Andrew Brown, Business Analyst, Benefits Policy

Tak Lam, Associate Business Analyst, Benefits Policy

Damon Tutein, Assistant Business Analyst, Benefits Policy

Wednesday, August 19, 2020

2021 Annual Enrollment Webinar Series

2021 Annual Enrollment Webinar #2

The Journey from Planning to Annual Enrollment

Today’s Agenda

Annual Enrollment Planning

Pricing and 2021 Renewals

• Pricing and Trends

• Annual Renewals

• Active and Retiree Health Plans

Disability Plan Selection and Member Enrollment Process

Reflections, Questions, and Discussion

2

Annual Enrollment Planning

3

The Journey from Planning to Enrollment

Policy

& Design

Plan

SelectionPricing

4

Overview of Our Seamless Annual Process

5

• Benchmarking

• Industry trends

• Client feedback

• Evolving needs

of the Church

Policy & Design

• Detailed analysis

of group experience

and industry trends

• Final plan pricing for

the coming year

Pricing

• Groups select plans

that will be offered

to employees

Plan Selection

• Employees and

their families

review their

choices and

enroll or make

changes for 2021

2021 Plan Selection and Annual Enrollment Timeline

Major Categories

• Plan array process

• Pricing

• Renewals

• Renewal

supporting

materials

• Member

communications

January

to July

• Plan Selection

Release Date: 08/26

• Group plan

selections: 08/26–10/07

• MLPS system

preparation

• Member

communication

mailings

August

• Group plan

selections continue to 10/07

• Active AE dates

– 1st Session: 10/12–10/30

– 2nd Session: 10/28–11/18

• Retiree AE dates: 10/15–12/07

• Pre-65 Retiree dates: 10/28–11/18

• Vendor / member account set-up

October

• CPG conducts a

Quality review of

AE transactions

• Member ID card

production and

mailing

December

to January

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2021 Administrator Education Opportunities

Member Education Opportunities

• IBAMS education sessions (by request)• Health plan care management programs (for current enrollees)

• Enrollment support via Health Advocate

Renewal and AE Webinars for Administrators(June–September)

2020 CPG Summer Sessions Virtual Conference(July 15 and 23)

Virtual Episcopal Benefits Administrators Conference(September 29 and October 1)

7

2021 Member Education Opportunities

Health plan care management programs

(for current enrollees)

Enrollment support via

Health Advocate

IBAMS education sessions

(by request)

Opportunity 01

Opportunity 02

Opportunity 03

8

2021 Annual Enrollment Planning

Communicating to your Related Entities and Employees

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Mail Date: September 28

Session 1:

Oct. 12 to Oct. 30

August 21

Dependent Aging Out Letter

September 4

Notice of Creditable Coverage (NOCC)

August 26

In Your Renewal Package

• Letter Template for Administrators

• Plan Comparison Chart

• Annual Enrollment Guide

• Summaries of Benefits and Coverage (SBCs) posted to CPG.org

Mail Date: October 14

Session 2:

Oct. 28 to Nov. 18

2021 Active Member AE Timeline

2021 Annual Enrollment Planning

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Mail Date: September 28

Session 1:

Oct. 12 to Oct. 30

Mail Date: October 14

Session 2:

Oct. 28 to Nov. 18

2021 Active Member AE TimelinePlans Going Away

• Should you elect to no longer offer a plan

in 2021 that you offer in 2020

• Annual Enrollment requires action

by employee

• MLPS tools and reports to help you manage

When Members Change Networks or Plan

Types

• Resources available to provide information

• Ensuring continuity of care for those in

treatment

Pricing and 2021 Renewals

11

Plan Selection and

Annual Enrollment Timeline

Pricing and Trends

12

Pricing: Overview—Key Factors

13

Overall Group Specific

Actual versus expected

• Large claims

Projected

• Cost trend assumptions

• Known/expected changes

• Stress testing

Relative positioning

• Medical Trust average

• National rate – Denominational

Health Plan groups

Group-specifics

• Demographics/geographic factors

• Experience

• Prior rate actions

Pricing: Focus on Cost Trend Assumptions

Projected percentage increase in the cost to treat patients from

one year to the next, assuming that benefits remain the same

What is medical and pharmacy cost trend?

14

Cost trend influencers:

• Unit cost inflation of medical products and services

• Per capita utilization or changes in the number or

intensity of service usage

Cost trends used to estimate what the same health

plan design will cost from year to year

Consolidation of healthcare providers

Aging of the coveredpopulation

Changes in federal or state legislation

Cost shifting from public payers (Medicare)to private plans

Impactof fixed deductibles and copays

Healthcare service utilization

Variations in provider treatment patterns

Medical technology and drug therapies

Changing health of the covered population

Price inflationor deflation

Pricing: Focus on Cost Trend Assumptions

What are some factors that can affect healthcare trends?

15

Pricing: Focus on Cost Trend Assumptions

What do the current trend studies show for 2021?

2021 medical cost projection could range from 4% to 10% —

uncertainty due to impact of COVID-19

Prices remain primary driver; growing at faster rate than utilization

Inflators: COVID-19 mental health impact, specialty drug spending,

chronic disease prevalence

Deflators: telehealth goes mainstream, narrow networks, worksite

clinics, lower-cost sites of care, increase in benefits communication

and navigation tools

Sources: PwC’s Health Research Institute – Medical cost trend: Behind the numbers 2021 16

Pricing: Focus on Cost Trend Assumptions

Medical Trust trend assumptions for 2021 pricing

17

Medical &

Behavioral

Health

(5.7%)

Prescription

Drug

(8.2%)

2021 Overall Average Preliminary Rates

Active Health

18

Composite Trend +7.10%

Prior Experience 1.00%

Demo/Geo Risk Profile 0.10%

Benefit Changes 0.80%

Cost Containment Strategy/Economies of Scale - 1.5%

Surplus - 2.10%

+ 5.44%

2021 Dental Rates—Actives

The average Dental Rate increase for 2020 is < 1%

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Some groups may see a modest rate increase

based on their claims experience.

0.91%

Basic Dental /

Dental and

Orthodontia

1.90%

Preventive

Dental

Plan Selection and

Annual Enrollment Timeline

Annual Renewals

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Health Plans Offered for 2021

• PPO 100

• PPO 90

• PPO 80

• PPO 70

• CDHP 15

• CDHP 20

• CDHP 40

• EPO High

• EPO 80

• CDHP 20

7 Plan Options with Anthem and Cigna 3 Plan Options with Kaiser

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Renewal Supporting Materials

Renewal Package

• Alerts master administrator to

go to MLPS for the

Group’s Plan offering

and selections

• Provides a link to instructions

for how to access information

22

Renewal Email

• Medical Trust Renewal Letter

• Participating Group Agreement

• Administrative Policy Manual

• Medical Trust Compass Report

and how to use it

• AE Timeline and Letter Templates

for Administrators

• Healthcare Compliance Notices

• Summaries of Benefits and

Coverage (SBCs) on CPG.org

• Health Plan Comparison Chart

2021 Active Renewals

• Review and share accordingly

with your key stakeholders

• IBAMS resources available to

assist you with questions

• Determine your 2021 Plan

offering and make elections

in MLPS

August 26 — Available in MLPS

• Plan Selection Deadline:

October 7

Plan Selection Timing

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MLPS—Plan Selection Page

Navigate to Plan Selections when it opens in the MLPS site

20xx_Billing_Schedule_for_Episcopal_Church_Medical_Trust.pdf

20xx_AE_Timeline_for_Administrators.pdf

1. Log into CPG as an administrator and select MLPS.

2. Click the Plan Selections Link.

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Plan Selection Page: Making Selections

To complete

Plan Selections:

1. Click Accept or

Decline next to

each plan (do

not leave any

blank radials)

2. Click Submit

3. Finished!

Review your offering

Rates Rates Election

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Plan Selection Page: Additional Option Requests

To request an

Additional Option:

1. Leave radial buttons blank

2. Click check mark in

Additional Option

Requested box

3. Enter comments in the

Plan Request box

4. Click Submit

Submitting a request for additional options

Rates Rates Election

✓ Additional Option Requested

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Plan Selection Page: Additional Option Requests

If you request a multiple Tier and/or Rx pricing, upon receiving notice

that your additional request is ready you will need to review your new

offering

Viewing Tier and Rx Changes

1. Adjust values for Rate Tiers /

Rx Options to changes

2. Click View Plans (to

complete use previous

instructions)

3. Finished!

Rates

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Plan Selection and

Annual Enrollment Timeline

Active and Retiree Health Plans

28

Enhanced Hearing Aid Benefits for 2021

Active Benefit Allowance

Active Health Plan Current Benefit 2021 Benefit

All Self-Insured Active

Health Plans

Hearing aid device

discount only

Maximum benefit of $1,500

per ear, every three years

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The Episcopal Church Medical Trust Designs and

Administers Retiree Medical and Dental Benefits

Health

• Medical Supplies and Services,

including Preventive Care

• Behavioral Health

• Pharmacy

• Vision

• Employee Assistance Program

• Health Advocate

• Hearing (discount and benefit)

• Global Travel (assistance and benefit)

• SilverSneakers™ (gym benefit)

Dental

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Comprehensive Plus Premium

Monthly Premium Rates (PMPM)

2021 $400 $520 $605

2020 $380 $505 $590

2021 Increase (versus 2020)

Dollar Amount $20 $15 $15

Medical Trust 2021 Medicare Supplement Plan Rates

31

Specialty drugs and future changes to Medicare and Part D subsidies

represent main pricing risks.

Plans with Rx

Comprehensive

(no Rx)

Plus

(no Rx)

Premium

(no Rx)

Monthly Premium Rates (PMPM)

2021 $215 $250 $300

2020 $210 $245 $295

2021 Increase (versus 2020)

Dollar Amount $5 $5 $5

Medical Trust 2021 Medicare Supplement Plan Rates

32

Plans without Rx

Retiree Enhanced Hearing Aid Benefits for 2021

Retiree Benefit Allowance and Hearing Aid Device Discount

Medicare Supplement Current Benefit 2021 Benefit

Comprehensive and

Plus Plans

$1,000 per ear,

every five

years

Maximum benefit of $1,500

per ear, every three years, plus

hearing aid device discount

33

Retiree Enhanced Hearing Aid Benefits for 2021

Retiree Benefit Allowance and Hearing Aid Device Discount

Medicare Supplement Current Benefit 2021 Benefit

Premium Plan $2,000 per ear,

every five

years

Maximum benefit of $2,000

per ear, every three years, plus

hearing aid device discount

34

2021 Dental Rates—Retirees

No Dental Rate increase for 2021!

35

Dental and Orthodontia

Basic Dental

Preventive Dental0%

2021 Retiree Member AE Timeline

2021 Retiree Annual Enrollment

36

October 15 to December 7

Disability Plan Selection and

Member Enrollment Process

37

2021 Fully-Insured Disability Enrollment Timeline

Employer- and Employee-paid Disability Plans

• Monitor plan performance

and vendor management

• Employer and member

communication production

January

to July

• Disability Plan Selection Release Date: 08/26

• Employers select employer-paid or employee-paid

disability offerings: 08/26–10/07

• No action is required for 2021 if employers are

satisfied with their current plan selection

• Disability enrollment dates: 10/12–11/18

• Administrators review employee compensation

records in ER and update as needed

• Enrollment process and system preparation

• Zurich / member account set-up

August

to November

• Medical

underwriting and

enrollment

approval

(Employee-paid

plans only.

Applicable to

employees who

previously declined

coverage and want

to enroll for 2021.)

December

to January

38

Have your client ID ready when completing the survey. You can

find your client ID in ER or on your Medical Trust invoice.

2021 Fully-Insured Disability Plan Selection

Three-step Plan Selection Process

Employer- and Employee-paid Disability Plans

39

1 • Receive email with a link to the plan selection survey

– Satisfied with current plans, no action is required for 2021

– Your plan options will roll over to 2021

2 • Want to change plans, complete and submit the survey to make

your 2021 plan selections

– A step-by-step guide to completing each screen of the survey

is located on ARC, along with a link to the survey

3 • Save the submission screen as confirmation of your changes

2021 Fully-Insured Disability Plan Selection Enrollment Process

Employers offering new employer-paid or employee-paid disability

coverage for the first time, in 2021

40

1 • Contact your IBAMS representative (if applicable)

or Client Services at (866) 802-6333

2• Complete the STD and LTD Employer Plan Selection Form located on

cpg.org under Forms and Publications, and return the form to CPG at

Admin-Assist@cpg.org

3• Enroll employees in MLPS, or fill out the Employer- or Employee-Paid

Enrollment Form for each employee, located on cpg.org under

Forms and Publications, and return the forms to CPG at

Admin-Assist@cpg.org

– For employee-paid coverage, enrollment can be completed in

MLPS, but a paper form must be returned for each enrollee

Reflections, Questions, and Discussion

41

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For your participation and feedback.

Thank you!

Important Disclosures

This material is provided for informational purposes only and should not be viewed as investment, tax, or

other advice. It does not constitute a contract or an offer for any products or services. In the event of a

conflict between this material and the official plan documents or insurance policies, any official plan

documents or insurance policies will govern. The Church Pension Fund (“CPF”) and its affiliates

(collectively, “CPG”) retain the right to amend, terminate, or modify the terms of any benefit plan and/or

insurance policy described in this material at any time, for any reason, and, unless otherwise required by

applicable law, without notice.

Short-term disability and long-term disability insurance products and services are offered by Zurich

American Life Insurance Company, NAIC No. 90557, a New York domestic life insurance company. The

information provided here is a summary of the group disability income insurance coverage and is for

illustrative purposes only. A certificate with more complete policy information is available upon request.

Please refer to the certificate or the group policy for a complete description of coverage, terms,

conditions, exclusions, and limitations. If any conflict exists between the certificate and/or policy and the

information described here, the terms of the certificate and policy will govern. Other self-funded disability

benefits may be provided by The Church Pension Fund.

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