FY19 - FY17 Meeting Minutes | Funded Retirement and Insurance Committee

FY19 Meeting Minutes

Funded Retirement and Insurance Committee

June 7, 2019 Meeting Minutes

Members Present: Jon Garfinkel (co-chair), Nancy Davin (co-chair), Dan Katz, Teri Schnelle, Mike Schueller, Sarah Tallman, Anand Vijh, Julie Urmie, Chuck Wieland, Cormac O’Sullivan

Members Absent: Steve Bernholtz, Nicole Nisly, Ben Rogers, Brian Kaskie

Administrative Liaisons: Joni Troester, Rebecca Olson

Guests: Susan Klatt, Cheryl Reardon, Richard Saunders, Julie Sexton, Dana Stafford, Cheri Smith, Heather Minehart, Jennifer Vermeer, John Laverty, Michael Hesseltine, Cristobal McKinney, Jill Valde, Russ Ganim

Introductions:
- Completed for members and guests.
- Welcome to Cormac O’Sullivan (faculty/College of Nursing) who has joined the FRIC committee as a replacement for Katherine Tachau.
Approval of May meeting minutes:
- Motion by Mike Schueller to approve May minutes; second by Nancy Davin. Motion passed unanimously.
New plan discussion

Rebecca Olson provided a review of new plan parameters related to how the deductible would be applied and example scenarios.
Group discussion of exception process if no level 1 services available. There is a standard process through University Benefits/WellMark to follow.
Julie Urmie provided an update on the proposed formulary change with the new plan. The main difference between formularies is that the formulary for the new proposed plan does not cover tier 4 drugs. Most tier 4 drugs are brand name drugs where a generic equivalent is available. Benefits staff plan to inform members who are currently on tier 4 drugs that their tier 4 medications would not be covered if they switch to the new plan. This notification will occur prior to the deadline for making 2020 plan enrollment decisions.
Joni Troester provided a presentation on modeling of rates for the proposed two plans based on 2019 data. It was emphasized that these rates are not the actual 2020 rates. Current estimates nationally are suggesting a 7% trend increase for 2020. Actual 2020 rates will be discussed at the September 2019 FRIC meeting.
Discussion of new plan and review of reasons for the change. Beginning in 2020, rate smoothing will occur across employee statuses to increase premium stability and across plans to account for employees with different levels of health choosing different plans. Point of emphasis from discussion was the importance of using any savings from the new plan structure to directly benefit employees.

Motion by Sarah Tallman to proceed with offering of a second health plan as outlined in the FRIC discussion to be available beginning January 1, 2020; second by Mike Schueller.

In Favor; 8 members
Opposed; 1 member
Abstain; 1 member

Motion by Dan Katz to cancel the June 13, 2019 meeting; second by Mike Schueller. Motion passed unanimously.

Meeting adjourned at 12:50 p.m. Meeting minutes submitted by Julie Urmie

May 10^th, 2019 – Funded Retirement and Insurance (FRIC) Meeting Minutes

Members Present: Jon Garfinkel*, Nancy Davin*, Ben Rogers, Dan Katz, Julie Urmie, Anand Vijh, Nicole Nisly, Teri Schnelle, Steve Bernholtz

*co-chairs

Members Absent: Sarah Tallman, Brian Kaskie, Michael Schueller, Chuck Wieland

Member Resigned: Katherine Tachau

Administrative Liaisons Present: Joni Troester, Rebecca Olson

Guests: Richard Saunders, Jessica Wade, Kara Wright, Cheryl Reardon, Julie Sexton, Jennifer Vermeer, Michael Hesseltine, Megan Hammes, Susan Klatt, , Siroos Shirazi, Megan Threlkeld, Lisa Mascardo, Alex Mersch, Chelsea McIntire, Laurie Textor, Brandon Johnson, Mike Weaver, Cristobal McKinney

Introductions and roll call:

Completed for members and guests

Approval of March and April 2019 minutes:

Katz motion/Urmie second
Unanimous approval of notes from both months approved

Specialty Pharmacy Update:

The Plan was to go live on 1/1/19. There are 700 members on Specialty Meds and 122 of the expected 210 member transitioned to the new plan. As we transitioned, we helped them with any known rebates and copay mechanisms. They gave several examples of success stories from those that had made the transition.

Next year there will be data available on the ramifications of the new plan.

Health Benefit Review update:

During the month of April, UHR staff met with shared governance leadership to further discuss the draft recommendations of the Health Benefit Advisory Group; specifically the proposed new health plan.

The timeline has been updated regarding the discussion and approval of the recommendations and the proposed new health plan. Discussion will be through mid June and include additional discussion with FRIC. A new health plan requires Board of Regent approval. Materials on a new health plan are tentatively planned to be part of docket materials (due July 1) and tentatively planned to be on the August 1 agenda.

There will be 2 FRIC meetings in June, the 7^th and 13^th for further discussion and review of the proposed new health plan

The new plan would have lower premiums with a higher out of pocket expenditures. Other proposed changes include deductibles defined and applied in a standard manner, different co-pay structure for PCP vs. Specialist visits, behavioral health co-pays, Rx formulary of Rx Value Plus, and Level 3 by exception only.

If the new plan is approved, campus communication and education will be a focus of the roll-out late summer through open enrollment in Fall 2019. This includes group meetings and the opportunity for one to one visits.

September Meeting Discussion

Motion to have two meetings in September (6 and 13) by Rogers; second by Urmie
Unanimous approval for two September meetings.

Meeting adjourned @1:00 p.m.

Meeting Schedule

Special FRIC meetings
- June 7; 11:30 a.m. to 1:00 p.m. in Room 302 USB
- June 13; 12:00 – 1:00 p.m. in Room 302 USB
Academic Year meetings
- First Friday of the month from 11:30 a.m. – 1:00 p.m.
- For September 2019- two meetings
  - September 6; 11:30 a.m. – 1:00 p.m.
  - September 13; 11:30 a.m. – 1:00 p.m.

May 10^th, 2019 – Funded Retirement and Insurance (FRIC) Meeting Minutes

Members Present: Jon Garfinkel*, Nancy Davin*, Ben Rogers, Dan Katz, Julie Urmie, Anand Vijh, Nicole Nisly, Teri Schnelle, Steve Bernholtz

*co-chairs

Members Absent: Sarah Tallman, Brian Kaskie, Michael Schueller, Chuck Wieland

Member Resigned: Katherine Tachau

Administrative Liaisons Present: Joni Troester, Rebecca Olson

Introductions and roll call:

Completed for members and guests

Approval of March and April 2019 minutes:

Katz motion/Urmie second
Unanimous approval of notes from both months approved

Specialty Pharmacy Update:

Next year there will be data available on the ramifications of the new plan.

Health Benefit Review update:

There will be 2 FRIC meetings in June, the 7^th and 13^th for further discussion and review of the proposed new health plan

September Meeting Discussion

Motion to have two meetings in September (6 and 13) by Rogers; second by Urmie
Unanimous approval for two September meetings.

Meeting adjourned @1:00 p.m.

Meeting Schedule

Special FRIC meetings
- June 7; 11:30 a.m. to 1:00 p.m. in Room 302 USB
- June 13; 12:00 – 1:00 p.m. in Room 302 USB
Academic Year meetings
- First Friday of the month from 11:30 a.m. – 1:00 p.m.
- For September 2019- two meetings
  - September 6; 11:30 a.m. – 1:00 p.m.
  - September 13; 11:30 a.m. – 1:00 p.m.

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

Introduction and roll of members: Steve Bernholz, Nancy Davin, Jon Garfinkel, Brian Kaskie, Dan Katz, Nicole Nisly, Teri Schnelle, Julie Urmie, Anand Vijh, Chuck Wieland, Michael Schueller, Sarah Tallman
Introduction and roll of administrative liaisons: Joni Troester, Rebecca Olson
Absent (members): Ben Rogers, Katherine Tachau
Visitors: Megan Hammes, Cheryl Reardon, Richard Saunders, Julie Sexton, Jessica Wade, Kara Wright, Jill Valde, Jennifer Vermeer, Jodi Felderman, Gina Krueger, Dan Fick

Approval of February 2019 minutes: Nisly motioned to approve meeting minutes. Second by Kaskie. Unanimous approval by committee.

Presentation on Proposed Network Design: Joni Troester shared background information on Level 1 providers and utilization, including the dissolution of the Health Alliance partnership and need to grandfather providers as Level 1 providers through end of 2019. Jennifer Vermeer presented overview of proposed Level 1 network as of January 1, 2020. UIHC’s goal is to be the provider of choice for the UI Family. The proposed network would focus on providing members access, high value and quality care. UIHC has implemented several initiatives to increase same day access for acute care, as well as access and capacity to primary care appointments by adding more providers. Vermeer provided information on access targets for primary, secondary and tertiary care, as well as plans to achieve benchmarks at UIHC. Vermeer will return for the April 5, 2019 FRIC meeting to provide more details surrounding the new Level 1 network for 2020. The committee tabled any recommendation until the April, 2019 FRIC meeting.

Q4 2019 Quarterly Metrics and Utilization by Age Band: Rebecca Olson presented metrics to the committee. Committee members requested enhancements to reporting to include split of health insurance data between medical and drug and number of claimants by age band.

The meeting was adjourned at 1:00 p.m. Next meeting is on Friday, April 5, 2019.

Funded Retirement and Insurance Committee (FRIC) Meeting February 1, 2019

Members present: Jon Garfinkel*, Nancy Davin*, Ben Rogers, Dan Katz, Chuck Wieland, Mike Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Nicole Nisly, Teri Schnelle, Brian Kaskie, Steve Bernholtz

*co-chairs

Members absent: Katherine Tachau

Administrative liaisons present: Rebecca Olson, Joni Troester

Guests: Richard Saunders, Jessica Wade, Kara Wright, Cheryl Reardon, Julie Sexton, Cristobal McKinney, Susan Klatt, Megan Hammes, Gina Krueger

Introduction and roll call: co-chairs

Approval of January minutes; Motion/Davin, Second/Urmie (Unanimous approval)

Follow up on FRIC Member Training Session held January 23, 2019

January 23, 2019

Health insurance premium being tied to pay: Garfinkel explained that the Health Benefit Review Committee discussed this and there was no consensus to make this change, whether it would make a positive or negative impact. Decision was to leave this issue for now.

Reserves: If a positive balance is achieved from revenues being greater than costs, this balance goes toward the reserve for health insurance. Reserves are managed under the direction of the CFO.

Additional data: It was suggested that FRIC review the current quarterly metrics that are provided to the group first. If additional questions arise, specific request for data can be made. Dan Katz requested a breakdown of utilization by age band. This will be provided at an upcoming meeting.

Speaker request: Katz also requested a guest speaker on behavioral economics. This topic will be added to New Business and a speaker identified.

Discussion regarding Health Benefit Review and use of potential savings from implementation: FRIC discussed the following options to explore related to potential use of funds:

Support for faculty and staff well-being services
Support for preventive health services
Financial assistance to low wage earning employees for out of pocket costs associated with catastrophic illness
Cost control of fringe rate expenses to allow for greater salary increases

This information would be conveyed by Jon Garfinkel to the Health Benefit Advisory Group at their next meeting.

Access and Capacity at UIHC was also discussed briefly: Reference was made to information distributed in early 2019 regarding access for UI Choice members. This information will be brought to the March meeting.

FRIC requested that an annual outcome summary regarding the Health Benefit Review recommendation implementation be provided.

The May 2019 meeting will be moved from May 3 to May 10.

Wieland requested a brief written summary after the May 10^th meeting for those individuals who are unable to attend.

Motion to dismiss – Davin / Rogers. (Unanimous)

Meeting Adjourned at 1:00 p.m.

Minute Taker: Sarah Tallman

Funded Retirement and Insurance Committee (FRIC) Meeting January 11, 2019

Members present: Jon Garfinkel*, Nancy Davin*, Ben Rogers, Dan Katz, Chuck Wieland, Mike Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Nicole Nisly, Teri Schnelle, Brian Kaskie

*co-chairs

Members absent: Steve Bernholtz, Katherine Tachau

Administrative liaisons present: Rebecca Olson, Joni Troester

Guests: George Johnson, Richard Saunders, Jessica Wade, Kara Wright, Cheryl Reardon, Julie Sexton, Cristobal McKinney, Susan Klatt

Introduction and roll call: co-chairs

Approval of December minutes; Motion/Wieland, Second/Schueller (Unanimous approval)

Health Benefit Review

Jon Garfinkel initiated the discussion regarding the Health Benefit Review and work of the Advisory Group.

Today’s meeting is to talk about Health Benefits Review (HBR)
Looking for FRIC’s feedback on current ideas from the HBR Advisory Group
Next HBR Advisory Group meeting is January 18th where FRIC feedback will be considered.

Discussion of material commenced. Specific points that were discussed included:

Guiding principles updated due to feedback from FRIC. Reviewed these updates.
One guiding principle contained language about benefits being an integral part of recruitment and retention as well as simultaneously paying attention to peer comparability of our benefit plans.
Motion was made to separate peer comparability from “recruitment and retention” and have two guiding principles instead. - Motion carried
Suggested language along the lines of “Offer competitive and comparable benefits in line with that of peers”

Pharmacy Benefits Manager (PBM) Efficiency Opportunity - Julie will present at April meeting to educate the group on PBM.

Joni Troester (Administrative Liaison) provided the following information.

UI leadership has asked for a lower cost health plan alternative to accommodate those employees who would like a lower premium option.
The HBR Advisory Group has an early proposal for two plans as opposed to the current structure that has only one health plan. In the proposal, one plan would be the current UI Choice plan. The second plan would be a lower monthly premium plan that has higher co-pays and out of pocket maximums. The covered services provided is proposed to be essentially the same across both plans.
The HBR Advisory Group is also recommending changes to the discounts that single and dual spouse family receive on their health plan premium cost share. At present these two family status’ receive their health plan at zero employee premium. This is different from all other family status’ which pay a premium of 20% of the total cost of the plan. The proposal was to keep the zero premium but only on the lower monthly premium plan while the current UI Choice plan would have some cost associated with it for all family statuses.

There was extensive discussion by the FRIC committee members about these changes.

Major points discussed regarding the second health plan option included:

Risk selection concern where healthier people will select low cost option and there will be administrative overhead to manage this and may impact plan cost/viability.
Missed opportunity to look at more innovative value based health.
There will be additional education overhead as we transition to this new structure.
Individuals have choice on other types of insurance they purchase (auto, life. etc.), should this be a different situation.

Joni Troester (Administrative Liaison)

University Benefits would work with Aon (actuarial consultant) related to actuarial methodology related to plan premium setting and to control for potential migration concerns.
University Benefits continues to seek out value based opportunities.

A motion was made by Nisly/second by Schueller to “support a second healthcare plan with the same covered services and a lower premium but with higher out of pocket costs”. This motion passed 8 in favor and 4 opposed.

Major points discussed regarding the proposed changes in premium cost share for employee only and dual spouse family for the current UI Choice health plan. The proposed changes include either a 5% cost share or 10% cost share for each of these family status for the UI Choice health plan.

That the dual spouse credit encourages the recruitment and retention of hard to recruit individuals to Iowa.
That in the current political climate reductions to family benefits, such as the dual spouse family credit, will be viewed as anti-family.
That this change has the potential to seriously impact staff morale and retention. For the last decade the average raise has been quite low in percentage terms and this reduction in benefits will be seen as a cut in pay at the same time pay checks are mostly flat.
Individuals in the E/S, E/C, Family pay premiums now (20%) and are considered a family status; this would provide some equity relative to all family status. Additionally, many faculty/staff who pay the 20% are still being retained by good benefits.
The proposed changes are viewed from an overall faculty/staff perspective and not from a specific family status view.

The committee was not able to come to near consensus on the proposed changes in premium but did take two votes. They were:

A motion was made by Wieland/second by Kaskie “to support UI Choice single and dual spouse family plans paying 5% of the total plan cost.” 6 For and 6 Opposing
A motion was made by Wieland/second by Kaskie “to support UI Choice single and dual spouse family plans paying 5% in the first year of total plan cost and 10% in the second year.” 6 For and 6 Opposing

Meeting Adjourned at 12:30 p.m.

Minute Taker: Ben Rogers

Funded Retirement and Insurance Committee (FRIC) Meeting December 7, 2018

Members present: Jon Garfinkel*, Nancy Davin*, Katherine Tachau, Dan Katz, Chuck Wieland, Mike Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Nicole Nisly, Teri Schnelle, Brian Kaskie

*co-chairs

Members absent: Ben Rogers, Steve Bernholtz

Administrative liaisons present: Rebecca Olson, Joni Troester

Guests: Siroos Shirazi, Megan Hammes, Richard Saunders, Jessica Wade, Kara Wright, Cheryl Reardon, Julie Sexton

Introduction and roll call: co-chairs
Approval of minutes with corrections; Motion/Katz, Second/Tallman
Specialty pharmacy transition: Rebecca Olson provided an update on the transition to the University of Iowa Hospitals and Clinics’ assumption of the role of specialty pharmacy prescription provider. Efforts to reach people affected by the transition have or will include a mailing with brochure, follow-up calls, and dedicated help phone line to assist people with questions.
Health Benefits Review: Joni Troester led an update and discussion on the progress of the Health Benefit Advisory Group (HBAG). The HBAG has identified guiding principles and goals. The group has been guided by the survey of benefits completed this Fall. Some potential recommendations from the Group were presented as falling into two categories: 1) Those affecting plan efficiency and access to care, and 2) changes to plan options and design.

In general, it was voiced that the language of the HBAG’s guiding principles be aligned with their goal statement by including that recruitment and retention of faculty be explicitly mentioned in the 7^th bullet of the guiding principle as it relates to competitive benefits.

Under the first heading of plan efficiency and access to care, the specific recommendation to study opportunities for cost saving through modifications to the pharmacy benefit manager (PBM) engendered robust discussion and was generally supported by the group, with the caveat that changes to the PBM not affect the delivery of quality health care and access to the best medications.

Related to plan options and design, the HBAG is focusing on expanding the health plan options (noting that there was general satisfaction and little need to make changes to the dental plans) and increasing utilization or participation in specific provider networks. Questions that were raised by FRIC members included whether, in an unrestricted market, high income or healthy members would migrate to a low premium/higher deductible plan, or if there would be other market factors that would concentrate beneficiaries with high-cost health needs in certain pools eventually leading to a disproportionate rise in these groups’ premiums. It was also expressed that the low-cost plans need to maintain quality. Other ideas were to give members information and education regarding healthy behaviors and support and influence those healthy decisions with incentives. There was also a discussion on the necessity of the plans to support chronic care management.

The FRIC committee then summarized the discussion in the following recommendation that the Health Benefits Advisory Committee consider the following:

1. Add explicit language in the 7th guiding principle on “competitive benefits” that states support of recruitment/retention of faculty and staff

1. With a new plan and its subsequent design, consider these features
  1. Support of healthy behaviors through incentives
  2. Support of chronic care management
  3. Emphasis on education

Motion to approve recommendation by Chuck Wieland, second Dan Katz

Unanimous approval by the committee

Funded Retirement and Insurance Committee (FRIC) Meeting
November 2, 2018
302 USB

Introduction and roll of members: Steve Bernholz, Nancy Davin, Jon Garfinkel, Ben Rogers Dan Katz, Nicole Nisly, Teri Schnelle, Michael Schueller, Katherine Tachau, Julie Urmie, Anand Vijh, Chuck Wieland, Introduction and roll of administrative liaisons: Joni Troester, Rebecca Olson
Absent (members): Brian Kaskie, Sarah Tallman
Visitors: Megan Hammes, Richard Saunders, Julie Sexton, Jessica Wade, Kara Wright, Jill Valde, Cristobal McKinney, Lena Peterson
Approval of October 2018 minutes: Dan Katz motioned to approve meeting minutes. Second by Katherine Tachau. Unanimous approval by committee.

Dependent Eligibility Verification Audit: University Benefits shared the outcomes of the audit and planned campus community communication. University Benefits web page is updated with the outcomes of the project. https://hr.uiowa.edu/benefits/dependent-eligibility-verification

The future management process was shared by University Benefits including policy/procedures, and discussed by the committee. When dependents are added to the plan, they will have to be verified. This will occur internally by University Benefits staff. Data security/privacy is very important and is being taken into account, documents will only be held temporarily. Committee had discussion and believes that University Benefits has a defined an appropriate process.

Health Benefits Review: The Health Benefit Advisory Group continues work on review of the medical plan, dental plan and flexible credit system. Four members of the FRIC committee are also members of this broader advisory group. Full faculty/staff survey results were shared with the FRIC committee and discussed by the group. Preliminary recommendation themes under discussion by the Advisory Group were shared with the FRIC committee, these included opportunities for plan efficiency, multiple plan options vs single plan option and premium cost share between the Employer/Employee. Additional information will be discussed at the December 7^th FRIC meeting.

The meeting was adjourned at 1:00 p.m. Next meeting is on Friday, December 7, 2018.

Recorder: Ben Rogers, FRIC member

Funded Retirement and Insurance Committee (FRIC) Meeting
October 5, 2018
302 USB

Scheduled for November 1 – 16, 2018.

Updates on benefits available during the open enrollment process; changes effective January 1, 2019

- UIChoice premium increase at 2.5% across all status
- Dental II premium increase at 0% across all status
- Health care flexible spending account annual maximum raised to $2650
- Supplemental Life Insurance under the UI benefits plan is renamed to Voluntary Term Life insurance. Besides, now an employee must purchase this coverage for himself or herself before purchasing it for a dependent.
- Benefit confirmation process will be completely on-line
- Informational sessions held across campus to provide assistance; on-line sessions available for remote workforce

Dependent eligibility audit: UI Benefits recently completed a dependent eligibility verification audit through a contracted third-party vendor (HMS). An estimated 98% of employees have responded. For remaining employees who have not responded, unverified dependents will be dropped from the benefits plan effective January 1, 2019. These employees will be advised to send proof of dependent eligibility during the November open enrollment period to resume dependent coverage for 2019 or they may select COBRA coverage for dependents that are no longer covered starting January 1, 2019.

Health benefits review: The Health Benefit Advisory Group continues work on review of the medial plan, dental plan and flexible credit system. Four members of the FRIC committee are also members of this broader advisory group. Recent activities of the advisory group were the administration of a faculty/staff survey to benefit eligible employees (approx. 18000). Preliminary survey results were shared with the FRIC committee. The response rate was 37%. Overall respondents have a high level of satisfaction with both the UIChoice and Dental II plans. A full report will be provided at the November 2^nd meeting.

Investment review committee update: An institutional investment review committee was formed in spring 2018. FRIC member Jon Garfinkel sits on this committee and provided a brief update. The committee is currently drafting an investment policy statement and operational guidelines.

The meeting was adjourned at 1:00 p.m. Next meeting is on Friday, November 2, 2018.

Recorder: Anand M. Vijh, FRIC member

Funded Retirement and Insurance Committee Meeting
September 7, 2018
302 USB

Introductions and Roll of Members: Joni Troester, Rebecca Olson, Nancy Davin, Michael Schueller, Ben Rogers, Nicole Nisly, Dan Katz, Chuck Wieland, Brian Kaskie, John Garfinkel, Teri Schnelle, Julie Urmie, Steve Bernholtz

Introduction and Roll of Administrative Liaisons: Joni Troester, Rebecca Olson

Absent (Members): Katherine Tachau, Sarah Tallman, Anand Vijh

Visitors: Richard Saunders, Dianne Wasson, Cheryl Reardon, Jessica Wade, Megan Hammes , Kara Wright, Laurie Textor

Approval of May 2018 Minutes: Chuck Wieland made a motion to approve the minutes. Michael Schueller provided the 2^nd. The minutes from the May 2018 FRIC meeting were approved unanimously.

Dependent Eligibility Verification Audit: Audit progress has been positive with multiple communications to UI Choice contract holders covering dependents. Communication began in May and is planned through September As of 9/7/2018, 85% of contract holders with dependents had responded to the audit. The verification process closes on 9/10/2018 with a grace period offered through 9/28/18. At the close of the grace period, the vendor (HMS) will provide UI Benefits with a full report and outcomes.
Next steps and follow-up will be through UI Benefits. An update will be provided at the October FRIC meeting.

Motion to Adjourn.

FY18 Meeting Minutes

Funded Retirement and Insurance Committee

May 4, 2018 Meeting Minutes

Members Present: Nancy Davin, Jon Garfinkel, Daniel Katz, Nicole Nisly, Ben Rogers, Michael Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Chuck Wieland,

Members Absent: Katherine Tachau, Brian Kaske, Steve Bernholz, Teri Schnell

Administrative Liaison: Joni Troester, Rebecca Olson

Guests: Mike Brownlee, Lisa Mascardo, Richard Saunders, Dianne Wasson, Kara Wright, Jessica Wade

Introductions:

Completed for members and guests

Approval of April 2018 minutes:

Minutes were approved without change.

Specialty Drug Presentation
- Mike Brownlee and Lisa Mascardo from UIHC Pharmaceutical Care gave slide presentation on specialty drug management at UIHC.
- Committee discussed pros and cons of using UIHC as the required dispensing/coordinating provider for specialty drugs. Committee members were supportive of the switch with recognition of the need for plan member education and outreach during the transition period.
- Motion by Chuck Wieland (Nicole Nisly second) to use UIHC as the sole dispensing/coordinating provider of specialty drugs beginning in calendar year 2019. The motion passed unanimously.

Diabetes Pilot Update:
- Dianne Wasson gave an update and slide presentation on the AIM@Diabetes pilot. The pilot has 33 active participants with 107 invited to date. Early results are positive. Another update with more results will be presented in one year.

Dependent Verification Audit:
- Rebecca Olson reported that they have selected a vendor for the dependent verification audit. Initial communication with employees will go out Tuesday (May 8^th) with multiple ongoing contacts throughout the process. Suggestion to add non-majority examples to the communication (e.g. partners and adoptions).

UI Center for Advancement/UI HC –Follow-up discussion:
- UI Health Care IT was made aware of opt-out screen issue and has implemented a fix that currently is in beta testing.

Benefits Review:
- Joni Troester gave an update on the benefits review group and survey. The survey will be pilot tested this summer. Group is looking at benchmarks and will report to FRIC in Sept 2018. Will be future discussion about whether to offer an HMO medical plan in addition to the current PPO medical plan.

September FRIC Meetings:
- Discussion of need to have additional September 2018 meeting.
- Motion by Chuck Wieland (Nicole Nisly second) to have meetings on Sept 7 and Sept 14, 2018. Motion passed unanimously.

Meeting adjourned at 1:00. Meeting Minutes submitted by Julie Urmie

Funded Retirement and Insurance Committee

April 6^th, 2018 - Meeting Minutes

Members/Administrative Liaisons Present: Steve Bernholz, Nancy Davin, Jon Garfinkel, Brian Kaskie, Daniel Katz, Nicole Nisly, Ben Rogers, Teri Schnell, Michael Schueller, Sarah Tallman, Chuck Wieland, Joni Troester, Rebecca Olson

Guests: Megan Hammes, Richard Saunders, Jessica Wade, Dianne Wasson, Kara Wright, Laurie Trextor, Keri Samrau, Brenda Byrom

Members Absent: Katherine Tachau, Julie Urmie, Anand Vijh

Introductions:
- Completed for members and guests.

Approval of February and March 2018 minutes:
- Minutes were approved as presented.

PAC Update (Access and Appointments at UIHC) Presentation
- Access and Appointments at UIHC provided an update on their initial presentation, including information on access and efficiencies.
- Asked the group how to better inform new employees about MyChart (and its features). University Benefits will work to add MyChart information to new employee orientation.

UI Center for Advancement/UIHC – Follow-up
- Awaiting additional information from UIHC. Will discuss during next meeting in May if available.

Dependent Verification Audit
- Update shared: Selection of vendors is down to two possible vendors, both with experience in higher education.
- There will be a comprehensive communication plan to inform employees of the audit process. Communication will happen early and often.
- University Benefits will work with vendor to outline plan for maintaining verification in the future.

ACA Compliance/Flexible Credits
- After consulting with General Counsel and outside legal counsel a solution has been found. We will be in compliance if employees choose UI Choice or complete an attestation letter that they have minimal essential coverage elsewhere. This will be a part of open enrollment planning in the future.

Specialty Drugs
- There is a recommendation that UIHC pharmacy be the provider/ coordinator of specialty drugs. All drugs would be filled through UIHC (or coordinated through UIHC if necessary). Mail order would be available.
- Any change will be supported with a communication plan and assistance making transfers to UIHC pharmacy.
- There will be no increases in costs for members.
- UIHC staff will attend the next FRIC meeting to provide more information. FRIC members should send any questions they have in advance for Joni to share with the UIHC staff.

Benefits Review
- Update on the faculty/staff survey. Survey will be administered in fall 2018, which still allows for 2020 calendar changes.
Quarterly Metrics
- Quarterly metrics were shared.
- The committee discussed uptick in use in 4^th quarter (which coincides with the end of year use), and increased education for members to use services all year long versus waiting for the end of the year.
- May 2018 metrics will include the new merit population.

New Business
- Diabetes Pilot Update: Will be discussed during May meeting
- ACO Progress Update: Will be discussed during May meeting

Old Business
- TIAA Retirement Plan: Continued discussion to occur in Fall 2018.

Meeting adjourned @1:00 p.m.

FRIC MEETING Minutes

March 2, 2018

Members Present: Steve Bernholz, Nancy Davin, Daniel Katz, Nicole Nisly, Ben Rogers, Teri Schnell, Michael Schueller, Sarah Tallman, Julie Urmie, Anand Vijh, Chuck Wieland

Members Absent: Jon Garfinkel, Brian Kaskie, Katherine Tachau

Administrative Liaison: Joni Troester, Rebecca Olson

Guests: Richard Saunders, Julie Sexton, Jessica Wade, Kara Wright, Jill Valde, Cheryl Reardon

Motion to adjourn and approved at 12:59PM

Meeting Minutes submitted by Ben Rogers

FRIC MEETING Minutes

February 2, 2018

Members/Administrative liaisons present: Anand Vijh, Brian Kaskie, Nicole Nisly, Katherine Tachau, Dan Katz, Ben Rogers, Chuck Wieland, Nancy Davin, Steve Bernholtz, Teri Schnell, Sarah Tallman, Julie Urmie, Rebecca Olson, Joni Troester

Members Absent: Jon Garfinkel, Michael Schueller

Guests: Megan Hammes, Susan Klatt, Richard Saunders, Dianne Wasson, Jessica Wade, Kara Wright, Cheryl Reardon, Joe Clamon, Lynette Marshall, Sheila Baldwin, Laurie Textor

INTRODUCTIONS

Completed for members and guests.

APPROVAL OF DECEMBER 2017 MEETING MINUTES

Meeting minutes were approved as presented. (Motion by K. Tachau, second B. Rogers)

UI Center for Advancement/UI Health Care

Philanthropy discussion: Lynette Marshall and Sheila Baldwin (UI Center for Advancement) along with Joe Clamon (UIHC General Counsel) presented regarding philanthropic efforts directed at UI employees as it relates to University of Iowa Health Care. They described how philanthropy plays a role in keeping healthcare at the University of Iowa affordable for all regardless of their ability to pay.

The goal of this philanthropy is to reach out to patients and alumni in an effective, passionate, sensitive form of fundraising. They differentiate between reaching out to patients in their approach compared to reaching out to alumni.

This approach meets legal requirements as it relates to HIPAA and exceeds the requirement of the law in protecting confidentiality. Their informal rule is "would I be comfortable if someone approached my parents or my family in this way."

Every patient has the option to opt out of being contacted regarding this philanthropic effort at the time of registration when signing the Privacy Practice Notice. Opt out can also occur at any time through the use of a function on My Chart.

Several questions came up from the floor regarding the visibility of the opt out for fundraising and where is it was located. A screenshot was used to provide a visual.

FRIC committee members tabled further discussion on this agenda item for the March 2018 meeting.

Open Enrollment Summary

Discussion of summary documents located in member notebook. Overall a very positive outcome related to open enrollment and merit staff transition to self-funded insurance plans.

There was a question from the floor about a $200 credit to decline health insurance. This was removed due to ACA regulations which would require the amount be counted towards the affordability calculation of the plan.

Dependent Verification Audit

An audit of University Benefit operations was conducted by Internal Audit in Summer 2017. As a result, University Benefits is conducting a dependent verification audit of plan members/dependents. A third party vendor will be chosen via RFQ process. Updates to FRIC will be provided at future meetings. It is anticipated the vendor will be chosen this spring with the audit complete by end of August 2018.

Health Benefits Review

The draft faculty/staff survey to be used as part of the Health Benefit Review process was distributed for review, discussion and recommended revisions. A small work group made of FRIC members (Julie Urmie, Nicole Nisly, Nancy Davin) worked with University Benefits staff in developing the initial draft. Suggestions for change included feedback on specific questions, literacy level, a Spanish speaking version and the importance of computer access for employees to complete the survey. An update draft will be shared with FRIC at a subsequent meeting.

Meeting Adjourn at 1:00 p.m.

Motion - C. Wieland

Second - K. Tachau

Motion approved

Minute Taker – Nicole Nisly

FRIC MEETING Minutes

December 1, 2017

Members/Administrative liaisons present: Anand Vijh, Jon Garfinkel, Nicole Nisly, Katherine Tachau, Dan Katz, Ben Rogers, Nancy Davin, Steve Bernholtz, Mike Schueller, Julie Urmie, Sarah Tallman, Rebecca Olson, Joni Troester

Guests: Megan Hammes, Richard Saunders, Susan Klatt, Jessica Wade, Kara Wright, Cheryl Reardon, Julie Sexton

Members Absent: Brian Kaskie, Teri Schnelle, Chuck Wieland

Introductions:

Completed for members/new members and guests.

Approval of November 2017 minutes:

Minutes were approved with the following edits. Joni will replace “Fund” with “Fund Families” in # 4. In # 5 - FRIC sub-committee will form to help create the survey that will be sent to faculty and staff for feedback in early 2018.

Open Enrollment Update:

Rebecca Olson provided a summary. Kudos and thank you to the Benefits Staff, HR Reps & IMHR who helped with this initiative. 99.5% signed up with only 24 who did not complete the open enrollment. Follow-up with these staff is in progress so we can get to 100%.

There was some discussion about feedback from merit staff during the process. No feedback was provided to the FRIC. Joni explained that we will see more data at the February meeting as they plan to map the changes from 2017 to 2018 and determine the impact of this change on merit staff.

UI Center for Advancement communication:

We discussed the 11/15/17 email communication sent by Sean Matthys, Director of Development – Health Care Philanthropy. Some history was shared with October 2012 FRIC minutes when UIHC & the University of Iowa Foundation sent a similar email soliciting donations from patients.

There were many opinions expressed. We will ask the Center for Advancement and UIHC representatives to attend the February meeting where we can ask questions and share concerns.

Is it legal to send this type of communication to patients?
Ethical concerns
Process of identification
Impact on care
Targeted email

Joni reminded us that FRIC is an advisory committee and can recommend course of action only.

TIAA Retirement Plan:

Discussed the current fee structure. The consensus was that the head count fee should not be on the table for consideration.

During an upcoming meeting, we will see more data on TIAA participation and the impact of fees. The most recent UI payroll indicates there are approximately 17,000 active employees contributing to TIAA accounts. The group agreed to continue discussion at future meetings.

Quarterly Metrics: Olson

In 2018, the quarterly metrics dashboard will begin to include the 10,000 additional covered lives as a result of the merit population being covered under the UI Choice plan. Results will be available in May 2018. We discussed separating the pharmaceutical expense in the “Cost of Care” section.

Benefits Review:

FRIC subcommittee will form to advise Joni and Rebecca on the survey that will go out to benefit eligible faculty/staff requesting feedback on health benefits. Drafting of the survey will occur in Dec – Jan timeframe with survey to campus during Spring 2018 semester. We need volunteers from FRIC for the subcommittee. Nicole Nisly, Nancy Davin and Julie Urmie volunteered to fill this role. A draft survey will be discussed at the February 2018 meeting.

The staff representatives on the Campus Advisory Committee will attend the December Staff Council meeting where an overview of the Health Benefits Review will be provided.

Information is posted on the Benefits website at https://hr.uiowa.edu/health-benefits-review

Feedback regarding the review may be sent to the following email hr-benefits-review@uiowa.edu

Meeting adjourned @1:00 p.m.

FRIC MEETING Minutes

November 3, 2017

Members/Administrative liaisons present: Anand Vijh, Jon Garfinkel, Nicole Nisly, Katherine Tachau, Dan Katz, Ben Rogers, Chuck Wieland, Nancy Davin, Steve Bernholtz, Mike Schueller, Julie Urmie, Rebecca Olson, Joni Troester

Guests: Megan Hammes, Richard Saunders, Susan Klatt, Jessica Wade, Dianne Wasson, Kara Wright, Cheryl Reardon, Brock Noel (TIAA), Katie Skorupski (TIAA)

Members Absent: Brian Kaskie, Steve Palmersheim, Sarah Tallman

Introductions: Completed for members/new members and guests.

The October 2017 minutes were approved.

An Update on the Open Enrollment Process and the transition of UI merit staff to UI health care plans was given by Rebecca Olson: an extensive, successful and ongoing effort has been made to educate and enroll the merit staff prior to the November 17 deadline. The majority of potential candidates have participated. The effort has involved University wide meetings, web based efforts and mailings (55 informational meetings, 4 online sessions, 24 computer lab sessions for online enrollment, 12 dedicated office hours). People who do not enroll by the deadline will still be able to enroll through December 5^th.

Continuation of Fee Leveling Discussion:
A presentation was given by Brock Noel from TIAA about the fee leveling proposal. By way of background, TIAA has had an 8 bps revenue requirement to satisfy the Recordkeeping Services Agreement. This fee is separate and in addition to any fund management expenses. As of January 1, 2018, the revenue requirement will be reduced to 6 bps. In conjunction with this adjustment, a proposal has been made to evenly distribute this fee across all TIAA-CREF asset classes. Currently the fee is applied to holdings among TIAA and CREF Annuities and some of the non-proprietary mutual funds. The fee applied to these fund classes ranges from 1 to 25 bps. TIAA-CREF Active Mutual Funds, Active Funds, Lifecycle Funds and some of the non-proprietary mutual fund families are currently charged no fee toward the Recordkeeping Services Agreement. Fee leveling proposes to apply an even 6 bps to all assets. About thirty percent of participants would be affected by a fee increase (up to $60 per $100,000 of holdings) and about 60% of participants would see a fee decrease of between $115 and $140 per $100,000. Non-proprietary fund families that would be affected by a fee increase include American Funds, Oppenheimer, PIMCO, Royce, and Vanguard. Other non-proprietary funds would experience a fee decrease.

Discussion followed the presentation. A point that was raised was that there is a trend toward greater participation in the Active Mutual Funds and Lifecycle Funds (assets that currently do not participate in the service management fee), which over time could decrease the revenue available to administer fund management.

The group agreed to continue discussion at future meetings.

Update on Benefits Review Process:
Two additional members have been included in the University wide Benefits Advisory Group. Advisory Group meetings will begin December 12^th. FRIC subcommittee will form to advise on the development of a faculty/staff survey.

Meeting adjourned 1:00 p.m.

FRIC MEETING Minutes
October 6, 2017

Members/Administrative liaisons present: Anand Vijh, Brian Kaskie, Jon Garfinkel, Nicole Nisly, Katherine Tachau, Dan Katz, Ben Rogers, Chuck Wieland, Nancy Davin, Steve Bernholtz, Mike Schueller, Sarah Tallman, Julie Urmie, Rebecca Olson, Joni Troester

Members Absent: Steve Palmersheim

Guests: Susan Klatt, Jessica Wade, Dianne Wasson, Kara Wright, Cheryl Reardon

INTRODUCTIONS

Completed for members and guests.

APPROVAL OF SEPTEMBER 1, 2017 MEETING MINUTES

Meeting minutes were approved as presented.

MERIT OPEN ENROLLMENT

The open enrollment period of current merit staff started September 29^th and runs through November 17, 2017. There will be over 45 educational sessions on the enrollment process for merit staff. There will be an addition of approximately 4,200 contracts and 10,000 covered lives. There are 21 computer labs to help those who don’t have direct access to a computer. As time draws down near the end of the selection time, those who still haven’t selected their new plan will be notified.

TIAA RETIREMENT PLAN

BENEFIT REVIEW

During the November 3rd meeting, the group will be discussing a new benefit review process that will begin late fall. With changing legislation and the addition of merit staff to the self-funded plans, it is an opportunity to review the plan design and ensure the needs of faculty and staff are met along with those of the organization.

Meetings adjourned at 13:01

Note taker: Steve Bernholtz

FRIC MEETING Minutes
September 1, 2017

Members/Administrative liaisons: Anand Vijh, Brian Kaskie, Jon Garfinkel, Nicole Nisly, Katherine Tachau, Dan Katz, Ben Rogers, Steve Palmersheim, Chuck Wieland, Nancy Davin, Steve Bernholtz, Mike Schueller, Sarah Tallman, Julie Urmie, Rebecca Olson, Joni Troester

Guests: Megan Hammes, Suzanne Hilleman, Richard Saunders, Susan Klatt, Jessica Wade, Dianne Wasson, Kara Wright, Cheryl Reardon

INTRODUCTIONS

Completed for members/new members and guests.

REVIEW OF COMMITTEE CHARGE/ATTENDANCE GUIDELINES

Co-chairs Garfinkel and Davin reviewed the Guiding Principles for the purpose and function of the committee. They also discussed attendance guidelines for the entire committee and stressed the importance of consistent attendance at each of the eight scheduled meetings in the academic year.

FRIC is an advisory committee to the President of the University and his cabinet. FRIC also has an exception for membership guidelines because of need for institutional knowledge on the committee. Thus, it is important to consistently attend each of the meetings. Attendance guidelines/thresholds were provided to the members. Some discussion ensued regarding these attendance thresholds and the wording of how/when a member could be removed based on lack of attendance. After some minor wordsmithing of the guidelines, Brian Kaskie made motion to accept the guidelines with suggested edits. The motion was seconded by Dan Katz and carried in the affirmative by unanimous vote.

Edited Guidelines are as follows:

If a member of the Funded Retirement and Insurance Committee (FRIC) misses three (3) meetings in a given academic year, the committee chairs and the member will jointly reassess the member’s ability to attend and participate in an effective manner. In consultation with the President of the relevant shared governance body (Faculty Senate or Staff Council), committee will move to consider member removal. Extenuating circumstances such as main-job requirements shall be considered.

APPROVAL OF MAY 2017 MEETING MINUTES

Katherine Tachau suggested minor changes to the minutes from the May 5, 2017 meeting. Chuck Wieland made motion to accept the minutes with suggested edits. Brian Kaskie seconded the motion which was then approved unanimously.

MERIT TRANSITION UPDATE

Joni Troester provided an update on the transition of UI merit staff to UI health care plans based on outcomes from Chapter 20 changes approved by the state legislature during the 2017 legislative session. An open enrollment process will take place this fall for merit staff. The open enrollment period of current merit staff will be September 29^th through November 17, 2017. There will be educational sessions on the enrollment process for merit staff. There will be an addition of approximately 4,200 contracts and 10,000 covered lives. Data analysis focused on the demographics of the new population added to the plans indicate some additional increase in plan costs.

Currently, discussions are in process of how merit staff will be represented through shared governance including membership on FRIC.

OPEN ENROLLMENT NOTES CY2018

Office co-pays are the primary change for each enrollment category. Level 1 co-pays will increase from $5.00 to $10.00 per visit. Level 2 co-pays will increase from $20.00 to $25.00 per visit. Level 3 coinsurance will increase from 40% to 50%.
Emergency Room copays will increase from $50.00 to $100.00.
Level 1 providers update: McFarland Clinic and Iowa Clinic PC (Des Moines area) will no longer be Level 1 providers as of January 1, 2018.
Quick Care visit co-pays will remain at $5.00 per visit.
Flexible spending account limit is increased from $2,550.00 to $2,600.00.

CY2018 PREMIUM RATES

Dental: Based on the rating experience period and information shared by Delta Dental regarding estimated dental trends, recommendation is 0% increase in Dental II rates across all four family status for CY2018.

Motion to approve rates as recommended was made by Brian Kaskie, seconded by Katharine Tachau and approved unanimously by the committee.

Health: Based on the rating experience period, inclusion of merit staff into the UI Choice health plan and estimated health trends, recommendation is a 5% increase in UI Choice rates across all four family status for CY2018.

Projected rates/factors/supporting information

Wellmark data indicates integrating merit will require increase as there will be additional cost trend based on the assessment of the population demographics
The national trend increase is 6-7%.
Requirement to cover costs of health care provided by UI self-funded plan
Proposed 5% increase in premiums for each family status (still keeps UI increase 1 – 2% below the national average increase).
Consideration for impact on merit staff as they experience a substantial increase in health insurance premiums relative to their previous plans. Substantial messaging will be coming from University Benefits to merit staff to assist with the change.

Motion to approve new premium rates for CY2018 as presented made by Mike Schueller, seconded by Nicole Nisley. Vote was 12/2, yea/nea.

BENEFITS AUDITS

Current UI practice requires no documentation to add or change covered lives during open enrollment periods or with change of status in insurance coverage. Based on Internal Audit review, UI Benefits will conduct a dependent audit verification. UI Benefits will proceed with selection of a third party vendor to conduct the audit. A discussion of issues related to privacy followed the introduction of this topic.

NEW BUSINESS

Motion to cancel FRIC meeting scheduled for September 8, 2017 was made by Chuck Wieland, seconded by Steve Bernholtz and unanimously approved by the committee. No need for this meeting given approval of CY2018 premium rates by the committee at current meet

FY17 Meeting Minutes

Funded Retirement and Insurance Committee (FRIC) Minutes from May 5, 2017

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

Members present: Steve Bernholz, Nancy Davin, Nicholas Fransisco, Jon Garfinkel, Brian Kaskie, Daniel Katz, Nicole Nisly, Michael Schueller, Bernard Sorofman, Anand Vijh, Chuck Wieland

Administrative officers present: Joni Troester, Rebecca Olson

Members absent: Mary Greer, Steven Palmersheim

Guests present: Megan Hammes, Suzanne Hilleman, Richard Saunders, Julie Sexton, Jessica Wade

Recorder: Anand M. Vijh

The University of Iowa Funded Retirement and Insurance Committee

4/7/2017 Meeting Minutes

Started: 11:30 am

Members Present: Steve Bernholtz, Brian Kaskie, Michael Schueller, Bernard Sorofman, Chuck Wieland, Nicholas Francisco, Nancy Davin, , Dan Katz, Anand Vijh, Nicole Nisly

Members Absent: Jon Garfinkel, Katherine Tachau, Mary Greer, Steve Palmersheim
Administration: Joni Troester, Rebecca Olson
Guests: Megan Hammes, Richard Saunders, Jessica Wade, Julie Sexton, Kara Wright, Dr. Brad Archer, Suzanne Hilleman

Introductions were given.
The minutes of the March 3, 2017 meeting were unanimously approved.
There are no new updates about the ACA. The UI will continue to monitor proposed changes and provide regular updates.
TIAA Fund Lineup Updates

On 03/31/2017, the TIAA CREF SP500 fund was eliminated from our fund lineup and participant funds transferred to the Vanguard Mutual Fund. Communications were sent to plan participants prior to the fund change.

The CREF Money Market fee waiver will be eliminated on April 14, 2017. An alternative to the CREF Money Market, the TIAA-CREF Money Market fund, was added on October 31, 2016 and at that time, future CREF contributions were redirected to the new fund. Those who have accumulations in the CREF Money Market fund may wish to consider moving them to another fund or start paying that fee. Communications were sent to plan participants with CREF Money Market fund accumulations.

Plan Design for FY2018

Committee discussion focused on plan design changes related to Level 1, 2 and 3 office visit co-pays/co-insurance and emergency room co-pay for CY2018. The initial philosophy was reviewed related to incenting use of Level 1 providers. Additionally, data from WellMark was shared regarding practices across their book of business related to cost sharing for office visits and emergency room care.

For Office Visit Co-Pays for CY2018 the motion was made by Chuck Wieland/second by Nicole Nisly to increase Office Visit Co-pays to the following.
Level 1 - $10
Level 2 - $25
Level 3 – 50% coinsurance
Motion approved 9 (in favor) and 1 (opposed).

For Emergency Room Visit Co-Pay for 2018 the motion was made by Chuck Wieland/second by Nicole Nisly to increase ER visit co-pay to $100 per visit. Motion approved 7 (in favor) and 3 (opposed).

Health Insurance Metrics: UI CHOICE

Metrics were reviewed with the group. CY2017 Q1 metrics will be available at the May meeting

Adjourned just before 1:00 pm.

Recorder: Steve Bernholtz

The University of Iowa Funded Retirement and Insurance Committee

3/3/2017 Meeting Minutes

Started: 11:30 am

Members Present: Steve Bernholtz, Brian Kaskie, Michael Schueller, Bernard Sorofman, Chuck Wieland, Nicholas Francisco, Nancy Davin, Mary Greer, Steve Palmersheim.

Members Absent: Jon Garfinkel, Daniel Katz, Anand Vijh, Katherine Tachau, Nicole Nisly.

Administration: Joni Troester, Rebecca Olson

Guests: Megan Hammes, Jeri King, Richard Saunders, Jessica Wade, Dianne Wasson, Kara Wright, Dr. Brad Archer

Recorder: Nicholas Francisco

The University of Iowa Funded Retirement and Insurance Committee

2/3/2017 Meeting Minutes

Started: 11:30 am

Members Present: Steve Bernholtz, Jon Garfinkel, Brian Kaskie, Daniel Katz, Michael Schueller, Bernard Sorofman, Anand Vijh, Chuck Wieland, Nicholas Fransisco

Members Absent: Katherine Tachau, Nicole Nisly, Nancy Davin, Mary Greer, Steve Palmersheim

Administration: Joni Troester, Rebecca Olson

Guests: Megan Hammes, Suzanne Hilleman, Richard Saunders, Jessica Wade, Dianne Wasson, Kara Wright, Cheryl Reardon, Frank Mitros

Introductions were given beginning with Jon Garfinkel who chaired the meeting.
The minutes of the December 2, 2016 meeting were unanimously approved.
An update on the Affordable Care Act and potential impacts to our benefits program was given by Ms. Olson. With the change in Federal administration, revisions to ACA are anticipated. The ACA Executive Order of Jan 20, 2017 was briefly discussed. The EO instructs federal agencies to exercise authority and discretion to waive, defer, grant exemptions from or delay implementation of the ACA provisions that impose fiscal or regulatory burdens on States or individuals, or various components of the medical-insurance-industrial complex. Members have expressed interest that popular ACA provisions such as the extension of dependency to age 26 be continued. Major changes to the UI self-funded health plan are unlikely to be experienced by repeal or revision of ACA. ACA update will be a standing agenda item for the spring meetings.
UI Health Care Accountable Care Organization (ACO)
Key concept:Accountable Care Organization (ACO) is a local health care organization that assumes accountability for the quality and cost of care delivered to a defined population.This creates a financial incentive to control cost and provide quality health care services to the covered population.Intended as a “win win” concept for employers and providers.

University of Iowa is in a unique position in terms of the being both an employer and a provider organization that has an ACO. UI does want the benefit of population health management and accountability for quality/cost delivered to our health plan members as available through the UI Health Care ACO.

In this type of arrangement, UI and UI Health Care are looking at the option of an Internal ACO agreement regarding any savings that would occur in CY2017 because of improved population health management of the UI attributed members to the UI Health Care ACO.

Targets for quality and cost management for CY2017 are established by WellMark using historical UI data with inflation factored in. Shared savings for CY2017 will be calculated by WellMark and information available in July 2018.

UI and UI HC would enter into an agreement to distribute any shared savings for CY2017 with UI retaining 70% of the savings and UI HC receiving 30% of shared savings.

A motion was made by Jon Garfinkel to support the shared savings agreement between UI and UI HC for one year (CY2017) and require a presentation at the March 2017 FRIC meeting on UI HC plans. This motion was seconded by Chuck Wieland. The vote was as follows: eight in favor, zero opposed and one abstain. Motion carried.

The group then continued the discussion from the November meeting on Level One Providers. The key question posed was whether level one coverage should be continued for care provided under all of the UI Health Alliance members. In support of continuing level one coverage to the entire Alliance was the possibility that beneficiaries outside of the Iowa City area might be harmed by restricting level one coverage just to the Iowa City area UIHC. Additional information on the financial ramifications of restricting level one within the Alliance was requested and the group agreed to continue discussion on this topic at a later meeting.
Adjourned 1:00 pm.

Funded Retirement and Insurance Committee (FRIC) Minutes from December 2, 2016

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

Members present: Steve Bernholtz, Nancy Davin, Nicholas Fransisco, Jon Garfinkel, Brian Kaskie, Daniel Katz, Nicole Nisly, Michael Schueller, Bernard Sorofman, Anand Vijh, Chuck Wieland

Administration present: Joni Troester, Rebecca Olson

Members absent: Mary Greer, Steven Palmersheim, Katherine Tachau

Guests present: Brad Archer, Megan Hammes, Suzanne Hilleman, Richard Saunders, Julie Sexton, Jessica Wade, Kara Wright, Pat Brophy, Pamela Villacorta, Cheryl Reardon

Jon Garfinkel and Nancy Davin co-chaired the committee.
Committee members, administration representatives, and guests introduced themselves.
The minutes of meeting from November 4, 2016, were approved unanimously.
The first agenda item for the day was a presentation on UIeCare by Dr. Patrick Brophy from the University of Iowa Hospitals and Clinics (UIHC). eCare is one of the emerging trends in healthcare across the country. UIHC began offering service through UIeCare in Fall 2015. UIeCare is available at present to all UI Choice plan participants as a no cost option.

The following is the UIeCare website and provides an overview of how the service works and is delivered to patients. https://uiecare.com/#/home. UIeCare provides an easily accessible, lower cost option for some routine medical issues and is a means of cost management for the health plan. At present, UIeCare can be delivered in 17 states.

In early 2017, there will be an email communication to all UI Choice participants informing them about the capabilities and availability of UIeCare. The committee very much appreciated the information provided by Dr. Brophy.

With a new administration taking office in January 2017, there are anticipated changes that may occur related to the Affordable Care Act. University Benefits will continue to monitor the situation and provide an update at subsequent meetings as more information becomes available. Current requirements remain in effect. 2016 employer reporting will occur in early 2017 as planned.
A sample quarterly health plan dashboard was distributed and reviewed by the committee. Additional information was requested regarding definitions for specific categories and a separation of ER visit costs from Outpatient Cost and Utilization. Additional information will be shared at upcoming meetings.
Proposed changes to the UI Choice health plan for CY2018 were reviewed and discussed that include changes to the co-pay and co-insurance structure. Further discussion will occur at subsequent meetings in 2017. These proposed changes parallel those already implemented or proposed by other healthcare plans in the region as identified by the WellMark book of business.
In 2017, the committee will continue to review data and discuss UI Choice health plan design changes for CY2018.
The next committee meeting will be held on February 3, 2017. The current meeting adjourned around 1 p.m.

Minutes recorder: Anand M. Vijh

The University of Iowa Funded Retirement and Insurance Committee

11/4/2016 Meeting Minutes

Started: 11:32 am

Members Present: Steve Bernholtz, Nancy Davin, Jon Garinkel, Mary Greer,, Daniel Katz, Steve Palmersheim, Michael Schueller, Bernard Sorofman, Chuck Wieland

Members Absent: Katherine Tachau, Nicole Nisly, Nicholas Fransisco, Anand Vijh

Administration: Joni Troester, Rebecca Olson

Guests: Brad Archer, Dan Fick, Suzanne Hilleman, Richard Saunders, Jessica Wade, Dianne Wasson, Kara Wright, Cheryl Reardon, Todd Patterson, Keri Semarau

Introductions were given.
Minutes. Motion to approve the October 7, 2016 minutes by Chuck Wieland and second by Michael Schueller. Motion carried unanimously and minutes approved.
Presentation: UIHC Access and Capacity – Todd Patterson/Keri Semarau. The initial discussion centered on the Patient Appointment Center, UI-PAC. PAC staff can receive their work through incoming calls, EPIC, and MyChart. Most departments and clinics at UI HC are a part of the system as to enhance scheduling. It is patient focused and provider friendly with improvements seen in call wait time, abandonment rate of calls and most important the ability to conveniently schedule appointments. An annual update will be provided on this issue going forward.
Health Insurance Metrics: UI CHOICE - Troester. Initial metrics were shared with the committee related to risk scores of the overall UI Choice population. Additional information and discussion to occur at the December meeting.
Level One Providers: UI CHOICE - Troester. UI Choice has three levels; each level having different provider groups and subsequent co-payments, co-insurance etc. for services provided. The committee will continue review of levels and determine if any changes will be recommended for CY2018 in the payment structures for the levels. Additional data from WellMark will be available for the December meeting for review and continued discussion.
Adjourned.

The University of Iowa Funded Retirement and Insurance Committee

10/7/2016 Meeting Minutes

Started: 11:32 am

Members Present: Steve Bernholtz, Nancy Davin, Nicholas Fransisco, Jon Garinkle, Mary Greer, Brian Kaskie, Daniel Katz, Nicole Nisly, Steve Palmersheim, Michael Schueller, Bernard, Sorofman, Anand Vijh, Chuck Wieland

Members Absent: Katherine Tachau

Administration: Joni Troester, Rebecca Olson

Guests: Bruce Harreld, Suzanne Hilleman, Richard Saunders, Julie Sexton, Jessica Wade

Recommendation for new business: Place on a future agenda a discussion of the number of family status categories (currently single, employee/spouse, employee/child, family) and whether we could have fewer groupings (such as single and family). This will be a substantial discussion that may take two or more years.

Adjourned: 12:57 pm

September 2, 2016

Members Present: Steve Bernholtz, Nancy Davin, Nicholas Fransisco, Jon Garfinkel, Mary Greer, Brian Kaskie, Dan Katz, Nicole Nisly, Steven Palmersheim, Michael Schueller, Bernard Sorofman, Katherine Tachau, Anand Vijh, Chuck Wieland
Administration: Rebecca Olson, Joni Troester
Guests: Brad Archer, Terri Hein, Suzanne Hilleman, Richard Saunders, Kevin Ward, Dianne Wasson

September 9, 2016

Members Present: Steve Bernholtz, Nancy Davin, Nicholas Fransisco, Jon Garfinkel, Dan Katz, Nicole Nisly, Steven Palmersheim, Michael Schueller, Bernard Sorofman, , Anand Vijh, Chuck Wieland
Members Absent: Mary Greer, Brian Kaskie, Katherine Tachau
Administration: Rebecca Olson, Joni Troester
Guests: Suzanne Hilleman, Julie Sexton, Richard Saunders

September 2nd Meeting

Minutes from the May 2016 meeting were reviewed and approved by the Committee.

A preliminary review of the Fall 2016 FRIC meeting schedule was presented by Jon Garfinkel. He reminded the Committee of the additional September meeting scheduled for September 9, 2016 to allow for complete discussion of the health and dental care premium rates for CY2017. He also reminded the Committee that President Harreld would be attending the October 2017 FRIC meeting.

Transgender care coverage under the UI Choice plan was approved and became part of the plan on September 1, 2016. This addition to the health care plan will be highlighted during the open enrollment period for CY2017.

Specific provisions of the Affordable Care Act (ACA) will have an impact on the UI CHOICE health plan in CY2017. The most significant impact will be on the $200/month “stay away” credit to members choosing to not take health care benefits through the University plans. Given ACA proposed regulations, this credit will not be offered in CY2017 to faculty and non-organized professional and staff members. Approximately 350 faculty/staff currently have chosen this option. Communication regarding this issue will occur during open enrollment. Follow-up information will be provided to FRIC after open enrollment.

Effective January 1, 2017, visits to UI Quick Care by a UI CHOICE covered members will be billed as a Level One provider under the UI CHOICE plan requiring a $5.00 co-pay at the time of visit. This change will improve the administration of the plan for UI. Bernard Sorofman requested that the Committee be provided with more data regarding how much Quick Care has benefited the UI health care plans.

University Benefits is initiating a change in the investment fund line-up available through TIAA due to the U.S. Department of Labor issuing new regulations covering fiduciary responsibilities for plan sponsors. In an effort to meet fiduciary responsibilities TIAA is recommending that the UI make available a new money market fund – TIAA CREF Money Market Mutual Fund – as an alternative to the CREF Money Market Account. The CREF Money Market Account expense waiver ends by April 14, 2017; those individuals with assets in this account may experience negative yields if interest rates remain low. There are approximately 4,100 members in the current CREF Money Market Account. Communication will occur to these members encouraging them to take action and voluntarily move assets to the TIAA Money Market Mutual Fund. The UI will also participate in re-direction of funds from the CREF MM Account to the TIAA CREF MM Fund. The redirection applies to current employees (only) making contributions and will not apply to future employees after the date of redirection.

A second TIAA recommendation for UI to meet fiduciary responsibilities is to eliminate a fund from the line-up. Currently UI has two funds; TIAA CREF SP500 Mutual Fund and Vanguard Mutual Fund that are identical in terms of the type of product. However, the TIAA fees are .06% and Vanguard fees are at .04%. UI has approximately 1800 individuals in the TIAA fund. Given the type of fund, UI can institutionally map the member assets from the TIAA fund to the Vanguard fund. Once done, the TIAA fund will be eliminated from the fund line-up. Communication with impacted members will occur in winter 2017 followed by appropriate action with TIAA to move assets and eliminate the identified fund.

This action is intended to reduce the fees of those individuals with assets in the TIAA fund. Katherine Tachau asked that educational materials be included in communications to members regarding why these changes in funds were happening and the cost savings they would provide to members.

Prior to group discussion on premium rates, Jon Garfinkel reminded group members regarding the advisory role of the committee.

Dental II premium rates for CY2017

The committee reviewed information regarding Dental II monthly premium rates for CY2017. Discussion included information provided by Delta Dental as well as claims history for the rating period. Katherine Tachau made a motion to accept the recommended premium rate increases for CY2017 as presented to the committee. Mary Greer seconded the motion. The Committee unanimously approved the motion.

UI Choice premium rates for CY2017

A comparative table of health care premiums for CY2016 and the proposed premiums for CY2017 were presented by UI Benefits staff. A discussion of the proposed increases ensued. After some discussion of the health care premium proposal on 9/2/2016 the meeting was adjourned at 1:00 P.M. with the intention of closing the discussion on 9/9/2016.

September 9th Meeting

The Committee re-convened on 9/9/2016 and continued the discussion of the proposed monthly premium increases for UI Choice for CY2017. A motion was made by Chuck Wieland to recommend to the University of Iowa administration that the premium rates as presented by the UI Benefits Office be accepted as the designated rates for CY2017. The motion gained a second from Nicole Nisley. The motion was passed unanimously by the Committee.

The 9/9/2016 meeting concluded with discussions of various topics that could/should be added to future FRIC meeting agendas. Issues such as specialty drugs, informational resources on the benefits provided under all levels of UI Choice, online resources and more data on the use of the UI plans were put forth as future agenda topics.

The meeting was adjourned at approximately 12:30 P.M.

Note taker: Michael Schueller

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