Title: DRAFT
Author: ebd
Last saved by: Paige Harrington
Company: State of Arkansas

State and Public School Employees Life and Health Insurance Board Meeting
Minutes
April 12, 1:00 p.m.

The 78^th meeting of the State and Public School Life and Health Insurance Board (hereinafter called the Board), met Friday, April 25, 2006, at 1:00 p.m. in the EBD Board Room, 501 Wood lane, Suite 500, Little Rock, AR  72201.

Members Present				Members Absent
Bobbie Davis					John Mattox
Shelby McCook				Robert Watson
	Janis Harrison				Renee Mallory
	Joe Musgrove
	Vance Strange
	Charlie Campbell
	Nancy Sheehan
	Dr. Joseph Thompson
	Tom Emerick

	Sharon Dickerson, Executive Director, Employee Benefits Division.

Others Present
Connie Diggs, Pat Minyard, George Platt, Cathy Harris, Ashli Davis, EBD;  Rhonda Jaster, ACHI/EBD; Mona Neal, PSC; Bryan Meldrum, Nova Sys; Martha Borders, Roy Lamm, QualChoice; Shonda Rocke, Dwight Davis, NMHC; Kathy Lavender, AGFC; Rose Gantner, Corp health; Barbara Melugin, Kathy Ryan, Ron DE Berry, David Bridges, ABCBS/HA; Nicola Patterson, Eddie Fryer, Usable; Marc Watts, ASEA;  Debbie Veach, ACHI;  Larry Hines, Ben Robbins, DPAS; Richard Brittain, DHHS; Diann Gwatney, AHTD; Paul Grier, AEA

Call to Order
Meeting was called to order by Bobbie Davis

Approval of Minutes
The motion was made by Davis to approve the minutes of the prior meeting, and seconded by McCook.  Minutes approved.

ASE/Retiree Rates by John Bauerlein, Milliman
Bauerlein discussed the January 1, 2007 ASE Active Benefit Strategy that included the $2.4 million in reserve. The High Deductible PPO previously reported of $1,200/single and $2,400/family will be adjusted to $1,250/single and $2,500/family.  

Bauerlein summarized the ASE and PSE Retiree rates using the following scenario.
$1.9 Million reserve allocation for ASE retirees.  
$5.6 Million reserve allocation for ASE retirees.  Includes $3.0 Million reserve allocation for PSE retirees (allocated 80% to retirees not Medicare eligible / 20% to retirees Medicare eligible
$5.6 Million reserve allocation for ASE retirees.  Includes $3.0 Million in reserve allocation for PSE retirees (allocating 70% to retirees not Medicare eligible / 30% to retirees Medicare eligible

The Board discussed several issues that contribute to rate increases (competitive issue between Plan and provider, different levels of risk and medical manage-ment.  

Board requested EBD bring back information on Transplant Services and MIlliman to bring back information on four-year trend on rates.  The Board also requested information on Medicare B and D rates. 

Sub-committee Reports by Janis Harrison  
Harrison reported on Sub-committee meeting held 04/21/2006. Harrison told the Board that the Sub-committee reviewed ASE Active and ASE and PSE Retiree reports provided by Milliman; however, they are not ready to make a recommendation to Board at this time.  Carriers provided reports to Shelby McCook at his request on Case Management. 

The Committee also viewed a presentation by Simply Well Integrated Health Solutions.   
 
Harrison made a motion that would allow ACHI to develop an HRA program and corresponding healthy lifestyle “point system” to award and promote healthy lifestyle changes for EBD (PSE and ASE), DHHS and the new “Safety Net Benefit Program.”  EBD will allocate $1.00 per member per year to support the development of this program and future support of this program for EBD.  Incorporated into this motion was:
a.	to revise and integrate EBD and DHHS ‘s HRA and HELP Program
b.	establish ACHI as coordinator and fiscal lead
Sheehan seconded the motion.  Motion approved.

Harrison made a motion to authorize expenditures up to $1 per-member-per-year.  Musgrove seconded.  Motion approved.

Harrison presented a recommendation to the Board for an Appeal Process for Prescription Drugs as follows: To go forth with having an appeal process for the dollar amount including non-formulary drugs to be given at the  3^rd- tier level after the appeal process. The request should come from the physician, based on clinical observation.   
 
Dr Thompson suggested some of the more bio-tech class of drugs be reviewed.  Dickerson stated that the Sub-committee would review certain class of drugs in future meetings.  

The Board decided to table discussion regarding appeals until consulting UAMS. The Board felt they needed clarification on appeal vs. pre-authorization issues. 

Harrison made a motion to give Dickerson the ability to develop framework and standards to negotiate rates with UAMS or RFP for Weight Loss Program statewide.  Musgrove seconded.  Motion approved.

Harrison made a motion that the Board would allow EBD the ability to pursue and negotiate rates with facilities that would perform the Gastric Bypass after completing step therapy.  McCook seconded.  Motion approved.

Davis added that any future recommendations should be presented to the Board in writing.
     
Director’s Report by Sharon Dickerson

Dickerson suggested that the Board effectively do a Case Management and Utilization Management RFP. 

McCook made the motion to give Director the ability to do utilization and review
Musgrove seconded.

There being no further business to discuss the meeting was adjourned.  

NEXT MEETING:
May 16, 2006