PMHIC 2024 Program Information

2024 Program Information

Groups working together to lower health benefit costs through self-funding.

It all started with four local government groups in 1991

Recognizing the effectiveness of group purchasing, Benecon pioneered self-funded consortium and cooperative programs. Today, we’re proud to manage fourteen programs across the country and maintain membership retention of more than 98%. With our full suite of services, Benecon is able to provide unlimited expert support through Account Management, Actuarial, Compliance, Finance and the Producer Services Divisions. With the unparalleled Nurse Navigation and Wellness Services of our subsidiary, ConnectCare3, Benecon is a powerhouse in the self-insurance marketplace.

A Letter to Our Members

October 1, 2023

Dear PMHIC Members,

Thank you for being a valued member of the Pennsylvania Municipal Health Insurance Cooperative (PMHIC). We continue to offer a cost-effective program with excellent service and stability to our members. On behalf of the PMHIC Board of Directors, thank you for your ongoing participation in the program.

For 2024, the average renewal increase for the 290 members of PMHIC is 8.5%. When developing the rates for individual members, the actuarial staff considered the following:

• Medical trend estimate (projected at 8% for 2024)

• Plan designs and demographics for each member group

• Claims experience for 2021, 2022 and the first six months of 2023

• Other relevant factors

PMHIC will continue to stabilize the reinsurance costs of its members through the collective purchasing power of the cooperative.

Your renewal is only one indicator of the total cost of your health insurance program. For the 2022 plan year, 77% of PMHIC members received a surplus. When combining surplus returns with your projected 2024 costs, many members experience level funding or decreases in their total costs.

This renewal booklet and accompanying packet include other information relating to your 2024 renewal, the PHMIC program, Benecon, your claim fund performance and dental & vision rates. We hope you take a few minutes to review this important information.

We appreciate your participation in PMHIC. It is our pleasure to work with you and we look forward to serving you in 2024.

Sincerely,

Michelle Joy VP Account Management

Zachary Peirson VP Program Management

Meet the PMHIC Team

Ashlen Kintner Associate Account Manager

Brian Zimmerman Account Manager

Danielle Omans Senior Account Manager

Tiia Huffer Associate Account Manager

Jo Schweitzer Associate Account Manager

LeeAnn Llewellyn Account Manager

Sandi Provost Associate Account Manager

Cindy McKillips Associate Account Manager

Kristen Abner Senior Account Manager

Kate Lobley Senior Account Manager

Amy Smith Senior Account Manager Missy Leader Associate Account Manager

PMHIC Board of Directors

9 Members - 2 Year Term (1/1/23-12/31/24)

Ernie McNeely Chairman

Patrick Caulfield Vice Chairman

Troy Bingaman Secretary

Greg Wilson Treasurer

Tom Vernau Assistant Secretary/Treasurer

Lower Merion Township, Township Manager 75 East Lancaster Avenue | Ardmore, PA 19003

Office: 610.649.4000 | emcneely@lowermerion.org

Schuylkill County Municipal Authority, Executive Director 221 South Centre Street | Pottsville, PA 17901

Office: 570.622.8240 | pcaulfield@scmawater.com

Amity Township, Township Manager 2004 Weavertown Road | Douglassville, PA 19518

Office: 610.689.6000 | tbingaman@amitytownshippa.com

City of Lock Haven, City Manager 20 East Church Street | Lock Haven, PA 17745

Office: 570.893.5907 | gwilson@lockhavenpa.gov

Lower Allen Township, Township Manager 2233 Gettysburg Road | Camp Hill, PA 17011

Office: 717.975.7575 | tvernau@latwp.org

Adam Brumbaugh College Township, Township Manager

1481 E. College Avenue | State College, PA 16801

Office: 814.231.3021 | abrumbaugh@collegetownship.org

Jason Stains

George Zboyovsky

Shannon Berkey

Borough of Waynesboro, Borough Manager 55 East Main Street, Box 310 | Waynesboro, PA 17268

Office: 717.762.2101 | jason@waynesboropa.org

Brentwood Borough, Borough Manager 3735 Brownsville Road | Brentwood, PA 15227

Office: 412.884.1500 | gzboyovsky@brentwoodboro.com

Lewisburg Borough, Community Dev. Grant Manager 55 S Fifth Street | Lewisburg, PA 17837

Office: 570.275.3091 x314 | sberkey@lewisburgborough.org

PMHIC Membership Report

New Groups 2023

We would like to welcome our new 2023 groups!

Members of PMHIC have the opportunity to receive any surplus money from their claim fund after all non-catastrophic claims have been paid. This does not happen in a typical fully insured plan. For the 2022 plan year, we will return in excess of $27 million in surplus claim funds to 77% of PMHIC members. When you consider your total cost for health expenses in our program, please include these surplus funds in your calculations. Most PMHIC members received a 50% distribution of their 2022 surplus in June. The balance will be distributed before the end of the year when all claims have been closed out. If you were eligible for surplus in 2022 and did not receive the initial distribution in June, you will receive the entire amount before the end of the year.

On behalf of the Board of Directors, thank you for your continued participation in the PMHIC program.

Wellness Grant

The PMHIC Board of Directors and our carrier partners have generously offered wellness grants to PMHIC member groups since 2016. The following wellness grant funds are available for 2024.

• Capital Blue Cross groups = $110,000

• Highmark Northeast PA groups = $30,000

• Highmark Western PA groups = $10,000

• Independence Administrator groups = $30,000

• UnitedHealthcare groups = $10,000

Wellness grant funds help PMHIC member groups improve the health and wellness of their employees, which potentially leads to lower claims costs. The funds must be used for wellness activities or equipment that will have a positive impact on overall employee wellness. Examples include:

• Biometric screenings

• AED machines

• Exercise equipment

• Fitness trackers

• Hearing tests

• Gym memberships

• Flu shots

• First aid kits/training

• Lunch & Learn education sessions

• Tobacco cessation classes

• Nutrition education

In early 2024, you will receive information from your PMHIC account management team with details about the amount of the wellness grant available to you, the application process, eligible wellness expenses, how to submit expenses for reimbursement, and deadlines to submit eligible expenses. We encourage you to take advantage of available wellness grants.

Enrollments, changes

Send completed universal benefit forms (UBF) via secure email to Account Services or fax the form for processing.

Need a new ID card for an employee? Send Account Services an email to request a new one. Most insurance carriers take 7-10 business days to generate and mail a new card. Don’t forget to include the employee’s address in your request!

Account Services is here to answer all of your billing/invoice questions!

Any other enrollment related questions, we have you covered!

Box.com Invoice Delivery

PMHIC invoices are delivered securely each month using Box.com. Upon receipt of your monthly notification email, you should log in to Box.com to retrieve your most recent invoice as well as review invoices from previous months. To avoid mispayments, please make sure you are accessing the newest invoice each month by following these steps:

• Log in to Box.com and click on “All Files”

• Click the arrow next to recent files to hide this section. The recent files section shows the last files you opened, not the most recent files uploaded.

• Click the “Billing” folder

• Click the most recent month’s folder “yyyy-mm”

Helpful tips: Including the following information in the memo section of your check helps to ensure payments are applied correctly.

• The month of the invoice you are paying

• Your Client Manager Key (this is the 3-digit or 4-digit number located under your Group’s Name in the upper left corner of the Medical Billing Invoice)

Please remember to submit all Open Enrollment changes to AccountServices@benecon.com no later than 12/15/2023; this includes new enrollments, changes, and terminations for an effective date of 1/1/2024. Any Open Enrollment changes submitted after the first of the year cannot be processed.

Anne Walls Senior Enrollment Specialist

Erin Willman Enrollment Specialist

The ConnectCare3 Benefit

The health and wellness solution for employers.

ConnectCare3 services are an enhancement to an individual’s medical benefits and available at no additional cost to employees and their dependents covered on a group’s health plan. We offer solutions to help our members build health literacy and reduce barriers to care while aiming to help employers with cost reduction strategies through our wellness solutions services. ConnectCare3 is a unique independent advocate, and we have no affiliation with any insurance carrier or hospital system.

Clinical Services Wellness Solutions

Patient Advocacy

• Supports the clinical team and provides resources

Nurse Navigation

• Assist patients in understanding their diagnosis and treatment options

• Prepare questions for physicians for second opinions

• Provide clinical expertise

Chronic Disease Management & Prevention

• Multidisciplinary team of registered nurses, registered dietitians, and certified health coaches

• Assist individuals with prediabetes, diabetes, high blood pressure, high cholesterol, or obesity

• Provide resources that help support and sustain health

Nutrition Education

• Help patients understand the connection between diet and health by providing nutritional assessments and healthy meal plans

Tobacco Cessation

• Work one-on-one with certified health coaches to achieve and maintain a tobacco-free life

• Can be used as reasonable alternative program

Collaboration

• ConnectCare3 will evaluate an organization’s needs and assist them in accomplishing a wide range of goals. This can be straightforward, such as developing an employee engagement strategy and providing readyfor-use educational tools, or as expansive as building a wellness committee and creating a 3-5 year strategic wellness plan.

Consultation

• ConnectCare3 will help employers design wellness programs suited specifically to their organization’s culture and demographics. We can provide wellness campaigns and educational resources on relevant and timely health topics. Employers can use these resources to support their wellness initiatives with minimal added work required for them. We can also assist employers in exploring incentives as an employee engagement tool.

Connection

• ConnectCare3 will equip groups with marketing materials, webinars, and other communication tools to help drive the utilization of ConnectCare3 services. We also connect employers with additional wellness resources from their insurance carriers, employee assistance program, or within the community that may be available at little to no cost. We can help identify the most appropriate wellness vendors, if needed, for screening services.

For more information, visit connectcare3.com.

Life & Disability Program

In 2010 the PMHIC Board endorsed Benecon to offer a Life & Disability program for all Members. PMHIC believes there is power and efficiency in group purchasing and encourages all Members to participate.

Program Specifics

1. Provide a significant rate reduction on current Life/STD/LTD Coverage

2. Match each group‘s current plan designs & level of benefits

3. Provide a multi-year rate guarantee

4. Place all Members with one carrier

Information Needed to Provide a Proposal

1. Current employee census (Name, DOB, DOH, Occupation, Salary)

2. Copy of current plan designs (Summary Page of Benefit Booklet)

3. Copy of most recent invoice

Insurance Provider: OneAmerica

1. “A“ financial rating from all rating agencies

2. 141+ years experience

3. $83 billion in assets

Experience: Benecon

Benecon has successfully aggregated the Members of many other Cooperatives to create a significant purchasing power for Life & Disability coverage.

To date 225+ PMHIC Members have taken advantage of this program, generating over $1,000,000 in savings!

Dental & Vision Coverage Through PMHIC

Did

you know that PMHIC offers dental and vision coverage?

With plans from United Concordia, Davis Vision and National Vision Administrators, we are sure to have a plan that works for you.

For more information, please contact your Benecon Account Manager.

Benecon Administrative Services Product Guide

With Benecon’s Administrative Services, gain access to a full suite of value-added services.

HSA COBRA

A Health Savings Account is an employee owned, taxadvantaged savings account used in conjunction with a High Deductible Health Plan (HDHP).

The Consolidated Omnibus Reconciliation Act gives employees who lose their benefits the right to choose to continue group health benefits provided by their employer for limited periods of time if the employee experiences a qualifying event.

HRA Retiree Billing

A Health Reimbursement Arrangement is an employer funded arrangement that may be used to reimburse employees for qualified medical expenses set by the employer.

Monthly billing services for eligible retirees.

FSA ICHRA

A Flexible Spending Account is an employer offered, tax-advantaged account funded by the employee to pay for qualified medical expenses with pre-taxed dollars.

An Individual Coverage HRA is an employer funded, tax-advantaged arrangement in which employers of any size can reimburse employees for some or all of the premiums that their employees pay for health insurance that they purchase on their own.

DCAP QSEHRA

A Dependent Care Assistance Plan is an employer offered, tax-advantaged plan funded by the employee to pay for care for eligible dependents, such as children or disabled family members.

Tuition Reimbursement Programs

Employer funded, tax-advantaged plan that can pay an employee up to $5,250 in educational assistance benefits each year.

Commuter Transit / Parking Benefits

Employer established, tax-advantaged account funded by the employee and/or the employer to pay for qualified mass transit and parking expenses on a monthly basis.

A Qualified Small Employer HRA is an employer funded, tax-advantaged arrangement in which employers with under 50 Full Time Employees can reimburse their employees for their health insurance premiums that they purchase on their own.

EBHRA

An Excepted Benefit HRA is an employer funded, taxadvantaged arrangement, under which employers provide funds towards the cost of vision, dental or short term limited duration insurance premiums that they purchase on their own.

Value Enhancements

In addition to our CDH & COBRA offerings, Benecon’s Administrative Services Team provides best-in-class customer service and access to industry-leading mobile and web-based services.

Administrative Portals/CDH Mobile App

24/7 access to Employer & Participant Portals

Enhanced Reporting Capabilities

Enrollment and Eligibility Management

Account Funding and Contribution Management

IOS/Android App That Makes Account Management Easy

Plan Management and Consumer Engagement

Personalized Customer Service

Representatives Available During Working Hours to Assist our Partners and their Clients

Personalized CDH Open Enrollment Presentations and Marketing Materials

Plan Setup and Renewals with no extra charges (*excluding Mini-COBRA)

No Minimum Requirements on Employee Plan Participation

Compliance Webinars and Instructional Videos

FSA / HSA Store and HealthShopper

Special deals on eligible FSA & HSA products

Industry Leading Web Browsers for FSA/HSA Eligible Items

Customized Communications for Participants

Purchased Products Require Zero Substantiation if paired with a Benecon FSA/ HSA Debit Card

Enhancing the Consumer Experience

Benecon Portal: www.my-healthshopper.com/?id=10624

Bringing together the leader in health spending accounts and the leader in online retail to deliver the easiest way to learn about, shop for, choose and purchase HSA/ FSA eligible retail items online. Under the “Eligible Expense List“ on the Home Page, learn about what expenses can be reimbursed under your program and what documentation may be required.

Search for products on Health Shopper, and when ready to purchase, you will be guided to Amazon to procure the product.The transaction experience will work similar to any other purchase a consumer makes on Amazon, including utilizing Amazon Prime benefits.

Get Started Today!

www.my-healthshopper.com/?id=10624

CDHServices@benecon.com

Amazon is responsible for delivery and customer service for purchases made via Health Shopper.