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  • FRIC Meeting Notes September 6, 2013 | Funded Retirement and Insurance Committee (FRIC)
    discussion lead by Chris Miller UIHC about Accountable Care Organizations took a large part of the committee time Ms Miller gave an overview of ACO initiatives at UIHC and how UIHC and to a minor extent UI beneficiaries are impacted through ACO activity nationally i e quality measures and locally i e Wellmark programs The UI plan does not completely fall under the ACO activities of UIHC and Wellmark however the quality monitoring and measures used for the ACO at UIHC are applied to UIChoice members by Wellmark There was a lot of discussion Ms Miller proposed that UI and FRIC consider developing an ACO for the benefit of UIChoice participants The committee was interested in continuing the discussion and encouraged Ms Miller to come back to the committee with more specific ideas about such a plan Discussion of 2014 insurance rates It was recommended with a motion that rates for UIChoice and Dental II our only plans remain the same as last year This was approved unanimously Tachau Dudley It should be noted that this is the second year in which rates have remained the same Costs that are increasing in some areas are being balanced by reduction in expenses in other areas Discussion noted the positive impact of the UI Wellness program and it was decided a more formal presentation of the Wellness program and its impact will be at a future meeting AY14 begins the second year of the new single dental plan Once there are two full years of data the plan and rates will be assessed For now the data indicated that we can wait for a second year before the assessment is done since the first year rates came out very close to the estimates Defense of Marriage Act DOMA the federal impact of

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-september-6-2013 (2015-11-11)
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  • FRIC Meeting Notes May 03, 2013 | Funded Retirement and Insurance Committee (FRIC)
    Miller UI HC Emily Algood UI HC Ms Miller provided a brief review of the Accountable Care Organization ACO concept and general information on the UI HC ACO structure and plan She proposed that we begin to consider connecting UIChoice to the UI HC ACO system Several benefits were presented costs and disadvantages were not available Further discussion will continue on this subject A quorum was declared at 12 17 pm Minutes from the April meeting were approved TIAA CREF Annuity Service Credit discussion The committee discussed how to use the 1 4M service credit Several options were given to the committee These were the same options as from last year A motion Greer died for a lack of a second The University would retain approximately 160 000 to help cover the operating costs of the Benefits Office related to the pension plan AND distribute the full remaining balance to the participants current and past employees who have deposits in an active annuity account not annuitized in equal amounts so long as they participated in the related funds that earn the credits A second motion Sorofman Garfinkel stating the following passed 7 yes 1 no The University would retain approximately 160 000 to help cover the operating costs of the Benefits Office related to the pension plan AND distribute the full remaining balance to the participants current and past employees who have deposits in an active annuity account not annuitized and in proportional amounts based on their account balance There was brief discussion that the FRIC committee would consider forming a committee early in the next academic year to consider options for retaining and using the service credit to develop programs and or services as defined and specified by the distribution rules Informational session Specialty drugs Mike Brownlee Chief Pharmacy

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-may-03-2013 (2015-11-11)
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  • FRIC Meeting Notes April 05, 2013 | Funded Retirement and Insurance Committee (FRIC)
    could be something like 5 000 for individuals and 10 000 for families By itself that may not sound like an additional burden because under the current health plan the out of pocket maximums are in fact lower However it could be a burden since the out of pocket maximums will include items currently not covered by the UI health plan such as copayments All these provisions cost money and at present Saunders can only guess that the incremental cost to the university from covering the additional employees and providing the extra coverage could lie anywhere between 1 and 9 million As a miscellaneous requirement of the Act Saunders informed the committee that the university would also have to pay various new Federal fees of around 1M per year for the next few years Finally the timeline of the Act is unclear Some provisions would presumably go into effect on January 1 2014 and some on January 1 2015 while other go even further out to 2018 All in all the university can look forward to many challenges and additional expenses due to the implementation of the Affordable Care Act In previous meetings Saunders had informed the committee that John Hancock is not offering Long Term Care LTC insurance plan to any more employees beyond the 900 who have already bought the insurance The new LTC provider is Genworth and it has already enrolled 750 employees in its insurance plan In addition 37 employees are covered under the LTC insurance plan offered by Metropolitan the provider before John Hancock It is entirely up to employees whether they want such insurance The insurance premium is neither tax deductible nor it can be taken out of flex credits Saunders informed the committee that after approval from the Board Office and as already agreed with Principal Financial Group employees retiring after July 1 2013 will not be offered the free life insurance coverage of 2 000 to 4000 The UI Cambus has several routes One of these routes covers Oakdale Research Park and makes a stop either way on 1 st Ave and 9 th Street in Coralville This stop serves Iowa River Landing IRL facility of UI Hospitals and Clinics Unfortunately the place where the Cambus drops passengers at this stop is not paved This can be a problem for passengers with some disability and during bad weather During recent discussions with the university the City of Coralville has agreed to pave this location In response to further questions Saunders pointed out that currently very few passengers are using this Cambus service to go to the IRL facility The daily passenger volume is estimated at around six on the north bound service and four on the south bound service The passenger volume may increase in the future In any case Dr Rami Boutros from UIHC University of Iowa Hospitals and Clinics Administration and Dave Ricketts from Parking will attend a future FRIC meeting to discuss this situation The next item was taken

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-april-05-2013 (2015-11-11)
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  • FRIC Meeting Notes March 01, 2013 | Funded Retirement and Insurance Committee (FRIC)
    Nicole Nisly Joni Troester Dianne Wasson Introductions were done Minutes from the December 2012 meeting were approved Two presentations on transgender care and coverage were made by Katie Imborek MD and Nicole Nisly MD The purpose was to initiate discussions regarding a proposal to cover transgender care in UIChoice Discussion ensued regarding both the expected benefits and expected costs of coverage Notably the AMA APA and Institute of Medicine cite significant benefits to coverage including potential long run cost savings from both an individual medical standpoint and a societal standpoint An example of costs based on San Francisco data suggests less than 4 000 per claim with fewer than 100 claims over the entirety of the coverage program 5 years Most of the medicines for transgender care are generic further limiting costs The committee made particular note of the AMA s view that transgender care is medically necessary The UI has covered other medically necessary care that is unavailable at UI but provided elsewhere in the past The UI also now has a transgender clinic that offers care since October 2012 Two key points were emphasized as the committee progressed towards a formal motion First given the medical necessity of such care coverage should be the same as that for any other medically necessary care Second coverage of transgender care is consistent with the UI s human rights policy The committee made a formal motion Katherine Tachau seconded by Sheldon Kurtz to extend UI coverage to cover medically necessary transgender care The motion passed unanimously on voice vote The next order of business was a return to discussions from the December 2012 meeting regarding the provision of patient information by the UIHC to the UI Foundation Sheldon Kurtz noted that he and co chair Davin spoke with VP Robillard and

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-march-01-2013 (2015-11-11)
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  • FRIC Meeting Notes December 7, 2012 | Funded Retirement and Insurance Committee (FRIC)
    handed out a document of endorsement titled Professional Organization Statements Supporting Transgender People in Health Care He discussed his conversation with the University of Michigan and that this institution has had transgender coverage for 10 years approximately 3 individual per year go through the program but not all participate in the surgery Michigan does not track the costs as it is small They do not cover items such as Adam s apple shaping facial cosmetic surgery and facial electrolysis The question was raised as to whether they require a specific local hospital to be the required provider Richard will check on this and get back to the group Discussion was held among the group and it was determined that the group needed more information before moving forward with any type of recommendation Richard will invite Dr Nicole Nisly to speak to the group on this issue and asked that any specific questions for Dr Nisly be forwarded to Richard in advance so that Dr Nisly can be prepared to address One question that was raised is what is the outline of recommended care ie what is essential and non essential care for those considering this type of treatment Dental II was discussed among the group Richard reported that this plan was created in 1990 and the plan design has not changed since that time A restorative maximum of 1500 per year per person has been in place and it has been requested from employees that the maximum be raised due to increasing costs Richard provided the follow data for 2011 810 people exceeded 1500 723 people between 1500 2000 90 people exceeded 2000 The highest claim was just under 4000 The group discussed that if the maximum was raised to 2000 there would be 1 40 per contract increase per

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-december-7-2012 (2015-11-11)
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  • FRIC Meeting Notes November 2, 2012 | Funded Retirement and Insurance Committee (FRIC)
    will be distributed to UI employees on a pro rata basis More accurately it will be re invested in their TIAA CREF funds That means employees would receive a rebate proportional to their holdings of TIAA CREF retirement funds Note this excludes funds from other investment companies annuity accounts mutual funds etc It works out to 98 per participant per year on average but there will be considerable variation depending on retirement assets The committee next took up the matter of UIHC University of Iowa Hospitals and Clinics privacy policy The matter concerns uninvited solicitations to contribute to various research programs of UIHC sent by the UI Foundation The Foundation was also being notified in advance of medical visits occurring It was facilitated by the UIHC disclosing consumer information to UI Foundation The practice was not in violation of any state or federal law as UIHC has an implicit agreement with consumers whereby this information can be disclosed unless they explicitly opt out But it is inconsistent with the Health Insurance Portability and Accountability Act of 1996 HIPAA and the desires of many consumers based on anecdotal evidence In October 9 2012 Sheldon Kurtz and Nancy Davin co chairs of FRIC had written a letter to UIHC Vice President Jean Robillard and UI Foundation President Lynnette Marshall concerning this privacy matter The officials have since agreed to discontinue the practice the advance notice practice and the inclusion of the provider s name The opt out clause in the patient agreement will be clarified and made simpler to accomplish including through the online medical record that is available The discussion moved on to the topic of transgender medical coverage This is a relatively rare medical procedure whereby a person changes his or her sex The treatment may involve surgery and or hormonal treatment It usually requires additional support services such as psychotherapy and it costs around 40 000 It is also relatively rare For example under the University of California system a total of 42 persons have had this procedure since 2005 That includes seven years and a population of over 300 000 employees which works out to about one case per year per 50 000 employees One should be cautious in extrapolating from this number however since the availability of coverage is bound to increase the number Richard Saunders informed the committee that there have been some queries about this procedure from UI students but none from current employees The University of Iowa has had around 4 known people who have undergone this treatment over the past 26 years Given low demand and the need for comprehensive services at present only around 14 states have medical providers performing this type of surgery Iowa is one of them with providers in Grinnell and Des Moines UI HC is discussing the option of offering this treatment The question before the committee is whether the UICHOICE should cover this treatment Coverage could involve the medical procedure counseling and incidentals The legal question of

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-november-2-2012 (2015-11-11)
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  • FRIC Meeting Notes October 5, 2012 | Funded Retirement and Insurance Committee (FRIC)
    document Currently the notice says that patient can opt out by notifying UIHC in writing that the patient does not want his or her information to be shared with the foundation In fact Thoman said UIHC will accept other forms of communication so long as it is clear which patient is opting out Thoman said that there are plans to change the notice to make this clear in the near future Kurtz asked Thoman whether HIPAA permitted sharing the name of the treating physician with the Foundation Thoman indicated that she understood that UIHC has some discretion about what information it shares and that multiple lawyers have said this is legal Kurtz indicated that he was shocked by that opinion Lewis explained that the Foundation uses the information to contact patients to solicit contributions to the Foundation to support the work of UIHC She said that the Foundation asks physicians to assist in this process by recommending the Foundation to patients who want to make some contribution to express their appreciation of the work done by UIHC Kurtz asked whether the solicitations were targeted in any way based on the type of treatment received by the patient Lewis indicated that appeals based on UIHC information were generic in nature but the Foundation did purchase information about potential contributors from other sources and that a person who had made a contribution to a cancer prevention society for example might receive a solicitation to contribute to the Holden Cancer Center based on the non UIHC information Tachau expressed her opinion that whether the practice of sharing the name of the treating physician was legal or not it was certainly unwise and likely to be counter productive in the long run since it has the potential of creating lots of negative feelings Tachau also asked why it was important to provide the information in advance of the appointment Lewis explained that the Foundation wanted the information in advance because that way it might be possible for the Foundation to provide extra attention at the time of the appointment to patients who are significant donors to the Foundation Several FRIC members expressed their feeling that having Foundation staff present during a patient s appointment was not appropriate Kurtz said he thought it might put physicians in an awkward position Lewis explained that no solicitation occurred during clinic visits Sharp indicated that in her experience some patients are grateful for the care they receive and do want to make a financial contribution to UIHC and that Foundation involvement is not always a negative experience Garfinkel asked whether it would be possible to change from an opt out to an opt in procedure and asked whether for example UIHC received a significant response rate to its patient satisfaction survey Thoman indicated that the rate of response was relatively high Garfinkel suggested if patients are responsive generally that would indicate that an opt in process would be workable Tachau asked whether it would be possible to display

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-october-5-2012 (2015-11-11)
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  • FRIC Meeting Notes September 14, 2012 | Funded Retirement and Insurance Committee (FRIC)
    It was also stated that since the 70 s there has been a deficit from costs and that deficit is slowly being reduced Disease Management There are roughly 4000 employees of the 49000 that are in this plan It ends 12 31 12 In was discussed that in general Disease Management is a good idea but the UI could not get good enough information if the new plan that could be offered would provide any beneficial use Retiree Paid Up Life Insurance The current plan gives retirees a 2000 or 4000 based on years of service life insurance policy that was paid in full It was previously voted to end this plan Principal would than allow retirees to purchase whole life insurance up to the amount of the group insurance they had at the time of retirement without a physical evaluation The committee made no motion to change this recommendation reaffirming their position to stop this program for active employees which allows those individuals a conversion option with Principal up to the value of their Group Life Insurance coverage at the date of termination 2013 Benefit changes due to ACA The UI will be required to notify employees of a summary of the differences of each health care plan available to them Spending accounts will be reduced to a total of 2500 This was decreased so that the IRS would be able to collect tax on that addition income There is an expansion on women s health services Women will be able to get any breast pump they want at no cost to them one per pregnancy All generic or name brand contraceptives without a generic will now be free Condoms will also be free when purchase through a pharmacist Long Term Care Insurance The plan will switch to Genworth

    Original URL path: http://www.uiowa.edu/fric/fric-meeting-notes-september-14-2012 (2015-11-11)
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