Thursday, January 13, 2011

PEBP modestly scales back CDHP proposal

Sondra Cosgrove reports from today's PEBP Board meeting

The PEBP Board met this evening and took the following actions: Due to lower than expected utilization in the current plan year there is an expected surplus of about $35 million. In light of this extra money the Board voted to add the dental benefits back in line with their recommendations made at the December meeting. Below is the language from tonight’s PEBP Board agenda with Board actions in bold.

V. Discussion and possible action regarding changes to the following benefits pursuant to the priorities set by the Board in Agenda Item X of the December 2, 2010 Board Meeting:

A. Increase HSA/HRA contributions for PPO participants from $600 to $700 Approved

B. Restore dental benefits with the following changes:

1. Increase the dental deductible from $50 to $100 for individuals and $150 to $300 for families Approved

2. Decrease the maximum dental benefit paid by the plan from $1,500 to $1,000 per individual Approved

3. Decrease the number of prophylaxis and periodontal cleanings from 4 per year to 2 per year No action taken so 4 cleanings per year remains. There was a discussion that reducing the cleanings to 2 per year saved a miniscule amount of money, while four cleanings could improve dental and with it overall health.

4. Change the coinsurance to 75% for any dental procedure that is currently paid at an 80% coinsurance level Approved

C. Reduce the in-network deductible:

1. Participant Only coverage tier: from $2,000 to $1,900 deductible Approved

2. Participant plus dependent tiers:

a. $2,400 individual family member deductible (remains the same) Approved

b. From $4,000 to $3,800 family deductible Approved

D. Set out-of-network deductibles equal to in-network deductibles Approved

E. Retain current out-of-network out-of-pocket maximum amounts Approved

At the Board of Examiners meeting the Board approved the contract of the company that will facilitate moving Medicare eligible employees over to the Medicare exchange program.

The PEBP Board will meet again on February 24th to set [premium] rates.

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