Minutes

Insurance Meeting                                                                  November 5, 2004

 

Attendees:

 

            Tina Byford, Chair                             Quentin Ford

            Denise Welsh                                      Joy Watkins   

Jacky Ryberg                                      Janet May

            Steve Gross                                         Hilda Moya

            Marge Hass

 

1.         Call to Order 12:00

 

2.         The October meeting minutes were approved.

 

3.         Updated Claims Data Report from Mercer

                        No new report

 

4.         NMSU Request for Proposal for Medical Benefits

The following items were discussed on the proposed bid document.

 

Pg. 20: Request for Proposal Timeline

a.     RFP Released:                                               11/17/2004

b.    Deadline for Census Request:                    11/29/2004

c.     Last Inquiry:                                                 12/06/2004

d.    Proposals Due:                                             12/21/2004

e.     Finalist Interviews:                                      02/2005

f.      Contract Awarded:                                      03/01/2005

              

               Pg. 49: Medical - Minimum Premium:

·      Characteristics of this plan: Liability is limited at stop loss; Premium includes: Administration Fee, pooling network access, and capitation on Mental Health Benefits.

 

Pg. 51: Medical – Self Insured

·      Characteristics of this plan: Premium includes: Administration Fee, full liability for any claims incurred. Not required to comply with state law on coverage requirements (don’t have to offer specific coverage) University maintains the run out.

 

           Pg. 52: Rate Response Forms

         For clarification each Bidder which prices administration fee coverage under the self insured option must declare if there are pricing for:

 

 

General Services

a.     Claim Forms

b.     ID Cards (providing cards)

c.      Eligibility maintenance

d.     Periodic meetings with client (plus any training of staff)

e.     Legal Support (writing booklets; claims adj)

f.      Underwriting and actuarial support

g.     Conversion Privilege (to individual policy) after cobra

h.     Fiduciary    (Pay or deny claim with appeal process)

i.       Subrogation          

j.       Plan Document (Client writes it or insurance co. writes it)

k.     SPDs/Booklets (Client writes it or insurance co. writes it)

l.       Employee Communication Materials

 

Claim Services

a.     Claim adjudication and payment (including verification of eligibility)

b.     Transfer of historical claim data (from prior carrier) – University will have to negotiate with Carrier.

c.      Administrative charges if outside stop-loss vendor utilized

d.     Coordination of Benefits

 

Note: The minimum premium coverage includes

all the services above.

 

5.         Discussion of the Health Insurance RFP

December 1, 2004: Wellness Wednesday

         Major Contributors:

·      Blue Cross Blue Shield

·      Delta Dental

·      TIF

·      Valic

 

 

6.            Future Meeting Time

December 3, 2004 11:30 pm

Employee Health Services Conference Room

            11:30: Delta Dental

            Lunch

            12:45: Blue Cross Blue Shield

 

7.     January Meeting Time:

January 19^th, 2004 8:30-12:00

To discuss bid; closed meeting.