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Pensions and Benefits
SCHOOL EMPLOYEES' HEALTH BENEFITS PROGRAM PLAN DESIGN COMMITTEE
MEETING MINUTES 2013

 

SCHOOL EMPLOYEES' HEALTH BENEFITS PROGRAM (SEHBP)
PLAN DESIGN COMMITTEE MINUTES, BY DATE


 


Meeting No. 12 Minutes
January 24, 2013, 10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013.  The meeting of the SEHBP Plan Design Committee was called to order on Thursday, January 24 at 10:08 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Kenneth E. Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO (via teleconference)
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Bart Gerber, Express Scripts
Stacey Decembrele, Express Scripts
Ken Vander Pyl, Express Scripts
Kristen Plauschinat, Express Scripts (via teleconference)
Susan Marsh, Aon Hewitt Consultants

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Committee Member Steinhauer made a motion to approve the minutes of December 3, 2012. The motion was seconded by Committee Member Kelleher, approved (6:0:0).
 
Committee Member Kelleher gave a brief update of the progress of the Committee over the last three months, including: the Pensions and Health Benefits Review Commission’s request that the Plan Design Committee review pending legislation; Mental Health Parity presentation by Aon Hewitt; wellness program presentations from Aon Hewitt, Express Scripts, and the Asheville Project (still pending); plans for a joint meeting with some members of the State Health Benefits Program Plan Design Committee.

Ms. Barrett introduced Mr. Gerber from Express Scripts, who gave a recap of the Socrates program, which was presented at the previous meeting. He presented slides addressing the Committee members’ questions regarding gaps in care. Committee Member Kelleher asked if there are any studies linking co-pay waiver incentives to increased member compliance. Mr. Gerber responded that research shows that a one-time, ten- to fifteen-dollar co-pay waiver seems to be enough to incent members to comply, but that he was unaware of any studies over a long time period. Committee Member Kelleher asked if there are any negatives associated with Socrates. Ms. Decembrele replied that patient satisfaction is very high, with only one complaint about the call being an invasion of privacy. This is not usually a problem, as members are notified in advance. Mr. Gerber supposed that one-time co-pay waivers could potentially pose problems, with members hoping for more rewards for remaining compliant. Committee Member Ridolfino failed to see how the one-time co-pay could be an adequate incentive. Mr. Gerber advised that the waivers are not required as part of the Socrates program; the counseling itself is an effective tool.

Aon was present to respond to questions regarding their presentations on wellness programs from the December 3, 2012 meeting. Ms. Marsh distributed documents regarding the participation rate of the Oregon Wellness Program. She included details of Oregon’s model, which boasts a high participation rate, relative to other states. Ms. Marsh also provided information regarding focused wellness initiatives, in response to the Committee’s request. Committee Member Kelleher asked if a wellness program should be offered to both active and retired members. Ms. Marsh theorized that offering the program to active members would be most cost effective, as it could possibly improve claims experience as well as reduce absenteeism.

Committee Member Steinhauer made a motion to go into Executive Session to seek counsel from the Attorney General’s office. Committee Member Kobylowski seconded the motion, all were in favor.

Upon returning to Open Session, Committee Member Kelleher suggested that representatives who instituted the Ashville Project be scheduled for the next meeting. The Committee would then discuss all of the materials presented to that point. He asked Ms. Marsh by what date Aon Hewitt would need the Committee’s recommendations on plan design changes for plan year 2014. Ms. Marsh stated that they would need the information by the May meeting at the latest and that Aon would like specific details of what the Committee intended for plan changes. Committee Member Kelleher stated that the Committee’s plan is to have Aon Hewitt attend the March meeting to begin discussing the benefits.

There being no further business, Committee Member Steinhauer made a motion to adjourn. Committee Member Leonard seconded the motion; all were in favor. The meeting adjourned at 11:25 AM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

 


Meeting No. 13 Minutes
February 5, 2013, 10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee
 

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013.  The meeting of the SEHBP Plan Design Committee was called to order on Tuesday, February 5 at 10:07 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO (via teleconference)
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Doug Martucci, Acting Secretary
John Miall, Rx Ally
Rajeev Verma, Rx Ally
Jim Christ, Aon Hewitt Consultants

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read.

Roll call was taken.  Committee Members Kobylowski and Ridolfino were absent.  Committee Member Pierce attended via conference call.

Minutes: Committee Member Steinhauer made a motion to approve the minutes of January 24, 2013. The motion was seconded by Committee Member Pierce, approved (4:0:0 Committee Members Kobylowski and Ridolfino were absent).
 
John Miall from Rx Ally provided a presentation on the Asheville Project, a professional service approach to cost containment which uses face to face counseling of plan members to encourage adherence to maintenance prescription drugs.   Committee Member Kelleher asked how plan members who are not filling their prescriptions are contacted.  Mr. Miall explained that advanced data systems identify risks using fill rates and other data, and that outreach is done via telephone and targeted mailings to encourage members to contact a participating pharmacist to receive an initial evaluation.  Committee Member Kelleher asked what percentage of plan members take up the offer and contact a participating pharmacist.  Mr. Miall answered that there is generally a slow uptake due to employee hesitation, but that by the second and third years there is an 80-90% enrollment rate of eligible members.  Committee Member Leonard asked if prescription copay waivers are used to drive members to participate.  Mr. Miall advised that a copay waiver is recommended, but not mandatory.  Copays for disease related medications were waived for twelve (12) months when the program was rolled out in Asheville, North Carolina, and did help drive adherence, especially with lower wage earners.  Committee Member Leonard asked if data is available on plans that chose not to offer a copay waiver, or plans with limited three (3) or six (6) month waivers.  Mr. Miall explained that most plans that choose not to offer a copay waiver find initial enrollment anemic, and generally end up implementing a copay waiver eventually, which increases enrollment significantly.  Another option is to move all disease related prescriptions to the lowest copay tier, regardless of whether they are generic, preferred, or non preferred drugs.  Committee Member Kelleher pointed out that not all participating educational employers participate in the SEHBP prescription drug program, which could cause problems.  Committee Member Leonard asked if data was available on the number of plan members who end up using mail order or a non recommended pharmacist.  Rajeev Verma from Rx Ally responded no, but said he could obtain that information.  Dave Pointer asked if the plan works with members’ primary care physicians.  Mr. Verma stated yes.  Committee Member Kelleher asked if the program had any experience working with CVS.  Mr. Miall responded no.  Dave Pointer asked how the ROI is calculated.  Mr. Miall indicated that it is calculated using claim costs, but that some plans have asked for worker productivity to be included.  Mr. Pointer asked if the figures are based on cost avoidance, Mr. Miall responded no.  Committee Member Kelleher asked how much the program would cost.  Mr. Verma stated that the cost would need to be calculated.  Mr. Miall indicated that the fees for the program are based on volume generated by the participating plan. Committee Member Kelleher asked how quickly the program could be implemented.  Mr. Miall responded that implementation takes 90 days or less. 

Dave Perry from Horizon gave a brief presentation on Horizon’s Journey to Health program.  He noted that the Plan Design Committee would need enthusiastic and engaged employers to make any wellness program work.  He suggested that any incentives should be owned and distributed at the employer level.  Committee Member Kelleher stated that refunds or incentives given to employers would have to be distributed amongst every employee, regardless of their participation in the wellness program.  Mr. Perry stated that there needs to be a way to motivate employers to engage their employees and encourage their participation in the program.  Committee Member Kelleher stated that the motivation could be a healthier workforce with increased productivity.  Committee Member Leonard stated that the committee would hope that employees would drive management to embrace the wellness program.  Committee Member Kelleher asked if Horizon could accommodate offsite biometric screenings.  Mr. Perry responded that each school district is set up in a unique way, and noted that wellness program engagement levels are lower for schools than for private employers in Horizon’s fully insured business.  Committee Member Kelleher asked if it might be prudent to launch the program as a pilot in selected school districts of varied sizes.  Mr. Perry responded that it is always worthwhile to start with a small model that allows troubleshooting.  Committee Member Kelleher reiterated his question regarding whether the biometric screenings could be completed at locations such as labs or CVS minute clinics.  Mr. Perry responded that the tests could be completed at offsite locations, but stated that there should be an effort to be proactive to engage employees who would not get biometric screenings under normal circumstances.  Committee Member Kelleher asked if it would be worthwhile to rent space in which to hold a wellness fair that would give employees the opportunity to have their testing done.  Mr. Perry stated that regardless of where they are held, the tests should be scheduled ahead of time to eliminate the need for employees to wait in line.  Committee Member Pierce asked if Horizon experienced complaints regarding privacy or confidentiality issues.  Mr. Perry responded no.

Katherine Impellizeri, Mike North, and Jen Moyer from Aetna gave a brief presentation on Aetna’s recommendations regarding wellness program.  Ms. Impellizeri noted that Aetna offers over 34 different disease management programs, all of which are currently under utilized by SEHBP members.  Aetna currently communicates the availability of the programs through letters, emails to registered users of their website, and topics of the month discussed with members who call Aetna customer service, but none of the current methods of engagement seem to drive participation in the programs on their own without additional incentive for plan members.  She noted that Aetna partners with both Quest Diagnostics and Summit Health, which offers flexibility with regards to onsite and offsite biometric screenings.  Committee Member Kelleher asked how employers of different sizes would be served.  Ms. Impellezeri noted that employees would need to be provided an incentive.  Committee Member Kelleher asked if Aetna would recommend a full roll out or a pilot program.  Ms. Impellizeri noted that it could be helpful to start with a group of selected employers who could then be leaders and help champion the program by spreading word of mouth.  Mike North stated that Aetna employees and their spouses get screenings at Quest Diagnostics, which allows employees to schedule the screenings on their own time.  Depending on test scores, high or medium risk employees receive phone calls to engage them in management programs.  Dave Pointer noted that a pilot program could be rolled out with 30 or so employers, and would not significantly burden rates for the entire population of SEHBP employers.  Committee Member Kelleher asked if plan members could obtain their biometric screenings at locations such as CVS minute clinics.  Ms. Impellizeri stated yes, and noted that a current Aetna pilot program in conjunction with CVS allows members to get screened at minute clinic locations with no copay.  Committee Member Kelleher asked if there was more detailed information on which fitness programs partner with Aetna.  Ms. Impellizeri responded that she could do additional research and follow up with that information. 

Committee Member Leonard noted that the committee wants to take some action regarding wellness initiatives, but wondered how the committee should go about submitting suggestions for a proposed program.  Committee Member Kelleher made a motion to go into executive session.  Committee Member Leonard seconded the motion.  All voted in favor (4:0:0, Committee Members Kobylowski and Ridolfino were absent).

Upon return from executive session, Committee Member Steinhauer made a motion to direct Division of Pensions and Benefits (DPB) staff to craft a proposal for a prescription drug adherence program involving one-on-one counseling for SEHBP plan members on maintenance medications for chronic conditions.  Committee Member Leonard seconded the motion.  Committee Member Leonard added that the proposed program should benefit the largest possible number of plan members and should identify how much the program would cost.  Committee Member Kelleher stated that the program should focus on Heart Disease and Diabetes.  The motion passed (4:0:0, Committee Members Kobylowski and Ridolfino were absent).  Committee Member Steinhauer then made a motion for DPB staff to craft a proposal for a wellness program, including incentives, with a focus on weight loss, smoking cessation, and any other issues revealed by SEHBP plan members’ biometric screenings.  Committee Member Leonard seconded the motion.  Committee Member Leonard stated that the wellness program proposal should also include a cost benefit analysis and identify specific opportunities for member engagement.  Committee Member Kelleher stated that the proposal should include a recommendation to either roll the program out all at once, or as a pilot involving a select number of school districts.  The motion passed (4:0:0, Committee Members Kobylowski and Ridolfino were absent).  Committee Member Steinhauer made a motion to request that the prescription drug adherence program proposal also include a cost benefit analysis.  Committee Member Leonard seconded the motion.  The motion passed (4:0:0, Committee Members Kobylowski and Ridolfino were absent).  Committee Member Leonard made a motion to request that DPB staff draft a memo to the State Health Benefits Program Plan Design Committee (SHBPDC) to communicate the SEHBP Plan Design Committee’s actions regarding wellness initiatives.  Committee Member Steinhauer seconded the motion.  The motion passed (4:0:0, Committee Members Kobylowski and Ridolfino were absent).

There being no further business, Committee Member Steinhauer made a motion to adjourn. Committee Member Leonard seconded the motion; all were in favor. The meeting adjourned at 12:21 AM.

  Respectfully submitted,
 

 

 

  Douglas Martucci
Acting Secretary, SEHBP Plan Design Committee

 


Meeting No. 14 Minutes
March 18, 2013, 10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee
 

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013. The meeting of the SEHBP Plan Design Committee was called to order on Thursday, January 24 at 10:00 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Kenneth E. Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Douglas Martucci, Division of Pensions and Benefits
James Christ, Aon Hewitt
Kimberly Meacock, Aon Hewitt
Mary Reilly, Aon Hewitt

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Committee Member Steinhauer made a motion to approve the minutes of February 5, 2013. The motion was seconded by Committee Member Pierce, approved (4:0:2, Ridolfino, Kobylowski, abstain).

 Ms. Sheppard gave a brief introduction to the meeting. She emphasized that the Division would need the support of the Committee in order for a wellness program to be successful. She urged the Committee members to ask questions so that they fully understand the forthcoming proposal.

Mr. Martucci gave an introduction to the wellness program proposal to be presented by Aon Hewitt. He gave a brief history of information presented to the Committee thus far. He explained that this had been a collaborative effort between the Division, Aon Hewitt, Aetna, Horizon, and Express Scripts.

Mr. Christ from Aon Hewitt introduced his team. He and Ms. Meacock then gave details of their first presentation, Wellness Program Overview and Planning

Regarding the overview, Committee Member Leonard asked how the premiums would be reduced for employers. DAG Weeden stated that her office had not researched the legality of reducing employer premiums, but would research that information. Mr. Christ explained that everyone would have the same rates, but credit would be given for the prior year based on employee participation. Committee Member Kobylowski asked if children could participate. Ms. Meacock replied that children could participate, but the incentive is only for members and spouses.

Committee Member Kelleher asked if the health assessment could be completed on paper. Ms. Meacock advised that paper forms are possible, but at an extra charge, and without the same interactive, branching capabilities of the online version. Committee Member Pierce asked if this meant that a paper version would produce different results than the online version. Ms. Meacock clarified that the online version would not produce different results, but more comprehensive ones.

Committee Member Leonard asked if members could receive a partial reward. For example, could members receive a fifty dollar reward for completing a health assessment without having biometric screenings. Ms. Meacock replied that there are no partial rewards for members. However, employers do receive credit for all points achieved by their employees.

Committee Member Kobylowski asked if members could get credit for screenings completed prior to the implementation of the program. Ms. Meacock responded that this could be done by allowing doctors to complete attestations based on previous results. Mr. Christ added that there would have to be limits applied as to how far back these screenings/tests would be allowed.

Committee Member Kelleher asked if healthy people could attain enough required points to receive rewards. Ms. Meacock replied yes, that they were very conscious of this scenario while creating the points system. Committee Member Kelleher asked how the number of employees per employer is determined, given that employees come and go throughout any given year. Mr. Christ suggested a “snapshot” approach would be the most reasonable, although that was yet to be determined.

Committee Member Ridolfino asked for examples of online activities. Ms. Meacock’s examples included exercise logging, food tracking, videos, and educational courses. Committee Member Kelleher asked about the possibility of people being dishonest in their reporting. Ms. Meacock stated that, although this is a possibility, the points assigned for these activities are relatively low, so it is not a great concern. The hope is that members will be encouraged to engage in healthier behaviors by the act of monitoring these activities. Committee Member Kelleher asked how often members speak with a telephonic coach. Ms. Meacock responded that this could be weekly, biweekly, or monthly, based on individual need.

Regarding biometric screenings, Committee Member Kelleher expressed concerns that the onsite option might not work for teachers. Ms. Sheppard advised that the Division was aware that this might not work for the SEHBP, and they were looking for other options. She suggested a centralized location. Committee Member Kelleher added that the NJEA has county fairs that might provide other opportunities for screenings.

Regarding the incentives, Committee Member Ridolfino commented that the logistics of the incentives need to be considered, including how the gift cards are used, taxed, reported on W-2 forms by employers, etc. Committee Member Leonard added that any unused gift cards might be required to go to the Office of Unclaimed Property after five years, depending on the type of card used. Ms Sheppard advised that she is looking into these details with Taxation and Unclaimed Property.

Regarding weight loss programs, Committee Member Kelleher asked if specific programs could be used, i.e. Weight Watchers, Jenny Craig, etc. Ms. Meacock replied that Aon Hewitt is working with the vendors on this possibility; the points would have to be determined. Mr. Christ added that this should not be built into the point system, as it would be administratively cumbersome.

Regarding the cost/benefit analysis provided, Committee Member Leonard asked if the Express Scripts 2.5 to 1 ROI was included in the figures given. Mr. Christ replied that it was, but that it is a relatively small cost, at approximately three-quarters of a million dollars. Committee Member Kobylowski asked where the increase in savings would level out. Mr. Christ responded that Aon Hewitt projected that, after year five, it would be roughly three percent per year savings for engaged members.  

Committee Member Leonard asked if we are already paying for wellness programs through Aetna and Horizon. Mr. Christ responded that they do not offer wellness programs, per se, but coaching and disease management programs are available, with relatively low participation rates. Ms. Meacock added that the proposed wellness program would be accessible to a much wider population, including those at risk, not just those who have been identified through claims.

Committee Member Kelleher expressed interest in a pilot program to track productivity. Mr. Christ advised that they would look into that. Committee Member Steinhauer inquired about premium increases for members. Mr. Christ advised that these would be much less than one percent.

The Aon Hewitt team then gave a presentation entitled Review of Other Prescription Drug Programs Presented to PDC, which covered RxAlly and Express Scripts’ Socrates program. Committee Member Kelleher asked if an RFP would be required if choosing RxAlly. Ms. Sheppard advised that this was true. Committee Member Leonard asked if they would have to bid if going outside of Express Scripts. Ms. Sheppard confirmed this. Committee Member Leonard asked if there are benchmarks for the vendors to ensure that they are doing their part. Mr. Christ advised that a baseline is needed before a benchmark is established. This would be part of the initial set-up.

Committee Member Leonard made a motion to share the Wellness Program Overview and Planning with the State Health Benefits Program Plan Design Committee (SHBP PDC). Committee Steinhauer seconded the motion. The motion passed, with all in favor.

Committee Member Leonard made a motion to request Aon Hewitt provide the Committee with the same motions as made by the SHBP PDC at the meeting held March 15, 2013.  Committee Member Steinhauer seconded the motion. The motion passed, with all in favor.

There being no further business, Committee Member Steinhauer made a motion to adjourn. Committee Member Pierce seconded the motion; all were in favor. The meeting adjourned at 12:10 PM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

 


Meeting No. 15 Minutes
April 15, 2013, 10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee
 

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013. The meeting of the SEHBP Plan Design Committee was called to order on Monday April 15 at 10:08 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Kenneth E. Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO (via teleconference)
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Douglas Martucci, Division of Pensions and Benefits
James Christ, Aon Hewitt
Kimberly Meacock, Aon Hewitt
Susan Marsh, Aon Hewitt
Dave Perry, Horizon Blue Cross Blue Shield of New Jersey

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Ms. Barrett advised that the minutes from the last meeting were not yet available for review.

Follow Up Regarding Wellness Program: Mr. Christ began the discussion by presenting a cost/savings analysis and expected participation rate of the proposed program. Committee Member Ridolfino asked how savings are measured. Ms. Marsh responded that they use clinical metrics and the associated costs to estimate savings. He then asked if costs would increase due to increased doctor visits. Ms. Meacock advised that the small costs of increased doctor visits and prescription use is worth the decrease in higher costs, such as hospitalizations. Committee Member Kobylowski asked if wellness incentives are currently available to the SEHBP members. Mr. Christ replied yes, but not as a part of a rewards system.

Follow Up Regarding Previous Motions: Mr. Christ went over the details of Motion 1, High Value Health Engagement Option, starting with the Patient Centered Medical Home (PCMH) model. Ms. Pierce asked if the PCMH relies on patients getting involved. Mr. Christ responded no, that it is more a partnership between the vendor and provider. Committee Member Kobylowski asked if PCMH only applies to Horizons in-network providers. Mr. Perry advised that it is more about data management, not necessarily limited to in-network.

Mr. Christ explained the concept of tiered networks. Reimbursement level is based on quality metrics. Quality metrics include readmission rates, lower length of stay, etc. as determined by claims. Members visiting doctors in a higher tier receive a higher level of benefits.

Gateway Plans were also discussed in response to Motion 1. Mr. Christ advised that some employers offer the opportunity to enroll in a richer plan design as an incentive for participating in wellness activities. He advised that this option would be in place of a wellness program, that both could not co-exist. Aon Hewitt had not priced it as of yet, but in their opinion, there would be few people choosing this option. Committee Member Ridolfino asked how the savings compare to wellness programs. Mr. Christ responded that there is not a lot of data yet to compare, that such programs are relatively new. Ms. Marsh added that gateway plans are an all-or-nothing incentive, whereas a wellness program incents people to participate at least part of the way.

Regarding Motion 2, Prescription Drug Step Therapy (PDST), Aon Hewitt presented information to their recommendation against a side-by-side PDST / non-PDST plan offering. Committee Member Kelleher asked if the SEHBP has PDST currently. Ms. Marsh replied yes. She added that the program in place is already robust and that she recommends keeping it as is.

Regarding Motion 3, Basic, Low-Cost Health Plan, Aon Hewitt presented a lower cost version of the current 2030 plan. Committee Member Kelleher asked how many members were currently in the 2030 plans. Mr. Pointer advised that there are between 200 and 300 SEHBP members in the plans. Committee Member Kelleher felt that it might be a good idea to better educate the members on their choices as opposed to offering new plans.

Health Care Reform Changes: Ms. Marsh explained that Federal Health Care Reform (HCR) sets a maximum out-of-pocket limit for member medical in-network plan cost sharing in Plan Year 2014. The maximum specified is $6,500 per individual. Committee Member Kelleher asked if this affects many SEHBP members. Ms. Marsh replied that it is very unlikely to affect members, but that the SEHBP must comply or pay a penalty. If any members were affected, it would only be for the benefit of the members and not detrimental to the plan.

Next Steps: Committee Member Steinhauer made a motion to choose three members to form a subcommittee to meet with the State Health Benefits Program Plan Design Committee to discuss wellness programs. Committee Member Leonard seconded the motion; all were in favor.

Committee Member Leonard made a motion to appoint Committee Members Leonard, Kobylowski and Ridolfino to the subcommittee. Committee Member Steinhauer seconded the motion; all were in favor.

Committee Member Kelleher summarized the follow ups for the next meeting. They included: a description of the current plan offerings; retiree prescription co-pays; mental health parity;  HCR requirement; wellness program; PDST expansion; lower cost plan options; a comparison of Screen Rx to Socrates; and pending legislation review for the Pensions and Health Benefits Review Commission. Committee Member Steinhauer requested that actives and retirees be handled as two separate presentations.

There being no further business, Committee Member Steinhauer made a motion to adjourn. Committee Member Leonard seconded the motion; all were in favor. The meeting adjourned at 12:08 PM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

Meeting No. 16 Minutes
May 10, 2013, 9:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee
 

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on May 3, 2013.  The meeting of the SEHBP Plan Design Committee was called to order on Friday, May 10, 2013 at 9:07 AM. The meeting was held at the Thomas Edison State College, Townhouse Room 104, 101 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Absent:

Ken Kobylowski, Department of Banking and Insurance

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Douglas Martucci, Division of Pensions and Benefits
James Christ, Aon Hewitt
Kimberly Meacock, Aon Hewitt
Dave Perry, Horizon Blue Cross Blue Shield of New Jersey
Bart Gerber, Express Scripts

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Committee Member Steinhauer made a motion to approve the minutes from March 18, 2013 and April 15, 2013. Committee Member Pierce seconded the motion; all were in favor.

Aon Hewitt distributed their presentation to Committee members, entitled 2014 Plan Design Issues for Decision. Committee Member Kelleher suggested that Aon Hewitt go through the presentation swiftly, as most of the information had been discussed at previous meetings. Committee members were free to ask questions at any time.

Mr. Christ began with a summary of the current plan designs. Committee Member Leonard asked if three-hundred dollars is the amount that an employer would put into a Health Savings Account (HSA) under the High Deductible 1500 plan. Mr. Pointer advised that it is directly funded by the employer. Each employee in that plan starts the year with a three-hundred dollar account per contract, regardless of coverage level.

Regarding retiree co-pays, Committee Member Kelleher asked why the calculation was changing now, despite the fact that the Committee made changes last year. Mr. Christ explained that it is based on regulation. DAG Weeden added that the regulation calls for the co-pays to be indexed annually. Absent action by the Committee, the regulation stands. Committee Member Kelleher questioned the suggested increase of nine percent in co-pays and six point seven percent increase in out-of-pocket maximum, citing an article that stated prescription costs should be “flat lining”. Mr. Christ explained that the co-pay increase is formulated by looking at the 2011 and 2012 data for the SEHBP and the State Health Benefits Program (SHBP), combined. It is based on the total drug cost, divided by the total number of days dispensed for those drugs to equal the cost for prescription per day. The out-of-pocket maximum has a different formula prescribed in the regulation, based on the increase in prescription drug claims per retiree. Mr. Christ said that it was Aon Hewitt’s opinion that these increases are consistent with current prescription drug trend.

Regarding mental health parity, Mr. Christ advised that, if the SEHBP went to full parity, Aon estimates that it would increase costs in the range of 2.6 to 4.4 million dollars in 2014. Non-biologically based illnesses are currently subject to day limits, depending on the plan. Committee Member Kelleher asked if passing mental health parity would mean that they would not have to look at each illness individually, such as the legislation they are being asked to consider related to posttraumatic stress disorder or eating disorders. Mr. Christ responded affirmatively. Committee Member Ridolfino asked if the estimate included out-of-network costs. Mr. Christ stated that the figures include in- and out-of-network costs combined, and that he would research the impact of in- vs. out-of-network impact, as a follow-up item. Mr. Perry added that the majority of the cost increase is associated with the co-insurance relative to the out-of-pocket hospital setting.

Regarding the out-of-pocket maximum change, Committee Member Kelleher asked for clarification that they had previously discussed raising the maximum. Mr. Christ responded yes, that this was based on Health Care Reform. There were no further questions on the topic.

Regarding the proposed wellness program, Committee Member Kelleher asked if there would be any tax implications for those not participating in the program. Mr. Christ confirmed that there is only a tax on those receiving gift cards. He also confirmed that the gift cards would be sent by the vendor or subcontractor of the vendor.

Regarding Prescription Drug Step Therapy (PDST) expansion, Mr. Christ explained that there are currently seven classes of drugs that are part of the program. Express Scripts has proposed expanding the program to include medications for such conditions as glaucoma, diabetes, and asthma. Committee Member Kelleher asked how the original list of 24 drugs increased to 53 drugs without the Committee or the SEHBC first being notified. Mr. Gerber responded that he believed the Committee approved certain categories of drugs be included in the program and that the drugs within each category would change depending on market conditions. Committee Member Kelleher expressed his disbelief that 30 new drugs were added in the last two years. Mr. Christ added that the prescription marketplace is incredibly dynamic. Ms. Sheppard suggested that a follow-up be done explaining the PDST process and accounting for the expansion of the original list from 24 to 53 drugs. Mr. Christ added that there is a coverage review process involved, so the non-preferred drugs are not completely unavailable to members. Committee Member Kelleher asked if this meant that a member must try and fail two preferred drugs before being allowed to fill the non-preferred drug. Mr. Gerber responded that the authorization rules vary depending on the drug category. In certain instances, the member need not try the preferred brand. If the doctor indicates that the member has an allergy to an ingredient in a preferred drug, the non-preferred drug would be authorized without a try/fail requirement. Mr. Pointer added that the Division’s agreement with Express Scripts is that none of the categories have more than one try/fail requirement. Committee Member Ridolfino asked if there was a check list for the doctor to follow. Mr. Gerber responded that there is a protocol in place that ESI clinicians follow during a coverage review of a non-preferred drug.

Mr. Christ gave a brief summary of the “Lower Cost 2030 Plan” and “60% Minimum Value Plan”, as described in previous meetings. He then summarized the comparison of Screen Rx to Socrates. Mr. Gerber clarified the criteria for being identified as non-adherent. Committee Member Leonard asked for confirmation that, if the Committee were to choose an entity other than Express Scripts to manage prescription non-adherence, there would have to be an RFP process. Ms. Sheppard confirmed this.

Committee Member Kelleher asked for confirmation that there are three pieces of pending legislation that the Committee was asked to review by the Pension and Health Benefits Review Commission, pertaining to post-traumatic stress disorder, eating disorders, and the HIV vaccine, respectively. Mr. Pointer confirmed this.

Committee Member Steinhauer wished to discuss the upcoming meeting schedule. He asked that any information voted on by the Committee be forwarded to the SEHBC as soon as possible. Mr. Pointer agreed to arrange this. Committee Member Kelleher stated that, at the next scheduled meeting, motions will likely be made for the 2014 plan year. He suggested that the June, July, August, and September 2013 meetings be cancelled. The Committee would meet again in October to start discussing the next plan year. Mr. Christ also added that the “Cadillac Tax”, part of Health Care Reform to be implemented in 2018, will need to be reviewed sooner, rather than later. Committee Member Kelleher suggested that the topic be considered when the Committee begins discussing the next plan year in October 2013.

There being no further business, Committee Member Steinhauer made a motion to adjourn. Committee Member Pierce seconded the motion; all were in favor. The meeting adjourned at 10:11 AM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

 


Meeting No. 17 Minutes
May 30, 2013, 10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee 

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on May 20, 2013. The meeting of the SEHBP Plan Design Committee was called to order on Thursday, May 30, 2013 at 10:00 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Ken Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Kierney Corliss, Division of Pensions and Benefits

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Ms. Barrett stated that the Committee had just been forwarded the minutes earlier that morning. The members were not prepared to make a motion on the minutes at this time.

Committee Member Steinhauer made a motion which included the following: conform with the Affordable Care Act (ACA) by approving the out-of-pocket maximum change as outlined in the presentation from Aon-Hewitt, dated May 10, 2013; to approve the wellness program, as outlined  on pages 14 through 16 of the same document; to approve Mental Health Parity, outlined on page 7 of that document, requiring non-biologically-based illnesses to be treated the same as biologically-based illnesses; to approve the retiree co-pay schedule, with modifications. Committee Member Pierce seconded the motion. Committee Member Leonard stated that the State representatives needed more time to fine-tune the details of the plan and would not be ready to vote affirmatively. He requested that a meeting be scheduled for June 11 or June 13, 2013. He mentioned that employees with an average salary of $83,000 would be seeing an increase of $114.00 per month starting July, 2013. He felt that the cost increases associated with the motion should be looked at carefully so as not to further burden the members unnecessarily. Committee Member Kelleher stated that on May 10, 2013, the last meeting, dates were picked for a subcommittee of this Committee and the State Employees Health Benefits Program Plan Design Committee; that meeting never occurred. A meeting was scheduled for May 24, 2013, but was postponed by the State representatives. He stated that Aon Hewitt originally gave a deadline of May 15 for approval of the wellness program in order to begin the initial implementation, but that the latest date to extend it to would be May 30. Meeting this deadline was vital in order to get materials out to school employees and their employers prior to the end of the school year. Any further delay in the implementation would decrease the likelihood of member participation and success. He added that the labor representatives have made these program changes their priority. Committee Member Leonard stated that the deadline was an arbitrary date and that he had every confidence that Aon Hewitt and the Division of Pensions and Benefits would be able to move forward with the implementation if it were delayed by a few weeks. A vote was taken on the motion. Motion failed 3:3:0(Committee Members Leonard, Ridolfino, and Kobylowski voted nay).

Committee Member Steinhauer made a motion to approve the out-of-pocket maximum according to the ACA, as outlined by Aon Hewitt in their presentation dated May 10, 2013. Committee Member Pierce seconded the motion. The motion passed, 6:0:0.

Committee Member Steinhauer made a motion to approve the retiree prescription co-pays, with the following modifications to the rates proposed by Aon Hewitt in their presentation dated May 10, 2013:

 

PPO 10+15

HMO 10
1525
2030
2013
2014
2013
2014
2013
2014
2013
2014
Retail Generic Copay
$10
$10
$6
$6
$7
$7
$3
$3
Retail Preferred Brand Copay
$20
$21
$12
$13
$16
$17
$18
$19
Retail Non-preferred Brand Copay
$40
$42
$25
$26
$35
$36
$46
$48
Mail Generic Copay
$5
$5
$5
$5
$5
$5
$5
$5
Mail Preferred Brand Copay
$30
$31
$18
$19
$40
$41
$36
$37
Mail Non-preferred Brand Copay
$50
$52
$30
$31
$88
$91
$92
$95
Out-of-Pocket Maximun
$1,322
$1,367
$1,322
$1,367
$1,322
$1,367
$1,322
$1,367

Committee Member Pierce seconded the motion. In discussion, Committee Member Leonard stated that he had not seen these figures and would not be prepared to vote on them at this time. He stated that he would need more time to make a comprehensive decision. Committee Member Kelleher asked for confirmation that any changes would be required before the rate renewal recommendations were presented in July. Mr. Pointer confirmed that the retiree co-pays are part of the calculation that Aon uses for the rate renewal information. Committee Member Leonard added that indexing automatically goes into effect if no action is taken. Committee Member Ridolfino asked about the financial impact of the proposed changes. Mr. Pointer said that Aon Hewitt was not present to comment. Ms. Sheppard stated that the Division would follow-up with Aon Hewitt. A vote was taken on the motion. Motion failed 3:3:0(Committee Members Leonard, Ridolfino, and Kobylowski voted nay).

Committee Member Leonard made a motion to hold the next meeting on June 11, 2013. Committee Member Ridolfino seconded the motion. Committee Member Steinhauer stated that he did not want to set a date until they were sure progress would be made. DAG Weeden noted that there are dates scheduled throughout the summer. Ms. Barrett confirmed that there is a meeting currently scheduled for June 17, 2013. A vote was taken on the motion. Motion failed, 3:3:0 (Committee Members Kelleher, Pierce, and Steinhauer voted nay).

Committee Member Ridolfino asked why the wellness program could not be implemented after the school year ended. Committee Member Kelleher responded that Aon Hewitt stated that if the process is delayed, there is a greater chance of the program failing. He added that it is not just the wellness plan on the table, but also the 2014 rate renewals. Committee Member Ridolfino asked if Aon Hewitt would be able to proceed if the dates were pushed back. Mr. Pointer responded that Aon will proceed however the Division directs them. Committee Member Kelleher asked Committee Member Ridolfino if he could provide one reason for his hesitance. Committee Member Ridolfino replied that the tax issue of unused gift cards is an important, unanswered question.

There being no further business, Committee Member Kobylowski made a motion to adjourn. Committee Member Ridolfino seconded the motion; all were in favor. The meeting adjourned at 10:40 AM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

Meeting No. 18
Minutes
June 17, 2013
10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013.  The meeting of the SEHBP Plan Design Committee was called to order on Monday, June 17, 2013 at 10:03 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Ken Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO (via teleconference)
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Danielle Schimmel, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Doug Martucci, Division of Pensions and Benefits

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Committee Member Steinhauer made a motion to approve the minutes from the last two meetings. Committee Member Pierce seconded the motion. May 10, 2013 minutes approved, (5:0:1 Committee Member Kobylowski abstained). May 30, 2013 minutes approved, (6:0:0).

Chairman Kelleher asked if anyone wanted to make any comments regarding the changes for Plan Year (PY) 2014. Committee Member Leonard commended Chairman Kelleher and his team for working with the management representatives in order to come to an agreement on a complete package of plan changes. However, there was one outstanding item on which they had not yet come to an agreement, and therefore would not be able to vote to approve the suggested changes on this date.

Committee Member Leonard asked about the retiree co-pay indexing. Mr. Pointer clarified that, if the Committee does not approve changes to the co-pays prior to the School Employees’ Health Benefits Commission (Commission) vote on the rate renewals, that the regulatory indexing would take effect. The first of those Commission meetings was scheduled for July 10, 2013. However, the Committee would have until the end of 2013 to approve a motion to amend the retiree co-pays for PY 2014. Chairman Kelleher asked what the latest date would be for the Committee to vote on changes for PY 2014 in order for Aon Hewitt to have sufficient time to present the rates to the Commission on July 10th. Mr. Pointer suggested any changes be made by the end of June.

Committee Member Steinhauer made a motion to schedule the Committee meetings for the next plan year on the third Monday of each month beginning September 2013 through May 2014, with exceptions for holidays in January and February. Committee Member Pierce seconded the motion. The motion was approved (6:0:0).

Chairman Kelleher noted that there would be a new chairperson for the September meeting. DAG Weeden confirmed that the law states that the chairperson alternates each year between an employee representative and a management representative. Chairman Kelleher asked if an agenda could be set in advance of the September meeting, considering there will be a new chair. DAG Weeden confirmed that it would be acceptable.

Committee Member Leonard asked the other Committee members about their availability for a follow-up in the coming week. Committee Member Steinhauer suggested that, in lieu of scheduling another meeting in June at this time, the management representatives contact the Division to schedule a teleconference once they get an answer to the one outstanding item that Committee Member Leonard had mentioned earlier. Committee Member Leonard agreed to do so.

There being no further business, Committee Member Steinhauer made a motion to adjourn.  Committee Member Leonard seconded the motion, all were in favor. The meeting adjourned at 10:22 AM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

 


Meeting No. 19
Minutes
August 23, 2013
10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee
 

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013, and a revised notice was sent on August 13, 2013.  The meeting of the SEHBP Plan Design Committee was called to order on Friday, August 23, 2013 at 10:01 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Ken Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO (via teleconference)

Absent:

David Ridolfino
Wendell Steinhauer

Also in Attendance:

Diane Weeden, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Doug Martucci, Division of Pensions and Benefits

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Ms. Barrett advised that the minutes from the last meeting were not yet available for a vote.

The Committee members were presented copies of a presentation by Aon Hewitt entitled School Employees’ Health Benefits Program Plan Design Committee PY 2014 Plan Design Issues for Decision. Committee Member Leonard made a motion to approve the following five changes to the SEHBP for Plan Year 2014, which begins January 1, 2014, as outlined in Aon Hewitt’s presentation of August 23, 2013:

1. Add the option for low cost 2035 PPO and HMO plans, for active employees only

2. Modify retiree prescription copayments for PY 2014

3. Provide a well care initiative, for active employees only, to be applicable to all plan options offered by the SEHBP

4. Provide the Screen Rx program for active employees only

5. Provide mental health parity, so that non-biologically based mental illness is treated the same as any other illness.

Except as modified above for PY 2014, all other components of the SEHBP plans and designs offered during PY 2013 shall continue. Committee Member Kobylowski seconded the motion. Chairman Kelleher asked if the Division would be able to implement all of these changes for January 2014. Ms. Sheppard confirmed. Committee Member Leonard advised the other Committee members that the Division has indicated a willingness to dedicate specific staff to helping all of the school districts understand the Wellness Program. Committee Member Kelleher added that the NJEA will assist in promoting the program through NJEA literature to its membership. Committee Member Pierce offered the same support from the American Federation of Teachers. Motion approved (4:0:0).

Ms. Barrett advised that the next meeting is scheduled for September 16, 2013.

Committee Member Leonard commended and thanked Chairman Kelleher for his leadership throughout the year. Committee members Kobylowski and Pierce also expressed their gratitude to the Chair.

There being no further business, Committee Member Kobylowski made a motion to adjourn.  Committee Member Pierce seconded the motion; all were in favor. The meeting adjourned at 10:12 AM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

 


Meeting No. 20
Minutes
September 16, 2013
10:00 AM
School Employees’ Health Benefits Program (SEHBP)
Plan Design Committee

Adequate notice of this meeting has been provided and filed with and prominently posted in the offices of the Secretary of State.  The meeting notice was mailed to the Secretary of State, Star Ledger and the Trenton Times on January 16, 2013.  The meeting of the SEHBP Plan Design Committee was called to order on Monday, September 16, 2013 at 10:03 AM. The meeting was held at the Division of Pensions and Benefits, 50 West State Street, Trenton, New Jersey, and was attended by the following:

Present:

Kevin Kelleher, NJEA
Ken Kobylowski, Department of Banking and Insurance
James Leonard, Department of Treasury
Jean Pierce, AFT AFL/CIO (via teleconference)
David Ridolfino, Department of Treasury
Wendell Steinhauer, NJEA

Also in Attendance:

Diane Weeden, Deputy Attorney General
Florence J. Sheppard, Division of Pensions and Benefits
David Pointer, Division of Pensions and Benefits
Susan Barrett, Acting Secretary
Doug Martucci, Division of Pensions and Benefits

Sunshine Act Statement: The Sunshine Act Statement and the Executive Session Resolution were read by Ms. Barrett.

Minutes: Committee Member Kobylowski made a motion to approve the minutes of August 23, 2013. Committee member Leonard seconded the motion. Approved (5:0:1, Committee Member Steinhauer abstained).

Committee Member Steinhauer made a motion to open the nominations for the new chairperson for the upcoming year. Committee Member Kelleher seconded the motion. Committee Member Kobylowski nominated Committee Member Leonard. Committee Member Ridolfino seconded. Committee Member Steinhauer made a motion to close the nominations; Committee Member Kelleher seconded. A vote was taken on the nomination of Committee Member Leonard as Chairperson, with all in favor.

Committee Member Leonard thanked the Committee for the opportunity. He asked Ms. Sheppard to comment on steps to be taken to promote the wellness program and other changes approved for Plan Year 2014. Ms Sheppard advised that Doug Martucci had been assigned as coordinator of the NJWELL program. Mr. Martucci gave an update on the plans to promote the program at various educator conventions.

Committee Member Leonard stated that one of the main focus points for the next plan year would be in the area of prescription drugs. He asked that the Committee be kept informed about the Prescription Benefit Management Request for Proposals (PBM RFP) process. He asked if there were other issues the Committee members would like to address for the next plan year.

Committee Member Kelleher requested a presentation on the upcoming Excise Tax in 2018. He also requested that the Division prepare a summary of plan enrollment. He proposed a discussion on whether members are migrating to the newer plans and if there has been any resulting cost-savings. This could be looked at district-by-district to see if there are different levels of migration and, if so, the reasons for it. It was decided that this should be presented early in 2014.

Ms. Sheppard thanked the Committee for its cooperation over the past year.

There being no further business, Committee Member Steinhauer made a motion to adjourn.  Committee Member Kelleher seconded the motion; all were in favor. The meeting adjourned at 10:23 AM.

  Respectfully submitted,
 

 

 

  Susan Barrett
Acting Secretary, SEHBP Plan Design Committee

 

 

 

 

 

 

 

 
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