NIC Chooses New HealthFlex Insurance Plan

by Brent Williams

After managing a self-insured health plan for its clergy for more than 20 years, the North Indiana Conference Board of Pension, Insurance and Moving has chosen the General Board of Pension and Health Benefits' HealthFlex program for its participants, beginning Jan. 1, 2005.

WHO IS INCLUDED?

Active and retired clergy in the North Indiana Conference of The United Methodist Church will move to the HealthFlex plan effective Jan.1, 2005. Conference lay employees and lay employees of local churches, currently enrolled in the North Indiana Conference Group Health Plan also will be moved to HealthFlex.

WHY THE CHANGE?

This decision was made carefully by the North Indiana Conference Board of Pension, Health Insurance and Moving following three years of negotiation with HealthFlex. There were three main reasons for the decision.

The current North Indiana Conference Self-Insured plan covers 386 active clergy, 450 retired clergy and a few conference and local church laity. Offering a quality health insurance program to such a small group has its challenges. The current NIC program is self-insured and has been for 20 years. With impending health care insurance cost increases from 10 to 20 percent on the horizon and dwindling reserves used to soften increases, it made sense to seek other options before a change would be mandated.

Eventually, the NIC would have joined with HealthFlex, a consortium of 26 annual conferences under the General Board of Pension and Health Benefits based in Evanston, Ill. The timing is right to move to HealthFlex in 2005. HealthFlex has purchased the Blue Cross/Blue Shield network that is currently being used by NIC for its participants. As a result, those participants in Indiana will see no change in their network doctors or hospitals. In addition, HealthFlex gave NIC a price that was very competitive with the estimated costs of remaining with our current program.

One of the more attractive reasons for selecting HealthFlex is their commitment to health and wellness. If we can become a more healthy population, our participants will be better off and, in addition, we should be able to have a beneficial impact on our costs. Any health insurance program can pay claims, but a good program will address improving the health and wellness of its participants.

NEW EMPHASIS ON WELLNESS

HealthFlex has contracted with several Wellness vendors, including WebMD, Harris Health Trends, and United Behavioral Health to provide its participants access to a wide menu of wellness and disease management programs. We are excited about introducing these programs to participants. All of the programs will be described at the HealthFlex workshops being offered this fall in each of the nine NIC districts.

The core of the wellness program will be the Health Risk Appraisal. Each participant will be asked to complete an Internet survey, a confidential appraisal of a participant's health, and will give information on choices that can be made to improve one's health. The only people who will see this information are the participant and Harris Health Trends, who will work with enrollees at risk of developing chronic illness. Harris will assist them by providing information, education, coaching and support in changing the risk factors that can lead to chronic conditions.

The North Indiana Conference Board of Pension will be providing an incentive to participants who take the Health Risk Appraisal. Information on this incentive will be shared at the HealthFlex workshops this fall.

SOME CHANGES REQUIRED

Some change is involved in the NIC move to HealthFlex. In addition to staying in the BC/BS Network, participants also will stay with United Behavioral Health for our Employee Assistance and Mental Health program. NIC will move from the Express Scripts Pharmacy program to the Medco Program. Medco uses most of the same pharmacies as Express.

Added to the program, in addition to the Wellness benefits, will be a 24-hour nurse line, pastoral counseling resources for clergy, life transition counseling and a single phone number by which participants can access all of the health vendors.

Active NIC participants will see their deductible increase from $400 to $500. However, at the same time, a $15 office visit co-pay will be instituted. In addition, an expanded wellness benefit from $250 to $500 over and above a yearly wellness examination is included. These benefits will more than offset the small increase in deductible.

NIC Medicare-age retirees will see their deductible decrease from $400 to $250.

The NIC will be instituting a three-tier pharmacy program in the new year. The NIC has been planning this benefit change since 2003. There will be three levels of pharmacy benefit: generic, preferred and non-preferred drugs with tiered co-pay.