10/1/2012 Benefit Committee Meeting
May 18, 2012
Table of Contents
Section 1:
SISC Renewal Summary
Section 2:
Financial Summary – Medical Only
Section 3:
SISC Blue Shield HMO & PPO Medical Renewal
- Current & Renewal Plans
- Contribution Analysis
- Plan Alternatives
- Contribution Analysis with Plan Alternatives
Section 4:
Individual Retiree Plans
-CompanionCare
-Kaiser Senior Advantage
Section 5:
SISC Enhancements
- Anthem Blue Cross Employee Assistance Program (EAP)
- New Individual Retiree Plan Option
- Zurich AD&D Insurance
Section 6:
SISC Changes
Section 7:
Next Steps
Appendix A:
Legislative Updates
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
2
Section 1: Renewal Summary - SISC
 There are no significant benefit changes to this year’s SISC renewal,
however, SISC is adding several enhancements
 Blue Shield HMO
 HMO High $10-0 Plan rate action – 5.2 % increase
 HMO Low $25-500 Plan rate action – 5.0% increase
 Blue Shield PPO
 90-E $10 with $100 Brand Rx Deductible rate action – 7.7% increase
 80-G $10 with $100 Brand Rx Deductible rate action – 7.9% increase
 High Deductible with HSA Compatibility rate action – 5.6% increase
 Individual Retiree Plans (Medicare Supplement Plan)
 CompanionCare Plan rate action – -12.6% decrease
 Kaiser Senior Advantage Plan rate action – rate pass
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
3
Section 1: SISC Renewal Summary
 SISC Renewal Summary

In 2011, SISC used ERRP reimbursements and other SISC reserves to subsidize the
renewal (approximately 4.8 %)

This year, SISC used ERRP reimbursements to subsidize the 2012 renewal
(approximately 2%)

SISC will not receive future ERRP reimbursements
SISC Renewal Summary with & without ERRP
Year
2011
2012
Cabrillo College – May 18, 2012
Renewal with
ERRP
6.70%
7.20%
Renewal without
ERRP
11.50%
9.20%
CA PPO Trend
10-12%
10-12%
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
4
Section 2: Financial Summary – Medical Only
Line of Coverage
10/1/2011
10/1/2012
$∆
%∆
$116,522
$335,456
$96,168
$42,739
$22,929
$122,575
$352,147
$103,559
$46,125
$24,216
$6,053
$16,691
$7,391
$3,386
$1,287
5.2%
5.0%
7.7%
7.9%
5.6%
$11,777
$8,912
$76,132
$2,322
$1,527
$12,465
$9,143
$79,142
$2,339
$1,588
$688
$231
$3,010
$17
$61
5.8%
2.6%
4.0%
0.7%
4.0%
$4,270
$3,730
-$540
-12.6%
1
$324
$324
$0
0.0%
644
$718,754
$757,029
$38,275
5.3%
$8,625,048
$9,084,348
$459,300
5.3%
Enrollees
BLUE SHIELD ACTIVE EMPLOYEES
HMO High ($10 copay)
78
HMO Low ($25 copay)
293
PPO High ($300 ded)
76
PPO Med ($500 ded)
33
PPO Low ($2,500 ded)
31
BLUE SHIELD RETIREE INCLUDING EARLY RETIREE
HMO High ($10 copay)
13
HMO Low ($25 copay)
11
PPO High ($300 ded)
94
PPO Med ($500 ded)
4
PPO Low ($2,500 ded)
2
COMPANIONCARE (Individual Ret Plan)
CompanionCare
8
KAISER PERMANENTE (Individual Ret Plan)
Kaiser Permanente
MONTHLY TOTAL
ANNUAL TOTAL
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
5
Section 3: SISC Blue Shield Medical Renewal
Current & Renewal Benefits
None
High PPO
(90-E $10, Rx 5-20 w $100 brand
deductible)
$300 p/ind; $600 p/fam
Medium PPO
(80-G $10, Rx 5-20 w $100 brand
deductible)
$500 p/ind; $1,000 p/fam
$1,000 / $2,000
$2,000 / $4,000
$600 / $1,800
$1,000 p/ind; $3,000 per fam
MAJOR MEDICAL
Physician Office Visit
Specialist Visit
Preventive Care
Inpatient Hospital
Lab & X-Ray
$10
$10/$30
No charge
No charge
No charge
Outpatient Surgery
No charge
$25
$25/$30
$0
$500 / Admit
No charge
$150 at an Ambulatory Surgery Center;
$300 at a Hospital
$100 (waived if admitted)
$500 / Admit
$500 / Admit
$25 per visit
Medco
Generic/Brand
$9/$35
$18/$90
N/A
Benefits
High HMO
$10-0 w/Chiro
Low HMO
$25-500 w/Chiro
None
Calendar Year Deductible
Calendar Year Copayment Maximum
Individual / Family
Emergency Room
Mental Health Care/Substance Abuse
Inpatient hospital facility
Outpatient Physician Visit
Outpatient Prescription Drugs
(At participating Pharmacies only)
Retail - 30 day supply
Mail order - 90 day supply
Annual Deductible
Active & Early Retiree
Employee Only
Employee + 1
Family
Total Monthly Premium
Total Annual Premium
$ ∆ to Current
% ∆ to Current
Retirees Over Age 65
Retiree
Retiree plus 1 dependent
Total Monthly Premium
Total Annual Premium
$100 (waived if admitted)
No charge
No charge
$10
Medco
Generic/Brand
$5/$10
$10/$20
N/A
35
19
32
86
5
Current
$780
$1,559
$2,149
$125,689
$1,508,268
Renewal
$825
$1,615
$2,270
$132,200
$1,586,400
$78,132
5.2%
Current
$522
Renewal
$568
$2,610
$31,320
$2,840
$34,080
$2,760
8.8%
63
96
300
4
Current
$644
$1,288
$1,777
$342,540
$4,110,480
Renewal
$677
$1,331
$1,877
$359,502
$4,314,024
$203,544
5.0%
Current
$457
Renewal
$447
$1,828
$21,936
$1,788
$21,456
-$480
-2.2%
0
0
5
141
Cabrillo College – May 18, 2012
4
42
11
117
51
2
53
$2,500 p/ind; $5,000 p/fam
$5,000 p/ind or $10,000 per fam
In Network
$10
$10
Ded waived; 100%
90%
90%
Out of Network
50%
50%
50%
$600 p/day
50%
In Network
$10
$10
Ded waived; 100%
80%
80%
Out of Network
50%
50%
50%
$600 p/day
50%
In Network
90%
90%
Ded waived; 100%
90%
90%
Out of Network
50%
50%
50%
$600 p/day
50%
90%
$350 p/day
80%
$350 p/day
90%
$350 p/day
$100 copay
90%
50%
90%
50%
90%
50%
Medco Rx plan $5-20 w/$100 brand ded
Generic/Brand
$5
$10
$20
$50
$100 per individual up to $300 per family
64
Low PPO
(HDHP -B w/HSA Compatibility)
Current
$853
$1,514
$2,320
$143,700
$1,724,400
Renewal
$911
$1,640
$2,507
$154,761
$1,857,132
$132,732
7.7%
Current
$520
$1,040
$28,600
$343,200
Renewal
$508
$1,016
$27,940
$335,280
-$7,920
-2.3%
$100 copay
80%
50%
80%
50%
80%
50%
Medco Rx plan $5-20 w/$100 brand ded
Generic/Brand
$5
$10
$20
$50
$100 per individual up to $300 per family
15
11
8
34
3
0
3
Current
$774
$1,373
$2,100
$43,513
$522,156
Renewal
$827
$1,489
$2,271
$46,952
$563,424
$41,268
7.9%
Current
$516
$1,032
$1,548
$18,576
Renewal
$504
$100 copay
90%
50%
90%
50%
90%
50%
Rx w/ Blue Shield Contracted Provider
Generic/Brand
$7
$14
$25
$14
$2,500 medical deductible must be met
25
2
4
31
1
1
$1,512
$18,144
-$432
-2.3%
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
2
Current
$577
$1,030
$1,611
$22,929
$275,148
Renewal
$606
$1,099
$1,717
$24,216
$290,592
$15,444
5.6%
Current
$497
$1,030
$1,527
$18,324
Renewal
$489
$1,099
$1,588
$19,056
$732
4.0%
6
Section 3: SISC Blue Shield Medical Renewal
10/2012 12thly Contribution Analysis using 2011 Stipend & Current Plans
MEDICAL
HIGH HMO
($10-0 w/Chiro)
Renewal Rate
Actives
Employee Only
EE
Contribution
LOW HMO
($25-$500 w/Chiro)
Renewal Rate
EE
Contribution
HIGH PPO
(90-E $10, Rx 5-20 w $100
brand ded)
Renewal Rate
EE
Contribution
MEDIUM PPO
(80-G $10, Rx 5-20 w $100
brand ded)
Renewal Rate
EE
Contribution
LOW PPO
(HDHP-B w/H.S.A.
Compatibility)
Renewal Rate
EE
Contribution
$825.00
$181.00
$677.00
$33.00
$911.00
$267.00
$827.00
$183.00
$606.00
$0.00
Employee +1
$1,615.00
$327.00
$1,331.00
$43.00
$1,640.00
$352.00
$1,489.00
$201.00
$1,099.00
$0.00
Family
$2,270.00
$493.00
$1,877.00
$100.00
$2,507.00
$730.00
$2,271.00
$494.00
$1,717.00
$0.00
ACTIVE EMPLOYEE
DENTAL
LIFE & DISABILITY
Actives
Employee Only
ACTIVE EMPLOYEE
$0.00
$133.93
$3.90
$133.93
$3.90
$133.93
$0.00
$198.50
$5.78
$198.50
$5.78
$198.50
$0.00
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
$0.00
$41.65
$0.00
$41.65
$0.00
EE
Contribution
Renewal Rate*
EE
Contribution
Renewal Rate*
EE
Contribution
$41.65
EE
Contribution
Renewal Rate*
Renewal Rate*
ACTIVE EMPLOYEE
Renewal Rate
$0.00
EE
Contribution
ACTIVE EMPLOYEE
EE
Contribution
Renewal Rate
$41.65
Renewal Rate*
$67.90
EE
Contribution
$0.00
$41.65
$1.98
$5.78
Renewal Rate
Renewal Rate
$67.90
$3.90
EE
Contribution
EE
Contribution
$1.98
$198.50
$5.78
ACTIVE EMPLOYEE
EE
Contribution
$133.93
$3.90
$198.50
Family
Renewal Rate
$67.90
$133.93
Employee +1
ACTIVE EMPLOYEE
Renewal Rate
$1.98
$67.90
$67.90
ACTIVE EMPLOYEE
EE
Contribution
Renewal Rate
$1.98
Employee Only
ACTIVE EMPLOYEE
EE
Contribution
Renewal Rate*
Renewal Rate
Actives
ACTIVE EMPLOYEE
EE
Contribution
EE
Contribution
TOTAL
Actives
Employee Only
$934.55
$182.98
$786.55
$34.98
$1,020.55
$268.98
$936.55
$184.98
$715.55
$0.00
Employee +1
$1,790.58
$330.90
$1,506.58
$46.90
$1,815.58
$355.90
$1,664.58
$204.90
$1,274.58
$0.00
Family
$2,510.15
$498.78
$2,117.15
$105.78
$2,747.15
$735.78
$2,511.15
$499.78
$1,957.15
$0.00
*2012 Dental Renewal is estimated at a 3% increase
Stipend (Medical)
Stipend (Dental)
Stipend (Life & Disability)
Single
$644.00
Single
$65.92
Life Insurance
$12.00
2-Person
$1,288.00
2-Person
$130.03
Disability
$29.65
Family
$1,777.00
Family
$192.72
Total
$41.65
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
7
Section 3: SISC Blue Shield Medical Renewal
10/2012 10thly Contribution Analysis using 2011 Stipend & Current Plans
HIGH HMO
($10-0 w/Chiro)
MEDICAL
Actives
Renewal Rate
EE
Contribution
Employee Only
HIGH PPO
(90-E $10, Rx 5-20 w $100
brand ded)
LOW HMO
($25-$500 w/Chiro)
Renewal Rate
EE
Contribution
Renewal Rate
EE
Contribution
MEDIUM PPO
(80-G $10, Rx 5-20 w $100
brand ded)
Renewal Rate
EE
Contribution
LOW PPO
(HDHP-B w/H.S.A.
Compatibility)
Renewal Rate
EE
Contribution
$990.00
$217.20
$812.40
$39.60
$1,093.20
$320.40
$992.40
$219.60
$727.20
$0.00
Employee +1
$1,938.00
$392.40
$1,597.20
$51.60
$1,968.00
$422.40
$1,786.80
$241.20
$1,318.80
$0.00
Family
$2,724.00
$591.60
$2,252.40
$120.00
$3,008.40
$876.00
$2,725.20
$592.80
$2,060.40
$0.00
ACTIVE EMPLOYEE
DENTAL
Actives
Renewal Rate
EE
Contribution
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
Renewal Rate*
EE
Contribution
Renewal Rate
EE
Contribution
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
Employee Only
$81.48
$2.38
$81.48
$2.38
$81.48
$2.38
$81.48
$2.38
$81.48
$0.00
Employee +1
$160.72
$4.68
$160.72
$4.68
$160.72
$4.68
$160.72
$4.68
$160.72
$0.00
Family
$238.20
$6.94
$238.20
$6.94
$238.20
$6.94
$238.20
$6.94
$238.20
$0.00
ACTIVE EMPLOYEE
LIFE & DISABILITY
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
EE
Contribution
$0.00
$49.98
$0.00
$49.98
$0.00
EE
Contribution
Renewal Rate*
EE
Contribution
Renewal Rate*
EE
Contribution
$1,224.66
$322.78
$1,123.86
$221.98
$858.66
$0.00
$2,178.70
$427.08
$1,997.50
$245.88
$1,529.50
$0.00
$882.94
$3,013.38
$599.74
$2,348.58
$0.00
$49.98
Renewal Rate*
EE
Contribution
Renewal Rate*
$219.58
$943.86
$41.98
$397.08
$1,807.90
$56.28
$598.54
$2,540.58
$126.94
$3,296.58
$49.98
Renewal Rate*
EE
Contribution
Employee Only
$1,121.46
Employee +1
$2,148.70
Family
$3,012.18
$49.98
Employee Only
Renewal Rate
$0.00
$0.00
Renewal Rate
ACTIVE EMPLOYEE
Renewal Rate
Renewal Rate
Renewal Rate
Actives
ACTIVE EMPLOYEE
EE
Contribution
EE
Contribution
EE
Contribution
EE
Contribution
TOTAL
Actives
*2012 Dental Renewal is estimated at a 3% increase
Stipend (Medical)
Stipend (Dental)
Stipend (Life & Disability)
Single
$772.80
Single
$79.10
Life Insurance
$14.40
2-Person
$1,545.60
2-Person
$156.04
Disability
$35.58
Family
$2,132.40
Family
$231.26
Total
$49.98
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
8
Section 3: SISC Blue Shield Medical Renewal
10/2012 HMO Plans
Benefits
High HMO
$10-0 w/Chiro
(Same as Current)
Low HMO
$25-500 w/Chiro
(Same as Current)
New HMO Option
30-20% Zero Facility, $9/$35 Rx
(New Plan)
None
None
None
$1,000 / $2,000
$2,000 / $4,000
$1,500 p/member
$10
$10/$30
No charge
No charge
No charge
$25
$25/$30
$0
$500 / Admit
No charge
$150 at an Ambulatory Surgery
Center; $300 at a Hospital
$100 (waived if admitted)
$500 / Admit
$500 / Admit
$25 per visit
Medco
Generic/Brand
$9/$35
$18/$90
$30
$30/$45
$0
20%
No charge
Calendar Year Deductible
Calendar Year Copayment Maximum
MAJOR MEDICAL
Physician Office Visit
Specialist Visit
Preventive Care
Inpatient Hospital
Lab & X-Ray
Outpatient Surgery
No charge
Emergency Room
Mental Health Care/Substance Abuse
Inpatient hospital facility
Outpatient Physician Visit
Outpatient Prescription Drugs
(At participating Pharmacies only)
Retail - 30 day supply
Mail order - 90 day supply
Active & Early Retiree
Employee Only
Employee + 1
Family
Total Monthly Premium
Total Annual Premium
Cabrillo College – May 18, 2012
$100 (waived if admitted)
No charge
No charge
$10
Medco
Generic/Brand
$5/$10
$10/$20
35
19
32
Current
$780.00
$1,559.00
$2,149.00
$125,689
$1,508,268
Renewal
$825.00
$1,615.00
$2,270.00
$132,200
$1,586,400
##
63
96
Current
$644
$1,288
$1,777
$342,540
$4,110,480
No charge
$150 (waived if admitted)
20%
20%
$30 per visit
Medco
Generic/Brand
$9/$35
$18/$90
Renewal
$677
$1,331
$1,877
$359,502
$4,314,024
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
Option
$627
$1,230
$1,733
9
Section 3: SISC Blue Shield Medical Renewal
10/2012 PPO Plans
Benefits
High PPO
(90-E $10, Rx 5-20 w $100 brand
deductible)
Medium PPO
(80-G $10, Rx 5-20 w $100 brand
deductible)
Low PPO
HDHP -B w/HSA Compatibility
(Same as Current)
New Replacement Option PPO
80-C $20, Rx 7-25
(New Plan replacement of High &
Med PPO)
$300 p/ind; $600 p/fam
$500 p/ind; $1,000 p/fam
$2,500 p/ind; $5,000 p/fam
$200 p/ind; $500 p/fam
$600 / $1,800
In Network
Out of Network
$10
50%
$10
50%
Ded waived; 100%
50%
90%
$600 p/day
90%
50%
90%
$350 p/day
$100 copay
90%
50%
90%
50%
90%
50%
$1,000 p/ind; $3,000 per fam
In Network
Out of Network
$10
50%
$10
50%
Ded waived; 100%
50%
80%
$600 p/day
80%
50%
80%
$350 p/day
$100 copay
80%
50%
80%
50%
80%
50%
$5,000 p/ind or $10,000 per fam
In Network
Out of Network
90%
50%
90%
50%
Ded waived; 100%
50%
90%
$600 p/day
90%
50%
90%
$350 p/day
$100 copay
90%
50%
90%
50%
90%
50%
$500 p/ind; $1,500 per fam
In Network
Out of Network
$20
50%
$20
50%
Ded waived; 100%
50%
80%
$600 p/day
80%
50%
80%
$350 p/day
$100 copay
80%
50%
80%
50%
80%
50%
Medco Rx plan $5-20 w/$100 brand ded
Medco Rx plan $5-20 w/$100 brand ded
Rx w/ Blue Shield Contracted Provider
Medco Rx plan $7-25
Calendar Year Deductible
Calendar Year Copayment Maximum
MAJOR MEDICAL
Physician Office Visit
Specialist Visit
Preventive Care
Inpatient Hospital
Lab & X-Ray
Outpatient Surgery
Emergency Room
Mental Health Care/Substance Abuse
Inpatient hospital facility
Outpatient Physician Visit
Outpatient Prescription Drugs
(At participating Pharmacies only)
Retail - 30 day supply
Mail order - 90 day supply
Annual Deductible
Active & Early Retiree
Employee Only
Employee + 1
Family
Total Monthly Premium
Total Annual Premium
Generic/Brand
$5
$20
Generic/Brand
$10
$50
$5
$20
$100 per individual up to $300 per family
64
42
11
Current
$853
$1,514
$2,320
$143,700
$1,724,400
Cabrillo College – May 18, 2012
Renewal
$911
$1,640
$2,507
$154,761
$1,857,132
Generic/Brand
$10
$50
$7
$25
11
8
Current
$774
$1,373
$2,100
$43,513
$522,156
Renewal
$827
$1,489
$2,271
$46,952
$563,424
$7
$25
$2,500 medical deductible must be met
$100 per individual up to $300 per family
15
Generic/Brand
$14
$14
25
2
4
Current
$577
$1,030
$1,611
$22,929
$275,148
Renewal
$606
$1,099
$1,717
$24,216
$290,592
$14
$60
None
25
2
4
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
Option
$887
$1,597
$2,439
10
Section 3: SISC Blue Shield Medical Renewal
10/2012 12thly Contribution Analysis with New Plans using 2011 Stipend
MEDICAL
HIGH HMO
$10-0 w/Chiro
(Same as Current)
Renewal Rate
Actives
Employee Only
EE
Contribution
LOW HMO
$25-$500 w/Chiro
(Same as Current)
EE
Contribution
Renewal Rate
New HMO Option
30-20% Zero Facility, $9/$35 Rx
(New Plan)
Option Rate
EE
Contribution
LOW PPO
HDHP-B w/H.S.A. Compatibility
(Same as Current)
New Replacement Option PPO
80-C $20, Rx 7-25
(New Plan replacement of High
& Med PPO Plan)
EE
Contribution
Renewal Rate
EE
Contribution
Option Rate
$825.00
$181.00
$677.00
$33.00
$627.00
$0.00
$606.00
$0.00
$887.00
$243.00
Employee +1
$1,615.00
$327.00
$1,331.00
$43.00
$1,230.00
$0.00
$1,099.00
$0.00
$1,597.00
$309.00
Family
$2,270.00
$493.00
$1,877.00
$100.00
$1,733.00
$0.00
$1,717.00
$0.00
$2,439.00
$662.00
DENTAL
ACTIVE EMPLOYEE
Renewal Rate
Actives
EE
Contribution
ACTIVE EMPLOYEE
EE
Contribution
Renewal Rate
ACTIVE EMPLOYEE
Renewal Rate*
EE
Contribution
ACTIVE EMPLOYEE
EE
Contribution
Renewal Rate
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
Employee Only
$67.90
$1.98
$67.90
$1.98
$67.90
$0.00
$67.90
$0.00
$67.90
$1.98
Employee +1
$133.93
$3.90
$133.93
$3.90
$133.93
$0.00
$133.93
$0.00
$133.93
$3.90
Family
$198.50
$5.78
$198.50
$5.78
$198.50
$0.00
$198.50
$0.00
$198.50
$5.78
LIFE & DISABILITY
Actives
Employee Only
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
$0.00
$41.65
$0.00
$41.65
$0.00
Renewal Rate*
EE
Contribution
Renewal Rate*
EE
Contribution
Renewal Rate*
EE
Contribution
$41.65
Renewal Rate*
EE
Contribution
$41.65
Renewal Rate*
EE
Contribution
ACTIVE EMPLOYEE
Renewal Rate
$0.00
$0.00
$41.65
ACTIVE EMPLOYEE
EE
Contribution
Renewal Rate
Renewal Rate
Renewal Rate
ACTIVE EMPLOYEE
EE
Contribution
EE
Contribution
EE
Contribution
TOTAL
Actives
Employee Only
$934.55
$182.98
$786.55
$34.98
$736.55
$0.00
$715.55
$0.00
$996.55
$244.98
Employee +1
$1,790.58
$330.90
$1,506.58
$46.90
$1,405.58
$0.00
$1,274.58
$0.00
$1,772.58
$312.90
Family
$2,510.15
$498.78
$2,117.15
$105.78
$1,973.15
$0.00
$1,957.15
$0.00
$2,679.15
$667.78
*2012 Dental Renewal is estimated at a 3% increase
Stipend (Medical)
Stipend (Dental)
Stipend (Life & Disability)
Single
$644.00
Single
$65.92
Life Insurance
$12.00
2-Person
$1,288.00
2-Person
$130.03
Disability
$29.65
Family
$1,777.00
Family
$192.72
Total
$41.65
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
11
Section 3: SISC Blue Shield Medical Renewal
10/2012 10thly Contribution Analysis with New Plans using 2011 Stipend
HIGH HMO
$10-0 w/Chiro
(Same as Current)
LOW HMO
$25-$500 w/Chiro
(Same as Current)
Renewal Rate EE Contribution
Renewal Rate EE Contribution
MEDICAL
Actives
Employee Only
New Option HMO
30-20% Zero Facility, $9/$35 Rx
(New Plan)
Option Rate
EE
Contribution
LOW PPO
HDHP-B w/H.S.A. Compatibility
(Same as Current)
New Replacement Option PPO
80-C $20, Rx 7-25
(New Plan replacement of High
& Med PPO Plan)
Renewal Rate
EE
Contribution
Option Rate
EE
Contribution
$990.00
$217.20
$812.40
$39.60
$752.40
$0.00
$727.20
$0.00
$1,064.40
$291.60
Employee +1
$1,938.00
$392.40
$1,597.20
$51.60
$1,476.00
$0.00
$1,318.80
$0.00
$1,916.40
$370.80
Family
$2,724.00
$591.60
$2,252.40
$120.00
$2,079.60
$0.00
$2,060.40
$0.00
$2,926.80
$794.40
ACTIVE EMPLOYEE
DENTAL
Actives
Renewal Rate EE Contribution
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
Renewal Rate* EE Contribution
Renewal Rate*
EE
Contribution
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
Renewal Rate
EE
Contribution
Employee Only
$81.48
$2.38
$81.48
$2.38
$81.48
$0.00
$81.48
$0.00
$81.48
$2.38
Employee +1
$160.72
$4.68
$160.72
$4.68
$160.72
$0.00
$160.72
$0.00
$160.72
$4.68
Family
$238.20
$6.94
$238.20
$6.94
$238.20
$0.00
$238.20
$0.00
$238.20
$6.94
ACTIVE EMPLOYEE
LIFE & DISABILITY
Actives
Renewal Rate EE Contribution
Employee Only
$49.98
$0.00
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
Renewal Rate EE Contribution
$49.98
$0.00
ACTIVE EMPLOYEE
ACTIVE EMPLOYEE
Renewal Rate
EE
Contribution
Renewal Rate
EE
Contribution
$0.00
$49.98
$0.00
$49.98
$0.00
Renewal Rate*
EE
Contribution
Renewal Rate*
EE
Contribution
Renewal Rate*
EE
Contribution
Renewal Rate
EE
Contribution
$49.98
TOTAL
Actives
Renewal Rate* EE Contribution
Renewal Rate* EE Contribution
Employee Only
$1,121.46
$219.58
$943.86
$41.98
$883.86
$0.00
$858.66
$0.00
$1,195.86
$293.98
Employee +1
$2,148.70
$397.08
$1,807.90
$56.28
$1,686.70
$0.00
$1,529.50
$0.00
$2,127.10
$375.48
Family
$3,012.18
$598.54
$2,540.58
$126.94
$2,367.78
$0.00
$2,348.58
$0.00
$3,214.98
$801.34
*2012 Dental Renewal is estimated at a 3% increase
Stipend (Medical)
Stipend (Dental)
Stipend (Life & Disability)
Single
$772.80
Single
$79.10
Life Insurance
$14.40
2-Person
$1,545.60
2-Person
$156.04
Disability
$35.58
Family
$2,132.40
Family
$231.26
Total
$49.98
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
12
Section 4: Individual Retiree Plans
CompanionCare
MEDICARE
Benefits
Pays all but first $1132 for 1st
60 days
Pays all but first $283 a day for
the 61st to 90th day
SERVICES
Inpatient Hospital (Part A)
Skilled Nursing Facilites
(Must be approved by Medicare)
Deductible (Part B)
Physical/Speech Therapy (Part B)
Blood (Part B)
Travel Coverage
(when outside the US for less than
6 consecutive months)
Outpatient Presrciption Drugs
CompanionCare EMPLOYEES
Retiree
Retiree plus 1 dependent
Total Monthly Premium
Total Annual Premium
$ ∆ to Current
% ∆ to Current
Cabrillo College – May 18, 2012
EE
6
2
8
Pays $283 a day
Pays $566 a day
Pays nothing after Lifetime
Reserve is used
Pays 100% for 1st 20 days
Pays all but $141.50 a day for
21st to 100th day
Pays nothing after 100th day
Pays 100% for 151st day to
515th day
Pays nothing
Pays $141.50 a day for 21st to
100th day
Pays nothing after 100th day
Pays $162
80% MA charges
20% MA charges including
100% of Medicare Part B
deductible
20% MA charges
100% of MA charges
Pays nothing
80% Medicare Approved (MA)
charges after Part B deductible
Medical Services (Part B)
Doctor, x-ray, appliances, &
ambulance Lab
Pays $1132
Pays all but $566 a day Lifetime
Reserve for 91st to 150th day
$162 Part B deductible per year
Basis of Payment (Part B)
CompanionCare
Benefits
20% MA charges up to the
80% MA Charges up to the
Medicare annual benefit
Medicare annual benefit amount amount. (Physical & Speech
Therapy Combined)
Pays 1st 3 pints unreplaced
80% MA charges after 3 pints
blood and 20% MA charges
Pays 80% inpatient hospital,
Not covered
surgery, anestetist and in
hospital visits for medically
* Generic: $9 co-pay for a 30day supply at a retail pharmacy
SISC will automatically enroll
or $18 co-pay for a 90-day
CompanionCare members into
supply through home delivery
Medicare Part D. No additional
service
premium required. SISC plans
* Brand: $35 co-pay for a 30are not subject to the
day supply at a retail pharmacy
'doughnout hole'.
or $90 co-pay for a 90-day
supply through home delivery
service
Current
Renewal
$427
$373
$854
$746
$4,270
$3,730
$51,240
$44,760
-$6,480
-12.6%
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
13
Section 4: Individual Retiree Plans
Kaiser Senior Advantage
Current
Renewal
Hospitalization
* Inpatient
* Emergency Room
$200/Admit
$50 co-pay/waived if admitted
$200/Admit
$50 co-pay/waived if admitted
Skilled Nursing Facility
Covered in full for 100 days per
benefit period
Covered in full for 100 days per
benefit period
$10 co-pay per visit
$10 co-pay per visit
No charge
No charge
No charge
No charge
$10 co-pay per visit
$10 co-pay per visit
$10 co-pay per visit; $5 co-pay per
group visit
$10 co-pay per visit; $5 co-pay per
group visit
SERVICES
Physician Services/Basic Health Services
* Office visits
* Consultation, diagnosis, and treatment by a
specialist
X-Ray Services
* Includes routine annual mammography
Laboratory Services
Annual Physical Examination
* Includes pap smears
Outpatient Mental Health/20visits
Vision Care
* Examination for eyeglasses
* Glaucoma testing
* Standard frame/lenses every 24 months
$10 per visit
$10 per visit
$10 co-pay per visit
$10 co-pay per visit
$150 frame and lens allowance every $150 frame and lens allowance every
24 months
24 months
Not covered
Not covered
$10 co-pay per visit
$10 co-pay per visit
Dental Care (DeltaCare)
Hearing Examination
Immunizations
* Includes flu injections and all Medicare
approved immunizations
Ambulance
No charge
No charge
$50/Trip
$10 co-pay per visit
(subject to medical necessity)
$50/Trip
$10 co-pay per visit
(subject to medical necessity)
Prescription Drugs
$10 co-pay per generic/$20 co-pay
per brand name up to $100 day
supply at Kaiser pharmacies
$10 co-pay per generic/$20 co-pay
per brand name up to $100 day
supply at Kaiser pharmacies
* Prescription drugs related to sexual dysfunction
50% co-insurance;
limited to 27 doses in any 100-day
period
50% co-insurance;
limited to 27 doses in any 100-day
period
Current
$324
$324
Renewal
$324
$324
$3,888
$3,888
Manual Manipulation of the Spine
Retiree Under Age 65
Retiree
1
Total Monthly Premium
Total Annual Premium
$ ∆ to Current
% ∆ to Current
1
Cabrillo College – May 18, 2012
$0
0.00%
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
14
Section 5: SISC Enhancements
Anthem Blue Cross Employee Assistance Program (EAP)
Effective July 1, 2012:



EAP – An Employee Assistance Program (EAP) will be added to all SISC medical plans
for both actives and early retirees. This will not apply to the Individual Retiree Plans
(IRP).
Anthem EAP will be added to both PPO and HMO plans
Districts with Blue Shield PPO and HMO currently have LifeReferrals which will no
longer be available as of 7/1/12 (it will be replaced with a full EAP program)
Features of the EAP include:









EAP services are available to all employees and retirees with SISC medical insurance
 Family members, domestic partners and anyone residing in the employee/retiree’s home
are eligible
There is no cost for EAP services; no co-pays or forms required
Up to 6 sessions are available thru the EAP per problem situation
Appointments are available by calling the telephone number
Appointments are scheduled at member’s convenience; evening appointments are available and
every effort is made to see clients within 48 hours
Emergencies are handled by staff members available by phone 24 hours a day on a toll-free
basis
People in crisis are provided same-day service
Anthem Blue Cross has contracted with licensed mental health professionals to provide
Employee Assistance services
If the presenting problem requires more lengthy or specialized treatment than the EAP is
intended to provide, the EAP will refer the member to the medical plan carrier to help locate a
participating provider on the member’s health plan
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
15
Section 5: SISC Enhancements
Anthem Blue Cross Employee Assistance Program (EAP)
Employee Assistance Program
Benefits
Counseling Sessions
Telephonic Counseling
Employee Services
Cabrillo College – May 18, 2012
Anthem Blue Cross EAP
6 Sessions per incident per household member
Unlimited
Relationship Difficulties
Marriage / Family situations
Stress
Managing Change
Legal & Financial Problems
Work-related concerns
Anxiety & Depression
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
16
Section 5: SISC Enhancements
New Individual Retiree Plan Option
Effective July 1, 2012:

In addition to the CompanionCare and Senior Advantage Individual Retiree plans, the
Blue Shield 65 Plus Medicare Advantage Plan is being added, effective 07/01/2012

The Blue Shield 65 Plus Medicare Advantage plan offers Medicare benefits through an
HMO

Offered to retirees over the age of 65 with Medicare Parts A & B who reside in a Blue
Shield service area
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
17
Section 5: SISC Enhancements
New Individual Retiree Plan Option – Blue Shield 65 Plus Medicare Advantage
SERVICES
Current
Ambulance
$0 co-pay per trip
Annual Physical Examination
• Includes pap smears
$0 co-pay*
$10 co-pay per visit
Durable Medical Equipment (DME)
Medicare covered services
$0 co-pay
Hospitalization
• Inpatient
$0 co-pay per admission
• Outpatient hospital services
$20 co-pay
$50 co-pay/waived if admitted within 24 hrs for the same
condition
• Emergency Room
Immunizations
• Includes flu injections and all Medicare approved immunizations
$0 co-pay*
Laboratory Services
No charge
Manual Manipulation of the Spine
$10 co-pay per visit (subject to medical necessity)
No charge for day 1-150
Member pays 100% from day 151 and over
Mental Health - Inpatient
Mental Health - Outpatient unlimited visits
$20 co-pay
Physician Services/Basic Health Services
• Office visits
$20 co-pay
• Consultation, diagnosis & treatment by a specialist
$20 co-pay
Prescription Drugs
30 day supply at Retail and 90 day supply through Mail Order
10/30/50 Three Tiered Plan
Generic
$10 Retail, $20 Mail order
Preferred Brand
$30 Retail, $60 Mail order
Non-Preferred Brand
$50 Retail, $100 Mail order
Injectables
20% up to $100 per prescription Retail, $300 Mail order
Specialty
20% up to $100 per prescription Retail, $300 Mail order
Skilled Nursing Facility
Covered in full for 100 days per benefit period
X-Ray Services
• Includes routine annual mammography
Rates
Retiree
Cabrillo College – May 18, 2012
$0 co-pay*
Current
$354
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
18
Section 5: SISC Enhancements
Zurich AD&D Insurance
Effective October 1, 2012:

A Zurich AD&D Insurance policy will now be automatically added to all SISC
medical plans for subscribers only

This does not apply to enrollees on the Individual Retiree Plans (IRP)

Employees and Retirees enrolled under a SISC medical plan are
automatically insured for $10,000 of Accidental Death & Dismemberment
insurance until age 70

Employees may not designate a beneficiary on this AD&D plan. The benefit
is designated to the employee’s spouse or heirs should the employee expire

The employee’s spouse or heirs must file a claim for the reimbursement
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
19
Section 6: SISC Changes
Effective October 1, 2012:
 Medco Rx benefits no longer cover OTC non-sedating antihistamines (NSA)
and proton pump inhibitors (PPI)
Effective January 1, 2013:

CompanionCare Medicare Supplemental Plan: Prescription drug coverage
will be aligned with Medicare’s formulary. Medco support will be available for
retirees after October 1st to discuss how the change will impact their
coverage.
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
20
Section 7: Next Steps

Benefit Committee Meeting

May 24, 2012 at 10:00am

Dental Renewal

Open Enrollment
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
21
Appendix A: Legislative Updates
Changes on the Horizon:
 2012 - 60-Day Advance Notice – If plan sponsor makes any materials modifications to the
plan, participants must be notified 60 days in advance of the effective date of the change

2012 – Uniform Coverage Model Notice – September, 2012, all health carriers will be
required to create coverage documents for Individual and group plans with uniform benefit
language

2012 – Minimum Essential Benefits, such as emergency, maternity & newborn care,
pharmacy, defined

2013 - Annual FSA Limit will be reduced to $2,500

2013 - W2 Reporting
 Employers must report the aggregate cost of employer sponsored coverage on form
W-2

2014 - Pay or Play – Effective 1/1/2014, if an employer covers 50 employees, they must
offer “minimum essential coverage” to full-time employees (30 hours) and dependents:
 Penalty for not offering coverage is $2,000, or $166.67 a month
 Penalty for not offering coverage that is good enough is $3,000, or $250 a month
 Penalty for an employee having to go to the exchange because their portion for
coverage is over 9.5% of household income (W2 earnings) = $3,000
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
22
Appendix A: Legislative Updates
Changes on the Horizon:

2014 - 90 day limit on eligibility waiting periods

2014 - No pre-existing condition exclusions allowed for any individual

2014 – Individual Mandates – US Residents must purchase health insurance, or pay an
annual increasing schedule of tax penalties
 2014: $95 per person (capped at $285 per family) or 1 percent of household income
 2015: $325 (capped at $975) or 2 percent of household income
 2016: $695 (capped at $2,085) or 2.5 percent of household income
 2017 and beyond: The $695 penalty is indexed for a cost-of-living adjustment and must
be rounded to the next lowest multiple of $50. For families, the flat-dollar penalty is
capped at three times the indexed value for an individual. For example, if in 2017 the
penalty is $700, the capped amount would be $2,100. As in 2016, the individual
mandate penalty is the greater of the flat-dollar amount or 2.5 percent of household
income

2018 – Cadillac Tax – a 40% excise tax on the amount of total premium over the
government determined threshold in 2018 ($10,000 Single/$24,000 Family)
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
23
Appendix A: Legislative Updates
• Comparative effectiveness research tax
on self-insured plans
• Temporary reinsurance
program for early retirees
(ages 55-64) established
2010
2011
2012
• Health Care FSA contributions
capped
• Medicare Hospital Insurance
tax
2013
• Lifetime dollar limits prohibited
• Annual dollar limits restricted
• Dependent child coverage expanded to age
26 (unless employer coverage is available –
applies to grandfathered plans only)
• Pre-existing condition exclusions prohibited
for dependents under 19 years of age
• Cost reporting and rebates effective
• Long-term care program (CLASS Act)
• W-2 reporting for 2011 begins
• OTC drugs ineligible for FSA, HSA, HRA
• Auto enrollment required (Appears to be
2014
2015
• High-cost insurance excise tax
(Cadillac tax) established
2016
2017
2018
2019
2020
• Annual dollar limits prohibited
• Pre-existing condition exclusions prohibited for
all enrollees
• Dependent child coverage to age 26 even if
employer coverage is available
• Waiting periods over 90 days no longer permitted
• State health insurance exchanges established
• Individual and employer mandates effective
• Low income premium subsidy in the exchange
• Employee “Free-Choice” vouchers for exchange
effectiv e 3/ 23/ 2010 but compliance is
effectiv ely delay ed until regulations are
issued)
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
24
Disclaimer
This proposal is for information purposes only and does not amend, extend or alter the policy in any way. Please refer to the policy
form for completed coverage and exclusion information.
Alliant embraces a policy of transparency with respect to its compensation from insurance transactions. Details on our compensation
policy, including the types of income that Alliant may earn on a placement, are available on our website at www.alliantinsurance.com.
For a copy of our policy or for any inquiries regarding compensation issues pertaining to your account you may also contact us at:
Alliant Insurance Services, Inc., Attention: General Counsel, 701 B Street, 6th Floor, San Diego, CA 92101.
*Analyzing insurers' over-all performance and financial strength is a task that requires specialized skills and in-depth technical
understanding of all aspects of insurance company finances and operations. Insurance brokerages such as Alliant Insurance typically
rely upon rating agencies for this type of market analysis. Both A.M. Best and Standard and Poor's have been industry leaders in this
area for many decades, utilizing a combination of quantitative and qualitative analysis of the information available in formulating their
ratings.
A.M. Best has an extensive database of nearly 6,000 Life/Health, Property Casualty and International companies. You can visit them
at www.ambest.com. For additional information regarding insurer financial strength ratings visit Standard and Poor's website at
www.standardandpoors.com.
To learn more about companies doing business in California, visit the California Department of Insurance website at
www.insurance.ca.gov.
Cabrillo College – May 18, 2012
Copyright © 2012 Alliant Insurance Services, Inc. Confidential; not for distribution
25