Notes From The CEBT Chairman
Hopefully, this newsletter finds you and your family healthy during these interesting times.
The CEBT Board of Trustees met virtually for their Quarterly meeting on Friday, January 29, 2021. During the January Board meeting, a major Board action item is setting the renewal rates for employer groups renewing July 1st. From the start of the pandemic last March, the number of claims has drastically been reduced from what would be expected in a “normal” year, which, in turn, has resulted in a favorable renewal. The claims reduction was caused in part by a decrease in the number of surgeries, optional procedures being delayed, and other factors. The drop in claims has created additional unrestricted surplus in the financial reports.
In addition to the rate renewal, two of CEBT’s newer programs, Surgery Plus and Triad EAP were reviewed at the meeting. In case you haven’t heard of the two programs, Surgery Plus is a program that provides concierge assistance to help plan and pay for covered medical procedures. The other program, Triad EAP, is an employee assistance program that provides short term solution-based counseling services.
As always, if you have a comment or suggestions, please contact your customer service representative at Willis Towers Watson (303) 773-1373 or (800) 332-1168.
Who is CEBT?
A question frequently asked by members is "Who is CEBT?" or "What is CEBT?" This is a great question as the CEBT Plan and how it is made up is different from what one typically thinks of when it comes to health coverage. There are a lot of names and logos involved within CEBT simply from the partnerships that CEBT has acquired over the years to help manage benefits, claims, and health care costs.
The Colorado Employer Benefit Trust (CEBT) is a self- funded multi-employer trust that provides employee benefits for roughly four hundred (400+) governmental entities, and over 33,000 employees and their dependents throughout the state of Colorado. The concept of this type of health benefit plan (not to be confused with an insurance plan) is “pooled risk”. What this means is that medical costs are combined and spread across all entities that make up the CEBT pool. The advantages of having pooled risk are: more favorable rates compared to those of a fully insured plan, long-term financial stability, and lower administrative costs.
The Trust is comprised of and governed by a seven member Board of Trustees who are chosen from CEBT employer groups throughout the state. They strive to include different group types and sizes of representation from the public employers that make up the Trust (i.e. school districts, municipalities, counties, and special districts).
The mission of the Trust is to “provide quality health benefit options at a competitive cost with superior service to eligible employer groups”. CEBT has partnered with Willis Towers Watson to help with the administration of the plan including customer service and premium invoice billing.
CEBT continues to grow each year, having an employer group retention rate of over 98% and annual rate increases in the single digits for over 10 years. These outstanding statistics are a testament to how the Board operates from a service and financial perspective.
Meet Frank Urman
Co-founder of CEBT
Frank Urman graduated from the University of Northern Colorado in 1978 and went straight into the insurance business, making this his 43rd year in the industry. In 1980 he and his father created CEBT with a base group of only 7 school districts/BOCES and 400 employees. This year the Trust will have over 400 Colorado public sector employers and over 20,000 participating employees. The premiums have grown from $ 400,000 in year one to over $ 225,000,000 in the 2020 fiscal year. The Urman Company managed CEBT until 2007 at which time the company merged with HRH, which later merged with Willis Towers Watson. At the time of the initial merger The Urman Company had 45 employees and four offices in Colorado and Wyoming.
CEBT was always structured to accomplish two objectives:
- Help employees and their dependents when they needed support related to their Medical, Dental, Vision, Life or Disability benefit programs.
- Provide financial stability for the Public Sector employers participating in the Trust.
If an employee had an issue with coverage, a medical provider or an invoice, CEBT wanted to provide a resource that they could access for help. As medical costs and resulting premiums were skyrocketing over the last 40 years, the goal was to provide a predictable, stable cost that employers could rely on.
Having an opportunity to interact with both the employees and their employers has been both a privilege and an honor for Frank while offering a chance to enjoy a very satisfying career.
As we enter the new year, it is a good reminder that the CEBT Triad EAP benefits renewed on January 1st. This means that as you continue to use the EAP services, new authorizations will need to be initiated for services. The EAP services available are listed below:
Mental Health Counseling: You, your spouse or domestic partner and dependents 26 and under have access to six sessions, per incident through December of each year. EAP counseling is a brief, solution-based counseling that helps you develop coping skills for a variety of issues.
Legal Assist: Benefits include a 30-minute consultation with an attorney on civil and criminal matters. You can also access a variety of downloadable legal forms including a free, state-specific Will Builder. Finally, you have access to an online legal library with articles covering topics such as: consumer rights, divorce, custody, real estate and estate planning.
Financial Benefits: Take advantage of free, telephonic consultation services with a certified credit counselor who can help you with debt management, budgeting and much more. As well, here is a closer look at some additional features that come with the financial benefit:
- Savings Center: Shop online for luxury or everyday items at a discount
- Tax Slayer: You have access to an online tax preparation software to file state and federal taxes
- Debt Management: Construct a debt management plan during a counseling session – for an additional fee, you can work with creditors to provide repayment plans for unsecured debt.
- Bankruptcy Protection Unit: Talk with a specialist to understand the ramifications of bankruptcy filing and determine other options.
- Credit Report Review: Get a credit report and credit score for $14 per report- specialists are also available to clarify content and discuss options.
- Housing Education: Get assistance with preparing for a home purchase, or in locating options for keeping the home in cases of financial distress.
Online Resources: Monthly webinars covering a wide range of topics are available on-demand or in the webinar archives. You can also find numerous articles and tip sheets that focus on improving your overall well-being.
24 Hour Crisis Support: In the case of a mental health emergency, call (877) 679-1100 24-hours a day, 365 days a year to talk with an on-call therapist.
There are still many unknowns as we move away from 2020, and a lot of people are experiencing significant amounts of stress in their lives. CEBT's Triad EAP program is here to give you tools to help develop a positive mindset because having optimism is a great way to manage stress. Below are some resources that can help with positive thinking skills.
• DIY: Tips for adopting a positive mindset. In this edition we look at reducing negative self-talk, the importance of reframing and not dwelling on the past.
• On-demand Webinar: Reframing Your World. Discover the practical ways to reframe your perspective to live a more present and positive life.
Surgery Plus Customer Experience
After finally choosing to address an ongoing foot issue, I decided to explore my surgery options through CEBT's new SurgeryPlus program. I am really glad that I made the choice as there was no out-of-pocket cost to me.
All my logistical needs were handled through my care advocate, DD. Before I left home for Salt Lake, I received a pre-paid visa gift card in my hand to pay for gas and meals, and confirmation for the hotel for me and my travel companion. I did panic a bit when the hospital called to ask for the results of my COVID-19 test. I wasn’t aware I needed that test and immediately went into 'how do I solve this' mode. Then, a light bulb went off in my head, no need to panic, I had a 'person' to do that for me. I called DD and in a short time i was on my way to get my COVID-19 test.
The surgery was a success, the facility and physicians were excellent, I would recommend their office to anyone. The icing on the cake was being able to fly from our small local airport directly to Salt Lake and then back for my follow-up appointment. I am very grateful that my employer has this benefit. SurgeryPlus is the way to go!
~Tammy Conway-Eagle County School District~
Amazon Pharmacy is available to CEBT members that get their prescription drugs through CVS Caremark
Members who are enrolled in the CEBT UMR medical plan have prescription drug coverage through CVS Caremark. Amazon Pharmacy is included in CVS Caremark’s pharmacy network therefore members can use it to purchase a 30-day supply of medication. If you choose to use the Amazon Pharmacy for your Rx fills, make sure to include your CVS Caremark information when signing up for the service.
The best maintenance medication deal remains with 90-day mail order
If a you get a prescription through Amazon Pharmacy, you can only get 30 days of medication, it will arrive in the mail but does not provide the traditional mail benefit that you have through your prescription plan. CVS Caremark has the strongest negotiated deals on 90-day prescriptions, which means you should still get your ongoing/maintenance prescriptions through mail order by setting up your prescription delivery at Caremark.com, filling a 90-day prescription at a CVS Pharmacy, or by calling (866) 885-4944. The benefit for a 90-day mail order is 2X your regular copay which allows you to get one month of your prescription at no additional cost. For members with a qualified high deductible plan who have not hit the deductible, they will realize a cost savings.
Amazon Prime Prescription Savings Benefit is a drug savings program, which works like a discount card. The service is specifically designed for patients without prescription drug coverage. If a member on a CEBT plan purchases medication through the service, it might not apply to their deductible or out-of-pocket maximum. Please note, this offering is available only to Amazon Prime members.
Shop to get the best deal
Amazon is an easy way to shop for all kinds of things. You can also shop for your prescription drugs at Caremark.com or the CVS Caremark app, which would house all of your benefit information if you choose to utilize this service.
As the vaccine hits the Colorado market and runs through the initial priority phase approach, CEBT members and dependents can receive the COVID-19 vaccine at zero cost share as they become eligible. There are no limitations on where you can receive the vaccine. It will be covered both in network or out of network at 100%. The timeline of when you can get the vaccine is controlled by the Colorado State government and the phases they deem appropriate based on CDC guidance. The best place to go to see information on the vaccine rollout timeline is https://covid19.colorado.gov/for-coloradans/vaccine/vaccine-for-coloradans.
UMR has launched a Vaccine Resource Locator tool link on umr.com. The launch of this COVID-19 Vaccine Resource Locator will help members navigate local vaccination planning and find resources for their area to help them take steps toward vaccination. This ZIP code-based tool finds online, public vaccine resources available through state and local health departments as well as national retail pharmacies.
For Kaiser members, once eligible to receive the vaccine they can visit kp.org/covidvaccine and sign up online or call 1-844-951-1932 to complete a short questionnaire and request a vaccine appointment. Vaccine administration will be available at 18 Kaiser Permanente locations.
Please refer to our cebt.org website for the latest information from UMR, Kaiser, and other providers concerning COVID-19 and the vaccine. You may also get more specific info from your local county government or health department.
Please Beware of COVID-19 Vaccine Fraud and Scams!
- If someone calls, texts, or emails a member promising access to the vaccine for a fee, the member should not share their personal or financial information.
- No one should ask a member to pay to put their name on a list to get the vaccine.
You can report suspected fraud by calling the UMR Fraud line toll-free at 1-800-356-5803.
Open Enrollment/Life Event Changes
Making changes to your plan can seem confusing, and with events that affect your family and the need for health coverage, its always good to know when and how to make these changes. There are two instances in which you can make changes to your benefits throughout the year. The first is open enrollment and the second is if you have a qualifying life event.
Open Enrollment: During open enrollment, members can add dependents, drop dependents, or change coverages. All full- time employees and their dependents are eligible to enroll in benefits.
Eligible dependents include: A legal spouse or civil union partner, dependent children under the age of 26, which includes biological children, step-children, foster children, and legally adopted children. When adding dependents to the plan, proof of dependency is needed. The most common types of proof documents are marriage license and birth certificates.
Qualifying Life Event: Outside of open enrollment, you can make changes to your benefits if you have a qualifying life event. This could include an event such as:
- Marriage, Divorce
- Birth, Adoption
- Loss of other coverage, Gaining new coverage
- Change in employment status
If one of these life events occurs, you must contact your HR/Benefits department within 30 days from the date of the qualifying event in order to make changes to your benefits. Also, if you want to drop or add dependents outside of open enrollment, you must show proof that they gained or lost other coverage.
Other Insurance Updates
Have you received a letter or explanation of benefits indicating that a claim is denied for more information as it relates to Other Insurance? If you have covered dependents on your plan, this request is initiated annually to help the plan determine coordination of benefits (COB), if necessary. When coordination of benefits is determined then the claim can be reviewed and reprocessed according to the information provided. If you have other insurance, the Plan will need to know this in order for claims to be processed appropriately based on coordination with the other plan. Many times, there is no other insurance involved, which makes these update simple. However, the plan will still need to be notified each year regardless if any changes occurred.
If/when a claim denies for this information, don't be alarmed. This is a routine process that occurs annually. Here is what you need to know to get your claim reconsidered:
- Information must be received within 180 days of the date of the explanation of benefits (EOB) for the claim to be reconsidered.
- Updates can be received in one of three ways: Go to the Contact Us section of the CEBT website and submit an online case; Call CEBT Customer Service at (800) 332-1168 or (303) 773-1373 and provide the information to a service representative over the phone; or, call the number listed on the letter received from UMR.
CEBT Wants to Hear From You
"Providing quality health benefit options at a competitive cost with superior service."
CEBT always strives to provide the best service for its members. Knowing what works great or how to improve helps to grow the relationships that are built through our partnerships. Feedback is always welcomed at CEBT.
If you have suggestions for topics or stories that you would like to see in these newsletters, please email Stacy Vogel on the CEBT Communications Team at email@example.com to get your ideas published.
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