Indiana Statewide
Group Insurance Trust
Transition Update
Aaron Curtis & Dan Bond
Capstone Benefit Advisors
Carrier Selection
Considerations:
• Provider Discounts
• Market Share
• Trust Experience & Capabilities
• Future Consolidation
Carrier Selection
Why Not NRECA?
• No Separate Plan for Indiana Co-ops
• SBC Offered Lower Rates in Recent Years
• Only Rental Provider Networks in Indiana
Discovery
Process:
• Information Exchange
• Questionnaire
• Q&A
Discovery
Network Analysis:
• Provider Disruption for Members
• Provider Discounts
Trustee Decision
• Report/Analysis from Capstone
• Final Interview With Trustees
• Carrier Selection
 Goal: No Later Than April 30, 2011
• Final Rate Determination
 Goal: No Later Than September 30, 2011
Transition
Transition to New Carrier
Completed By:
January 1, 2012
What To Expect
• Business as Usual
• Same Principal Contacts
• Continue Using Benefit Solver
• Look for Updates as Progress is Made
 Sign-Up for SBC Newsfeed
www.isabenefitsblog.com
Questions ??
Health Care Reform: 1/1/2011
SBC Plans Will Be
Non-Grandfathered
Health Care Reform: 1/1/2011
Dependent Coverage to Age 26
• Other Eligibility Criteria Does Not Apply
– Marital Status, Student Status, Dependency,
Residency, Other Coverage
• Tax Exempt To Age 27
• Notice Distribution Required
Health Care Reform: 1/1/2011
Lifetime / Annual Limits
• Lifetime/Annual Limits Eliminated
• Applies to Essential Benefits
• Notice Distribution Required
Health Care Reform: 1/1/2011
No Pre-Ex for Under Age 19
• Pre-Existing Condition Exclusions
Currently Only Apply to Late Enrollees
– This is Now Eliminated for Anyone Who
Has Not Reached Age 19
Health Care Reform: 1/1/2011
Preventive Care Services
• No Cost Sharing for Many Preventive Care
Services and Immunizations
• For a Complete List, Go To:
www.HealthCare.gov/center/regulations/prevention.html
Health Care Reform: 1/1/2011
External Review Process
• Member Initiated
• Claim Decision Review
• Independent Organization
– Not Associated with the Carrier
Health Care Reform: 1/1/2011
Nondiscrimination–Problem Areas
• Different Benefits for Exec/Exempt
Employees
• Shorter Waiting Periods for Exec/Exempt
Employees
• Larger Contributions for Exec/Exempt
Employees
Health Care Reform: 1/1/2011
FSA Limitation
• No Longer Cover OTC Drugs
• Requires Prescription
• Insulin is an Exception
• Master Cafeteria Plan has been Updated
CONTACTS
Aaron Curtis, Capstone Benefits Group
317-328-7880, ext. 145
[email protected]
Dan Bond, Capstone Benefits Group
317-328-7880, ext. 147
[email protected]
Questions ??
THANK YOU!