse-$84, child-$100, and family-$126. The motion passed by a unanimous vote of the FRIC members present at the meeting.
6. Item of Business:  Health Care Spending Account (HCSA) Carryover Option.  The IRS in December 2013 changed their rules for employers allowing employees with Health Care Spending Accounts to carryover unspent monies in their account from year-to-year up to a maximum of $500 in carryover. Currently, any unspent HCSA monies in UI employees’ accounts reverts back to the University and is used to fund the UI Wellness programs. This carryover amount approximates $1 million each year. The option for employees to carry over up to a maximum of $500 would reduce funding to the wellness programs by approximately $600,000/year if the new carryover was implemented.  The committee discussed the merits of recommending the carryover versus the merits of funding the wellness programs. After significant discussion, a motion was made to not make any recommendation that the carryover be put into place at the UI. The motion carried by unanimous vote.

OLD BUSINESS

One item of old business, health care coverage for gender change procedures, was carried over from the previous FRIC discussions and addressed briefly at the meeting. Prior meeting notes from March 2013 cover the discussions on this issue. The FRIC members requested that the Committee Co-Chairs along with member Nicole Nisly draft a letter to President Mason reaffirming FRIC’s interest in pursuing implementation of coverage for this care.  

The next FRIC meeting is scheduled for Friday, October 3, 2014.

Meeting adjourned at 1:00 P.M.

Recorder:  Michael Schueller

Funded Retirement and Insurance Committee Minutes from May 2, 2014

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Sheldon Kurtz,  Steve Bernholtz, Nancy Davin, John Garfinkel, Matthew Glasson, Mary Greer, Nicole Nisly, Bernard Sorofman, Lynn Vining, Daniel Katz, Anand Vijh, Amber Seaton.

Members absent: Katherine Tachau, Katherine Dudley

Administrative Officers present: Sue Buckley, Richard Saunders

1. Committee members, administration representatives, and guests introduced themselves.
2. The minutes from the April 4, 2014 were approved
3. INFERTILITY COVERAGE – Craig Syrop

Our plan pays for infertility coverage for medical purposes.  Since January 1^, 2014 non-medical purposes were added to our coverages. Since this went into effect, seven procedures were conducted prior to the onset of chemotherapy and five were conducted to preserve options for the future. The efficiency and survival rates have improved. Dr. Syrop brought documents with updated statistics on clinical pregnancy results following embryo transfer and, the estimated number of mature oocytes needed for fertility preservation.

Pregnancy rates are egg-age related. Efficiency declines as they age. They need 2.5 embryos for every normal one to set. Once they are frozen, it is an infinite time period for their use. The charge for storage is $697 for first three years and $317 per year after that.

If fifteen eggs were harvested during one procedure, all 15 would be fertilized to become embryos. Let’s say twelve fertilize, but only four make it to the blast stage. So now you would have just one or two “straws” to store.

The committee had lots of discussion and questions for Dr. Syrop. The discussion was tabled until next year when Dr. Syrop will be asked to return with more information and statistics.

4. DENTAL CHANGES

Discussion centered on the option for participants to carry over what they do not use up to $2,000 for a total of $4,000. This will cost us $.5M per year.

Three tiered dentist PPO. The PPO includes dentists at College of Dentistry and 45% of community dentists. What’s in it for the dentists? More business, perhaps.

Both options were approved for 2015.

5. The meeting adjourned at 1 p.m.
6. Recorder: Mary Greer

Funded Retirement and Insurance Committee (FRIC) Minutes from April 4, 2014

Meeting was called to order at 11:30 a.m. in 302 USB.

Members in attendance: Nancy Davin, Katherine Dudley, Jon Garfinkel, Mary Greer, Daniel Katz, Sheldon Kurtz, Amber Seaton, Bernard Sorofman, Katherine Tachau, Anand Vijh.

Members absent: Steve Bernholtz, Matthew Glasson, Nicole Nisly, Lynn Vining.

Administrative Officers present: Sue Buckley, Richard Saunders.

Guests present: Dan Fick, Gary Gussin, Suzanne Hilleman, Debra Hughes, Julie Sexton, Joni Troester, Nancy Williams, others.

1. Committee members, administration representatives, and guests introduced themselves.
2. The minutes of meeting from March 7, 2014, were approved unanimously.
3. The discussion started with whether UI Choice should adopt and fund an ACO (Accountable Care Organization). In the past two years the committee has listened to several presentations about ACO’s from Christine Miller of UI Hospitals and Clinics. During her last presentation on March 7, 2014, she suggested that UI Choice participants who seek medical care from UI Hospitals and Clinics can be covered by an ACO for an annual cost of $800,000. Most of this cost would go to employee salaries besides a small part for equipment and facilities. However, no additional breakup of costs was provided. Given an approximate enrollment of 10,000 contracts in the UI Choice plan, this ACO cost works out to about $80 per year per contract. An estimated 54% of enrollees seek their medical care from UI Hospitals and Clinics, so the remaining 46% would bear the costs but receive no benefit.

The committee members expressed several doubts about the costs and. benefits of an ACO. ACOs are known to benefit the poorer, less educated, older, and higher risk individuals. However, this is not descriptive of the UI Choice participants, who tend to be younger, better educated, and more health-conscious. Besides, as pointed out by Dan Katz, if an ACO is cost effective, then it should be implemented by the UI Hospitals and Clinics without waiting for a separate budget.

There was also concern over UIHC having medical claim information on care received outside of that facility.

Sheldon Kurtz moved the proposal that there is not enough evidence at this point to recommend that UI Choice should adopt an ACO. The committee voted unanimously in favor of this proposal.

1. The discussion shifted to OPM (out-of-pocket maximum) amounts for UI Choice participants. The ACA (Affordable Care Act) requires that the combined total OPM under a health plan should not exceed $6,350 for an individual or $12,700 for a family. However, it does not require any further breakdown. UI Choice is well within these norms, with an OPM of $1,700 for medical and $1,100 for drugs for a single contract. Richard Saunders asked whether we should change our OPM to one OPM for the combined total of medical and drugs. That would increase the burden for some employees who would pay more than $1,700 for medical treatment or $1,100 for drugs in absence of separate OPM’s, but not exceed both limits. The committee discussed and decided the current arrangement is fine. There was no proposal to amend the current terms.
2. Richard Saunders informed the committee that there has been a recent House proposal to one of the ACA requirements. Employers were required to mandatorily cover all employees working more than 30 hours a week. The new proposal only requires coverage of employees working 40 hours or more a week. The Senate said they will not consider moving the hour limit.
3. Specialty drugs are an emerging area of concern to all medical plans. These drugs cost an extraordinary amount per covered person. Even though taken by very few participants, their cost impact rivals the cost impact of all prescription drugs. There is an additional concern that if these drugs are obtained from physicians instead of from pharmacies, then there is a further significant markup. At present, the UI Choice plan covers specialty drugs as a drug under the medical side rather than under the pharmacy side. The committee decided to leave the current arrangement as it is under the medical side.
4. Under the new IRS rules for 2013, employees may carry over unused HCSA (health care spending account) funds in the maximum amount of $500 to the next year. This is also the cumulative carryover allowed under the plan, and the employers are required to make it available for 18 months after an employee is terminated. Richard Saunders informed the committee that in 2012 an estimated 3,500 employees had some leftover HCSA funds, and that 1,800 of them had less than $500. These leftover funds have supported the liveWELL program of UI headed by Joni Troester. This program could have a budget shortfall in the range of $1 to 2 million, which the Benefits Office would have to fund from other sources.
5. Richard Saunders next raised the issue of infertility coverage. In recent years there has been a increase in the number of young women who store their own eggs for future use. While previously eggs could not be stored for more many years, technology has now made it possible to store eggs for a long period of time. This storage costs approximately $300 per year per woman. In the past, UI covered these costs without time limit since technology placed a natural cap on how long the eggs could be stored. But now there is a significant issue of how long such coverage should last, especially given the increasing number of women who are choosing this arrangement for reasons outside of medical issues. The committee listened to the issue but did not act on it. Craig Syrop, MD, from UI HC will discuss this issue at the next meeting.
6. Delta Dental has asked UI whether it would like to modify the dental plan coverage along one or both of two dimensions. First, the present plan allows an annual maximum benefit of $2,000 for Parts B & C. This could be modified to allow a carryover of the unused part of the benefit up to $2,000, for a maximum possible benefit of $4,000 in any one calendar year. This modification would cost the plan an additional $420,000 annually. Second, to reduce costs, UI could allow Delta Dental to add a network of preferred providers. There would be 3 levels of providers, similar to our UICHOICE health plan.  Level 1 providers would be dentists in the PPO network, all other Delta Dental dentists would be Level 2 providers, and non-participating dentists would be Level 3 providers. Currently Family Practice dentists in the College of Dentistry participate in Level 1, while the Specialists are in Level 2.  This plan would reduce how much the employees have to pay for care and also reduce the employer payment to providers. Adopting such a proposal would save the plan $400,000 annually. The committee listened to the proposal did not yet act on it.
7. The meeting adjourned at 1 p.m. The May meeting will be the last one for this academic year.

Recorder: Anand M. Vijh

Funded Retirement and Insurance Committee Minutes from 3/7/2014

Meeting was called to order at 11:30 am in 202 USB.
Members in attendance: Steve Bernholtz, Nancy Davin, Matthew Glasson, Nicole Nisly, Lynn Vining, Daniel Katz, Anand Vijh, Katherine Tachau, Sheldon Kurtz
Administrative Officers present: Sue Buckley, Richard Saunders

1. Introductions were done.   
2. The February minutes were approved.
3. Joni Troester provided the 2013 annual Univ. of Iowa LiveWELL report, which can be found at http://hr.uiowa.edu/files/hr.uiowa.edu/files/liveWELL-Annual_Report_2013.pdf  
   She also shared a PowerPoint presentation on Creating a Culture that Supports Health and Well Being.
   Highlights included:
   1. Departments may apply for $500 grants for worksite wellness initiatives
   2. Wellness has established a social media presence
   3. U of I Wellness program is ranked among the top nationally
   4. U of I has over 150 Wellness ambassadors
   5. Apple logo for healthy choice options has been trademarked
4. Christine Miller shared additional information regarding a proposed accountable care organization (ACO) proposal for UI Choice members.  The ACO’s focus would be on chronic and complex conditions that have been identified and approximately 3000 active employees/employee family members meet the criteria.  The identified goals would be to improve access, increase patient satisfaction (as measured by Press Ganey, UIHC’s satisfaction survey vendor), and improve quality and costs.  The requested funds to implement are projected $800,000 annually to support nurse coordinator/social service and technology needs.  Mr. Kurtz queried what the benefit for the University/UI Choice would be if savings beyond the cost were achieved, and that had not yet been determined.  Concerns were expressed regarding funding what may be perceived as administrative costs.
   Ms. Miller will follow up on questions that were raised.
5. 2015 OPM change- Richard Saunders shared with the group that he was informed the week of February 24^th that we no longer will be required to have one Out of Pocket Maximum (OPM) as discussed at the February meeting.  This will be placed on the April agenda for further discussion.
6. Other agenda items tabled to the April agenda.

Recorder: Lynn Vining

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, John Garfinkel, Matthew Glasson, Mary Greer, Nicole Nisly, Bernard Sorofman, Lynn Vining, Daniel Katz, Anand Vijh, Amber Seaton..

Members absent: Katherine Tachau, Sheldon Kurtz

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, Rami Boutros, Dan Fick, Gary Gussin, Terri Hein, Suzanne Hilleman, Debra Hughes, Susan Klatt, Dan Schropp, Julie Sexton, Joni Troester, David Ricketts

• Committee members, administration representatives, and guests introduced themselves.
• The minutes from the November 1, 2013 and December 6, 2013 were approved as corrected.
• IRL CAMBUS UPDATE – Rami Boutros, David Ricketts

Dr. Boutros began with an update on the usage and future plans for Iowa River Landing. Patient visits are exceeding expectations with 600+ visits per day. Future plans include same day appointments, expanded hours and a new procedure suite. Many of the services that have moved to IRL have some duplication with services at UIHC. There will always be some duplication. Behavior health is not at IRL yet, although there is a wellness component with Women’s Health that addresses some behavioral health needs.

Dave Ricketts from parking addressed questions regarding the Cambus transportation out to IRL from campus. Ricketts explained that UIHC administration asked for and received a cost analysis for obtaining a direct Cambus route to IRL. Other less expensive options were also provided, but UIHC has elected to use the existing Oakdale route, which runs 45 minutes and stops at the top of the IRL hill on First Avenue. There is very light ridership at this point, around 12 passengers per day.

Several concerns regarding the use of the Oakdale route were introduced, including the need for:

• Efficient transportation for health care students traveling to and fro from IRL to campus in time for clinics and classes
• Accessible transportation and drop off location for ill patients traveling from campus to their providers at IRL
• Accessible drop off location for handicapped patients traveling to and from the bus on the sidewalk and hill
  Committee members suggested that Cambus/UIHC conduct a ridership analysis to assess why there is such low ridership on Cambus for IRL. Committee members asked Rickets to communicate with Coralville transit to understand its future plans for bus transportation to IRL area.
• UI CHOICE ACO

Chris Miller was unable to be at the meeting. Committee members discussed what they understood about the ACO proposal. Buckley indicated that for the ACO to be in place, it would need identifiable health information from those we insure. Saunders indicted that the identifiable information will be held by our data warehouse Truven and only 2 Benefits staff members will have access to the information. Several members discussed what they felt were the pros and cons of an ACO. Providers in attendance discussed the advantages of having managed care to assist with difficult cases. Nisly discussed the movement toward “population health.” After several comments and helpful information from people in attendance, it was generally understood that ACOs and Care Management is great….it just can’t pay for itself.

• 2015 OPM Change

Saunders impressed upon the committee that recommendations regarding Federal changes need to be made before we conclude in May. We are only allowed one OPM for Levels 1 and 2. Or, we can combine with Level 3. A lengthy discussion occurred, but no decision was made. More on this topic at the next meeting.

• The meeting adjourned at 1 p.m.

Recorder: Mary Greer

Funded Retirement and Insurance Committee Minutes from December Funded Retirement and Insurance Committee Minutes from December 6, 2013
Meeting was called to order at 11:30 am in 302 USB.
Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, John Garfinkel, Bernard Sorofman, Lynn Vining, Daniel Katz, Anand Vijh, Amber Seaton, Katherine Tachau.
Members absent: Matthew Glasson, Mary Greer, Sheldon Kurtz, Nicole Nisly
Administrative Officers present: Sue Buckley, Richard Saunders

1. Committee members, administration representatives, and guests introduced themselves.
2. The minutes of meeting from November were not available for approval.
3. UICHOICE ACO – Chris Miller

UIHC would like to provide more follow up for those with certain chronic conditions (Hypertension, Asthma, Diabetes, and Musculoskeletal conditions) in the hopes of reducing the risk of repeat admissions and in maintaining or reducing their claim costs along with the severity of their chronic conditions. Measures would be developed to judge the success of the program in caring for those patients.

4. ACA Update - Saunders

As a higher education institution, the UI would be required to cover more employees than the currently are doing now. If any students, fellows, adjunct faculty or PT workers are working more than 50% time, they would have to be given the opportunity for insurance benefits. This would include temporary employees. This will add more employees to the insurance pool with increased premium cost to the UI.

5. Dental Coinsurance – Saunders

At the prior meeting FRIC agreed to increase the percentage covered by the University for Orthodontic Care from 30% to 50% for 2015. This change would increase the total cost by approximately $157,000.

6. Dental Annual Maximum – Saunders

Another new option that is available for 2015 is the ability to carryover up to an additional amount of the unused maximum benefit for Parts B & C, not to exceed $2000. This carryover would continue forward until needed. This change would increase the total cost by approximately $420,000.

7. Dental Network – Saunders

Another new option for 2015 is to create a three tier dental network. Tier 1 would consist of a preferred provider group, which includes the University of Iowa Dental College, Tier 2 would be all other Delta Dental providers, and the 3rd Tier would be all other dental providers. Both the UI and the employee save when the employee chooses a dentist from the Tier 1 network. The savings would be approximately 25%. The savings is estimated to be approximately $400,000.

8. Supplemental Life Insurance – Saunders

The current supplement life insurance goes up to 3.5 times the salary with no limit. The insurance company would like to limit that amount so that no one single large claim would affect the rates for the rest of the participants. The group voted to limit supplemental insurance to $1 million. Only 62 employees would be affected by this move.

9. Long Term Disability Insurance – Saunders

Drugs/Alcohol/Mental Health claims are increasing at an alarming rate. Mental Health/Drugs/Alcohol is about 10% of the cases but is 33% of the total cost of this plan. We will get more data on the breakdown of claims before a decision is made on whether or not to limit the period of time a person on disability could collect. Currently, the standard policy written has a 24 month limitation on these type of claims, while our policy has no limitation.

10. 2015 OPM – Saunders

Under the ACA, we can no longer have separate out of pocket maximums for our health and drug claims. We will need to set a new amount for 2015 for just one OPM for everything.

11. Health Care Spending Accounts.

There are more than 10,000 people in spending accounts with the UI. The Federal rules have changed and will allow a person to rollover up to $500/year into their next year’s account. Before the rollover funds can be used each year, a person must exhaust the funds in the current years account. This could create a perpetual rollover into spending accounts, even if the employee leaves the UI. Currently the funds left over in the accounts at year are forfeited back to the University. These funds are used to finance the various Wellness programs that are offered to the employees.

12. The meeting adjourned at 1:00 pm.

Recorder: Steve Bernholtz

FRIC Minutes For November 1, 2013 Meeting

Present

Committee: Bernholtz, Davin, Garfinkel, Glasson, Greer, Katz, Kurtz, Nisly, Seaton, Sorofman, Tachau, Vijh, Vining

Admin: Buckley, Saunders

Guests

Minutes of the October meeting were approved.

HCSA

IRS changed the rules on the health care spending account allowing a carried forward amount of $500 too following year. The decision is up to employer. May consider for future years, pros and cons were discussed. Unused funds currently go back to fund the various wellness programs for employees. In 2012, 2 million dollars were returned. A suggestion to consider sending a message to campus explaining why we cannot operationalize this immediately was discussed but not decided upon.

The previous option of allowing a 2.5 month extension is that it only really works once, which is why it was not implemented.

Wellness programs funded with these unused funds save money by helping employees be healthier

ACO

Chris Miller, Assistant VP with UIHC, presented on creating a UI Choice ACO, similar to currently in place for Medicare. Adds care coordinators who identify patients at risk for poor outcomes and facilitates and coordinates care. Improves access, quality and reduces cost, improves patient experience.

Data on outcomes, same day appointments and service excellence are part of plan. IRL has brought patient satisfaction up significantly.

They wish to obtain data from Wellmark on utilization of other services such as OT, Chiropractor, Home healthcare, pharmacy, data difficult to obtain.

Expanding care management improves outcomes while saving resources.

The meeting adjourned at 1pm.

Nicole Nisly, M.D.

FRIC Minutes
October 4, 2013
Meeting started at 11:30 am

• Funded Retirement and Insurance Committee Minutes from October 4, 2013

Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Bernard Sorofman,, Lynn Vining, Daniel Katz, Sheldon Kurtz, Anand Vijh, Nicole Nisley, Amber Seaton, Mary Greer.
Members absent: Katherine Tachau, Jon Garfinkel, Matthew Glasson
Administrative Officers present: Sue Buckley, Richard Saunders
Committee members, administration representatives, and guests introduced themselves.

• The minutes of meeting from September 6, 2013, were approved unanimously.
• TIAA-CREF Revenue Credit – Richard Saunders

University retained $160K to help cover the operating costs of the Benefits Office related to the pension plan. Remaining 1.4 million to be distributed to TIAA-CREF employees not annuitized. Motion to continue to distribute the full/remaining balance to the participants, current and past employees, who have deposits in an active annuity account (2 TIAA & 8 CREF) not annuitized, and in proportional amounts based on their account balances made by Daniel Katz, motion passed. It was also determined that as long as the University continues to receive these funds, it will not need to be brought back to FRIC unless something changes.

• UICHOICE ACO – Group

No new information.

• Affordable Care Act (ACA) Update – Richard Saunders

There are many technical glitches with the website. Iowa is using federal system website HealthCare.gov.

• UICHOICE Levels – Richard Saunders

UI HC has developed an alliance with MercyCare of Cedar Rapids, Mercy Des Moines and Genesis from the Quad Cities. The primary care providers of the partners will be incorporated into level 1 allowing the $5 co-pay rather than the Level 2 $20 co-pay. The goal is to implement this by January 1, 2014.

• 2014 OPM – Ricard Saunders

Traditionally coinsurance and deductibles count towards out of pocket maximum, co-pays do not apply. For 2014 the medical OPM will include all co-pays. All drugs count towards OPM for prescription drugs. This change was mandated by the ACA.

• 2015 OPM – Richard Saunders

The ACA will require one OPM for medical and prescription drugs. OPM can’t be separated anymore and cannot exceed a Federal limit for OPM $6053 for singles and $12,700 for families. Currently the UICHOICE combined medical and drug OPM is $4,800 for singles and $9,600 for families.

Anand Vijh requested information on what OPM people have paid so we can see how many people hit their OPM? Most inpatient stays will cause a person to have hit their OPM.

• Dental Coinsurance – Richard Saunders

Currently under Dental 2, 100% preventative care is paid, 80% restorative, 30% orthodontic. This is in line with other comparable employer plans, except for the orthodontic which typically is provided at a 50% benefit paid by employer and 50% paid by employee. $235K spent last year on orthodontic/implants. If we increase our coverage it would increase the total cost approximately $165K which translates to $13 per contract per year.

Nancy Davin motioned it was 2^nd by Nicole Nisley to increase the percent coverage from 30% to 50% for the orthodontic care , motion passed.

• Dental Annual Maximum – Richard Saunders

A new concept from Delta Dental of a rolling deductible was created. If a person uses $1K of their $2K benefit limit for one year, the next year they would have $3K as their benefit limit (1K prior year benefit limit balance + Current year benefit limit). Maximum benefit carried forward would be equal to the benefit limit. This could potentially double the benefit limit for the next year. The cost would be $500K-$600K a year which translates to approximately $50 a person. Approximately 600 people could have potentially carried forward used balances last year. No action was taken on this matter.

• Dental Network – Richard Saunders

Delta Dental created a new provider network program for PPO dentists. PPO dentists will accept a reduction of 25-26% in payments, thus creating savings to both the employer and employee. The provider accepts the reduction, but hopefully creating more business since patients will change for the savings. As an example, a charge of $230 for a non-PPO provider claim would cost $140 under the PPO provider, creating a saving of $90 which is hared by both the university and the employee. The University of Iowa Dental School is a participating PPO provider. Every area of the state does not have PPO providers. This change would save an approximate $420K per year. No action was taken on this matter.

10. The meeting adjourned at 1:00 pm.

Recorder: Katherine Dudley

FRIC Minutes
September 6, 2013
Meeting started at 11:32 am

• The committee started its AY14 year with introductions of members of the committee and guests. Members in attendance were Steve Bernholtz, Nancy Davin, Katherine Dudley, Sheldon Kurtz, Daniel Katz, Amber Seaton, Bernard Sorofman, Katherine Tachau, Anand Vijh. Sue Buckley, Richard Saunders, Rick Borchard, Gary Gussin, Terri Hein, Suzanne Hilleman, Debra Hughes, Susan Klatt, Christine Miller, and Joni Troester.
• Approval of the May 2013 minutes (Davin; Tachau) was unanimous.
• UIChoice ACO Discussion. A substantial discussion lead by Chris Miller, UIHC, about Accountable Care Organizations took a large part of the committee time. Ms. Miller gave an overview of ACO initiatives at UIHC and how UIHC and to a minor extent UI beneficiaries are impacted through ACO activity nationally (i.e., quality measures) and locally (i.e., Wellmark programs). The UI plan does not completely fall under the ACO activities of UIHC and Wellmark, however, the quality monitoring and measures used for the ACO at UIHC are applied to UIChoice members by Wellmark. There was a lot of discussion. Ms. Miller proposed that UI and FRIC consider developing an ACO for the benefit of UIChoice participants. The committee was interested in continuing the discussion and encouraged Ms. Miller to come back to the committee with more specific ideas about such a plan.
• Discussion of 2014 insurance rates. It was recommended with a motion that rates for UIChoice and Dental II (our only plans) remain the same as last year. This was approved unanimously (Tachau/Dudley). It should be noted that this is the second year in which rates have remained the same. Costs that are increasing in some areas are being balanced by reduction in expenses in other areas. Discussion noted the positive impact of the UI Wellness program and it was decided a more formal presentation of the Wellness program and its impact will be at a future meeting. AY14 begins the second year of the new, single dental plan. Once there are two full years of data, the plan and rates will be assessed. For now the data indicated that we can wait for a second year before the assessment is done since the first year rates came out very close to the estimates.
• Defense of Marriage Act (DOMA) – the federal impact of Supreme Courts ruling against DOMA is slowly emerging. As information becomes available and as rules are promulgated to address DOMA, UI will implement as appropriate and communicate accordingly to our same sex married couples.
• Infertility benefits – Influenced by the Accountable Care Act, rules changes were proposed and then modified related to infertility benefits. At the moment the UI fertility treatment benefit limit is $25,000 and will be retained but only for treatment costs, the aspects of care associated with the diagnosis costs will not have a limit for UI beneficiaries. This is a small change in UI benefits.

Meeting adjourned at 12:56 pm.

Minutes from May 3, 2013

Members in attendance: Steve Bernholtz, Jon Garfinkel, Mary Greer, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman, Anand Vijh, Katherine Dudley.

Members absent: Nancy Davin, Matthew Glasson, Daniel Katz, Victoria Sharp, Katherine Tachau, Michael Wichman.

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Emily Algood, Rick Borchard, Mike Brownlee, Gary Gussin, Terri Hein, Suzanne Hilleman, Lisa Mascardo, Christine Miller, Julie Sexton, Joni Troester, Mike Schueller, Julie Sexton.

Meeting was called to order at 11:34 am in 302 USB. There was not sufficient attendance to represent a quorum. It was noted that this was the first time this has happened in anyone’s memory that was present.

• Introductions were done.
• Informational session – Accountable Care Organization at UIHC. Christine Miller, UI HC & Emily Algood, UI HC. Ms. Miller provided a brief review of the Accountable Care Organization (ACO) concept and general information on the UI HC ACO structure and plan. She proposed that we begin to consider connecting UIChoice to the UI HC ACO system. Several benefits were presented; costs and disadvantages were not available. Further discussion will continue on this subject.
• A quorum was declared at 12:17 pm.
• Minutes from the April meeting were approved.
• TIAA-CREF Annuity Service Credit discussion. The committee discussed how to use the $1.4M service credit. Several options were given to the committee. These were the same options as from last year. A motion (Greer) died for a lack of a second – The University would retain approximately $160,000 to help cover the operating costs of the Benefits Office related to the pension plan AND distribute the full/remaining balance to the participants, current and past employees, who have deposits in an active annuity account, not annuitized, in equal amounts so long as they participated in the related funds that earn the credits. A second motion (Sorofman; Garfinkel) stating the following passed (7 yes, 1 no) -- The University would retain approximately $160,000 to help cover the operating costs of the Benefits Office related to the pension plan AND distribute the full/remaining balance to the participants, current and past employees, who have deposits in an active annuity account, not annuitized and in proportional amounts based on their account balance.

There was brief discussion that the FRIC committee would consider forming a committee early in the next academic year, to consider options for retaining and using the service credit to develop programs and/or services as defined and specified by the distribution rules.

• Informational session – Specialty drugs. Mike Brownlee, Chief Pharmacy Officer at UIHC with acknowledgement of the help of Professor Julie Urmie, College of Pharmacy, presented an overview of the concept and rapid increase in the costs of ‘specialty drugs’. It was clear that specialty drug costs were increasing at a rate that will challenge the UI health care insurance plan. Two questions will be visited by the FRIC committee in the fall – 1. Should there be different system of co-pay / co-insurance for specialty drugs and 2. Should specialty drugs be moved (where possible) from the medical to the pharmacy side of the insurance plan?
• The committee lost the quorum at 12:47 pm.
• Discussion continued about specialty drugs. The results were that UIHC and UI Benefits will have further discussions about specialty drugs in the months to come.

The meeting was adjourned at 12:59 pm

Recorder: Bernard Sorofman

Funded Retirement and Insurance Committee (FRIC) Minutes from April 5, 2013

Meeting was called to order at 11:30 a.m. in 302 USB.
Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Matthew Glasson, Mary Greer, Daniel Katz, Bernard Sorofman, Victoria Sharp, Katherine Tachau, Anand Vijh, Michael Wichman.
Members absent: Jon Garfinkel, Sheldon Kurtz, Heather Schnoebelen.
Administrative Officers present: Sue Buckley, Richard Saunders.
Guests present: Rick Borchard, Suzanne Hilleman, Joni Troester, Dianne Wasson, others.

Nancy Davin chaired the committee.

Committee members, administration representatives, and guests introduced themselves.

The minutes of meeting from March 1, 2013, were approved unanimously.

The discussion started with Richard Saunders giving a detailed update on the implications of the Affordable Care Act (more popularly known as Obamacare, henceforth the Act). The Act has many implications for employers and employees. At present, the implications are not fully known or understood. Saunders expects that the federal government will be sending out a great deal of new rules sometime during fall 2013 for the 2014 changes.

Some implications can be reasonably anticipated. Foremost, the university, like any other large employer, will have to monitor the health care insurance of its employees. It will have to make sure that all eligible employees are covered. There are stiff penalties for non-compliance with this requirement. The health care plan would have to include all employees working more than 30 hours a week. Recall that the university already covers all regular employees working more than 20 hours. There will be the additional burden because now the health plan will be required to cover all employees working more than 30 hours a week. That includes adjuncts, visitors, and temps. In many cases it is not clear how many hours a non-regular faculty member works, which is currently a departmental matter. Thus, new guidelines will have to be drawn to calculate the work load of such employees. For example, one anticipated federal guideline says that one hour of classroom time requires two hours of outside-classroom time. That means all faculty teaching at least 10 hours a week will have to be covered under the health plan. The departments would have to pay for this coverage from their budgets. One of the committee members asked whether student employees would have to be covered by the university’s health plan. Saunders clarified that graduate student employees working as a TA or RA more than 10 hours a week are already covered through contractual agreements with the Campaign to Organize Graduate Students (COGS). Other types of student employees might be covered if they meet the 30 hour rule.

There will be further requirements of the Act that affect the employees and in turn the university. First, in 2015 employers would have to mandatorily include all eligible employees under the plan, and the burden will shift to employees on whether they want to opt-out of the plan. Second, starting in 2014 there will be a federal guideline on out-of-pocket maximums. This could be something like $5,000 for individuals and $10,000 for families. By itself that may not sound like an additional burden because under the current health plan the out-of-pocket maximums are in fact lower. However, it could be a burden since the out-of-pocket maximums will include items currently not covered by the UI health plan, such as copayments. All these provisions cost money, and at present Saunders can only guess that the incremental cost to the university from covering the additional employees and providing the extra coverage could lie anywhere between $1 and $9 million.

As a miscellaneous requirement of the Act, Saunders informed the committee that the university would also have to pay various new Federal fees of around $1M per year for the next few years. Finally, the timeline of the Act is unclear. Some provisions would presumably go into effect on January 1, 2014, and some on January 1, 2015, while other go even further out to 2018. All-in-all, the university can look forward to many challenges and additional expenses due to the implementation of the Affordable Care Act.

In previous meetings Saunders had informed the committee that John Hancock is not offering Long Term Care (LTC) insurance plan to any more employees beyond the 900 who have already bought the insurance. The new LTC provider is Genworth, and it has already enrolled 750 employees in its insurance plan. In addition, 37 employees are covered under the LTC insurance plan offered by Metropolitan, the provider before John Hancock. It is entirely up to employees whether they want such insurance. The insurance premium is neither tax-deductible nor it can be taken out of flex credits.

Saunders informed the committee that after approval from the Board Office, and as already agreed with Principal Financial Group, employees retiring after July 1, 2013, will not be offered the free life insurance coverage of $2,000 to $4000.

The UI Cambus has several routes. One of these routes covers Oakdale Research Park and makes a stop either way on 1^st Ave and 9^th Street in Coralville. This stop serves Iowa River Landing (IRL) facility of UI Hospitals and Clinics. Unfortunately, the place where the Cambus drops passengers at this stop is not paved. This can be a problem for passengers with some disability and during bad weather. During recent discussions with the university the City of Coralville has agreed to pave this location.

In response to further questions, Saunders pointed out that currently very few passengers are using this Cambus service to go to the IRL facility. The daily passenger volume is estimated at around six on the north-bound service and four on the south-bound service. The passenger volume may increase in the future. In any case, Dr. Rami Boutros from UIHC (University of Iowa Hospitals and Clinics) Administration and Dave Ricketts from Parking will attend a future FRIC meeting to discuss this situation.

The next item was taken up by Sue Buckley. She informed the committee that the university is considering another early retirement plan. There have been two recent early retirement plans in 2009 and 2010. The 2009 plan required that the employee be over 57 years of age, but there was no requirement on years of service. 800 employees applied, and 335 were approved. The 2010 plan required that the employee be over 55 years of age and have at least 10 years of service. 250 applied and 88 were approved. In both cases, the early retirement required department’s approval. The plans were mainly intended to reduce costs without causing any disruption in work. Both plans were strategic in nature and not meant to be an entitlement or a benefit to eligible employees simply for asking. The plans gave the approved employees some additional benefits, such as health plan coverage and retirement plan contributions for several years. Both plans resulted in considerable savings to the university. The first plan is estimated to have saved $13 million in the first year and $65 million over five years. Similarly, the second plan is estimated to have saved $3 million in the first year and $13 million over 5 years.

While the university is contemplating another early retirement plan, the parameters are not yet clear. Any such plan requires approval from the Board of Regents before it is offered to the employees. While it is very preliminary, a few parameters have been thought about but are not final. The proposed early retirement plan could cover employees who are at least 55 years of age and have at least 10 years of service. There are 3,900 such employees. Some fraction of them will apply for the benefit, and a smaller fraction still would be approved. The approved employees would probably get five years of health coverage and some type of contribution to the retirement plan.

The last topic of the day was the coverage of specialty drugs. Saunders informed the committee that there are many such drugs and circulated a list showing some of them from the Wellmark Pharmacy list. Specialty drugs are used by a very small number of patients and can be extremely expensive. Their costs are beginning to increase in UIChoice. The general pharmacy drugs taken by all covered employees and their families account for 17% of the total health care costs. This proportion is going down as there are fewer new drugs coming to the market and many old drugs are losing patent protection and becoming generic. At the same time, the proportion of health care costs accounted by specialty drugs taken by just a few employees is definitely up. It was 22% and 20% of the total costs in January and February of 2013. As an extreme example, one person is taking a specialty drug that costs $350,000 each time it is needed. Committee member Bernard Sorofman agreed to bring in a pharmacy expert to educate the committee about these specialty drugs that could become a bigger issue in future years.

The meeting adjourned at 1 p.m.

Recorder: Anand M. Vijh

Funded Retirement and Insurance Committee Minutes from March 1, 2013

Meeting was called to order at 11:30am in 302 USB.

Members in attendance: Steve Bernholtz, Nancy Davin, Jon Garfinkel, Matthew Glasson, Sheldon Kurtz, Heather Schnoebelen, Victoria Sharp, Katherine Tachau, Anand Vijh, Michael Wichman

Members absent: Katherine Dudley, Mary Greer, Daniel Katz, Bernard Sorofman

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, William Buss, Terri Hein, Suzanne Hilleman, Debra Hughes, Katie Imborek, Nicole Nisly, Joni Troester, Dianne Wasson

• Introductions were done.
• Minutes from the December, 2012 meeting were approved.
• Two presentations on transgender care and coverage were made by Katie Imborek, MD and Nicole Nisly, MD. The purpose was to initiate discussions regarding a proposal to cover transgender care in UIChoice. Discussion ensued regarding both the expected benefits and expected costs of coverage. Notably, the AMA, APA and Institute of Medicine cite significant benefits to coverage (including potential long-run cost savings from both an individual medical standpoint and a societal standpoint). An example of costs (based on San Francisco data) suggests less than $4,000 per claim with fewer than 100 claims over the entirety of the coverage program (5 years). Most of the medicines for transgender care are generic (further limiting costs).

The committee made particular note of the AMA’s view that transgender care is medically necessary. The UI has covered other medically necessary care that is unavailable at UI (but provided elsewhere) in the past. The UI also now has a transgender clinic that offers care (since October 2012).

Two key points were emphasized as the committee progressed towards a formal motion. First, given the medical necessity of such care, coverage should be the same as that for any other medically necessary care. Second, coverage of transgender care is consistent with the UI’s human rights policy.

The committee made a formal motion (Katherine Tachau seconded by Sheldon Kurtz) to extend UI coverage to cover medically necessary transgender care. The motion passed unanimously on voice vote.

• The next order of business was a return to discussions from the December 2012 meeting (regarding the provision of patient information by the UIHC to the UI Foundation). Sheldon Kurtz noted that he and co-chair Davin spoke with VP Robillard and Lynette Marshall. FRIC’s concerns with this were communicated. Kurtz then noted that the federal government has changed HIPAA to allow hospitals to release to their foundations the following information (patient name, date of visit, clinic visited, doctor who provided care, care provided and outcome of care).

The committee (Katherine Tachau seconded by Matthew Glasson) moved to reaffirm FRIC’s opposition to the provision of patient information to the UI Foundation, regardless of whether federal law allows it. The motion passed unanimously on voice vote.

The meeting was adjourned at 1 pm

Recorder: Jon Garfinkel

No February 2013 Meeting. 

Funded Retirement and Insurance Committee Minutes from March 1, 2013

Meeting was called to order at 11:30am in 302 USB.

Members in attendance: Steve Bernholtz, Nancy Davin, Jon Garfinkel, Matthew Glasson, Sheldon Kurtz, Heather Schnoebelen, Victoria Sharp, Katherine Tachau, Anand Vijh, Michael Wichman

Members absent: Katherine Dudley, Mary Greer, Daniel Katz, Bernard Sorofman

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, William Buss, Terri Hein, Suzanne Hilleman, Debra Hughes, Katie Imborek, Nicole Nisly, Joni Troester, Dianne Wasson

• Introductions were done.
• Minutes from the December, 2012 meeting were approved.
• Two presentations on transgender care and coverage were made by Katie Imborek, MD and Nicole Nisly, MD. The purpose was to initiate discussions regarding a proposal to cover transgender care in UIChoice. Discussion ensued regarding both the expected benefits and expected costs of coverage. Notably, the AMA, APA and Institute of Medicine cite significant benefits to coverage (including potential long-run cost savings from both an individual medical standpoint and a societal standpoint). An example of costs (based on San Francisco data) suggests less than $4,000 per claim with fewer than 100 claims over the entirety of the coverage program (5 years). Most of the medicines for transgender care are generic (further limiting costs).

The committee made particular note of the AMA’s view that transgender care is medically necessary. The UI has covered other medically necessary care that is unavailable at UI (but provided elsewhere) in the past. The UI also now has a transgender clinic that offers care (since October 2012).

Two key points were emphasized as the committee progressed towards a formal motion. First, given the medical necessity of such care, coverage should be the same as that for any other medically necessary care. Second, coverage of transgender care is consistent with the UI’s human rights policy.

The committee made a formal motion (Katherine Tachau seconded by Sheldon Kurtz) to extend UI coverage to cover medically necessary transgender care. The motion passed unanimously on voice vote.

• The next order of business was a return to discussions from the December 2012 meeting (regarding the provision of patient information by the UIHC to the UI Foundation). Sheldon Kurtz noted that he and co-chair Davin spoke with VP Robillard and Lynette Marshall. FRIC’s concerns with this were communicated. Kurtz then noted that the federal government has changed HIPAA to allow hospitals to release to their foundations the following information (patient name, date of visit, clinic visited, doctor who provided care, care provided and outcome of care).

The committee (Katherine Tachau seconded by Matthew Glasson) moved to reaffirm FRIC’s opposition to the provision of patient information to the UI Foundation, regardless of whether federal law allows it. The motion passed unanimously on voice vote.

The meeting was adjourned at 1 pm

Recorder: Jon Garfinkel

Meeting was called to order at 11:30 am in 302 USB.
Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Matthew Glasson, Mary Greer, Daniel Katz, Sheldon Kurtz, Bernard Sorofman, Anand Vijh, Michael Wichman.
Members absent: Jon Garfinkel, Heather Schnoebelen, Victoria Sharp, Katherine Tachau.
Administrative Officers present: Sue Buckley, Richard Saunders.
Guests present: Rick Borchard, William Buss, Carla Clark, Dan Fick, Suzanne Hilleman, Debra Hughes, Susan Klatt, Gerald Rose.

• Committee members, administration representatives, and guests introduced themselves.
• The minutes of meeting from October 5, 2012, were approved unanimously.
• Richard Saunders updated committee members about the expected refund of $1.4 million every six months from TIAA-CREF. Like any other fund management company, TIAA-CREF charges fund fees. These fees exceed their costs, which may be due to increased asset values in a rising stock market or improved cost efficiencies. They say that they cannot easily lower their expenses for specific organizations since such action would require a substantial approval process. Since they are a non-profit organization, they are passing on the rebate to us. It is a significant amount. The University of Iowa has about $6 billion in retirement funds, out of which $3.8 billion is in TIAA-CREF funds eligible for this rebate. It works out to a payback of $2.8 million / $3.8 billion = 0.07% of fund assets every year (compared to fund expenses in the range of 0.40% to 0.50% every year).

The received rebate amount will be distributed to UI employees on a pro-rata basis. (More accurately, it will be re-invested in their TIAA-CREF funds.) That means employees would receive a rebate proportional to their holdings of TIAA-CREF retirement funds. Note this excludes funds from other investment companies, annuity accounts, mutual funds, etc. It works out to $98 per participant per year on average, but there will be considerable variation depending on retirement assets.

• The committee next took up the matter of UIHC (University of Iowa Hospitals and Clinics) privacy policy. The matter concerns uninvited solicitations to contribute to various research programs of UIHC sent by the UI Foundation. The Foundation was also being notified in advance of medical visits occurring. It was facilitated by the UIHC disclosing consumer information to UI Foundation. The practice was not in violation of any state or federal law as UIHC has an implicit agreement with consumers whereby this information can be disclosed unless they explicitly opt out. But it is inconsistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the desires of many consumers based on anecdotal evidence. In October 9, 2012, Sheldon Kurtz and Nancy Davin, co-chairs of FRIC, had written a letter to UIHC Vice President Jean Robillard and UI Foundation President Lynnette Marshall concerning this privacy matter. The officials have since agreed to discontinue the practice the advance notice practice and the inclusion of the provider’s name. The opt-out clause in the patient agreement will be clarified and made simpler to accomplish including through the online medical record that is available.
• The discussion moved on to the topic of transgender medical coverage. This is a relatively rare medical procedure whereby a person changes his or her sex. The treatment may involve surgery and/or hormonal treatment. It usually requires additional support services, such as psychotherapy, and it costs around $40,000. It is also relatively rare. For example, under the University of California system a total of 42 persons have had this procedure since 2005. That includes seven years and a population of over 300,000 employees, which works out to about one case per year per 50,000 employees. One should be cautious in extrapolating from this number, however, since the availability of coverage is bound to increase the number. Richard Saunders informed the committee that there have been some queries about this procedure from UI students, but none from current employees. The University of Iowa has had around 4 known people who have undergone this treatment over the past 26 years.

Given low demand and the need for comprehensive services, at present only around 14 states have medical providers performing this type of surgery. Iowa is one of them with providers in Grinnell and Des Moines. UI HC is discussing the option of offering this treatment.

The question before the committee is whether the UICHOICE should cover this treatment. Coverage could involve the medical procedure, counseling, and incidentals. The legal question of whether we can be required to cover such treatment is not clear. In general, gender discrimination is illegal, but this is just a medical procedure. Employers not offering any health coverage at all are not accused of gender discrimination, so it is not clear how employers not offering this coverage could be accused of gender discrimination. Saunders will discuss the legal issue with the University General Counsel’s Office.

Most committee members seemed favorable to considering transgender medical coverage. Saunders will also contact the University of Michigan since it was mentioned that they might be covering it.

• Michael Wichman raised the question of whether secretarial help could be obtained for taking the minutes of FRIC meeting. The issue is nontrivial as it may set a precedent for all other charter committees to ask for such help. Besides, Sue Buckley pointed out that the points discussed by the committee are rather deep and anyone other than a fully involved committee member is unlikely to do justice to the minutes of the meeting.
• Among miscellaneous issues, Sue Buckley informed the committee that there had been barely any complaints and only a couple of queries about the elimination of CHIP 2 health insurance plan. Thus, this change is going well despite concerns expressed by some committee members. It is notable that a significant proportion of UI employees have already registered their benefits choices. Finally, Sheldon Kurtz informed the committee of Iowa Governor Terry Branstad’s recommendation that state employees volunteer to pay 20% of their health plan costs.
• The meeting adjourned around 12:45 p.m.

Recorder: Anand M. Vijh

Committee members present: Steve Bernholtz, Nancy Davin, Katherine Dudley, Jon Garfinkel, Matthew Glasson, Daniel Katz, Sheldon Kurtz, Heather Schnoebelen, Victoria Sharp, Katherine Tachau.
Absent: Mary Greer, Bernard Sorofman, Anand Vijh, Michael Wichman
Administration: Sue Buckley, Richard G. Saunders
Guests: Rick Borchard, William Buss, Carla Clark, Suzanne Hilleman, Debra Hughes, Susan Klatt, Gerald Rose, Joni Troester, Deb Thoman, Jackie Lewis, Terri Hein

Minutes of the September meeting were presented and approved with corrections.

UIHC Privacy Notice & UIHC/Foundation. At the request of FRIC, Deb Thoman and Jackie Lewis attended the October meeting, representing UIHC and the University Foundation respectively, to explain the policy and practice of sharing limited patient information between UIHC and the Foundation and to respond to questions from FRIC.

Thoman explained that UIHC is required by HIPAA to provide patients with written notification about its privacy policies, including its practice of sharing certain information with the Foundation. Patients are asked to sign a copy of the notification as an acknowledgement of their receipt of the policy, but signature is not mandatory.

Patients must be notified when the policy is first adopted and whenever there is any material change in the policy. The most recent notification to patients was promoted by UIHC’s decision to become part of an ACO (Accountable Care Organization) with Mercy Hospital in Cedar Rapids, not by any change in the privacy policy relating to sharing information with the Foundation.

UIHC’s policy is to share limited information with the Foundation, including advance notification of patient visits. The information shared would include the patient’s name and contact information (address and phone number), the date and time of the appointment and the “provider”, i.e., the name of the physician. Thoman said that no information was shared with the Foundation concerning prisoners, Iowa Cares patients, and “possibly” Medicaid patients. In response to a question, she also indicated that no pharmacy information was shared and she thought that no information was shared concerning psychiatric appointments.

Thoman also explained that any patient could prevent information sharing with the Foundation by “opting out” of the process. The opt-out process is explained in the privacy notice, about midway through a multi-page document. Currently, the notice says that patient can opt-out by notifying UIHC in writing that the patient does not want his or her information to be shared with the foundation. In fact, Thoman said, UIHC will accept other forms of communication so long as it is clear which patient is opting out. Thoman said that there are plans to change the notice to make this clear in the near future.

Kurtz asked Thoman whether HIPAA permitted sharing the name of the treating physician with the Foundation. Thoman indicated that she understood that UIHC has some discretion about what information it shares and that “multiple lawyers have said this is legal”. Kurtz indicated that he was shocked by that opinion.

Lewis explained that the Foundation uses the information to contact patients to solicit contributions to the Foundation to support the work of UIHC. She said that the Foundation asks physicians to assist in this process by recommending the Foundation to patients who want to make some contribution to express their appreciation of the work done by UIHC.

Kurtz asked whether the solicitations were targeted in any way based on the type of treatment received by the patient. Lewis indicated that appeals based on UIHC information were “generic” in nature, but the Foundation did purchase information about potential contributors from “other sources” and that a person who had made a contribution to a cancer prevention society, for example, might receive a solicitation to contribute to the Holden Cancer Center, based on the non-UIHC information.

Tachau expressed her opinion that whether the practice of sharing the name of the treating physician was legal or not, it was certainly unwise and likely to be counter-productive in the long run, since it has the potential of creating lots of negative feelings.

Tachau also asked why it was important to provide the information in advance of the appointment. Lewis explained that the Foundation wanted the information in advance, because that way it might be possible for the Foundation to provide extra attention at the time of the appointment to patients who are significant donors to the Foundation.

Several FRIC members expressed their feeling that having Foundation staff present during a patient’s appointment was not appropriate. Kurtz said he thought it might put physicians in an awkward position. Lewis explained that no solicitation occurred during clinic visits.

Sharp indicated that, in her experience, some patients are grateful for the care they receive and do want to make a financial contribution to UIHC and that Foundation involvement is not always a negative experience.

Garfinkel asked whether it would be possible to change from an opt-out to an opt-in procedure and asked whether, for example, UIHC received a significant response rate to its patient satisfaction survey. Thoman indicated that the rate of response was relatively high. Garfinkel suggested if patients are responsive generally, that would indicate that an opt-in process would be workable. Tachau asked whether it would be possible to display the opt-in choice on “My Chart”. Kurtz expressed his strong preference for opt-in rather than opt-out.

Kurtz also asked for a poll of the Committee. Members of the Committee preferred opt-in and several members of the Committee expressed their concerns about the names of treating physicians being disclosed to the Foundation. Kurtz summarized by saying that FRIC’s recommendation to UIHC was that UIHC should discontinue the process of sharing the names of the treating physicians and that it switch from opt-out to opt-in. Thoman indicated that she would communicate that recommendation to UIHC administration.

Open Enrollment. Saunders announced that the annual open enrollment period would be October 30 through November 17 and that the notification would include an explanation that Chip 2 and Dental I were no longer available as well as other changes. Glasson asked whether current participants in Chip 2 would receive any special notification about the elimination of Chip 2. Saunders said that he will be sending emails and a home mailing to each current participant explaining that the Chip 2 and the Dental I option were being eliminated and explaining the reasons for the eliminations.

Transgender Coverage. Saunders presented reports to the Committee about Transgender-Inclusive Benefits (TGIB) at Colleges and Universities and US Corporations. He mentioned that some information is now available about the cost of providing TGIB, but since only a small number of institutions currently provide TGIB, there is still uncertainty about the costs. He asked the Committee to review the information and be prepared to discuss the topic of TGIB at the November meeting.

TIAA-CREF Refund. Katz asked for clarification about the TIAA-CREF refund discussed at the previous meeting. He wanted to know why FRIC was asked to decide the issue of the distribution of the refund and why TIAA-CREF was not deciding that issue. Saunders explained that, by law, the refund is due to the employer (the University) since it is an employer retirement plan so it rather than TIAA-CREF has the right to determine how the refund is distributed. Saunders explained that IRS rules specify the options on how the refund can be distributed. He reminded the Committee that the option FRIC preferred must still be approved by the IRS.

Submitted by Matthew Glasson

Attendees: Committee: Steve Bernholtz, Nancy Davin, Matthew Glasson, Mary Greer, Daniel Katz, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman.

Administration: Richard Saunders.

Guests: Dan Fick, Debra Hughes, Susan Klatt, Julie Sexton, Joni Troester, Lynn Vining, Rick Borchard, Carla Clark.

There were no meeting minutes from the previous meeting.

Health/Dental Insurance Rates for 2013: There will be no increase in the health insurance plans under the UI Choice plan. Costs to the overall plans did not warrant an increase. CHIP II rates will be increasing for the Single and Employee Child groups. There is only 1 Dental plan for 2013 and the rates are generally lower than the previous Dental II plan. A discussion was started about what to do with CHIP II. The people still in that plan are steadily decreasing and it’s only a matter of time before it falls below the allowable level of employees that must keep the plan viable. It was decided that 2012 would be the last year for CHIP II. It was also stated that since the 70’s there has been a deficit from costs and that deficit is slowly being reduced.

Disease Management: There are roughly 4000 employees of the 49000 that are in this plan. It ends 12/31/12. In was discussed that in general Disease Management is a good idea, but the UI could not get good enough information if the new plan that could be offered would provide any beneficial use.

Retiree Paid Up Life Insurance: The current plan gives retirees a $2000 or $4000(based on years of service) life insurance policy that was paid in full. It was previously voted to end this plan. Principal would than allow retirees to purchase whole life insurance up to the amount of the group insurance they had at the time of retirement, without a physical evaluation. The committee made no motion to change this recommendation reaffirming their position to stop this program for active employees which allows those individuals a conversion option with Principal up to the value of their Group Life Insurance coverage at the date of termination.

2013 Benefit changes due to ACA: The UI will be required to notify employees of a summary of the differences of each health care plan available to them. Spending accounts will be reduced to a total of $2500. This was decreased so that the IRS would be able to collect tax on that addition income. There is an expansion on women’s health services. Women will be able to get any breast pump they want at no cost to them, one per pregnancy. All generic or name brand contraceptives without a generic will now be free. Condoms will also be free when purchase through a pharmacist.

Long Term Care Insurance: The plan will switch to Genworth in 2013. This is the last insurance company that offers this type of group insurance. Current employees can stay with John Hancock, but future employees will have to choose Genworth if they wish this type of insurance.

TIAA/CREF Service Credit: TIAA is refunding $1.4 million to the University as a reduction in fees. This refund will occur every six months, but the amount will vary. A decision has to be made as to what to do with this refund. FRIC voted to allow the UI Benefits Office to receive $160,000 for expenses incurred by managing the pension program and the remainder would be divided proportionally based on how much a participant had in their accounts. If possible, only those participants who participated in the TIAA and CREF funds would be reimbursed, instead of across the board, but it is not known if this would be allowed. The refund to the participants will appear on their accounts as a Service Credit. Additional discussions will occur concerning looking at the using more of the funds by the Benefits Office for financial educational programs.

Minutes by Steve Bernholtz.

Funded Retirement and Insurance Committee Minutes April 6, 2012.

FRIC Report to Staff Council 5/9/2012

• Minutes are posted on the FRIC website.
• FRIC doesn’t meet over the summer months. Next meeting will be Sept 14 due to Labor Day.

Updates since last report:

• We’ve been given several updates on Iowa River Landing by Dr. Boutros.
• Discussed long term care insurance since John Hancock has moved to issue no new contracts effective January 1 of this year.. The company will honor current contracts in place. A new vendor has been identified _______________. Current subscribers can choose to stay with Hancock or move to the new vendor.
• Discussed vitamin coverage about the cost effectiveness and ultimately decided not to offer vitamin coverage because they would have to be purchased by prescription and not OTC. Wellmark would charge a processing fee which would often outweigh the cost of the vitamin. Wellmark would charge a minimum of $100,000 annual to get it up and running plus a $25/claim charge. Continually discuss CHIP 2 since there are dwindling numbers each year. HR conducted a brief survey of random subscribers to determine why people are choosing to continue to stay in the plan. There are so few subscribers that if there is a major claim, it will adversely affect CHIP premiums. Eventually enrollment will drop below 100 and Wellmark will not allow a self-funded group to remain open with less than 100 enrollees due to risk. Enrollment has dropped from 745 in 2008 to 283 in 2012. A phone survey was conducted and 87 out of 230 staff were contacted directly with questions related to why they continue to participate in CHIPS 2. Of the 87 responses, 63 did not consider switching from CHIP 2 to another plan. 51 of 87 automatically re-enrolled. The primary reasons respondents stay in CHIP 2 were actually mostly misperceptions (i.e., that there are limitations on using any provider). CHIP 2 is a less expensive option for Employee + children. We’ve discussed marketing ideas so subscribers will be better informed before open enrollment. At the May meeting it was decided to contact the College of Business’ marketing department to discuss marketing communications related to continuation of CHIP 2 coverage.
• Next year Dental I will be phased out and all participants will be moved to Dental II.
• University initiated international insurance to cover faculty, staff, and students who travel overseas. Covers medical claims in places where BC/BS isn’t accepted. Dependents accompanying the traveler can be added to the coverage. An email with details was sent out about a month ago.
• Discussed complementary medicine (acupuncture, massage, etc., which aren’t currently covered. They are, however, eligible for reimbursement under the healthcare spending account.

Questions?

Funded Retirement and Insurance Committee Minutes April 6, 2012.

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance:

Steve Bernholtz, Nancy Davin, Katherine Dudley, Jon Garfinkel, Matthew Glasson, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman, Katherine Tachau, Anand Vijh, Lynn Vining and Michael Wichman

Members absent:

Daniel Katz, Victoria Sharp

Administrative Officers present:

Sue Buckley and Richard Saunders

Guests present:

Rami Boutros, Rick Borchard, Gerald Rose, Daniel Fick, Suzanne Hilleman, Debra Hughes, Susan Klatt, Christine Miller, John Swenning and Diane Wasson

• Meeting called to order at 11:35 a.m. Committee members, administration representatives, and guests introduced themselves.
• The minutes of the March 2, 2012 FRIC meeting were approved unanimously. Later in the meeting Sue Buckley clarified item 6. International Insurance to note that ”. . . international travel insurance to cover faculty & students that travel overseas.” This must be corrected as staff are also covered, “. . . international travel insurance to cover staff, faculty & students that travel overseas.”
• UI HC Update – Dr. Rami Boutros, Executive Medical Director for Off-Site Ambulatory Care Programs, gave a presentation to the committee about progress on the new Iowa River Landing Clinic for UI Health Care. The Iowa River Landing (IRL) Clinic is scheduled to open October 8, 2012, which is a non-home game football weekend. Clinical departments at the IRL will include, General Internal Medicine, General Pediatrics, Women’s Health Services, Cardiology, Cardiac Rehab, Dermatology, Diabetes Center, Gastroenterology, General Surgery, Ophthalmology, Otolaryngology, Urology, Lab/Pathology, Radiology and Pharmacy. The IRL clinic will be open to accept patients from 8:00 a.m. to 8:00 p.m. Monday through Thursday, 8:00 a.m. to 5:00 p.m. Fridays, and 8:00 a.m. until 12:00 Noon on Saturdays. Parking is available for staff and patients and will be free for patients. Dr. Boutros also mentioned that UIHC is expanding Quick Care services and will be opening a new clinic on Mormon Trek.

John Swenning, Associate Director Hospital Clinics gave a presentation about patient access, throughput and satisfaction within UI healthcare. They are developing a centralized system to manage scheduling. They are working on developing a phone tree and may not change current telephone numbers and hope to go to just one number but do not when at this point. The intention is to make it easy to make an appointment at UIHC. Mr. Swenning presented some statistics on patient scheduling call volumes, 29, 924 calls were answered by an average of 11.94 UIHC staff with 5.11% of calls abandoned by those calling in. Their goal is to reduce abandon rate to 2%. There were 119.34 calls per UIHC agent per day with an average speed of answer of 43 seconds. Overall goal is to improve access and throughput.

• Out-of-state coverage – Committee discussed individuals that are out-of-state residents and using UI Choice plan for health care. There are some issues related to coverage associated with visits to Emergency Room. Emergency Room visits are paid at Level 1, but unless admitted to the hospital, when checked out from emergency room, coverage is paid at lower level, level 2 or level 3. The traditional Wellmark model pays at Level 1 for the emergency room plus any related expenses incurred during the next seven days. This issue primarily impacts retirees that spend part of the year in Iowa and the remainder of the year in a warmer climate and employee children that are in college out of state. Committee did not identify any resolution to payment.
• CHIP 2 – Saunders provided copy of CHIP 2 survey results conducted by benefits office staff. 84 out 230 staff were called directly with questions related to why they continue to participate in CHIP 2. There appear to be many misperceptions associated with CHIP 2. Of current participants, of 87 participants that responded, 63 did not consider switching from CHIP 2 to another plan. 51 of 84 just automatically re-enrolled in CHIP 2. Primary reasons or stay in the CHIP 2 program was the perception or misperception that there are limitations on using any provider, premium, no reason, satisfied with coverage, children out of state covered, do not like UIHC, travel overseas, do not use UIHC, drug coverage, etc. The survey results showed that most current participants in CHIP 2 have the misperception that they must remain in CHIP 2 to have the option to choose any provider. The fact remains that the employee with children category is less expensive currently with CHIP 2. Committee discussed various marketing ideas to end enrollment in CHIP 2. As enrollment continues to decrease, eventually CHIP 2 coverage will no longer be available. Sue Buckley and/or Richard Saunders will contact Business School to discuss marketing communications related to continuation of CHIP 2 coverage.
• Health Insurance Plans for 2013 – at the present the committee continues to support CHIP 2 as several staff and faculty continue to enroll in that program. Committee continues to support discontinuation of Dental I and move all participants to Dental II coverage.

Meeting adjourned at 12:53 pm.

Recorder: Michael Wichman

Funded Retirement and Insurance Committee Minutes March 2, 2012.

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Jon Garfinkel, Matthew Glasson, Heather Schnoebelen, Bernard Sorofman, Victoria Sharp, Lynn Vining, Michael Wichman

Members absent: Daniel Katz, Sheldon Kurtz, Katherine Tachau, Anand Vijh

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, Suzanne Hilleman, Debra Hughes, Susan Klatt, Gerald Rose, Julie Sexton, Joni Troester

• Committee members, administration representatives, and guests introduced themselves.
• The minutes of meeting from February 3, 2012, were approved unanimously.
• Richard Saunders provided additional demographics about employees with Chip plan as well as a comparison of out of pocket costs for UI Choice and Chip. Remarkable points included:
• Under worst case scenario, single status could potentially pay more with UI Choice at an out of pocket maximum of $4,800 if seen by in and out of state providers (scenario 3) than the CHIP out of pocket maximum of $4,200.
• Under worst case scenario, Employee & Children status could potentially pay more with UI Choice at an out of pocket maximum of $11,784 if seen by in and out of state providers (scenario 3) than the CHIP out of pocket maximum of $8,400.
• For all family status groups UI Choice is less expensive using Level 1 & 2 (scenario 1) and in state providers (scenario 2) than Chip.
• Enrollment was up by 1 for Family election for Chip plan from 2011 to 2012. This is the only status election group that increased in enrollment for the Chip plan.

Eventually enrollment will drop below 100 and the Wellmark will not allow a self funded group to remain open with less than 100 enrollees due to risk. If there was a large deficit not covered by Chip premiums, then by rule of the FRIC committee, premiums can only be increased by 30% annually. Any deficit not covered by a 30% increase in premium would be carried forward to future years and could be transferred over to UI Choice if Chip is closed. It is possible that Chip plan will only have enrolled the Employee & Children status due to the free premium. Over past 5 years enrollment for Chip has dropped from 745 in 2008 to 283 in 2012 and is expected to continue to drop. There is the possibility that a few high dollar claims within Chip could drive premiums up and cause enrollment to decrease dramatically.

Questions asked of the committee:

Do we want to close the Chip program?

Do we want to do a survey of Chip enrollees to see why they are staying in the Chip program?

Potential misconceptions of the Chip program may be contributing to enrollment numbers. One misconception of the Chip program was that Chip plan is a better deal if you are older and have health concerns and want to seek services out of state. A survey was suggested to better understand misconceptions of Chip and better understand how enrollees made their decision. Additionally, more data was request to see how many people auto enrolled for Chip by default election. Richard Saunders informed the group that if healthcare reform passes everyone must enroll or opt out each year starting on 1/1/2014.

The decision was made to perform a phone survey in March.

• Vitamin Coverage

Richard Saunders informed the group he spoke with Wellmark to see how vitamin coverage would work. Wellmark said they have no plans that provide vitamin coverage. There would be a minimum cost of $100,000 annually to get it up and running plus claim charges. Another stipulation was vitamins must be purchased from a pharmacy. In many cases the claim charge would exceed the cost of the vitamin. A motion was made to drop vitamin coverage issue and was seconded. Motion passed.

6. International Insurance

University is moving to international travel insurance to cover faculty, staff & students that travel overseas. Currently there are 1800 faculty/staff and over 4000 student that travel overseas. Existing health coverage is under any of the UI health plans. Proposed coverage would help get claims paid in places that don’t take BCBS overseas for the claimant. Coverage is meant for business trips only and does not extend to vacations. Dependents accompanying the traveler can be added to the coverage. An email will be sent out shortly to campus and a web site is being developed.

7. Complementary Care

Nicole Nisly spoke last year about complementary medicine to the FRIC committee. The hospital is currently researching this to see if they want to set up a more formal program based around complimentary medicine. If they want to proceed, they will make a recommendation for the FRIC committee to consider. Part of the research the hospital is doing involves answering questions like are UIHC physician’s currently prescribing these types of services? Acupuncture and massage therapy are considered complementary medicine and are not currently covered. These are both covered under the health care spending account if patient has a prescription from provider. Richard Saunders commented that as new items are covered under health insurance usage increases.

8. Health Insurance Plans for 2013

Benefits has not received any requests from employees for changes in coverage at this time, this indicates that employee body is generally satisfied with current coverage.

9. The next meeting will take place in April 2012.

10. The meeting adjourned at 1:00 pm.

Recorder: Katherine Dudley

Funded Retirement and Insurance Committee Minutes February 3, 2012.

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Nancy Davin, Katherine Dudley, Matthew Glasson, Daniel Katz, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman, Anand Vijh, Lynn Vining, Michael Wichman, Steve Bernholtz

Members absent: Jon Garfinkel, Victoria Sharp, Katherine Tachau

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, Carla Clark, Carol Fethke, Dan Fick, Debra Hughes, Joni Troester

• Committee members, administration representatives, and guests introduced themselves.
• The minutes of meeting from November 4, 2011, were approved unanimously.
• We looked over the 2012 data. CHIP 2 continues to decrease in active employee enrollment. There are still a lot single employees in CHIP 2 and the coverage is much better under UI Choice. There is a big risk to employees who stay in CHIP 2 that if there is a large claim, there would be few employees to spreads this across, making a large hit to a small group of employees to cover the increased cost. At some point the closure of the CHIP 2 might have to happen. The idea of actually contacting employees who are staying in CHIP 2 to see what their reasoning is for staying was mentioned. The idea was actually floated twice. The need for actual communication and not another survey was stressed to get their opinion and have less of a chance of getting a non-answer. More data was requested and no action was taken on this agenda item.
• There was a series of slides and a presentation given by Anand Vijh advocating for the need to increase the rates of the CHIP 2 plan. The idea behind this thought is to protect the rest of the employees under that plan from an increase to their rates due to a possible single catastrophic incident. The idea of contacting those still in CHIP 2 was again discussed, with emphasis on actual communication and not a survey. Another item that was mentioned was to base the employer contribution for the CHIP 2 single rate on the UICHOICE single rate. This would treat that employee category like all of the other family categories. No action was taken on this agenda item.
• The last item discussed was again that the Principal Insurance has expressed some discomfort with providing coverage of supplemental life insurance without any cap as at present. In cases where an employee has a very large salary exposes the provider to excessive risk with a result of increasing the premiums for all of the employees. Notice at present the group-life insurance is capped at $400,000. The committee considered this issue, however, no decision was taken.
• The next committee meeting will be in March 2, 2012 when the existing and new topics will be taken up.
• The meeting adjourned..

Recorder: Steve Bernholtz

Funded Retirement and Insurance Committee Minutes December 02, 2011, 11:30 am 302 USB Funded Retirement and Insurance Committee (FRIC) Meeting

Funded Retirement and Insurance Committee Minutes from December 2, 2011

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Nancy Davin, Katherine Dudley, Matthew Glasson, Daniel Katz, Heather Schnoebelen, Katherine Tachau, Anand Vijh, Lynn Vining, Michael Wichman, Steve Bernholtz

Members absent: Jon Garfinkel, Sheldon Kurtz, Bernard Sorofman, Victoria Sharp

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Dan Fick, Suzanne Hilleman, Debra Hughes, Susan Klatt, Christine Miller, Gerald Rose, Julie Sexton, Joni Troester

• Committee members, administration representatives, and guests introduced themselves.
• The minutes of meeting from November 4, 2011, were approved unanimously.
• Richard Saunders updated the committee on the status of long-term care insurance. During previous meetings he had informed the committee that John Hancock, the existing insurance provider, has a pending application with Iowa Insurance Commissioner for a rate increase on existing policies. At present 941 employees from the University of Iowa are covered through their policies (out of about 15,000 who are eligible). John Hancock is also not taking on new cases effective 1/1/12 (except for new employees if they so choose within first 30 days of their joining), which makes it necessary to shop for a new provider. However, a new provider will not be available until July 2012 at the earliest. Employees covered by John Hancock could choose to stay with it or move to the new provider.
• The discussion moved on to the topic of whether the health plan should cover vitamins. There are pros and cons of it, and proponents and opponents of it within the committee. Proponents (Dan Katz) say that vitamins are as important as some prescription drugs and can save very expensive procedures such as hip fractures or heart transplants at a later date. He pointed out that we cover expensive wigs, which are mostly of cosmetic value, whereas vitamins are essential to good health. Opponents point out that most vitamins are over-the-counter and cheap, coverage may shift employees to more expensive brand names, their benefits are not certain, and most plans by other employers do not cover them. The more necessary prescription vitamins are already covered by the UI plan in any case. To this Richard Saunders pointed out that administration could also pose challenges. If WellMark is not set up to routinely cover vitamins, then they would charge $25 to process each claim. He will check with them and inform the committee. No formal vote was taken on this issue.
• Next Richard Saunders took up the issue of DAW (Dispense As Written) code relating to coverage of (cheap) generic vs. (expensive) brand name versions of the same drug when both exist. During October 2011 meeting the committee had discussed this issue. There are three codes: DAW=1, when doctor considers brand name necessary and prescribes it, DAW=2 when doctor prescribes brand name but does not consider them necessary, and DAW=0 the default code in absence of an explicit code. At present the plan covers DAW=1 cases like any other brand name prescription drug (i.e., subject to only the appropriate coinsurance). In interests of fairness to all employees, Richard Saunders proposed that we should modify the rules relating to DAW=0 or 2 cases. In such cases the plan will pay only the cost of the generic and the employee will be required to pay the difference between the brand name and generic drug in addition to the appropriate tier coinsurance. This happens now in many cases, but is not consistently handled that way by the prescriber or the pharmacy. The new policy will also save $150,000 a year to the health plan. In addition, it would remove certain ambiguities arising from many doctors not knowing the DAW codes or the difference between generic and brand name prices. A motion was passed and unanimously approved by the committee to adopt this proposal.
• Richard Saunders informed the committee that the existing provider of long-term disability coverage has raised the issue of limiting coverage due to mental disability to two or three years. This lesser period (compared to physical disability) seems to be the norm with most employer plans. The provider has suggested that this could lower the long-term disability insurance rates for everyone. A motion was made to not support the proposal to restrict mental health claims for LTD. The motion passed unanimously.
• Last, Richard Saunders informed the committee that the provider of supplemental life insurance has expressed some discomfort with providing coverage up to 3.5 times salary without any cap as at present. In cases where an employee has a very large salary it exposes the provider to excessive risk with a result of increasing the premiums for the employees. Notice at present the group-life insurance is capped at $400,000. It is not even clear that very large coverage is in the employee’s interest as there is a heavy tax penalty on coverage in excess of $50,000. The committee considered this issue sympathetically. However, no decision was taken. The committee asked how it benefits the employees at large since no rate reduction is proposed by the provider if we reduce their risk of very large policies. Richard will gather some additional data for a future meeting.
• The next committee meeting will be in February 2012 when the existing and new topics will be taken up.
• The meeting adjourned around 12:45 p.m., earlier than scheduled.

Recorder: Anand M. Vijh

Funded Retirement and Insurance Committee Minutes November 04, 2011, 11:30 am 302 USB Funded Retirement and Insurance Committee (FRIC) Meeting

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Steve Berholdtz, Nancy Davin, Katherine Dudley, Matthew Glasson, Daniel Katz, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman, Katherine Tachau, Anand Vijh, Lynn Vining, Michael Wichman

Members absent: Jon Garfinkel, Victoria Sharp

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, Rami Boutros, William Buss, Amber Goedken, Debra Hughes, Susan Klatt, Christine Miller, Gerald Rose, Joni Troester, Dianne Wasson

• Committee members, administration representatives and guests introduced themselves.
• Minutes from the October 7, 2011 meeting were approved with no corrections.
• Dr. Boutros introduced himself to the committee and gave a presentation on the UIHC Iowa River Landing project currently under construction. At this time they expect to start occupying the building beginning in July 2012 with the facility opening to patients beginning in October 2012. The facility will have many clinics and services available to patients including but not limited to General Internal Medicine, Cardiology, Dermatology, OB/Gyn, Radiology, a full lab will be onsite as will other diagnostic testing. The facility will have parking facilities and bus service from main campus. Many clinics will have physicians who will practice at both the main hospital and the River Landing location to provide options for the patients. The goal is to maintain better access to patient care based on the needs of the patient. Many questions were asked by the committee members with some concerns raised about access and convenience of the facility and scheduling appointments for UI employees.
• Richard Saunders reported that John Hancock will be leaving the long term care insurance business and will stop selling new business as of January 1^st, 2012. The company will honor current plans already in place. There will be a request for proposal going out jointly with the Board of Regents to start looking at other long term care companies.
• The committee discussed vitamin coverage and heard a presentation from Amber Goedken from the Benefits Office about the cost effectiveness of using calcium/vitamin D for hip fractures. The presentation prompted discussion about whether it is cost effective to include vitamins in UI health plans. There are still many issues to consider and more discussion of this topic will continue at future meetings.

The meeting was adjourned at 1:00 pm

Recorder: Heather Schnoebelen

Funded Retirement and Insurance Committee Minutes October 7, 2011, 11:30 am 302 USB Funded Retirement and Insurance Committee (FRIC) Meeting

Funded Retirement and Insurance Committee Minutes from October 7, 2011

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Jon Garfinkel, Daniel Katz, Bernard Sorofman, Katherine Tachau, Anand Vijh, Lynn Vining, Michael Wichman

Members absent: Matthew Glasson, Sheldon Kurtz, Heather Schnoebelen, Victoria Sharp

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Amber Goedken, Suzanne Hilleman, Debra Hughes, Susan Klatt, Christine Miller, Joni Troester, Dianne Wasson, Nancy Williams, William Buss

• Committee members, administration representatives, and guests introduced themselves.
• Nancy Davin chaired the meeting as Sheldon Kurtz could not be present.
• The minutes of meeting from September 9, 2011, were approved unanimously.
• The committee first took up the topic of whether the UI health plan should cover vitamins (and supplements). This is a controversial topic. Some research points out that Americans take too many vitamins that cannot be absorbed by the body. Other research says that vitamins are essential and as necessary for human body as some of the medicines.

The committee sought expert opinions from two committee members and one visitor. First, Bernard Sorofman from Pharmacy informed the committee that vitamins are in fact required by many people and not just wasteful expenditure. Second, Dan Katz from Surgery gave a presentation on vitamins. He believes that vitamins are as necessary as medicines and can save expensive procedures such as hip fractures that are caused by calcium deficiency leading to osteoporosis. He informed the committee that five or six vitamins and supplements (namely, Calcium, Vitamin D, Iron, Folate (or Folic Acid), and Potassium) account for 71% of vitamins usage. The longer list includes 62 vitamins and supplements, based on his research survey. Third, Amber Goedken, PHD student in Pharmacy shared a list of common vitamins and supplements from Wellmark/Blue Cross.

At present some vitamins are covered and some are not covered. As a rule of thumb, over-the-counter vitamins are not covered while prescription vitamins are covered. This motivates some employees to shift to expensive prescription vitamins. The committee wanted more information on the cost aspects of vitamins coverage, but this is not easily available. The committee is still discussing this issue and will continue next time.

• The committee next discussed product selection penalties for prescription drugs. As is well-known, generic drugs cost less than brand name drugs. The FDA requires generics to be identical to brand name drugs, yet some generics do not work as well as brand names, at least for some patients. On such occasions the UI health plan accepts that the doctor may prescribe a brand name drug and put a code of Dispense As Written (DAW)=1 on the prescription. With that code in place the health plan provides coverage like any other brand name drugs, which means there is a co-insurance requirement. There is no co-pay requirement for generic drugs in order to induce employees to use them, which benefits everyone in the plan.

Some employees still want to use brand name drugs even though the doctor does not consider them necessary. In such cases the doctor uses DAW=2 code. Alternately, even if there is no DAW code (equivalently, a default code of DAW=0), employee may insist on the brand name drug. In either case the current health plan imposes a product selection penalty. However, this penalty is the difference of the price of the generic vs. the name brand drug which can in some cases be smaller than the required co-insurance under DAW=1. The net effect is a cost increase to the plan and doubtful (if any) benefit to the employee.

One solution is to require DAW=0 or DAW=2 patients to pay greater of co-insurance and product selection penalty, but Wellmark systems cannot handle this option. Wellmark says that in such cases plans by other employers all of their fully insured plans typically require the employee to pay the sum of the product selection penalty and the co-insurance. Based on 2010 data, Richard Saunders estimates that there will be a saving to the plan of about $160,000 a year.

There was considerable discussion between committee members. Most felt that this is an unintended consequence, a design flaw, or a loophole. However, during this meeting a motion was not proposed to say that in DAW=0 or DAW=2 cases the employee should be required to pay the product selection penalty plus the co-insurance penalty. There will be more discussions during a future meeting.

• The last substantial discussion focused on the dental plan for 2013. At present, and continuing into 2012, there are two dental plans available: Dental 1 and Dental II. Their costs and coverage are described on the following web-site:

http://www.uiowa.edu/hr/benefits/dental/facps_plans.html

Dental I plan has lower premiums and lower coverage than the Dental II plan. Both plans are provided by Delta Dental of Iowa. It is important to note one important difference between health plans and dental plans. For health plans you have the potential risk of large catastrophic claims, while under dental insurance there are much lower limits to what can be covered in a calendar year.

It has been suggested that the University move to one common plan for all employees. Thus, instead of Dental I and Dental II there will be just one Dental Plan II. The Dental I plan would be closed. The costs and coverage under this alternative are attractive. The employee cost will be lower than currently under Dental II, and only slightly higher than Dental I. The estimated savings to employer are the order of $680,000, and to the employees another $120,000. The total savings of $800,000 are a compelling reason to go for this plan. It is a win-win situation. The University also saves with lower administrative costs from Delta Dental of Iowa by only having one plan. This change is slated to go into effect during 2013. This was moved and approved by the committee.

• Mr. Saunders informed the committee that during the November 2011 meeting there may be a presentation by Dr. Boutros on the new Iowa River Landing facility of UI Hospital and Clinics. This facility will house General Internal Medicine and other specialties that are not equipment intensive. The committee also suggested additional topics to Christine Miller to be forwarded to Dr. Boutros to be included in his comments.
• The meeting adjourned around 1:00 p.m. as scheduled.

Recorder: Anand M. Vijh

Funded Retirement and Insurance Committee Minutes September 9, 2011, 11:30 am 302 USB Funded Retirement and Insurance Committee (FRIC) Meeting

FRIC meeting notes from 9/9/11

Funded Retirement and Insurance Committee Minutes from September 9, 2011

Meeting was called to order at 11:30 am in 302 USB.

Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Jon Garfinkel, Daniel Katz, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman, Katherine Tachau, Anand Vijh, Lynn Vining, Michael Wichman

Members absent: Victoria Sharp, Matthew Glasson

Administrative Officers present: Sue Buckley, Richard Saunders

Guests present: Rick Borchard, William Buss, Carla Clark, Dan Fick, Amber Goedken, Suzanne Hilleman, Debra Hughes, Susan Klatt, Christine Miller, Joni Troester

• Committee members, administration representatives and guests introduced themselves.
• Michael Wichman moved and Lynn Vining seconded that the minutes from the May 6, 2011 meeting be approved. The vote was unanimous in favor, with no corrections.
• Potential insurance rates for 2012 were viewed and discussed. Materials are confidential. Katherine Tachau moved and Nancy Davin seconded that the rates be approved. The vote was unanimous in favor.
• Long-term care coverage was discussed. John Hancock (our current provider) requested a rate increase several months ago. The Iowa Insurance Commissioner’s office hasn’t approved it yet. The Federal government is looking into Iowa’s review of health rate increases. The insurance commissioner’s office is responding to the probe and this may be influencing the delay on the long-term care rate increase request.
• Joni Troester presented information on UI’s integrated approach to developing and sustaining a healthy campus culture.
• Dental insurance plans for 2012 were discussed briefly; the same two plans will be offered in January 2012. It was noted that the largest “gap” in costs between Dental I and Dental II, is $7 per month (family status). While this indicates Dental II is more expensive per month, Dental II provides much larger coverage of restorative care and orthodontic care. The committee was asked to think about combining Dental I and II into one plan with the Dental II design features. It was noted that removing Dental I would increase the size of the “pool” of users for Dental II, and this might lower what would have been the gap, from $7.
• Co-chair Kurtz asked if we could get a presentation about the new facility at the Iowa River Landing. UI HC representative Christine Miller will try to have a presentation at a future meeting.

The meeting was adjourned at 1:00 pm

Recorder: Jon A. Garfinkel