STATE & PUBLIC SCHOOL LIFE & HEALTH INSURANCE BOARD BENFITS SUB-COMMITTEE MEETING
MINUTES
JUNE 15, 2004 – 10:00 A.M.
1509 W. 7TH, 1ST FLOOR CONFERENCE ROOM,
LITLE ROCK, AR

The Benefits Sub-Committee of the State and Public Schools Life and Health Insurance Board (hereinafter called the Committee) met on Tuesday, June 15, 2004 at 10:00 a.m. in the 1st Floor Conference Room of the Department of Finance and Administration, 1509 West 7th Street, Little Rock, AR.

Members Present		Members  Absent

Shelby McCook		Dr. Bobbie Davis
Janis Harrison		Janie Roach
Jeff Altemus		Nancy Sheehan
Becky Walker		

Sharon Dickerson, Executive Director, Employee Benefits Div., DF&A.

Others Present

Doris Williams, Employee Benefits Div.; Ted Borgstadt, Trestle Tree; Rose Gantner and Richard Citrin, Corphealth; Eddie Freyer and Nicola Patterson, USAble Life; Larry Carnes, FBMC; Marc Watts, ASEA; Barbara Melugin, Blue Cross/Health Advantage; Joe Carter, Novasys; Ben Robbins and Jason Lee, DataPath.

Call to Order

The meeting was called to order by Sharon Dickerson.

Approval of Minutes

A motion was made by Janis Harrison to approve the minutes of the previous meeting.  The motion was seconded by Becky Walker.  Motion carried.

Update of DUE Committees	

Dickerson gave the Committee an update on the two DUE Committees – the Fiscal and the Clinical.  Dickerson stated it was her charge this month to bring back to the Board a recommendation for tobacco cessation products.  The two Committees met jointly and recommended that we
approve two products for smoking cessation – the generic Zyban and the nicotine patch.  It is recommended that counseling sessions be mandatory, and suggested using Corphealth for the counseling services.  There would be no co-pay or coinsurance for the counseling services, and there would be a 50% co-insurance on the drugs.  The lifetime benefit would be four terms;  8 week terms for Zyban and 12 week terms for the nicotine replacement patches.  One Committee member asked what the costs would be for the tobacco cessation products and the counseling services, and asked why the DUE Committees recommended using Corphealth for the counseling services.  Dickerson advised the counseling is around $600,000 a year.  The smoking cessation products would be an additional $400,000 a year.   Corphealth was the only vendor to respond to the RFP, so Corphealth is the behavioral health provider for the next few years.  Dickerson asked the Committee what their recommendation would be regarding whether or not to include retirees in the tobacco cessation program.  Do we want to include retirees in the smoking cessation program, because in factoring in the cost of this service it is a per employee per month cost.  Dickerson stated that this recommendation regarding tobacco cessation is going to be offered to both the State and School groups, and we don’t have anything factored into the premiums on the school side.  One member asked if there were different premiums based on behavior and Dickerson’s response was no.  He stated if there is not a difference in premium, then it is his feeling that this should not be offered to the retirees, because he doesn’t feel retirees are likely to change their behavior.  Other members of the committee agreed with this opinion.  Becky Walker at APERS advised there could be an article put in their newspaper informing the retirees that it is not offered to them and the reasons it was not being offered to them, such as cost, etc.  McCook made a motion to not include retirees in the smoking cessation program, and that there be no change in retirees’ premiums.  Harrison seconded this motion.  Motion carried.  

Marc Watts asked about the cost on drugs.  Dickerson advised him that there would be a 50% co-insurance on the tobacco cessation products.  She advised it was a general consensus of the DUE Committees that the members need to be accountable in some way.   They decided to not have any co-pay or co-insurance on the counseling services, but decided to have cost sharing on the drugs.    

Tobacco Cessation Counseling Services

Richard Citrin presented Corphealth’s program for Smoking Cessation.  The Program’s goals are to provide a comprehensive smoking cessation program for employees and spouses of the state of Arkansas, reduce the number of active smokers among employees of the state, provide EBD with reporting which details program effectiveness, create the first link in building the Employee Healthy Arkansas Program, and it can be offered as an expansion of the STAR EAP.  Telephonic outbound and inbound calls are similar to the Health Department’s Quitline.  Corphealth will provide individual smoking cessation counseling, group smoking cessation counseling, and nicotine replacement therapy.  There will be up to three free smoking cessation individual counseling sessions.    Corphealth has ten sites stateside.  The group smoking cessation counseling sessions are an eight week program with 12-20 participants.  Participation in group sessions is unlimited.  Participants are evaluated for appropriateness of nicotine replacement therapy.  Projections are 50% will use the patch, 34% Zyban, and 16% no nicotine replacement therapy.  Corphealth’s goal is to enroll 5% of the smokers.  There will be five outbound calls to employees, and the calls are spaced according to the needs of the caller and will typically last for six months.  The patch is over the counter but Dickerson stated that the member will have to have a script in order for the plan to pay for it, and they also must participate in the counseling sessions in order to get scripts covered.    The program fixed charges are $.43 and variable charges are $200 per participant.  Corphealth will bill EBD the fixed rate each month.  Corphealth will bill EBD the actual variable cost of employees and spouses served each month.  One of the Committee members asked if Corphealth could provide a letter which would serve as a prescription for the patch in lieu of a physician’s prescription, which would allow members to be able to obtain the patch at the pharmacies?  Dickerson stated she would need to speak to the Arkansas Pharmacy Association to see if the pharmacists would accept that in lieu of a prescription.  Dickerson stated as far as EBD was concerned it would be validation, and that is all EBD would need.  One Committee member asked if the counseling could be monitored, as she feels the participant would initially sign up for the counseling and then try to drop the counseling and only want to keep using the scripts.  Dickerson stated that the script would not be refilled the second month if the counseling is not continued.  

Rose Gantner went over Corphealth’s linking with the various state agencies in getting participation in this program.  

One Committee member asked Corphealth to give the schools printed materials to give out in the teacher lounges with information on how to enroll in this program.  

Dickerson stated that information on this new program will be given out in July and August in the open enrollments and communicated to the participants.  

One Committee member asked if there would be follow-up sessions by Corphealth on the counseling services, and Rose Gantner stated that there would be.  Another Committee member had a question about the information gathered in the Health Risk Assessment.  If a person answers truthfully and has an unhealthy lifestyle, what can a participant do to get off the “bad list” and have the information reflect a change to a healthy lifestyle and get the premium discounts?  Dickerson stated that the Health Risk Assessment should be re-filed so that EBD could reevaluate and rescore the participant.  Dickerson went over the details of the Health Risk Assessment Committee.  

Dickerson advised the counseling would include three face to face counseling sessions and unlimited group sessions.  Dickerson stated that most smokers use a pack a day and that is around $90 a month and the smoking cessation products would be around $50 to $60 a month, so the smoking cessation products would be less than the amount usually spent on cigarettes per month.  Dickerson advised that the patch can be provided by Corphealth, and she will have to find out if it will be cheaper to buy the patch from Corphealth or elsewhere.

Medical Claim Recovery

Dickerson passed out a letter from ProClaim Medical Recovery on auditing the health claims.  There is no charge for the service, but would have to go out with an RFP as there are several vendors that do this same thing.  Dickerson asked for comments on getting a third party to go in an audit the plan.  McCook didn’t think the Benefits Sub-Committee should make a recommendation because it is not a benefit.  McCook feels that EBD should go out with an RFP if we feel there is any abuse.  Dickerson doesn’t feel there is abuse, but the area of deficiency might be by the PBM.    The rest of the Committee was of the same consensus as McCook.

Items for Discussion by TrestleTree

Ted Borgstadt made a presentation on a pilot program for disease management services.  The initial pilot plan is defined as QualChoice population. There are guaranteed savings.  This program started with the Arkansas State Employees.  Also in that time period TrestleTree asked if there was anything they could do for the schools.  Ted Borgstadt started with one school, Rogers Public School System, for disease management services and is 100% risk free.  TrestleTree is also addressing smoking and obesity 100% free.  TrestleTree is a health transformation company, not really a disease management services company.  They have pharmacists, nurses, registered dieticians, and exercise physiologists.  

Ted Borgstadt asked the Committee to consider sending out an RFP on a smoking cessation program.  Dickerson feels the plan has room for two vendors for the Healthy Arkansas Initiative.  She feels some people will not want to participate in the STAR EAP behavioral management program. It was asked if TrestleTree would work with our new vendor, Novasys, and the answer was in the affirmative.  Dickerson feels we might miss getting part of the employees participating in a counseling program with a behavioral program, EAP, such as Corphealth, but they might enroll in TrestleTree’s program.  It was the Committee’s consensus that it wouldn’t hurt to include a second vendor.  

Barbara Melugin stated Blue Cross is providing health coaching at no additional cost through Health Blue.  Ted Borgstadt wanted to know if he could extend the pilot out to Novasys also.  One member asked how long the pilot would run.  Dickerson advised the pilot would run for a year with TrestleTree. 

Richard Citrin of Corphealth advised he would have a report for EBD in August for a six month period on their pilot program.  

Dickerson stated EBD will start July 19th for the schools to select new vendors/open enrollment for October 1st.  The Novasys representative stated they would be willing to partner with both Corphealth and Trestle Tree.  One member asked Blue Cross what they had to offer in comparison to TrestleTree and Corphealth.  Barbara Melugin very briefly went over the Health Blue product and stated it was already included in the cost.  One Committee member asked that a representative from Blue Cross come to this Committee’s next meeting to go over the coverage we are already paying for.   This Committee member stated that if we go out with an RFP and describe the services we are soliciting, it is this member’s opinion that when we get all the information in and all have agreed to do the same thing and pricing from each vendor, that the state should select the vendor with the lowest price.  Dickerson said pricing is factored in but that the scoring includes more than pricing.  This same Committee member questioned why we have multiple vendors with different prices.  Dickerson stated that one reason we have multiple vendors is because of the servicing areas provided.  On the behavior health Dickerson feels some state or school employees would take Trestle  Tree’s counseling services because of the negative connotation in the EAP – behavioral services, and feels there is room for more than one vendor in this area because of their different approaches to accommodate a different variety of people.  TrestleTree has a sole source contract and includes only four diseases.  Procurement said EBD would have to go out with an RFP if this Committee decides they want to use TrestleTree also.  One Committee member asked if Blue Cross covers the patch.  Barbara Melugin said she would have to find out.  A motion was made by Shelby McCook to ask the staff to provide criteria for multiple vendors and go out for RFPs and put on paper exactly what we want these people to do over the next two years.  Also included in this motion are the plans EBD wants from the people in the behavioral health coaching as to what we want them to do for us and what the RFP should cover.  Harrison seconded the motion.  The motion carried.  

Barbara Melugin of Blue Cross advised that they will be at this Committee’s next meeting with a presentation of exactly what is covered in their smoking cessation program.  One Committee member feels TrestleTree should partner with the vendors such as Novasys and not EBD and the Benefits Sub-Committee.  Dickerson stated that it is beneficial to carve out some of the services and that the plan saves money when they do.  The plan has had savings of 21% with Corphealth by carving out some services instead of leaving behavioral health services with the health provider.  

Next Scheduled Meetings

The board will meet the second Tuesday each month.  Dickerson asked the Committee what dates they want for their meetings.  The Committee feels that the Benefit Sub-Committee meetings should not be changed but should be left as is as to dates.  After the 2005 schedule is set up, EBD will send out a new schedule of meetings to these Committee members.

One member asked if this Committee could start looking at dental plans.  Dickerson said this would be put on the agenda at the next meeting to look at both dental and vision plans and several options to review.  

There being no further business, the meeting adjourned.