Faculty Healthcare Council

Attendees: Gary Stone, Tunga Kiyak, Dave Byelich, Linda Keilman, John Goddeeris, Sarah Mainville, Cherie
Booms, Kara Schrader, Nancy Rhodes, Victor Rodriquez, Titun Maiti
Absent: Deborah Moriarty

The meeting, conducted via Zoom, began at 3:05 pm.

Pre-Meeting Business
Cherie Booms is currently the Interim Director of Benefits.
The Director of Benefits position was posted, first round interviews were completed, and then there was an unexpected change in HR’s structure. Compensation has been moved under Alice Smith in Solutions Center. Because the compensation component moved, the posting was reevaluated and will be posted for benefit-specific capabilities. Also, before the position was reposted, Sharon Butler, AVP, announced that she will be retiring effective January 1, 2022, and will be off on medical leave until that date. Rick Fanning is currently Interim AVP. The Director of Benefits position will not be filled until the AVP position has been filed. Cherie Booms will keep the Committee informed moving forward.

Approval of minutes
Linda Keilman made a Motion to approve the March and April minutes. Seconded by Kara Schrader. Motion passed.

Update on Open Enrollment
MSU HealthTeam will be attending a future meeting to discuss their partnership with Henry Ford and HAP. Affidavit - The Affidavit must be completed every year for employees. The threshold remains at $1,500 for plan year 2022. AHR will help with communications to faculty members who have not completed the Affidavit toward the end of October.

Open Enrollment Fair – The Open Enrollment Fair will be October 12 and 14th. There will be live chats at each event. MSUHR would have preferred to conduct the Fair in person; however, many vendors had policies prohibiting them from attending in person. The virtual platform will be live the entire month of October with booths for each vendor. There will be two full days dedicated to live chats with vendors and HR. October 12 (12 p.m.–7 p.m.) and 14 (7 p.m.–5 p.m.). Site labs will be available on October 5, 19, 26 and 29, held via zoom, between 8:30am – 4:30pm, by appointment only.

Humana virtual meetings are scheduled as follows:
– Medicare
o October 13, 10:00am – 11:30am and 4:00pm – 5:30pm
– Non-Medicare
o October 13, 2:00 – 3:00pm
o October 15, 10:00 – 11:30am

AD&D Changes – The benefit for AD&D has been increased to $1.5M for employee and $750K for spouse. There is no change to the child benefit. Additional enhancements include spouse and child benefit amount from 50% spouse/15% child to 50% spouse/20% child. The child-only benefit increased to 25% from 20%.

Upgrade to Critical Illness Plan - Critical Illness was bought out by Farmer’s Insurance and upgrades have been made to the plan to align the plan across their book of business. Anyone currently enrolled will automatically be in the enhanced coverage level. They are still referred to as MetLife. There are no changes in rates.

Open Enrollment Guides are available at the MSU HR website as follows:
Faculty: https://hr.msu.edu/benefits/documents/2022-FAS-OE-Guide.pdf
Special: https://hr.msu.edu/benefits/documents/2022-Special-OE-guide.pdf
Retirees: https://hr.msu.edu/benefits/documents/2022-Retiree-OE-Guide.pdf

FSA Changes – Due to COVID, dependent care contributions were increased to $10K for 2021. Contributions will return to $5K in 2022.

National Emergency Adjustment Reason – Due to COVID, members were able to make mid-year plan changes. Due to the pandemic, a qualified life event wasn’t required in order to make changes. This benefit expires on December 31, 2021. Any changes for the 2022 plan year will be in effect for the entire year unless the employee has a qualifying life event.

All the resources listed above can be found on the MSUHR website.
The first email regarding open enrollment will be sent to faculty and staff on Monday, September 27. Another email will be sent on October 1. Different emails will be sent throughout October regarding FSA, Affidavit, etc.

Humana Retiree Plan Discussion

Frustration with Humana has been expressed via social media, letters to HR and administration. MSU continues to try to balance quality with cost. Humana is a Medicare advantage plan and has been on the market for quite some time. MSU did not implement a Medicare Advantage plan in the past because this type of plan was new and had issues to address and work through. In 2019, pre-COVID, an RFP for a Medicare Advantage plan was submitted and approved. Although it is not ideal to switch a healthcare plan during a pandemic, MSU had approved and signed the contract with Humana prior to the pandemic. Humana was selected because of their reputation, with the caveat that they are an employer Medicare advantage plan. Humana also provides individual plans, and there has been much confusion with providers in that regard. None of the other vendors had the breadth of experience within this type of plan. BCBS indicated that if MSU was not going to have Medicare retirees on the BCBS plan, they were unwilling to only cover Non-Medicare retirees because it is a much smaller group.

The coverage is the same across the board for most issues. The Medicare advantage plan operates differently than a Non-Medicare advantage plan. There has been a significant learning curve for MSU, retirees and Humana to work through with this transition. MSU has received positive feedback from those on the Medicare advantage plan. A lot of the issues are related to providers not having the proper information regarding the Humana Plan. Many believe it is an individual plan. Once providers realize it is a group plan, they accept the plan. Prescription coverage did change, and there was a disruption to about 3% of the retiree population. Some disruptions were positive (lower co-pay) some were not positive (higher co-pay). Humana reached out to enrollees to explain options when co-pays were changing, etc. MSU has been working with retirees regarding challenges and processes and continues to make sure providers are educated. MSU continues to try to make positive changes to increase the coverage levels where possible for retirees.

The Chair of this Committee has heard from several retirees around the country that they aren’t covered because they do not live in Michigan. In many instances, retirees have had to buy additional coverage. Retirees may not realize they can reach out to MSUHR for clarification or guidance. The Chair would like an additional communication sent to retirees who reside outside of Michigan to explain their options.

There is a difference between in-network and out-of-network coverage on the non-Medicare plan. If Humana reaches out to a provider directly to explain the plan, many times the provider will join the network. MSUHR is trying to communicate with individuals, as well as the MSU Retiree Association. Cherie Booms will look into what additional information can be sent to retirees to better explain that they should reach out to their providers to notify them that their Humana coverage is a group plan.
Cherie Booms will circulate the Open Enrollment slides to all Committee members.

The next meeting is scheduled for Oct. 22, 2021 – 3:30–5 p.m.

Adjourn: 4 p.m.

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Attendees: Gary Stone, Kara Schrader, Lalitha Gundamraj, Linda Keilman, Nancy Rhodes, John Goddeeris, Deborah Moriarty, Katherine Dontje, Dave Byelich, Renee Rivard, Cherie Booms.

Guests (MSU Health):
Chris Mack and Kristin Hausherr, Livongo/Teladoc

Absent: Tunga Kiyak, Sarah Mainville, Titun Mati, Jeff Brodie

The meeting, conducted via Zoom, began at 3:34 pm.

Welcome and Introductions
Chris Mack and Kristin Hausherr from Livongo/Teladoc attended the meeting to present the annual report and discuss future services/trends.

Approval of minutes

The approval of the March Minutes did not occur and consensus was to approve the minutes at the next meeting.

Livongo/Teladoc Presentation
 
The meeting schedule during the summer was discussed and it was determined that a poll would be sent out to determine the schedule for summer.

Meeting adjourned at: 5 p.m.
Next meeting: TBD

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Attendees: Gary Stone, Tunga Kiyak, Dave Byelich, Linda Keilman, John Goddeeris Renee Rivard, Sarah
Mainville, Katherine Dontje, Cherie Booms, Nancy Rhodes, Kara Schrader, Nancy Rhodes, Victor Rodriquez.

Guests (MSU Health):
Annette Cawley and Kristine Allen

Absent: Deborah Moriarty, Dave Byelich

The meeting, conducted via Zoom, began at 3:35 pm.

Welcome and Introductions
Annette Cawley and Kris Allen from MSU Health attended the meeting to present current and future services.

Approval of minutes
Sarah Mainville made a Motion to approve the minutes and seconded by Linda Keilman. Motion passed.

MSU Health Presentation
MSU Health Care is the faculty medical practice representing 340 physicians, nurse practitioners and physician assistants across 14 clinical departments who are both researchers and academic professors, spanning 46 adult and pediatric specialties committed to high-quality patient care. Its outpatient visits are nearly 400,000 and total net revenues are over $108 million for fiscal year 2018.
Opportunity focused: recruitment of additional specialists to meet community needs and joint ventures with McLaren and Henry Ford.

Future considerations include a lab and urgent care center.

At the conclusion of the presentation from MSU Health representatives, Reneè Rivard discussed an opportunity to explore a vendor, Omada Health, whose focus is assisting patients manage pre-diabetes symptoms. The Council suggested a future presentation from MSU Extension on their diabetes programs perhaps at the same meeting as Omada Health presents.

The meeting schedule during the summer was discussed, as previously, meetings were paused beginning in May through August. This will be discussed during the April meeting after the Teladoc/Livongo annual report presentation.

Meeting adjourned at: 5 p.m.
Next meeting: April 23, 2021 from 3:30 – 5 p.m.

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Attendees: Gary Stone, Tunga Kiyak, Dave Byelich, Linda Keilman, John Goddeeris Renee Rivard, Sarah
Mainville, Katherine Dontje, Cherie Booms, Nancy Rhodes, Kara Schrader, Nancy Rhodes, Victor Rodriquez.

Guests (Mercer):
Raymond Brown, RPh. - Consultant
John Lapinski – Health and Welfare Consultant

Absent: Linda Keilman, Lalitha Gundamraj, Titun Maiti, Deborah Moriarty
The meeting, conducted via Zoom, began at 3:35 p.m.

Welcome and Introductions
Raymond Brown and John Lapinski from Mercer both attended the meeting to discuss trends in employer-sponsored healthcare plans.

Approval of minutes
Nancy Rhodes made a Motion to approve the minutes. Motion seconded by Sarah Mainville. Motion
passed.

Trends in Employer-Sponsored Healthcare
John Lapinski and Raymond Brown both introduced themselves to the Committee. Lapinski is a health and welfare consultant with Mercer and has worked with MSU for approximately five years. Brown is a
pharmacist and consultant and has worked with MSU for approximately seven years.

Lapinski and Brown discussed their presentation, titled "Trends in Employer-Sponsored Healthcare
Plans."

Currently, 130 million people have employer-sponsored coverage. The results tend to lean toward group
plan sponsors like MSU.

At MSU the faculty have three plan offerings. Currently, Blue Care Network (BCN) has 70% of the enrollment/membership, Community Blue has 20% and the Consumer Driven Health Plan (CDHP) has
9%. Community Blue has more latitude and limited requirements for prior authorization of services.
Community Blue also has a much higher premium that faculty pay each month. Both BCN and Community Blue pays about 90% of services. Community Blue is a fee-for-service plan and is the easier
choice for those whose dependents live out of state. BCN is very regional to Michigan. While the provider networks between both plans are very similar, BCN has 10% fewer physicians than Community Blue.

The average age of Community Blue members is 55. The average age for BCN is 45. The annual cost of
BCN is approximately $10K and Community Blue is closer to $18K. BCN is more efficient and effective
in plan management. There is a 3.5–5% increase in healthcare costs for every year after someone turns
40. Community Blue has an older demographic and therefore, accounts for the difference in cost  between the plans.

Many health plans now offer what are called point solutions. These are largely start-up firms funded by
venture capital which are targeted for specific disorders such as diabetes, heart disease, sleep disorders, etc. MSU offers access to Teladoc Medical Experts (formerly Best Doctors), Teladoc for on-line medical care and Livongo for diabetes. There is currently no copay to access Teladoc.

The requirement for a Spousal Affidavit at MSU is challenging to administer. Coverage with other
employers is not audited. If the Affidavit were more strictly enforced, about 5% of spouses could be moved from primary to secondary which would save MSU approximately $770K.

Regarding pharmacy coverage – MSU Adopted CVS’s Advance Control formulary on January 1, 2021,
and PrudentRx (coupon program for specialty medications) will become effective on July 1, 2021. Much
of the savings is coming from generic medications and rebate programs. These plans offer savings for the patient/member and plan sponsor.

Advanced Care Management – There are pros and cons to offering this type of program. Although the
focus is on the sickest members and their care, support is available to all members. There is an average
engagement of 60-70% of high-cost claimants. However, it is expensive, and probably not a worthwhile
expense with the BCN plan.

Pharmacy initiatives – MSU is already addressing some of the trends shaping pharmacy today. Steps were taken last year and will continue in 2021 to drive more generic and rebate utilization. Specialty drugs continue to be a big issue. Pharmacy clients are not excluding these therapies. If medications aren’t covered, there is a risk that a patient’s condition will worsen, causing hospitalization and higher medical bills as a result of not receiving proper treatment.

Currently there are no copays for the COVID vaccine. There is also no charge if you receive a vaccine
through the health department. If a consumer without health insurance goes to a pharmacy to receive a
COVID vaccine, the cost is billed back to the government.

Meeting adjourned at: 5:05 p.m.
Next meeting: March 26, 2021 – 3:30 – 5 p.m.

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Attendees: Titun Maiti, Tunga Kiyak, Reneè Rivard, John Goddeeris, Sarah Mainville, Gary Stone, Kara Schrader, Deborah Moriarty, Dave Byelich, Lalitha Gundamraj, Nancy Rhodes, Katherine Dontje; Jeff Brodie, Chris Hanna, Cherie Booms, Becky Proctor.

Absent: Linda Keilman

The meeting, conducted via Zoom, began at 3:35 p.m.

Welcome and Introductions
Kara Schrader made a motion for approval of the November minutes. Tunga Kiyak, second. Motion approved. 

Update on CVS – PrudentRx implementation – Reneè Rivard
Recall the PrudentRx program modifies Specialty drug copays from the current $75.00 to 30% of the cost of the medication. The copay will be reduced to zero provided the member/patient enrolls in the PrudentRx program. This program takes advantage of current programs/coupons offered by the drug manufacturer to assist patients with lowering their cost or co-pay.
The draft Agreement with PrudentRx is being reviewed by Purchasing with an effective date of July 1, 2021.

Reviewed data related to COVID utilization provided by BCBSM - Reneè Rivard
Data is helpful for budgeting purposes and related forecasting.

Reviewed data related to Teladoc utilization - Reneè Rivard
Data review is useful to understand patterns of utilization and continued need to offer access to virtual services.

Medicare Advantage Implementation Update (MAPD) - Reneè Rivard
5,000 +/- retirees were transitioned from BCBSM/CVS health/prescription coverage to a Humana plan. Overall, the transition process went well; however, continued monitoring will occur to ensure smooth transition.

Reviewed healthcare financial dashboard – Chris Hanna and Jeff Brodie

The document provides a snapshot of enrollment, high-cost claims, and prescription costs.
Reneè Rivard announced her July 2 retirement.

Next meeting: February 26, 2021 – 3:30–5 p.m.

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Attendees: Renee Rivard, Tunga Kiyak, Kara Schrader, Linda Keilman, Sarah Mainville, Deborah Moriarty, Dave Byelich, Jeffrey Brodie, John Goddeeris, Nancy Rhodes, Lalitha Gundamraj, Katherine Dontje.
Guest: Cherie Booms
Absent: Gary Stone, Titun Maiti

The meeting, conducted via Zoom, began at 3:35 p.m.

Introduction of Marni Goodwin. Marni replaces Claudia Orlando as scribe for FHCC meeting minutes.

The council was asked to elect a new chairperson. The formal process for nomination was discussed including what, if any, background should be considered. Prior chairpersons have not had a medical background. Tunga Kiyak nominated himself for Chair. Motion passed unanimously.

Motion to approve June and September 2020, minutes and have both sets of minutes posted on the Academic Governance website. Motion passed.

Open Enrollment Update – Open enrollment will continue through October 31, 2020. A report generated the week of October 19 indicated there were approximately 800 faculty who had not completed their spousal affidavit. If the spousal affidavit is not completed prior to October 31, 2020, spouses and/or OIE individuals will be removed from the faculty member’s health plan effective January 1, 2021. Reminders will be sent the week of October 25th.

MSU Radiology Update – Mercer will pull all radiology services in order to give a better analysis of the full picture and overall cost savings. The analysis will be presented to the council in the near future.

A meeting with CVS to discuss prescription savings for specialty medications will be scheduled in the near future. Pharmaceutical companies that manufacture specialty medications put money aside to help with advertising and to offset costs and reduce copays for patients. Currently there are approximately 113 faculty at MSU who are using a specialty medication. If MSU can access the money available from the pharmaceutical company, MSU could potentially see a savings of $600,000. In addition, patients who take advantage of the cost-savings would not pay a copay for their medication. The November FHCC meeting will be focused on a discussion with CVS representatives regarding the specifics of the program. The date of the meeting is yet to be determined. The council discussed the possibility of changing the monthly occurrence of the FHCC meeting in order to better accommodate everyone’s schedule. Marni will reach out to council members to find mutually agreeable dates/times.

Meeting adjourned 4:25.

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Attendees: John Goddeeris, Gary Stone, Deborah Moriarty, Kara Schrader, Lalitha
Gundamraj, Tunga Kiyak, Titun Maiti, Nancy Rhodes, Katherine Dontje, Reneè Rivard.

Guests: Representatives from MSU Radiology, Colleen Hammond and Annette Cawley

The meeting, conducted via Zoom, began at 3:30 p.m.

Minutes of the June meeting were not reviewed or officially approved.

A review of high-tech radiology utilization and overall costs and service at the MSU location. Overall costs for these services are less than other local locations including UM.

A discussion ensued on how to incent employees to schedule services at the MSU location. An ongoing educational campaign and perhaps financial incentives were discussed however, no decision was made. This topic will be revisited at future FHC meetings.

Highlights of Open Enrollment were shared as well as an update on the Humana plans available to retirees and those with Medicare as the primary payor effective January 1, 2021. A reminder that the spousal Affidavit must be completed annually during Open Enrollment.

The Council will elect a Chair for FHC at the next meeting and an updated roster needs to be published on the Academic Governance website.

A series of Zoom meetings will be scheduled soon.

The meeting adjourned at 4:40 p.m.

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